- Thanks for joining us.

I'm Grover Silcox.

Some of the most significant moments in our lives happen while under medical care.

The day we're born, the day our kids are born, the day someone saves our life.

Health care workers are vital to a functioning society.

So what happens when there aren't enough doctors and nurses to go around?

That's the crisis faced by hospitals and patients across the country, especially after COVID-19.

The very same health care workers whose expertise we need more than ever before.

Well, they're burnt out.

41% of nurses reported burnout in 2019, and nearly half reported burnout in 2022.

And the question facing hospitals around the country is how to balance the well-being of patients with the wellbeing of practitioners.

And sometimes, that means getting creative.

We've gathered a panel of experts from Lehigh Valley Health Network to discuss this important topic.

Lynn Turner is Senior Vice President and Chief Human Resources Officer at Lehigh Valley Health Network.

Annmarie Chavarria is Senior Vice President, as well as LVHN's Chief Nurse Executive.

Also joining us are LVHN Academic Career Consultant Diane Hegedus, and Nicole Persing, Director of Patient Care Services.

Lynn, Annmarie, Diane and Nicole, thanks so much for being here.

Let's start with the problem and its impact.

We'll start with Lynn.

Can you give us a brief overview of the health care staffing issue nationally, and how it impacts the Lehigh Valley?

- Yes, absolutely.

First, I'd like to thank you for having us here.

This is such an important issue that we talk about on a frequent basis.

So, if I could think about the health care crisis and the staffing crisis, much of what you talked about in your opening comments concerning burnout, certainly that has impacted the staffing.

I would also say supply, absolutely the supply of health care workers, and then the ability to offer those health care workers flexibility when it comes to child care and work and family, and the balances that they need to... That they're responsible for on a day-to-day basis.

And I would say also, Lehigh Valley is probably no different than many other large health care organizations in the country.

- And we mentioned burnout at the top of the program.

Annmarie, what does LVHN do to care for the well-being of its nurses?

- So LVHN has really robust programs to take care of all of our colleagues.

And so, obviously the nurses participate in those programs.

There are programs as far as healthy eating, exercise, we have gyms.

They can get access to mental health services, like a full gamut of things that we do for them.

But specifically, to nurses in particular, we've started some unique programs around caring and holistic nursing, which is not really done at many other places, and we're really hoping that that has a great impact on our nurses and how they learn how to take care of themselves and the people they work with, and their patients.

In addition to that, what I really want to say is the most important thing to reduce nursing burnout is we have to decrease the workload.

Right?

We are in the middle of a really terrible national shortage for nurses, so to Lynn's point, we just don't have enough nurses, right?

So what else can we do?

What creative things can we put in place to take the workload off of the nurses?

And so, we really developed quite a few things that are working towards that, right?

Using all of our ancillary teams, other specialists that can do things so nurses can work to the top of their license.

And then, we've implemented a lot of technology, things that will help integrate work and take some things off that nurses used to have to do before.

- Right, how does an aging population of health care workers impact staffing?

- So our nurses, the average age of the nurse across our nation is 52, and it's about the same at Lehigh Valley Health Network.

So we are definitely going to have more nurses retire in the next ten years than we are projected to bring into the health care workforce at the same time frame.

So there's a large body of work being done on how we grow the pipeline of our nurses, right?

How do we work with our academic partners and our schools, how do we work together, as health systems and schools, to increase that pipeline?

That's really important right now.

I can't think of anything more important than that, because we are going to have so many nurses retire in the near future.

- Right.

My wife is a retired nurse, Peg, and she always talked about the shortage, even before the pandemic, of support staff, qualified support staff for patient care.

- Yeah, that's also a challenge, right?

It isn't just nursing, but all health care workers are seeing a shortage right now.

We are fortunate at Lehigh Valley that we have a lot of entry-level positions, and then, we have a lot of supports, which I know we'll talk a little bit about later today, and how we can get those folks that come and join us at those entry-level positions and give them a real career path moving forward.

