Empowering Nurses In Leadership & Innovation with Rebecca Love | E. 66

The Healthcare Leadership Experience

Giving nurses a voice in healthcare is the mission of Rebecca Love, Chief Clinical Officer at IntelyCare & President of SONSIEL. Here she explains why to Jim Cagliostro, and how a hackathon changed her life.

Episode Introduction

In a powerful conversation, Rebecca discusses the impact of the Woodhull study, plummeting post-Covid retention rates in nursing, and how the perception of nursing as ‘’cost’’ is damaging to healthcare. She also reveals the imminent launch of the Commission for Reimbursement, why every hospital should run a hackathon, and how encouraging others raises the voices of the entire nursing profession.

Show Topics

• How a hackathon changed Rebecca’s life

• Nurses as innovators: changing the perception

• The findings of the Woodhull study

• The real reason nurse retention levels are falling

• Gaining a voice during the pandemic

• Advice for the C-Suite: Run a hackathon

• Encouraging nurses into leadership

04:25 How a hackathon changed Rebecca’s life

Rebecca described her experience of being a nurse in a room full of decision makers.

‘’… It was at a hospital in Boston. I'll never forget crossing into it being the nurse, not knowing anybody there. And everybody in Boston was there. All of the major tech startup CEOs, the CEO of the hospital, all the doctors, engineers, scientists, everybody was in this room, hundreds of people. And that's when I walked around and I realized there were no other nurses in that room, James. I was like, "Oh my God, I'm not supposed to be here as a nurse, this is where the decision-makers are." We feel this way constantly as nurses, we know everybody that makes all the decisions are in rooms that we're not in. But nobody asked me to leave that weekend, James, and I ended up joining a team, and that's when my whole life changed because we were sitting in these rooms where we were hashing out. I had a doctor and my team, I had an engineer and an occupational therapist. I had a scientist, were all in there. And in walked the CEO of the hospital and he literally sat down next to me and he said, "So, tell us what is your problem and what's your solution that you're fixing?" And this gentleman, our physician starts talking like, "Well, here's the problem and here's how we're going to solve it on the floor." And I'm squirming, right. Because I'm hearing this doctor explain a solution that's not going to work. So, I finally speak up and I say, "That's not how it's done on the hospital floor. If we do it that way, it's just going to create more work for the nurses." And they looked at each other and the CEO looks at me and goes, "Well, how did I not know that's not how it worked on the floor of the hospital?" And I said, "Well, did you ever ask a nurse?" And they started laughing. So then, I started laughing because I didn't really know what was funny. And then, I realized they thought it was funny to have ever thought about asking a nurse how they should solve these problems.’’

07:22 Nurses as innovators: changing the perception

Rebecca explained how SONSIEL (Society of Nurse Scientists, Innovators, Entrepreneurs and Leaders) evolved out of her first nurse hackathon.

‘’And that's when I hypothesized, oh my God, if we had nurse hackathons, we could change the future of healthcare because nurses have the practical knowledge and experience that they are closest to the problem. That if they were given the opportunity a team to be heard and seen and built towards the solution, we could solve all of the insanity that we live every day as nurses that we could fix healthcare. So, I went on, and that was the story. We finally, after 200 phone calls connected with the dean at Northeastern, Nancy Hanrahan didn't hang up the phone on me and she said, "Next summer, Rebecca, I'm running a conference on innovation entrepreneurship. Why don't you run a hackathon?" …. And I said, "Sure, I've been through a hackathon. I'll run one for you." And just jumped in. And that event, that nurse hackathon at Northeastern that we built to which nobody talked about innovation or entrepreneurship as nurses back, if you look in 2015, there was like a handful of articles that mentored those words, but none of them in the same sentence. Like nobody believed nurses could be innovators. And we built to that event in 2016 that ended up changing my life and ended up changing the idea that nurses could be innovators and entrepreneurs because we built the first nurse innovation and entrepreneurship program out of Northeastern for two years and then spun that out into SONSIEL. So, James, that was a very long story about one of the things that we didn't talk about, but change the credit, and I'd say this to nurses all the time, A hackathon is going to change your life because it empowers you to take ownerships of the problems you want to solve.’’

10:35 The findings of the Woodhull study

Rebecca said the study revealed how the views of nurses were overlooked during important discussions around healthcare.

‘’... It was founded by Nancy Woodhull, who was the editor of USA Today, who in 1998 wanted to understand why nurses were missing from so many media stories in the mainstream media when they represented at the time 3.5 million in the entire country, the largest healthcare workforce like it is today. But they were absent from many of the conversations that they would've been centered to germane to the story as she said. So, they found in 1998 that 4% of all media stories were nurses would've been relevant. That is all they were quoted of the 100% of our only 4% of news stories mentioned or quoted nurses at that time. So, they reran the study in 2018, co-sponsored by woman under the name of Barbara Glickstein. Now in 2018, did we expect that number would've gone up or down?You would hope up, except the study showed not only had it not gone up, it had gone down by half. Nurses in 2018, were now sourced, incited less than 2% in all major media stories and absolutely devastating one. So, nurses have abdicated their voice to everybody else except ourselves to speak on our behalf. ‘’

16:37 The real reason nurse retention levels are falling

Rebecca said the view of nurses as a ‘’cost’’ is causing nurses to leave the healthcare sector.

