Next Up Podcast: Strategic planning for the nursing shortage with Kathleen Sanford (Pt. 2)

MODERN HEALTHCARE: I need to take a step again to provide some recommendation to nursing leaders who may be going by a change of their well being techniques. You’ve gone by a well being system that has merged and rebranded. What does nursing strategic planning appear to be once you’re headed towards turning into a brand new entity? Are you able to simply give some recommendation and heads up for nursing leaders who may be in that state of affairs?

KATHLEEN SANFORD: It appears to be like similar to as when you didn’t go collectively right into a merger or come collectively.


KATHLEEN SANFORD: I typically say to individuals, when you can’t reside within the grey and when you can’t take the a number of change that’s going to be occurring, you’re going to be depressing. As a result of it’s going to occur repeatedly for the remainder of our careers. As a result of the world is altering so quickly and expertise is altering so quickly. And the rationale I say it’s the identical is — when you’re in a company that’s been fairly regular for some time, it most likely wants to vary anyway. I imagine we ought to be our organizations, whether or not they’re going into one thing like a merger or whether or not they’re doing the identical issues. Each of them most likely want main change. I don’t suppose it’s actually all that totally different, whether or not you’re a merger of two or a merger of three or staying a single. Now, it is a bit more tough in a merger as a result of persons are hanging on to a few alternative ways of doing it. And crucial factor is once you do come collectively, it must be about creating one thing new — not about hanging on to something outdated.

MODERN HEALTHCARE: , when you’ve been doing the identical factor for 50 years, 100 years, it’s time to change — completely. So, what do you think is being neglected or underappreciated once you’re doing this planning for the nursing workforce? You’ve already talked about nurses having a voice. Speaking to that nurse that, , simply retains issues occurring the night time shift and possibly has not been on the desk. However what else ought to nursing leaders be contemplating? Whether or not it’s salaries, coaching, work-life stability — what are among the blind spots they should actually be looking out for?

KATHLEEN SANFORD: Properly, I’ll inform you the issues that they need to be doing after which I’ll inform you those that I believe are the blind spots, so it ought to assist. I believe we must be reassessing how we work collectively as groups — what our groups are. We have to reassess how we will use expertise. We have to reassess who’s on our groups. We have to reassess all types of insurance policies, procedures — all of that, that needs to be executed. However what I believe will get neglected are issues which are form of sacred cows which are very tough for individuals to know that want to vary. I believe we now have two proper now. And certainly one of them is productiveness and workload. 

Now, that’s one thing that nurses have talked about for a very long time, and we benchmark how productive all of us are in opposition to one another. We have to completely relook that. Now we have totally different sufferers within the hospital versus outdoors of the hospital as we now have a unique acuities that we didn’t have earlier than. As our sufferers could have completely totally different wants and we have to cease pondering nearly acute care. So, when individuals are available, we speak quite a bit about ensuring there’s fairness of care and we speak quite a bit about ensuring that we aren’t sending individuals again to unhealthy conditions, however we don’t do it. And that’s going to take time and vitality and it’s going to be a brand new precedence. So, we have to relook workloads, relook acuity. We have to cease what we’re doing proper now and rethink: How are we really staffing for what the individuals we’re caring for want now? Not hours.

I’ve at all times been in opposition to ratios and I do know that some states have them however I’ve at all times been in opposition to them. I had a possibility to speak to my state legislature again after they have been occupied with doing it on this state. That they had lately executed it in one other state, had a ratio. “Oh, we’re going to guard the sufferers!” I stated no, you’re not. You’re going to be tying our fingers to do what’s proper sooner or later, as a result of when you’re caught with ratios based mostly on an outdated manner of caring for sufferers, you can’t be progressive. You can’t use expertise to ensure that sufferers are getting what they want since you’re caught with these outdated ratios. You can’t assist workers, together with nurses, work on the prime of their license and do the correct issues for his or her sufferers. And even when the one change individuals make is to vary the phrases from “hours for affected person day” to “{dollars} spent per affected person day,” that will go an extended, great distance.