So I think that's another big advantage that we have, being part of such a great strong health system in the area.

- Right.

Diane, as an academic career consultant, how are you acclimating, supporting, preparing new nurses who are entering the workforce with these current challenges?

- So, being that I was a bedside nurse myself during COVID, during the pandemic and experiencing firsthand what it meant to be burned out, I had a real lived experience through that process.

I was an emergency room, emergency department nurse.

I was pregnant at the time with our fourth child.

And it was, you know, echoing what my colleagues here are saying, having that work-life balance and having that process that helps you keep that passion, I think is key.

So to have experienced the career path myself and having gone back to school utilizing the resources that the network did provide for me as a nurse, to now be able to give that back to colleagues, mentoring them, providing them those resources, and just telling them that there is a light at the end of the tunnel and how to get to that end of the tunnel is key.

- Right.

Your own personal experience really must come into play here.

So... Yeah, can you talk more about your personal experiences?

- Here in the network?

- Yeah.

- So I started in the network back in 2007, and at that time, I was almost 18 years old.

So I'm aging myself here slightly, but I did start as a room service hostess, so at that time, I was pushing carts of food around to patients, still trying to figure out what I wanted to be when I grow up.

Still trying to figure out what I want to be when I grow up.

And I had progressed through that and just watched the different dynamic and culture that was developing here in the network.

And I started to realize that very young in my career.

From that, I became a patient transporter here in the network.

So again, experiencing the multidisciplinary effects that the network has on both patients and our colleagues.

From there I became a technical partner, which is now patient care partner, so truly entered and that foundational role gap of what was occurring in my career.

From there, I utilize the many resources and benefits the network provided, and I went to nursing school, I got my registered nurse.

I've been a nurse for over ten years now, in multiple aspects of health care.

And from there, long story short, bridged out into academia, have taught at nursing schools, have worked with professional development of nurses, and essentially, as my role currently an academic career consultant.

And if I may add, if that wasn't enough, I got married.

I am married for eight years now to my husband, and we have four beautiful children.

Their ages are seven, five, four, and two.

And why I say that is to show that the one thing that has stayed constant since I was that almost 18-year-old as a room service hostess, was the network.

The possibilities are endless.

The opportunities I had, to reflect back, it really is humbling.

So I think as a lived experience, it truly does say, you know, no matter what external or internal factors are in health care, the one thing that did stay constant was the network and the resources they provided for me to be successful.

- Right, and Nicole, as Director of Patient Care Services, you're out on the front lines, is that right?

- Yes.

- And what are your colleagues saying right now in the face of these shortages?

- So I think, I mean, what I do is I really create an open platform for them.

So, even though I am technically like their leader and their boss, we all work together as a team.

And I give them that opportunity to feel, and that safe space to express their concerns with me, because what better way to learn what they really need?

So a lot of them are still just expressing the shortage, and then, feeling that, you know, that shortage of nurses and ancillary staff.

However, we have built a really good culture, I feel like on the units that I am a director on, and we really have created this strong teamwork and bond even between the units and between the hospital across the board, that even with limited resources, they know that they can still accomplish what they need to, to provide safe patient care.

- Right, that must mean an awful lot to the existing staff.

- Yes.

- And so, Lynn, as Chief of Human Resources, Chief Human Resources Officer, what are the biggest staffing challenges that you're seeing?

- Right, so again, it gets back certainly to the supply of clinical staff.

But I also want to mention, in terms of support, that we have so many competing organizations in the area, in the Lehigh Valley that for entry-level positions, it's equally difficult to recruit and retain staff.

So what we have done, in terms of, you know, Diane mentioned it, she has spent her whole career at Lehigh Valley, that we talk about from hire to retire.

Right?

We want our colleagues to join the organization, create career paths, and give them an opportunity to advance their career within the network.

So for many of those reasons, those are the challenges, and then, what we do to retain staff.

- Right.

And I guess the causes of the shortage are myriad, right, and diverse?

- They, I'm sorry, absolutely they are.

