The State of Nurse Hiring w/ Dr. Beth Brooks
HR Collection PlaylistFebruary 05, 202400:27:17

The State of Nurse Hiring w/ Dr. Beth Brooks

The State of Nurse Hiring w/ Dr. Beth Brooks

The State of Nurse Hiring w/ Dr. Beth Brooks

In case you missed it, the nursing profession is going through a pretty challenging time. Whether it's COVID burnout, a severe lack of skilled workers or the Baby Boomers putting immense pressure on the health care system - just to mention a few - times are tough. It's certainly an issue Chad & Cheese aren't qualified to solve, let alone fully understand. That's why Dr. Beth A. Brooks, president of The Brooks Group, joined the boys to discuss a wide variety of topics, such as the current state of nursing, how the gig economy is impacting the profession, the power of pay transparency and if / when the robots will finally be the ones giving colonoscopies. It's a must listen for nurse recruiting professionals, healthcare networks around the country and, frankly, nurses themselves.

[00:00.000 --> 00:06.880] Hi here kids, lock the doors, you're listening to HR's most dangerous podcast. Chad Slowish and [00:06.880 --> 00:12.660] Joel Cheeseman are here to punch the recruiting industry right where it is? Complete with breaking [00:12.660 --> 00:24.220] hoots, bratche convenience, and loads of snarp buckle up boys and girls, it's time ooh yeah it's [00:24.220 --> 00:29.080] your proctologist's favorite podcast, AKA the Chad and cheese podcast. [00:29.080 --> 00:33.360] I'm your co host Joel Cheeseman joined as always the woody to my buzz. [00:33.360 --> 00:34.080] Mr. Chad. [00:34.080 --> 00:38.480] So washes in the house and we are just giddy to welcome Dr. [00:38.480 --> 00:42.840] Beth a Brooks president of the Brooks group Beth. [00:42.840 --> 00:44.320] Welcome to the podcast. [00:44.440 --> 00:44.880] Hi. [00:44.880 --> 00:48.000] And thank you for having me on this nice cool December. [00:48.280 --> 00:52.840] You can't see her face on the podcast, but she was totally shocked and odd by [00:52.840 --> 00:53.480] that intro. [00:53.480 --> 00:55.400] So we'll, we'll try to bring it down a little bit for you. [00:55.760 --> 00:58.120] Now my, my intro was pretty sparse. [00:58.120 --> 01:00.660] I know you have a long resume and a lot of things that you do. [01:00.660 --> 01:05.180] So spend a few, few seconds on your Twitter bio to let our listeners know who you are. [01:05.240 --> 01:09.680] So I've been a nurse executive nurse leader for, gosh, 30 years. [01:09.680 --> 01:10.720] Um, been a nurse. [01:11.080 --> 01:14.520] And the last, probably 20 years of my career have really focused on nurse [01:14.520 --> 01:17.600] recruitment, retention, healthy work environment. [01:17.680 --> 01:21.040] Um, I've designed a questionnaire to measure the quality of nursing work [01:21.040 --> 01:26.120] life that's been used in 50 countries and it's been translated into 10 languages. [01:26.120 --> 01:31.160] So I kind of have a lot of expertise and knowledge around healthy work [01:31.160 --> 01:34.640] environment, work life, recruitment and retention of nurses. [01:34.640 --> 01:37.480] And it's just been my, my sweet spot and my passion. [01:37.560 --> 01:41.520] And it's, we've gone through some crazy times these last couple of years [01:41.520 --> 01:43.680] with nurse recruitment and retention local. [01:43.760 --> 01:44.440] Yes. [01:44.480 --> 01:47.600] Well, let's talk about the state of nursing today. [01:47.600 --> 01:51.000] I mean, we're, we're coming on the backside of a, of a pandemic. [01:51.000 --> 01:55.280] I mean, COVID's still out there, obviously, but we're on the backside of a pandemic. [01:55.320 --> 02:01.080] That was a very large load for nurses and healthcare to actually carry. [02:01.400 --> 02:02.880] So where are we at now? [02:02.960 --> 02:05.800] Do we still have a higher attrition rate, higher turnover? [02:05.800 --> 02:06.920] What's, what's going on? [02:06.920 --> 02:08.160] Everything's back to normal, right? [02:08.760 --> 02:10.640] And what should we expect? [02:10.640 --> 02:11.680] What should we expect? [02:11.720 --> 02:14.840] I think we should expect not knowing what's coming next. [02:14.880 --> 02:19.320] There's a lot of talk