Across the U.S., healthcare worker burnout rates are rising as the COVID-19 pandemic continues to strain the healthcare system.
In Fort Wayne, the largest regional employer is Parkview Health, which has approximately 9,400 clinical coworkers. Of that number, approximately 4,700 are nurses who play a critical role in the healthcare system by providing high-quality patient care and creating a healing environment.
But creating the right culture to care for Parkview’s co-workers is a key part of the equation, too, says Erin LaCross, Senior Vice President of Nursing Professional Development Parkview. Ultimately, caring for clinical and non-clinical co-workers benefits patients as much as it does employees.
As a result, Parkview has pursued unique ways to recruit future nurses, support its current nursing staff, and transition its retiring nurses into more flexible, value-added roles to strengthen mentorship and retention rates.
"I think with any organization, it's really important to make sure that you have ways to develop people,” LaCross says. “As leaders in the organization, it's our job to take care of the people in the organization, so they can turn around and take care of our community."
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Michaela Weir, pictured in back, is shown during a recent Helping Hands shift with fellow RNs Danielle Gombas, middle, and Kelli Bultemeyer on the ortho trauma unit at Parkview Regional Medical Center.
LaCross says several of Parkview’s education and development programs for nurses have been designed directly by Parkview nurses or through feedback from nurses. Many of the programs are intended to empower nurses to self-select their career path through the healthcare provider, too.
"It's important for us that we give opportunities for Parkview nurses in whatever it is that they want to do,” LaCross says. “So if they want to be leaders, we want to make sure they have opportunities for leadership development or opportunities to be mentored and to grow."
In 2017, Parkview hospitals gained Magnet recognition by meeting the highest standards and expectations for quality in nursing care. LaCross notes that only about 8 percent of healthcare organizations globally are Magnet recognized. She sees this achievement as a sign that Parkview is on the right track.
"Magnet is like the recipe book for the best care for patients and the best practice environment for nurses, and inside that recipe book are all of the ingredients that an organization needs to make it such," LaCross says.
Here are a few programs Parkview has developed to give nurses greater confidence, competence, and capability throughout all stages of their careers, from college to retirement.
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Parkview hosts a Signing Day for nurses at schools like Indiana University, similar to when a high school athlete commits to a university.
Recruiting high school and college nursing students
When it comes to attracting and retaining talent in the region, a logical place to begin is at regional high schools and colleges. Parkview is enlisting recruitment specialists to attract college students in nursing school and high schoolers about to enter college to join the Parkview nursing team. The organization's recruitment specialists engage students both in-person at high schools and colleges and personally on social media.
"The schools have excellent social media platforms, but there's a lot of organic movement through social media with our own nurses, and that's really a tool that we've elected to use here," says Jonathan Liechty, Director of Nursing Professional Development. For instance, nurses often share their stories, which reach students and generate interest in nursing.
Parkview also created a Student Nurse program for high school seniors and college students to prepare them for their next steps in becoming a nurse. The program entails students being placed in a student-nurse role, primarily working in Parkview’s patient care areas. Student Nurse Assistants, Student Nurse Technicians, and Student Nurse Apprentices work under the supervision of a licensed nurse and perform various basic patient needs, such as recording vital signs.
If a student is offered and accepts a Registered Nurse position at Parkview through the apprenticeship, Parkview hosts a Signing Day for them, similar to when a high school athlete commits to a university. The new nurse formally signs with Parkview, and a photo-op for them and their family members takes place.
This idea came from LaCross watching her husband, a university basketball coach, partake in these events for college athletes.
"We thought that there would be some parallels in that opportunity in the feeling that it evokes," she says.
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Parkview hosts a Signing Day for nurses at schools like Ivy Tech, similar to when a high school athlete commits to a university.
Like playing sports, nursing requires dedication, hard work, and teamwork to succeed. The idea is to let nurses know that they are recognized and supported by the organization they are signing with. On 2022’s Signing Day, Parkview partnered with four schools and 21 graduating nursing students participated.