And what we find, because we always do exit interviews, right, why are people leaving the organization?

And many times it has to do with, again, getting back to that work-life balance, right?

Is there child care, is there flexibility?

Are we providing schedules that they can work with?

Which we absolutely do.

We provide hybrid schedules.

We provide remote work.

We provide flexibility certainly in the clinical areas, as well.

But, you know, it's never only one thing.

It's never only one thing.

It's usually a myriad of reasons.

Right, there's aging health care workers who are retiring or leaving.

- Correct.

And younger health care workers, nurses who are going to other fields, perhaps?

- Yes.

You know, there's a lot of opportunity out there for young professionals.

And what we've tried to do is certainly show them that, within the health care profession, there are so many different opportunities.

And I think it was mentioned by... We are a large network.

So, even though you begin in one place, in one career, there are so many other opportunities that you can move into, either promotionally or laterally, or to do something different, both on the clinical side and the non-clinical side, as well.

- That seems like a real positive for folks getting into the field.

- Absolutely, it is.

- If I could just tag on to that, actually, my teenage daughters had an opportunity to spend a day with a nurse at our education center, and that's what sold them on becoming nurses, because they saw the diversity and the opportunities in the nursing profession.

- Right, and Nicole, could you tell me about team nursing?

In particular, explain the concept and how it's worked at LVHN?

- So, at the height of our pandemic, we had to really become very strategic on staffing and figuring out how to take care of our critically-ill patients.

And in order to do that, we had to expand and open other areas, other units that were vacant at the time to care for our ICU-level patients to help offload our already-existing ICUs.

And we had to do that by... We knew we only had X amount of critical care nurses, so we had to come together, and I paired a medical med-surg nurse with an ICU-level nurse, or a stepdown-level nurse, and the team together cared for a larger patient population of our critically-ill COVID patients.

And what we thought was a quick Band-Aid ended up kind of expanding into a network initiative.

- Right.

I just want to say right now, folks, if you're just tuning in, we're discussing shortages of health care professionals and workers with a panel of experts from Lehigh Valley Health Network.

Now let's focus even more on solutions to the shortages.

So, let's begin with Lynn.

I understand there's a three-pronged strategy to curb the shortage of health care workers.

Could you explain it?

- Absolutely.

I'd love to.

So, when we talk about the three-pronged strategy, recruitment, retention, and then professional development.

And we talk about recruitment, certainly we love recruiting in the Lehigh Valley and the northern regions, but we've begun to recruit internationally and out of the state to help with supply.

When I think about retention, it's about establishing a culture where our colleagues want to work, and we do that in many different ways.

I mean, Annmarie spoke about all the well being programs that we do, but we also have fun.

We have engagement committees, we have care carts that visit the units.

We have free coffee days.

We just try to create an environment where our colleagues want to work.

We offer new benefits to our colleagues because we know it's not only about the colleague, but it's about their family, as well.

So this year, we're enhancing adoption benefits or offering surrogacy benefits, enhanced fertility benefits, all because of the culture that we want to create, so, so important.

And the last piece that we've alluded to is the career path.

And having someone like Diane, Diane's position is actually a new position in the network, because we believed it's so important to offer that support to our colleagues so that they feel like they have a future and opportunities within the network.

So absolutely a three-pronged approach.

- Right.

And Annmarie, tell us more about how you attract people into the health care professions.

You've got to get them right from the beginning, right?

- So obviously, to just tag on to what Lynn was saying, recruitment and retention is really our biggest priority, but really transforming care and the way we provide care, finding innovative ways to provide care now is really a big attractor into our system.

So we are in the middle of rolling out, and we've had, for many years, actually other virtual care that we provide.

And now, we're expanding on that.

We have video observation.

We're now looking at wearables that can collect some vital statistics from our patients so people don't have to do it manually.

We are looking at integrating a lot of our systems so that the documentation goes right from the monitor that's watching the patient to the EHR, which is our health record, and the nurses, and have to take the time to do that.

