Cultivating Support, Resilience, and Retention for the Health Professions

This episode and blog post are Part 2 of the first special report of our Vaccine Confidence Special Reports series on At the Core of Care. Over the course of 6 episodes, we'll do a deep dive on three different facets of the COVID-19 vaccination effort. Stay tuned for new episodes in the coming weeks by following us on Twitter and subscribing to our newsletter. 

In this episode, we hear from Dr. Paula Milone-Nuzzo from Boston, who has an extensive career in academia as both a professor and an executive administrator. Paula is currently a professor and the president of Mass General Hospital's MGH Institute of Health Professions. In this episode, Dr. Milone-Nuzzo joins us to discuss the current workforce crisis in healthcare and the continued need to reframe training and education for the health professions. We’ll also explore solutions that could help cultivate more support, resilience and retention.  

Dr. Milone-Nuzzo has seen decades of nursing workforce changes over her career. She started working in homecare in the 1980’s, and watched as more hospitals bought home-visiting practices and as more resources were funneled into homecare nursing over the 1980’s and 1990’s. During this time, she taught at the first homecare program for advanced practice nurses in the country, preparing a new generation of homecare nurses. Dr. Milone-Nuzzo’s well-trained eye keeps her alert to nursing workforce changes happening now. COVID-19, she says, is just a catalyst for changes that were underway long before the pandemic hit. “We already knew that we were going to be facing some shortages as more baby boomer registered nurses are retiring. There's just a nursing shortage in general. You know we were in a crisis mode before the pandemic. But …. it's really amplified now.”

Many healthcare workers are starting to feel burned out, ready to leave the field, and unable to meet the needs of their families and friends outside of work. Dr. Milone-Nuzzo explains “this blow with Omicron has really put a level of uncertainty in everyone's perspective. And I think that makes it even harder to practice effectively.” She notes other stressors, including pay equity, as compounding factors in nurses’ decision to stay or leave the profession.

Dr. Milone-Nuzzo offers short-term solutions for moments of crisis like this; the first is staffing. In order to decrease the stress of nurses, it is crucial that hospitals bring in additional resources. Years ago, many hospitals decided to eliminate LPNs. Dr. Milone-Nuzzo argues that bringing LPNs back into the acute care setting might reduce the stress of RNs on staff.

Long-term, Dr. Milone-Nuzzo says the future stability of the workforce depends on nursing students. Many hospitals and universities paused their clinical placement partnerships due to the COVID-19 pandemic. Students were seen as a burden to train and supervise at a time when hospitals were already overwhelmed. This reduced the number of nurses entering the workforce and amplified the nursing shortages we attribute to the pandemic. Clinical placement partnerships should be an opportunity to support nurses and stabilize the workforce long-term. Dr. Milone-Nuzzo proposes that stronger training programs would better prepare students to enter their clinical placements without demanding so much from their mentors.

Academic nursing programs should also be building workforce resilience through course curricula. It is important to help students learn how to take care of themselves, how to recognize when they need help, and where to get help. Along with building academic programs, it is imperative that academic institutions increase enrollment. Paula states that 80,000 qualified nursing applicants are turned away every year. The healthcare system needs more nurses, and so the workforce needs to grow to meet this need. “That's going to require sometimes changes in legislation, sometimes changes in statute, sometimes changes in accreditation standards. All of that is possible, because we are in a new area of healthcare.”

Nurses and other health professionals across the country are using innovative methods to vaccinate their communities against COVID-19. Follow along as we explore their stories in depth as part of our Vaccine Confidence Special Reports. 

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This project was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number NU50CK000580). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource center do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.