Training RN graduates
Parkview requires every new graduate/first-year Registered Nurse to complete their 16-month Residency Program. The Residency Program is designed to help nurses transition from being students into being working professionals. LaCross says Parkview makes it a team effort to provide knowledge and comfort to nurses in the Residency Program by teaching their nurses about different topics that range from self-care to taking care of patients that may be at the end of their life. The Residency Program is meant to set nurses up for success and provide the highest quality of health care for their patients.
Before nurses enter the Residency Program, they must undergo an interview process. Parkview uses the interview stage to help nurses to learn about their culture and determine if it’s a fit. They also create a realistic job preview by having candidates participate in job shadowing, and nurses go through a peer interview process.
In the process, they are introduced to their potential team members. A Nursing Professional Development Practitioner is a nurse who guides new nurses and supports them from their first day on the job through the rest of their nursing careers. A Nursing Professional Development Practitioner is a clinical practice specialty, meaning these are nurses with a specific educational background, training, and certification. NPD Practitioners partner with nursing leaders and direct clinical nurses to take new nurses under their wing and help them excel, ensuring they have everything they need to do their job.
Additionally, new nurses complete monthly cohort-based residency seminars, so they can establish relationships and bonds with the other nurses they will be working alongside. Through these courses, they learn professional skills, communication skills, and the ability to work together as a team. With this cohort-based style of learning, Liechty says the Residency Program increases the retention of those nurses in their first year.
Robert Black, Jr., who goes by R.J., is a pediatric nurse at Parkview’s Women’s and Children’s Hospital. He began his nursing residency at Parkview in the Fall of 2019 and graduated from the program the following year. R.J. says the program ultimately boosted his confidence as a nurse because he was able to meet and talk with other first-year nurses that were dealing with the same issues and going through similar experiences.
“On the floor where I worked at the time, there were not many new nurses, but the Residency Program was an opportunity for me to connect with other new nurses and reconnect with people I went to school with,” Black says. “In school, you are following someone, so it is not really all on you. Whereas being a professional nurse, once orientation is over, you are ultimately the one calling the shots. The Nurse Residency Program extended past my orientation and gave me the opportunity to connect with other new nurses going through the same experiences as me and be able to learn from those experiences.”
Along with connecting with other novice nurses, attending the monthly seminars provides nurses with the ability to learn new skills, as well as a recap of what they learned in nursing school. Black was still finishing his residency when the pandemic hit its peak. One of the courses he took involved how to properly wear personal protective equipment or PPE. While putting on gloves, goggles, and gowns sounds simple, Black emphasizes the importance of knowing how to properly wear the equipment.
“Obviously, that is something I learned in nursing school, but to have that refresher was super helpful because if one of my PPE was not properly fastened, not only could I get sick, but my patients could also get sick,” he says.
LaCross says Parkview’s Residency Program is built on the Practice Transition Accreditation Program (PTAP), which sets the standard for first-year nursing residencies. Parkview has been nationally accredited since 2020. LaCross highlights this accreditation, which differentiates the Parkview Residency Program from other health system residency programs because of the rigorous accreditation process. PTAP reviews the complete transition process from the date of hire to the end of the Residency Program. It uses evidence-based criteria to determine if a program is eligible for accreditation. There are several phases within the accreditation process: the initial application, a self-study, quantitative review, qualitative review, a virtual visit, and then a final report is sent to PTAP’s commission, which approves whether or not a program is deserving of the accreditation.
Supporting nurses with mental healthcare
While a nurse’s job is to care for others, not all caregivers are accustomed to speaking out when they need help themselves. As a result, Parkview implemented a Holistic Response team to instigate mental health support for its nurses and reduce stress. Parkview's Holistic Response Team consists of nurses specializing in holistic nursing practice. These teams go to units to check on nurses’ well-being. Sometimes, holistic nursing involves listening to a nurse dealing with a difficult situation or a stressful shift. Holistic nursing also helps nurses find stress-reducing activities such as aromatherapy or massages.