amongst my colleagues and a lot being written about [02:19.800 --> 02:24.000] COVID will reshape the nursing workforce in a way that we've not seen in the past. [02:24.040 --> 02:28.720] We'll have a whole segment of the workforce that will prefer this gig [02:28.720 --> 02:33.600] economy type work, which is very new for someone like me, who was a, you know, [02:33.880 --> 02:37.920] baby boomer nurse who eight hours a day, five days a week, staff nurse. [02:38.280 --> 02:41.360] So I think we'll have this gig economy component. [02:41.720 --> 02:46.120] We are definitely going to have, I believe, and I think some colleagues would [02:46.120 --> 02:51.560] agree a movement away from the 12 hour shifts back to an eight hour work shift. [02:51.560 --> 02:55.800] And that's for a couple of reasons, but primarily from fatigue and burnout. [02:55.800 --> 02:59.920] We've, we've really learned through COVID that the 12 hour shift and there's [02:59.920 --> 03:04.840] enough data now that we know about the impact on nurse and patient outcomes that [03:05.000 --> 03:10.160] I see a shift in the hours that nurses work about the gig economy. [03:10.160 --> 03:15.720] And then I think a whole group of nurses who have come to realize, [03:15.800 --> 03:20.560] unlike before, what their value is to the organization and they want to be [03:20.600 --> 03:24.720] respected, they want to be compensated fairly and they want to be listened to. [03:25.120 --> 03:29.160] And that's sort of the message in every study that's coming out. [03:29.200 --> 03:31.560] That has been those have been the themes. [03:31.600 --> 03:35.920] So I think it's going to be a more demanding workforce and wanting a better [03:35.920 --> 03:38.360] work environment that we've had in the past. [03:38.440 --> 03:40.800] So are we going to move away from the traditional? [03:40.800 --> 03:44.240] Or do you see us slowly moving away from the traditional, not just 12 hours, [03:44.280 --> 03:48.840] but also we're seeing a lot of apps that are out there that help healthcare [03:48.960 --> 03:53.200] systems really focus on being able to manage their people better. [03:53.200 --> 03:57.600] Although those people also have the opportunity as you talk about the gig [03:57.600 --> 04:01.840] economy, not just to work in their healthcare system, but also to be able to go [04:02.040 --> 04:03.880] outside of that healthcare system. [04:04.160 --> 04:07.440] And it's almost like an Uber where it's, you know, you're calling an [04:07.440 --> 04:10.760] art, you see what shifts are open and you go down to, let's say, for instance, [04:10.760 --> 04:14.080] here in Columbus, Indiana, we go to Seymour or we go to Greenwood. [04:14.080 --> 04:17.720] If there's something open and they're paying a little bit more, do you see [04:17.720 --> 04:20.800] that happening where it's a more of a traveling kind of workforce? [04:20.960 --> 04:21.560] I do. [04:21.560 --> 04:24.000] And I think there's a, but not for everybody, right? [04:24.000 --> 04:26.560] I think like anything, it's a big workforce. [04:26.560 --> 04:30.520] And there are segments of the workforce that enjoy that kind of flexibility, [04:30.520 --> 04:31.760] autonomy and freedom. [04:31.800 --> 04:36.200] What's interesting about what you said though, Chad, is there have been a couple [04:36.200 --> 04:42.600] of large organizations that have made employees sign almost like a pledge where [04:42.600 --> 04:43.440] you're first. [04:43.720 --> 04:49.240] And so you are employed by us and your loyalty, if you will, is to us. [04:49.560 --> 04:54.640] And so we expect you to give your hours to us. [04:54.640 --> 04:57.680] And I'm kind of generalizing how I'm saying this. [04:57.840 --> 04:59.320] I call it a loyalty pledge. [04:59.320 --> 05:03.400] I'm sure that's not what they call it, but there have been organizations that [05:03.400 --> 05:09.320] are trying to, um, more stickiness, keeping those employees in their workforce, [05:09.400 --> 05:14.640] knowing that yes, many nurses have another job and they're picking up a shift and, [05:15.200 --> 05:16.880] and maybe that's okay. [05:17.200 --> 05:22.080] But then if that's the fifth shift of 12, then you start to ask yourself about [05:22.080 --> 05:24.160] fatigue and errors and other things. [05:24.160 --> 05:26.680] And that's something that we've never gotten our arms around. [05:26.680 --> 05:28.800] Are they, are they paying a premium for that? [05:28.800 --> 05:31.120] I mean, is that kind of maybe a good thing for nursing? [05:31.120 --> 05:35.200] Like the best of the best get, get sort of like brought into the fold and we're [05:35.200 --> 05:38.800] paying you more money and like, we'll make it worth your while to give us sort of [05:38.800 --> 05:42.360] a first try to refusal or to be your number one opportunity. [05:42.360 --> 05:43.360] Is that a good thing, maybe? [05:43.480 --> 05:49.120] I think it's a good thing when hospitals, um, do and put in systems that [05:49.120 --> 05:51.360] allow that to work for the nurse, right? [05:51.400 --> 05:55.560] If you were going to give us your blood, sweat and tears, we're going to offer [05:55.560 --> 05:59.720] self scheduling so that you can have control over the schedule. [05:59.720 --> 06:04.240] We're going to try to place you on a shift that you want to be primarily on. [06:04.240 --> 06:09.880] So I think it's that give and take about if you're going to be loyal to our [06:09.880 --> 06:15.680] organization, we're going to sort of meet you halfway on how we offer benefits, [06:15.680 --> 06:20.680] compensation, maybe it's more continuing education dollars. [06:20.880 --> 06:25.520] So it's those kinds of other benefits besides salary that also make a difference. [06:25.640 --> 06:30.600] Depiscence of what percentage breakdown right now nursing is sort of contract [06:30.600 --> 06:35.320] gig work and what percentage is the traditional hourly one employer? [06:35.600 --> 06:40.360] That jewel is a really good question and I can answer it maybe in a slightly [06:40.360 --> 06:43.720] different way because I don't know that that's actually tracked. [06:44.160 --> 06:47.880] Part of the challenge we have in the country across the country is there is [06:47.880 --> 06:50.120] no one way to identify a nurse. [06:50.360 --> 06:53.880] You have a license number, but that could be different in every state. [06:54.480 --> 07:00.080] You have some nurses have a DEA number where they can prescribe medication. [07:00.200 --> 07:05.000] Some nurses have a what's called an identifier that you receive after you [07:05.000 --> 07:06.600] take the licensing exam. [07:06.800 --> 07:10.840] So it's really hard to know who the workforce is and where they're going because [07:10.840 --> 07:14.040] we just don't have a great standard method to measure. [07:14.040 --> 07:18.920] But what we do know is how many nurses are in the Bureau of Labor Statistics [07:18.920 --> 07:21.000] category about travel nursing. [07:21.120 --> 07:25.920] So the travel nursing segment of nurses doubled during COVID. [07:25.960 --> 07:29.360] Now when I say doubled, that sounds like, ah, it's a lot. [07:29.440 --> 07:32.280] But when it was 2%, it went to 4%. [07:32.440 --> 07:37.680] So that piece, we have better clarity around how many nurses are actually [07:37.720 --> 07:43.480] traveling than say, I'm a full-time staff nurse versus I'm a full-time per diem nurse. [07:43.600 --> 07:47.080] Can you explain the travel nurse to everybody's? [07:47.080 --> 07:51.480] They who might not understand what a travel nurse is versus your full-time, you [07:51.480 --> 07:52.360] know, on staff? [07:52.400 --> 07:56.600] There has always been for as long as I've been a nurse, there's always been an [07:56.600 --> 07:58.640] opportunity to be a travel nurse. [07:58.640 --> 08:01.520] And so by that, you don't have a home institution. [08:01.600 --> 08:05.680] You work for a company that contracts with a hospital. [08:05.760 --> 08:10.040] You choose to work at that hospital on a 13-week contract. [08:10.120 --> 08:16.280] When that 13-week contract is over, sometimes the hospital will want you to renew [08:16.720 --> 08:24.120] or sometimes the need, perhaps you were covering an LOA or an FMLA or something. [08:24.160 --> 08:27.200] And so that need is gone, so they don't renew your contract. [08:27.200 --> 08:32.600] But there are nurses who live their life as a travel nurse, and they might [08:32.600 --> 