Bon Secours’ outgoing chief nurse officer on the challenges ahead for nursing
Andrea Mazzoccoli is retiring from her role as Bon Secours chief nurse and quality officer in June after nearly 15 years in the position. The 13-hospital system with locations in Kentucky, Virginia and South Carolina, like others, has dealt with staffing shortages and labor challenges throughout the pandemic.
Reflecting on her time in the role, here’s what she wants future leaders to consider and trends she’ll keep an eye on as pandemic recovery continues and a new generation of nurses and nursing leaders begin entering the workforce.
Editor’s note: This interview has been lightly edited for clarity.
HEALTHCARE DIVE: What advice do you have for your successor, and others in similar positions?
ANDREA MAZZOCCOLI: My sense in terms of what’s happening now and the advice that I have for the next generation of nursing leaders is to be excited about what is happening today and what it brings for us for the future.
There’s no question that there are challenges today in terms of our systems being able to respond to what I believe are just new demands and needs of the next generation of professional nurses, both those nurses who will choose to deliver care directly, deliver care in an advanced practice way or help us to lead the profession.
I think our biggest challenge that we have, is challenging ourselves to respond differently in the structures and processes and the ways that we've always done them. Like scheduling, staffing, considering retention and turnover. And how we respond as a health system to begin to do things differently.
That means flexibility, mobility, ability to connect with purpose and meaning, ability to have their own choice about growth and how quickly they’re able to accelerate in their growth.
Those are things that we can do and we should be doing. I think many other industries have responded and done that. And my excitement about the challenges that we have is I think it will force us to do some of these things.
How do you think hospitals are handling current nursing shortages and workforce challenges, what more needs to be done?
Some of the shortages are handled by bringing help in and trying to provide the resources that we need. I think every hospital is thinking about the model of care.
In our own system a study that we did of over 500 nurses working in medical surgical units suggested that 30% of the time that a nurse spends is on non-professional activity that they themselves believe could be delegated.
So I think every hospital is trying to respond to the shortage by providing a model of care in which nurses do the work that professional nurses could and should be doing, and trying to figure out how to build a model of care around them that supports the work that they don't need to do.
How long do you think it will take for hospitals to fully minimize their use of temporary nurse staff?
I think hospitals who are wise and can see the future will learn how to build that flexibility in their own systems. I think it's our job to figure out how to use them effectively, and allow them to be integrated into places where we need them, that doesn't have an impact on our outcomes.
They are paid a premium for the choices that they make about their flexibility, their willingness to travel, but we have lots of opportunities internally to do that ourselves.
At Bon Secours Mercy Health for instance, we’ve started our own traveling nursing program so we can respond, allowing a traveler-like program around our states and offering our own premium dollar inside our system with nurses who we believe are connected to our mission and our vision and our values.
I think we’ll see a lot more of that. I think we'll see a lot more people developing their own response to what is the need for travelers? I don't think travelers will ever go away though.
Some nurses don’t necessarily want to travel all the time, but they want the experience to do it. The value that we saw is we have nurses who will be like, “Yeah, I’d like to go there for six months, and then I want to come home.” Our value is that we allow people to maintain benefits and their tenure within our ministry and be able to know the systems that they have.
I think we’ll see how systems come together around this, and also unusual partners.
For instance, we have a unique opportunity like other health systems in the country and we are now beginning an international program. So we have a health system in Ireland, we offer a very unique opportunity for nurses to be able to travel and work internationally by exchanging the nurses from Ireland to the U.S. and the U.S. to Ireland.
Are there any other specific trends playing out in the nursing workforce you’ll keep an eye on?
Probably more in the short term, but the implications of how new-to-practice nurses were educated and trained is real. We have a whole generation of nurses who didn’t get trained the way the generations before them did. They weren’t in hospitals, most of their training was through simulation. We are receiving nurses today who graduate, have passed an exam and have yet to take care of patients.
So that's a real implication, particularly for hospitals, about what it’s going to mean to bring the next generation of nurses inside the walls of the hospital, and assume a burden of training and building competence that we never had to do before.
As the pandemic has eased and our understanding of the where and how we use student nurses during these kinds of situations grew, I think we’ve learned a lot. But at least the next two years are going to be very challenging. We already knew that our first year turnover of new-to-practice nurses is one of the single biggest workforce challenges that we have, and so this is just an additional burden.