More lessons from the nurse shortage front

In last week’s column, we explored how the nurse shortage has become so severe at one South Dakota hospital that it had to shut down some beds. Now comes more news of how rural hospital leaders are aiming to fill RN staffing gaps by getting a little more creative with recruitment. reports that, of late, there’s been an anecdotal uptick in rural hospitals having a hard time filling open nurse positions, with baby boomers continuing to age into retirement. In particular, the pinch is being felt by hospitals in places such as central Washington state, eastern Idaho, Wisconsin, Illinois and Montana. As we all know, recruiting nurses to rural areas can be especially trying, with limited populations to draw from, lower pay and scarce jobs for their spouses.

“In the last 13 1/2 years, I don’t remember such a universal cry for help,” Casey Blumenthal, R.N., vice president of the Montana Hospital Association, tells the website.

Rural executives are using a variety of tactics to attract and retain nurses, including boosting pay and offering tuition reimbursement programs, although those don’t guarantee they'll stick around. Data show that those who prefer rural lifestyles and come from such areas often stay in jobs longer, so some rural hospitals are building programs to recruit high school students into becoming nursing assistants. Professional growth is a concern, and some have joined cooperatives to provide residency and training for clinicians.

Other tactics include moving RNs into leadership positions, having them teach classes at a community college, or creating community wellness programs, according to

“It’s always been an issue. We always have to be creative, coming up with new ways to entice people, to engage people, to attract people to our organizations,” Cella Janisch-Hartline, R.N., nursing leadership senior manager and coordinator of the residency program at the Rural Wisconsin Health Cooperative, tells the website.

Reports of the shortage’s effect are coming in from all over, it seems. Hospitals in Charleston, S.C., are also desperate for more nurses, and local universities are making a nationwide push to recruit more, ABC 4 News reports. Efforts are working, with the Medical University of South Carolina’s nursing school enrolling the most students in a decade this year, at 578. Meanwhile, New Hampshire Hospital has added more than $2 million to its budget over the next couple of years to boost nurse pay and aid in recruitment.

Keeping nurses engaged for the long run

We know that engagement can be one key piece of keeping nurses on board at a hospital, and just last week, patient experience firm Press Ganey released a new report with some handy tips.

Such engagement can be kind of a intangible, squishy thing for nurse leaders, but the new white paper, “Building a High-Performing Workforce,” offers execs some data-driven ways to establish different “tiers” of engagement and consistently measure and sustain it with nurses and other clinicians.

Barbara Reilly, senior vice president of employee, nurse and physician engagement for Press Ganey, thinks this is the missing piece of the Institute for Health Care Improvement’s Triple Aim.

“The industry has come to recognize engagement as the ‘fourth aim’ to optimizing health system performance along with improving the patient experience, population health and reducing health care costs,” Reilly said in a press release. “To build a high-performing organization, health care leaders need a focused understanding of where to drive change in order to create and sustain an engaged, patient-centered culture that reduces stress for caregivers and suffering for patients.”

The essential traits of a nurse leader in pop health

As hospitals evolve into entitles focused on the health and wellness of populations, rather than just treating illness and injuries, so too, the skills of nurse leaders will have to evolve.

The American Organization of Nurse Executives recently released a breakdown of the five competencies required for RN leaders to excel in population health. Here’s a quick breakdown, but you can find all the specifics in the 13-page report here.

  1. Communication and relationship building — including effective communication, relationship management, influencing behaviors, diversity, shared decision-making, community involvement, and provider and academic relationships.
  2. Knowledge of the health care environment — such as clinical practice knowledge, delivery models and work design, health care economics, policy, governance, evidence-based practice and outcome management, patient safety, utilization/case management, quality improvement and risk management.
  3. Leadership — including foundational thinking skills, personal journey disciplines, systems thinking, succession planning and change management.
  4. Professionalism — personal and professional accountability, career planning, ethics, evidence-based clinical and management practice, advocacy and active membership in professional organizations.
  5. Business skills — financial management, human resources management, strategic management, marketing, information management and technology.