Katherine Virkstis

The COVID-19 pandemic has left frontline staff burned out and exhausted. Meanwhile, executives need to ask more of their staff to ensure organizational viability. In this article, the authors propose that executives commit to taking specific actions to create a more supportive work environment and form an executive-clinician compact. This article outlines the 5 actions executives should take to bolster staff engagement and resilience long-term.

Despite increased onboarding and training for new graduate RNs, it is taking longer for nurses to develop clinical competence in today's complex care environment. At the same time, hospitals and health systems are facing a shortage of experienced nurses. If left unaddressed, patient quality and safety could be at risk.

Hospitals and health systems are facing a new kind of shortage among the nursing workforce: a shortage of experience. As older nurses retire and the influx of new nurses continues to grow, the net effect is a decline in the overall experience of the nursing workforce. At the same time, care delivery is becoming more complex. We call this phenomenon “the experience-complexity gap.” If left unaddressed, the experience-complexity gap will widen and could put quality and safety at risk. In this… Show more

Hospitals and health systems are facing a new kind of shortage among the nursing workforce: a shortage of experience. As older nurses retire and the influx of new nurses continues to grow, the net effect is a decline in the overall experience of the nursing workforce. At the same time, care delivery is becoming more complex. We call this phenomenon “the experience-complexity gap.” If left unaddressed, the experience-complexity gap will widen and could put quality and safety at risk. In this article, the authors explore this new challenge and suggest 3 key strategies for addressing it. Show less

Despite deeper investment in security measures, the rate of violence and point-of-care safety threats in healthcare settings is rising. As a result, nurses do not always feel safe while delivering care. In this article, the authors describe strategies for addressing point-of-care violence. This is the 2nd article of a series. The 1st article of this series, Cracks in the Foundation of the Care Environment Undermine Nurse Resilience, in the December 2018 issue (volume 48, issue 12) of The… Show more

Despite deeper investment in security measures, the rate of violence and point-of-care safety threats in healthcare settings is rising. As a result, nurses do not always feel safe while delivering care. In this article, the authors describe strategies for addressing point-of-care violence. This is the 2nd article of a series. The 1st article of this series, Cracks in the Foundation of the Care Environment Undermine Nurse Resilience, in the December 2018 issue (volume 48, issue 12) of The Journal of Nursing Administration, the authors explained how nursing leaders can reduce frontline nurse stress and burnout by addressing 4 “cracks in the foundation” of the care environment that can undermine nurse resilience. This article aims to help leaders address 1 of the foundational cracks: that violence and point-of-care safety threats are now commonplace in healthcare settings. Show less

To see a meaningful change in nurse burnout, leaders must address the factors in the care environment that undermine nurse resilience. In this article, the authors describe why leaders should focus on the care environment rather than individual resilience building.

Despite increased staff engagement and improved new hire on-boarding, organizations struggle to retain millennial nurses. One dominant trait is shared by organizations that have successfully reduced turnover for this group: investment in select strategies that cement loyalty to the organization. In this article, the authors describe 2 strategies for retaining early-tenure millennial nurses. In the 1st article of this series, the authors described why nursing leaders must supplement their… Show more

Despite increased staff engagement and improved new hire on-boarding, organizations struggle to retain millennial nurses. One dominant trait is shared by organizations that have successfully reduced turnover for this group: investment in select strategies that cement loyalty to the organization. In this article, the authors describe 2 strategies for retaining early-tenure millennial nurses. In the 1st article of this series, the authors described why nursing leaders must supplement their organization’s current investments in engagement with strategies targeted at millennials in their 1st 3 years. This 2nd part of the series will outline these strategies. Show less

A concern for nurse leaders is rapid turnover of engaged, early-tenure millennial nurses. In this 1st article in a 2-part series, the authors describe why leaders should supplement their organization’s current investments in engagement with retention strategies targeted at millennial nurses.

To transform healthcare delivery, frontline nursing staff must be committed to their work and to driving their organization’s mission forward. However, Advisory Board Survey Solutions data show that nurses are the least engaged as compared with other frontline staff. In this article, the authors identify a top opportunity for improving nurse engagement: ensuring that nurses understand how executives’ actions reflect their organization’s missions and values.

The nursing workforce is at the center of many changes associated with care delivery transformation. To achieve this transformation, frontline staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. In this article, the authors describe strategies for addressing 1 of the greatest opportunities for improving nurse engagement identified using these data: ensuring nurses feel professional development and promotion opportunities… Show more

The nursing workforce is at the center of many changes associated with care delivery transformation. To achieve this transformation, frontline staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. In this article, the authors describe strategies for addressing 1 of the greatest opportunities for improving nurse engagement identified using these data: ensuring nurses feel professional development and promotion opportunities offered at their organization help them to improve. Show less

The nursing workforce is at the center of many changes associated with care delivery transformation. To achieve this transformation, frontline nursing staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. To identify top opportunities for driving nursing engagement, researchers from The Advisory Board Company analyzed engagement survey responses from more than 343 000 employees at 575 healthcare organizations. In this… Show more

The nursing workforce is at the center of many changes associated with care delivery transformation. To achieve this transformation, frontline nursing staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. To identify top opportunities for driving nursing engagement, researchers from The Advisory Board Company analyzed engagement survey responses from more than 343 000 employees at 575 healthcare organizations. In this article, the authors describe 3 strategies for addressing 1 of the greatest opportunities for improving nurse engagement: ensuring nurses feel their organization helps them reduce stress and burnout. Show less