The second factor that will get forgotten about is that your office is made up of all types of small issues — small issues that individuals don’t take into consideration and so they don’t perceive how these issues add up, possibly for themselves, even. Even subconsciously, proper? We speak somewhat bit now greater than we used to about microaggressions. We do speak about that, however there are different issues that we wouldn’t suppose have been aggressions that add as much as saying to me as a nurse, or to me as a housekeeper, or to me as a clerk that you’re lower than. The complete workforce is required and none of us are lower than — and but our very language makes us imagine that. So, the small issues must be paid consideration to, even when individuals say, “Oh no, that doesn’t trouble me.” They add up! They do trouble us and we simply don’t realize it.

So, I’m going to provide a few examples. One factor is the way in which we use titles. I like my physicians. They’re in my household and I like my doctor colleagues. However I don’t perceive why your Dr. Smith and I’m Kathy — in the identical sentence. We’re having a gathering with Dr. Smith and Kathy. Or we’re having a gathering with Physician Smith, Mr. Jones, and Kathy. There’s a message that’s despatched that we don’t imply to ship, even amongst our personal genders. We ship these messages that sure persons are deserving of a title and others aren’t. And I don’t care when you name somebody Dr. Smith, however then I shouldn’t be Kathy. And I’m actually not saying I’ve to be referred to as Dr. Sanford as a result of I’ve a doctorate. I’m not even saying that — name me Ms. or Mrs. with my final title. It’s a micro insult to totally different individuals when they don’t seem to be handled with the identical title respect as different individuals. So, that’s one instance.

The second instance is — as I moved up, it’s astonishing to me how once you get into government apply, our techniques suppose that the feminine occupation — largely feminine occupation, nursing — ought to report back to the largely male occupation, physicians. Now, why ought to one government who’s working an enormous a part of a company robotically report to a different government who’s working a component? Why couldn’t they be dyads? I don’t know when you checked out my autobiography in any respect, however I’m actual huge on dyads.


KATHLEEN SANFORD: And so they could sound foolish or self-serving however these are two examples of the micro insults that every one add as much as a nurse on the entrance ground, or in any place, of pondering, “I’m lesser than different individuals.”

MODERN HEALTHCARE: That’s extremely highly effective. And I believe with our dialog concerning the nursing scarcity and getting ready for it, and the way are we going to coach and discover these individuals — this youthful technology will choose up on these microaggressions and they won’t suppose that they’re being too delicate. They anticipate them to be addressed and corrected.

KATHLEEN SANFORD: I agree and I’ve typically stated — I’ve most likely stated for 20 years when it was once that we thought we have been great if we labored on a regular basis and didn’t go to lunch. We didn’t go to the lavatory. Simply have a look at me, have a look at me, look what I’m doing. This subsequent technology isn’t going to place up with that. They’re going to desire a life, and so they’re proper.

MODERN HEALTHCARE: So, talking of the final query is for the kind of youthful nurse who has her eye or his eye on the C-suite. They need to get into strategic planning, they need to be in additional of that administrator position. What would you say are the highest three items of recommendation you’d give that nurse to achieve that degree?

KATHLEEN SANFORD: I’ll inform you the three that individuals say after which I’ll inform you the three that I believe, which aren’t the three that individuals say.


KATHLEEN SANFORD: Folks at all times say get a mentor. They are saying study finance, study issues that you simply don’t know, and settle for each new factor that you would do that you simply’re provided, so you’ll be able to present you’ve gotten a whole lot of expertise. I believe they’re great issues, however they’re not the three issues which are going to assist younger leaders transfer up and be ok with themselves, and be ok with the work that they’re doing, and have a beautiful profession. As a result of it’s not simply frontline workers nurses we must be involved about, it’s our total workforce. Our total workforce has to have a beautiful profession. So right here’s my three after which I’ll inform you why. The primary one is be competent. I’ll speak about that in only a minute. The second is have an ideal humorousness. And the third one is love. Now, let me inform you why I believe these are the three.

So, the competency — the entire issues that individuals normally inform you about helps you with competency. You’ll want to have administration and management understanding. I actually imagine that management and administration — let’s simply not speak about management for a minute. Administration is a specialty. And it’s a nursing specialty, however we’ve by no means handled it as a specialty. We might suppose you’re an ideal nurse, you’d be an ideal supervisor. You’re an ideal physician, we’ll have you ever be the chief medical officer. Proper? It’s a specialty and it has as a lot analysis behind it — and apply proofs, I’d need to say, behind it — as medical finest practices do. And but, we don’t suppose we have to practice that and study that and perceive that.