08:37.640] spend the winters in Florida working on 13-week contracts, right? [08:38.160 --> 08:38.520] Yeah. [08:38.520 --> 08:43.120] Or they spend their winters in Colorado skiing, you know, and then they might go [08:43.120 --> 08:44.880] to California. [08:45.320 --> 08:50.440] So there's this cadre of nurses who literally move around the country going [08:50.440 --> 08:54.400] to where they're needed in 13-week increments. [08:54.400 --> 08:55.640] And the pay better? [08:56.040 --> 08:58.080] The pay is always better. [08:59.000 --> 09:02.240] But it's that old apples and oranges, right? [09:02.240 --> 09:06.320] You want to compare your hourly rate to total comp. [09:06.360 --> 09:10.440] And then that's where those travel nurses have to think about housing and they [09:10.440 --> 09:12.600] have to think about health insurance. [09:12.600 --> 09:17.760] And so that's, you know, maybe that hourly rate is not as much more than the [09:17.760 --> 09:19.320] full-time staff person. [09:19.320 --> 09:19.840] Gotcha. [09:20.120 --> 09:24.320] Talk about the state of recruiting for nurses, because in this environment [09:24.320 --> 09:29.360] where it's sort of a marketplace, maybe nurses are getting reviewed by where [09:29.360 --> 09:32.560] they've worked and you're sort of calling them on when times are, you know, [09:32.560 --> 09:33.800] need is higher than others. [09:33.800 --> 09:38.320] It's not their traditional post-a-job, you know, hope to get some resumes, [09:38.360 --> 09:41.760] you know, go hit up the, you know, the schools and try to get people in your [09:41.760 --> 09:43.080] facilities early. [09:43.120 --> 09:45.520] How is this changing the dynamics of recruiting? [09:45.600 --> 09:49.480] So I'll start answering your question by revealing my bias. [09:49.480 --> 09:54.920] Way back in the day, nurse recruiters, tail and acquisition, was done by a nurse. [09:54.960 --> 10:01.120] When our ends were in HR doing recruitment, my perception, I don't have any data, [10:01.560 --> 10:04.920] better understanding of the role, better understanding of where a candidate [10:04.920 --> 10:10.000] would fit on a department or in a specific unit and better able to do all [10:10.000 --> 10:15.480] the pre-screening down in the HR department before that candidate got to the office. [10:15.600 --> 10:17.480] So that model has changed. [10:17.480 --> 10:21.080] Healthcare has gone to what I call this retail recruitment model. [10:21.080 --> 10:26.720] You see all kinds of other folks coming in to HR in healthcare to be tailing [10:26.720 --> 10:30.200] acquisition professionals, and they have no experience in healthcare. [10:30.280 --> 10:34.080] And that's not to say they can't learn, but it's a two year learning curve. [10:34.120 --> 10:39.680] And so the cross list has gotten slow, time to fill has significantly slowed. [10:39.720 --> 10:44.480] And quite frankly, we haven't modernized our workflow in HR. [10:44.480 --> 10:48.560] And so nurses, you have to be pretty quick and nimble because those candidates [10:48.560 --> 10:51.560] have many offers, they have many options. [10:51.760 --> 10:56.400] And if you're not quick with your process and bringing someone through, [10:56.440 --> 10:58.280] you're going to lose the top candidates. [10:58.280 --> 11:00.280] And that's what we're seeing, definitely. [11:00.640 --> 11:05.040] Can you tell us the impact that because the US used to have vocational high [11:05.040 --> 11:11.480] school programs, which were great feeders to our community healthcare system? [11:11.480 --> 11:12.280] Great. [11:12.640 --> 11:14.640] Can you tell us the impact that had? [11:14.640 --> 11:15.840] Was it a great impact? [11:15.840 --> 11:17.120] Did it really not impact that much? [11:17.120 --> 11:21.760] Because kids still had to go to college to be able to get their nursing [11:21.760 --> 11:23.800] degrees or their certificates or what have you. [11:23.960 --> 11:25.840] Can you tell us what kind of impact that had? [11:26.000 --> 11:27.160] It had an impact. [11:27.160 --> 11:32.800] It always has had an impact only at certain times in our labor economy. [11:32.920 --> 11:35.920] Nursing has forever gone through cyclical shortages. [11:35.920 --> 11:40.120] And