‘’There is a shortage of nurses willing to work in the healthcare environments again, that they are today. And the numbers showed out even before COVID, 57% of new grads left the bedside within two years of practice. Nobody wanted to address that, right? They're like, "We're just going to produce more nurses." And a lot of the conversations I'm hearing at the federal level are saying, "We're just going to produce more nurses." We produce plenty of nurses. What we don't do is we don't retain them. Do you know that since COVID, before COVID, the average length of an experience on a 12-hour shift was six years of experience. Today, it's 2.7 years of experience of a nurse. That is your average nurse length of experience. That's still a novice nurse, but it dropped almost three years from length of experience on being on 12-hours shift. So, here's the reality. Why is this existing? The reason exists today is because nurses are cost to healthcare system, James, and because they are cost, we deinvest in that there is always an argument to say, "We need more nurses," and hospital systems will say, "Well, we can't afford more nurses now," but they always can afford more physical therapists or occupational therapists or doctors, right? They're not a cost to healthcare systems. They have a reimbursable service that pays for them. But as nurses, we only are cost. ‘’

26:43 Gaining a voice during the pandemic

Rebecca gave examples of how nurses are gradually becoming more involved in the decision-making process.

‘’… I still think that there's barriers, but I think even in COVID, we saw that nurses really were able to take charge of a lot of their systems and supply chains failed, GPOs, group purchasing organizations and vendor management platforms. They all failed in the name of code and allow nurses to get really savvy about getting what they needed into hospital systems. Now, you have people like Hiyam Nadel, the first director of Innovations at Massachusetts General Hospital nurse appointed over to really recognizing, "Hey, what products would help us work better for our nursing workforce?" We saw a rollback of the role of the chief nursing informatics officers after EHR's rolled back, but now we're seeing a resurgence of those chief nurse informatics officers who are being employed by hospital and healthcare systems to basically validate the technology from the nursing perspective. So, this has been a really exciting thing. So, you just saw Becky Fox just be chain, the chief clinical informatics officer for all of Intermountain, for example, you have Brian Weirich, he's the chief nurse information executive for all of Banner Healthcare. These are newer roles that are helping hospitals shape, you know what? Okay, we're going to roll out this product. We better have our nurse informaticist officer check to make sure that it's going to work out. That is super exciting, and I think the best hospitals are starting to see that this is going to happen. And so, there is the American Nurse Association of Informatics, really cool group of rockstar nurses who are pioneering this space and demanding that their voices are heard.’’

36:10 Advice for the C-Suite: Run a hackathon

Rebecca said a hackathon can offer health systems the opportunity to value nurses and deliver vital solutions.

‘’... I feel the stress that our leadership is under in these executive positions because they're caught in some really difficult positions. That being said, we know that healthcare does not function without nurses. And for a very long time, we have not given nurses a seat at the table to drive the changes they have. So here's my advice, instead of spending the millions of dollars that you are on your consultants, you have a problem you want to solve with falls, readmissions, bed throughput, run a hackathon with your healthcare system and ask the nurses to solve it. I guarantee those answers that you get for the small amount of dollars you spend are the answers that you have been looking for to solve those problems. Not only then do you solve two issues you solve, basically solving a problem for your institution, but suddenly you made that nursing workforce feel, seen, heard, and valued by one single event. So, here's my answer to you. Start looking at your workforce, not as the competition or as the enemy, but as the solution. And if you feel like this is something that you need to tackle head on, one thing that we know today is what we've been doing has not been working. So, it is the time for radical change, and that is hard. But find those people who want to own it, empower them to do it, and you're going to get back tenfold from anything that you do to empower your frontline. That's not pizza parties, and that's not a banana for nurses' week. It's a hackathon that makes them identify the problems they want to solve and actually drive your healthcare system forward together. So, that would be my advice.’’

38:24 Encouraging nurses into leadership

Rebecca said championing colleagues and rising together as a profession can help to empower all nurses.

‘’Stop being hidden, get out on social, and if you don't feel comfortable making a post, start commenting on the posts or liking the posts of those nurses who are being brave enough to do so. The truth is, it's time for us as one profession to come together and control the narrative that everybody else has controlled for us for a very long time. So, if you don't see yourself as that leader, be the champions of the others who do, I'm a big believer that a rising tide raises all boats and more nurses that have success in this world. The more nurses who start companies and are successful and are financially successful, more nurses who are getting airtime in the media, the more nurses who are getting senior leadership positions in untraditional nursing roles like chief clinical officers or CEOs, we want to amplify them because the more that we can get up high levels, the entire profession is going to rise with them. So, champion every nurses forward, if you are one of those nursing leaders, reach back through and pull up that next one for tomorrow too long. As nurses, we have been threatened by other success, and I am telling you that mindset has kept our profession down. So, if you want to do something great, stand up and applaud every single amazing nurse around you. And let me tell you, it is going to come back to you, not tenfold, but a hundredfold because the energy you put out there, helping other people to be successful comes back to you in ways that you don't even realize today. And I think that in all honesty, is the only reason I am here today is because I realized if I can help other people be successful, I didn't care.‘’

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You’ll also hear:

Finding soul sisters and soul brothers in nursing: ‘’..every day ..they give you hope for a better future. And I think that's what's so incredibly powerful on nursing is that the reason that we do our jobs, it's not because it was ever about the money… it's about everything that we do is about making the world better.’’

Lessons from a hackathon: ‘’I learned more in the course of that weekend about the business of healthcare than I had ever learned in my life of trying to build a company.’’

Reversing the trend and empowering nurses: How Rebecca uses LinkedIn to reclaim the voice of nursing.

Changing the status quo in healthcare: ‘’The status quo of healthcare doesn't speak for nurses anymore because the truth is we've allowed you to do that, and you haven't listened. And because of it, our entire profession is crumbling because the status quo has failed nursing, and it's time we change it.’’

Launching the Commission for Nurse Reimbursement: ‘’.. Until we fix the reimbursement and financial model around nursing, we will not be able to fix the nursing crisis because healthcare can no longer afford nursing as it is structured today.’’

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