So, lots of innovative ways that are making it easier for our teams to work, and they can concentrate on just taking care of the people.

Some of the other things I think are outstanding - and I have worked in other health systems, I'm relatively new here.

I've only been here for five months, but we have the most outstanding nurse residency program that I have seen anywhere.

It really takes our nurses, our new-to-practice nurses, puts them in a program for one year.

And lots of hospitals have this, not everyone, but ours is outstanding.

It actually won an accreditation of distinction, which means nationally, it's been recognized as one of the top programs, and that program really helps set our new nurses up for success.

It gives them not only clinical skills, but critical thinking skills.

It gives them skills about how to interact with people, social interactions.

We have a huge simulation lab, so they get lots of practice before something happens in real life.

So it's just an outstanding program, and we've had great success with supporting those new nurses that way.

And I think that's key because you mentioned that earlier, if anybody's been following the statistics here, our newer nurses are the ones that are leaving, right?

They're the ones that really, if you don't take care of them when they come in, they just say, "I'm going to try something else," right?

"This is not for me."

So taking care of them is really, really important.

We've actually also focused on training the people who train our nurses, right?

So the preceptors, the people who take care of our nurses when they first start, what kind of education do we give them?

What kind of programs are they in, so they can always be expert in that role?

So I think that's really one of the ways to attract new people to our system, is how we take care of them when they first get there.

- Right.

So important.

And Diane, tell us a little bit about your career path.

You started at Lehigh Valley Health Network, I think you did talk a little bit about it, 16 years ago?

Was that... Did I get that right - Something like that, yes.

- And what kept you on the staff?

We're talking about retention.

How did that work for you?

- So...

Excuse me, sorry.

I'm sitting here and just hearing what my colleagues are saying, and I can't help but be humbled in this moment to realize just how far those 16 years feel.

But at the same time, it's truly a circle-back moment.

I went and I was a nurse resident when I graduated nursing school, and I went through our nurse residency program, and there's longevity there.

You know, I've stayed.

And, as Lynn mentioned, it is a three-pronged system.

If one of those prongs isn't working right, the entire system is going to be shaken.

And, you know, I hear my fellow colleagues - and you asked what made me stay, and I think it's, you know, colleagues want to be heard.

And I think that became very evident through the pandemic, that the ones that are doing it, they're at the bedside.

They're feeling that burnout, they're feeling that pressure.

And to have our leaders here willing to hear that and make changes to that is huge.

I think it's what silos this network from a lot of other health systems.

Of course, nothing happens overnight, though we would love to have that happen.

And we have room for growth and improvement.

And where that stems from is assessing what our colleagues are saying.

So, yes, recruiting, but then, also retaining.

And at the same time, to retain that, there's that professional development component involved.

So those three prongs truly have kept me here.

And the multiple resources that make the culture of Lehigh Valley Health Network the culture it is.

And going on with what my colleague Nicole said, each of the hospital systems are their own culture, and then, each of the units within those hospital systems are their own cultures.

I've worked med-surg, emergency department was a majority of my career, and pre-hospital, and each of those cultures are their own cultures.

And those are some of the conversations I have with our colleagues in our consultations to say, you have to find that passion to stay.

No one's going to make you stay.

It's only going to be a short-term fix.

But if we can help facilitate that passion, that's, I think, the golden ticket to recruit, retain, and promote professional development.

- Right.

And talk about how you're keeping that passion going.

You know, once they get in there, that motivation and that desire to care for people.

Because I think, at the heart of it, I think every health care worker wants to care for people.

They're there for the best of reasons.

- It's truly a downstream effect.

So if we're caring for our colleagues and caring for one another, that is going to have a direct impact on our patients.

You know, I've been a patient, had four children myself.

You know, you can feel the words that are not spoken from someone.

And I think that's really the key there, is finding out what is going on with the work-life balance, you know, providing individualized, personalized coaching to our colleagues, and not word of mouth.

You know, what may work for one colleague is not going to work for another, and they could be on the same unit.