Nurses play a critical role in care transformation. To achieve transformation, frontline staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. Data from the Advisory Board Survey Solutions show that nurses are both the least engaged and most disengaged among all frontline staff. To identify the most promising opportunities for driving engagement, researchers from The Advisory Board Company analyzed engagement survey… Show more

Nurses play a critical role in care transformation. To achieve transformation, frontline staff must be engaged in their work, committed to their organization’s mission, and capable of delivering high-quality care. Data from the Advisory Board Survey Solutions show that nurses are both the least engaged and most disengaged among all frontline staff. To identify the most promising opportunities for driving engagement, researchers from The Advisory Board Company analyzed engagement survey responses from more than 343,000 employees at 575 healthcare organizations. This article describes 3 strategies for addressing 1 of the greatest opportunities identified from the data: ensuring that nurses feel that their ideas and suggestions are valued by the organization. Show less

Given today's resource-limited environment, nurse leaders must make judicious staffing decisions to deliver safe, cost-effective care. Investing in 1 element of staffing often requires scaling back in another. A national cross section of acute care hospital unit leaders was surveyed regarding staffing resources, including nurse workload, education, specialty certification, experience, and level of support staff. The authors report findings from the survey and discuss the trade-offs observed… Show more

Given today's resource-limited environment, nurse leaders must make judicious staffing decisions to deliver safe, cost-effective care. Investing in 1 element of staffing often requires scaling back in another. A national cross section of acute care hospital unit leaders was surveyed regarding staffing resources, including nurse workload, education, specialty certification, experience, and level of support staff. The authors report findings from the survey and discuss the trade-offs observed among units regarding nurse-to-patient ratios and the proportion of baccalaureate-prepared nurses. Show less

Frontline nurses are foundational to any organizational goal concerning patient care. In addition, healthcare delivery reform has supported the formalization of specific goals that hospitals must advance to stay financially viable and to deliver high-quality care. As a result, goals for frontline staff are continuously evolving. Frontline nurses must demonstrate a commitment not only to delivering excellent patient care but also to advancing larger institutional performance. The authors discuss… Show more

Frontline nurses are foundational to any organizational goal concerning patient care. In addition, healthcare delivery reform has supported the formalization of specific goals that hospitals must advance to stay financially viable and to deliver high-quality care. As a result, goals for frontline staff are continuously evolving. Frontline nurses must demonstrate a commitment not only to delivering excellent patient care but also to advancing larger institutional performance. The authors discuss a framework for nurse executives to help organizations achieve enhanced nurse investment in organizational goals. Show less

Enhancing the critical thinking skills of frontline nurses has been a longstanding concern for hospital nursing leaders, but increased complexity of care now lends renewed urgency to this challenge. Rising patient acuity and decreasing length of stay contribute to an environment that challenges even tenured nurses long recognized as strong critical thinkers. To ensure safe patient care in a fast-paced care environment, nurse leaders must invest in more individualized development of key… Show more

Enhancing the critical thinking skills of frontline nurses has been a longstanding concern for hospital nursing leaders, but increased complexity of care now lends renewed urgency to this challenge. Rising patient acuity and decreasing length of stay contribute to an environment that challenges even tenured nurses long recognized as strong critical thinkers. To ensure safe patient care in a fast-paced care environment, nurse leaders must invest in more individualized development of key critical-thinking competencies. As part of a broader research initiative on elevating frontline critical thinking, the Nursing Executive Center has developed a diagnostic tool for assessing individual performance on 25 critical thinking skills. The authors discuss the tool's development, methodology, and potential applications. Show less

In the wake of recent changes by the Centers for Medicare and Medicaid Services to the Inpatient Prospective Payment System and a profoundly weakening economic climate, concern about preventable, hospital-acquired conditions (HACs) has captured the attention of healthcare executives nationwide. Despite the rapidly growing concern about reimbursement at risk, however, data suggest that the greatest financial opportunity for all HACs is to prevent them from happening in the first place. Based on… Show more

In the wake of recent changes by the Centers for Medicare and Medicaid Services to the Inpatient Prospective Payment System and a profoundly weakening economic climate, concern about preventable, hospital-acquired conditions (HACs) has captured the attention of healthcare executives nationwide. Despite the rapidly growing concern about reimbursement at risk, however, data suggest that the greatest financial opportunity for all HACs is to prevent them from happening in the first place. Based on analysis conducted by the Nursing Executive Center's Data and Analytics Group, the authors quantify reimbursement at risk due to HACs and calculate the cost-savings opportunity, building the business case for investment to prevent nursing-sensitive HACs. Show less

New graduate nurses now comprise more than 10% of a typical hospital's nursing staff, with this number certain to grow given the increasing numbers of entrants into the nurse workforce. Concomitantly, only 10% of hospital and health system nurse executives believe their new graduate nurses are fully prepared to provide safe and effective care. As part of a multipronged research initiative on bridging the preparation-practice gap, the Nursing Executive Center administered a national survey to a… Show more

New graduate nurses now comprise more than 10% of a typical hospital's nursing staff, with this number certain to grow given the increasing numbers of entrants into the nurse workforce. Concomitantly, only 10% of hospital and health system nurse executives believe their new graduate nurses are fully prepared to provide safe and effective care. As part of a multipronged research initiative on bridging the preparation-practice gap, the Nursing Executive Center administered a national survey to a cross section of frontline nurse leaders on new graduate nurse proficiency across 36 nursing competencies deemed essential to safe and effective nursing practice. Based on survey data analysis, the authors discuss the most pressing and promising opportunities for improving the practice readiness of new graduate nurses. Show less