And so you have to be a reliable chief. You don’t simply must be a reliable nurse, since you’ve gotten me speaking to a younger nurse. It’s a must to be a reliable supervisor and a reliable chief, and you have to perceive what meaning and what the analysis says about what makes it. And it’s been evolving, too. , all the way in which from the Nice Man principle— , the primary one was the Nice Man principle, and now we’re as much as groups and dyads. So, perceive — perceive that analysis and perceive the stuff that all of us hear about, your individual emotional intelligence, and so on. Be competent and perceive that being a pacesetter is a specialty. A proper supervisor.

The second factor is to domesticate a humorousness as a result of when you can’t snigger at your errors, you’ll be depressing. I used to be the primary lieutenant on the age of 21 and I had my very own nursing unit. I used to be incompetent — and I had been educated to be an officer and I had educated to be a nurse. However I at all times inform individuals, I ought to write apology letters to the those that I first had as a result of I made so many errors. And when you don’t have a humorousness about it, you’re going to have an issue with that. I inform new, younger individuals who first go into their administration job — and anybody who’s ever labored with me will snigger — I say welcome to at all times being mistaken.

As a result of once you come into administration, you’ll at all times have somebody who thinks you’re mistaken. When you’re doing it to be fashionable, when you’re doing it since you suppose you’re excellent and also you’re going to at all times make the correct resolution — neither of these issues are right. You’re not at all times going to make the correct resolution, and you must have a humorousness and the flexibility to forgive your self simply as a lot as you forgive different individuals. However you additionally should have a humorousness of, “Yeah, I do know — doesn’t matter what I do, it’s going to be mistaken to any person.” And that’s simply how it’s. You simply do what you suppose is true and what you’ve discovered since you’re assured.

And the third one is love. We get somewhat antsy about saying that. I’ve a robust perception that our healthcare techniques can be so a lot better if we balanced our love between a bunch of stakeholders — certainly one of that are, after all, the individuals we handle. The second are the individuals who work for us, which are our workers and what they should do. The third is the communities themselves. Now we have to have love and concern for what occurs to our communities. The fourth is the group! We have to care sufficient about our group that we would like it to be great and profitable. After which the final one is managers and leaders, together with themselves. As a result of each resolution we make, you have to think about the entire stakeholders and what’s vital for them. And what I inform individuals is, there shall be selections made that may not be good for one group and higher for an additional. However as a part of your management competency, you need to think about the impact on each single stakeholder in these teams — the teams that I used to be speaking about — earlier than you make the choice in order that what you’re doing. So, these are my three: competency, a humorousness, and love.

MODERN HEALTHCARE: I like it and also you’re proper. I’ve heard each one of many first three you talked about that everyone says on this podcast. So, thanks for bringing a unique perspective to it. That’s superior. Thanks a lot to your time. This was so motivating.

KATHLEEN SANFORD: Properly, I hope so. I believe we’re in an thrilling time. I actually do. I really feel unhealthy once I have a look at my colleagues and all of us look drained as a result of it’s been — it has been onerous. It’s difficult. It’s tough. Nevertheless it’s an thrilling time to determine how we’re going to make it higher as a result of among the issues that I’m speaking about once you’re speaking about technique — these have been issues we should always have executed whether or not there was COVID or not. Now, we now have an impetus to do the correct factor — much more than we had earlier than.

OUTRO COMMENTS: Thanks, once more. That wraps up our dialog with Kathy Sanford, giving strategic perception on planning for the approaching nursing scarcity.

Once more, I’m your host, Kadesha Smith, CEO of CareContent. We assist well being techniques attain their goal audiences by digital advertising and marketing that focuses on the correct content material.

Search for extra episodes of Subsequent Up at, or subscribe at Apple Podcasts, Google Podcasts, or your most popular podcatcher. When you’ve been having fun with Subsequent Up, please go forward and depart us a evaluate in your most popular podcatcher as properly. Thanks once more for listening.

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