So I think it's really, step one, hearing, you know, I'm a nurse, my brain works like a nurse.

It's assessing the situation, thinking of opportunities and options, providing interventions, or in this case, tools, resources within the network, and then, ultimately evaluating that, so touching back with that colleague and saying, "How did this process work for you?

"Is there something we can change?

"What can we do different?"

And of course, that takes time to do that.

But the fact that this network has processes and resources in place to allow that system to work and allow the process to be effective, I think is the gold standard.

- Right.

And Nicole, have things gotten less chaotic over the past few months?

Can you explain why that is?

More colleagues starting, innovative staffing?

- Health care's always chaotic.

That's why we love it!

We kind of all thrive in the chaos a little bit.

We want a little bit of it, but I think overall, people are calmer.

I do sense a...

It's actually a really great time for us in nursing, like this is a pivotal time for us, and we make it how we want to make it, you know, and I think we're ready for a big change in a positive direction.

And I see each other, I think COVID actually brought us all closer together, and we take care of each other a lot better.

And, by taking care of each other, we're, of course, going to take care of our patients.

Like the other day, we were singing "Happy Birthday" to two of our colleagues.

And when I went in to do patient rounds then and was talking to a patient, she's like, "I overheard you guys singing and that made me feel so good, "because I knew that my nurse was then going to come in "in a positive mood," and, you know, and we were going to have a good day.

- Right.

Yeah.

You know what you're saying, all of you, actually, is that you're really addressing the human needs of human beings.

They're not robots.

And I'd like to open this question up to any one of you, or all of you.

What are your colleagues hopeful for right now, given the circumstances?

Go ahead.

- Having had over 200-plus consultations with colleagues since this role came to fruition, and my role came to fruition based off of colleagues' desire for career-growth opportunities and academic opportunities.

I think it's bridging the gap between our community partners.

You know, our motto is "a partner in care".

We want to be your partner in health care.

So we have to start internally before we can bridge that truly externally.

And we have multiple academic partners out there that we are affiliated with to help streamline the process for growth for colleagues.

We have internal resources, that was echoed here quite a bit, of helping colleagues really find that passion.

When I started in this network, our motto was "a passion for better medicine," and I don't think that's gone away.

I think the passion is still what keeps colleagues going, but our passion is defined differently for each of us.

So hearing what that is and trying to see, do we have the resources to do that?

And if we don't, how do we get them?

So I think our colleagues truly have hope.

I think that's really what has kept us going post-COVID, and what was quite evident during COVID is that there is hope, there is that light at the end of the tunnel, and one bad day doesn't negate an entire career.

I joke with my, you know, I mentor colleagues, and I joke and say, "Maybe I've regretted jobs or positions.

or people, "but I've never regretted this profession," and I have never regretted this profession in this network.

- Right.

And if your colleagues would also... That's very hopeful.

And if your colleagues would also share with us how they feel about the future, very quickly, and what you hear from your colleagues, as well.

- I think people are ready to just rebuild, and not rebuild it the way it was before.

Don't take the things that were broken before.

Let's take this opportunity, rebuild and do it the right way, and get all the broken things and the waste out of there.

And people are very excited about change now.

We used to be afraid of change in health care, but COVID told us like, we don't have to be afraid.

We can be creative, we can be innovative, and we can take care of people in a new way.

And people are excited about that.

- Got it.

- Our 20,000 colleagues, they are passionate, they are dedicated, and they are hopeful and anxious to take care of the communities that we care for, for sure.

- Yeah, I agree with that.

I think, we all really, that's the goal.

We all want to take care of our community.

- Right.

Well, I want to thank all of you for joining us for this program, because this is such an important topic and it's good to get an idea of what the problem is, but also, all the many solutions that you've offered here today.

Thank you so much.

- Thank you.

- Thank you for having us.

- I want to thank our friends from Lehigh Valley Health Network again for sharing their perspectives and plans with us.

This has been a co-production of Lehigh Valley Health Network and PBS39.

I'm Grover Silcox.

Thanks so much for watching.