Parkview created this team before the pandemic, and it proved to play a key role in helping nurses through their shifts.
"The Holistic Response Team did a lot of work on proactively seeking out these new nurses who were most vulnerable, rounding, and checking in on them, making sure they were mentoring them through the difficulties," LaCross says.
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Parkview's Holistic Response Team consists of nurses specializing in holistic nursing practice.
Upskilling experienced nurses
Nurses who are in the middle of their careers now have the opportunity at Parkview to advance their careers, whether that involves furthering their education or participating in activities within Parkview’s online eXceed Nursing Recognition Program.
If a Parkview coworker wants to further their education, Parkview offers a Tuition Assistance Program for nurses or other employees to return to school while working. Nurses can receive tuition assistance by attending regional accredited colleges, universities, and online programs. The type of tuition assistance they receive is determined by what they are returning to school for. LaCross says coworkers can request financial support every six months as they are going through school.
If nurses feel there may be a role that is a better match for their talents, or want to explore other options in the healthcare system, Parkview also offers a matchmaking program that enables them to connect with a team and explore other opportunities. LaCross says rather than letting nurses burn out and leave, it is important for Parkview to connect them with the right fit for the individual and the organization. This relatively new program gives workers somewhere to turn to when they are unsure what their next step should be.
Another way Parkview is helping nurses develop themselves and grow their career is through its new eXceed Program, which was recently launched at the end of May. LaCross says Parkview has been working on this program for more than a year, and it was created in response to a direct request by Parkview nurses, who came forward to ask for a program to be developed that would help to enrich their careers and provide them with recognition.
The eXceed Program provides nurses with a menu of everything Parkview offers annually to help them develop themselves and acquire new skills. In the eXceed platform, options are divided into different categories with a point-based system, aligned with activities that are important to Parkview’s strategic goals. For example, activities with higher point values are more critical to Parkview’s growth, helping nurses to identify what gaps and priorities the healthcare system has so they know what’s expected and needed.
Activities in the eXceed Program include becoming certified in specialty areas of nursing, teaching, mentoring, volunteering in the community, and more. In addition, nurses will receive incentives and recognition for participating in and completing activities on the platform.
"We tell our nurses they can do anything they want to do, and they can be whomever they want to be at Parkview,” LaCross says. “eXceed gives them a roadmap for that, and it gives us a place where we can continually feed new programs and new offerings that we have."
LaCross believes the eXceed Nursing Recognition Program will strengthen talent retention by encouraging nurses to grow within the company.
Retaining retiring nurses
Nurses who are eligible for retirement but may want to continue working on a more flexible schedule can participate in Parkview’s Emeritus Nurse Program. This program launched in 2017 and now has around 50 nurses.
LaCross says that rather than having nurses officially retire and be rehired, the Emeritus Nurse Program can help these experienced nurses make a smooth transition into a work schedule that better fits their talents and interests.
Since they are experienced nurses, Emeritus Nurses can provide guidance and an extra helping hand while working a much more flexible schedule. An Emeritus Nurse may take on many roles, such as mentoring, checking on patients, or doing other valuable jobs to help Parkview’s nursing teams.
LaCross says this allows many experienced and dedicated Parkview nurses to share their stories and experiences with the newest generation in the workforce.
The program also has helped to have more trained staff on hand in times of emergency. For example, during the Covid-19 pandemic, Emeritus Nurses played a crucial role in distributing vaccinations. Since many of these nurses are versatile, they jump into roles needing to be filled, and they also intimately understand the challenges nurses face firsthand, realizing that caring for others can sometimes keep nurses from caring for themselves.
While many of Parkview’s nurse-driven programs help retain talent, LaCross says these programs act as a source of talent attraction, too. Her coworkers understand that nurses outside of Parkview have a lot to offer, including diverse experiences and viewpoints, and they encourage nurses who are interested to join the team.