so whenever we go through a cyclical shortage, there's this all hands on deck. [11:40.120 --> 11:42.400] Let's enhance our community pipeline. [11:42.440 --> 11:44.400] Let's work with the community colleges. [11:44.400 --> 11:49.760] Let's have opportunities for someone who's in school to do some clinical work. [11:49.760 --> 11:51.920] And then they're a part-time employee. [11:51.920 --> 11:55.160] And then they move through their education program while they're working. [11:55.200 --> 11:59.800] So as soon as we have those downturns where there's a nursing shortage, [11:59.800 --> 12:02.760] there's all kinds of activity and it has worked. [12:03.080 --> 12:08.400] It's worked incredibly well to even take right now, take one, someone from EVS, [12:08.400 --> 12:12.720] environmental services or someone from dietary services who wants to be worse, [12:13.160 --> 12:15.520] help them through school and bring them back. [12:15.520 --> 12:17.640] So yes, those programs work. [12:17.640 --> 12:20.880] Unfortunately, I don't want to say that they're not sticky, [12:20.880 --> 12:28.800] but the urgency of the value of them changes based on where the shortage is [12:28.800 --> 12:31.120] happening for registered nurses when we go through. [12:31.120 --> 12:32.440] Well, there's a lag time, right? [12:32.440 --> 12:36.840] I mean, because you can't just turn the spigot on and here comes nurses. [12:36.840 --> 12:37.840] You've got a lag time. [12:38.200 --> 12:40.080] Right, exactly right. [12:40.080 --> 12:43.120] And there's all kinds of reason for the lag time. [12:43.120 --> 12:44.440] But yes, you're exactly right. [12:44.440 --> 12:46.280] And what's the shortage like now? [12:46.280 --> 12:49.840] I mean, my perception as an outsider is you have aging baby boomers, [12:49.840 --> 12:52.080] you have burnout from the pandemic. [12:52.080 --> 12:56.440] I have to imagine shortages are at an all-time high maybe right now? [12:56.720 --> 12:57.760] I think yes. [12:57.760 --> 13:01.760] And what's interesting about what happened during this last COVID. [13:01.760 --> 13:03.280] So enrollment went down. [13:03.320 --> 13:08.000] Graduations did not keep up where we thought it would. [13:08.000 --> 13:10.080] And as that enrollment went down a little bit, [13:10.080 --> 13:13.280] then 100,000 nurses left the job market during COVID. [13:13.280 --> 13:19.240] And everyone assumed those 100,000 RNs were baby boomers nearing retirement. [13:19.240 --> 13:21.400] Well, that wasn't the case. [13:21.400 --> 13:27.520] It was young moms and dads trying to balance homeschool with their jobs, [13:27.520 --> 13:30.000] with no daycare and available. [13:30.000 --> 13:32.280] And so we lost that 100,000. [13:32.280 --> 13:40.240] So right now, the latest predictions I've seen is 500,000 nurses by 2026, [13:40.240 --> 13:44.240] at least 500,000 nurses in the next five, six years, [13:44.240 --> 13:48.720] we need to find new in addition to the retirements. [13:48.720 --> 13:52.360] So talk to me about solutions for that gap. [13:52.360 --> 13:56.840] Chad was in the military and we read stories about immigrants coming over. [13:56.840 --> 14:00.200] And if they are of fighting age and ability, they go to the military [14:00.200 --> 14:01.520] if they want to come to the country. [14:01.520 --> 14:05.080] Why should we be thinking about immigration differently, [14:05.080 --> 14:08.080] bringing people in that want to be healthcare providers, [14:08.080 --> 14:11.200] get them in the school system, get them into the country. [14:11.200 --> 14:14.680] And also the other side of that, we talk about automation, a ton. [14:14.680 --> 14:19.040] And I know that there are robotics in hospitals and in healthcare systems, [14:19.040 --> 14:23.400] but what's your take on immigrants and at robots for lack of a better term, [14:23.400 --> 14:27.080] taking some of these openings, which are going to be a plenty? [14:27.080 --> 14:31.320] Yes. Well, I will say, and now there has always been. [14:31.320 --> 14:35.480] Always, always a very active pipeline of nurses coming to America [14:35.480 --> 14:37.240] from other parts of the world, right? [14:37.240 --> 14:39.880] That that has always been the case. [14:39.880 --> 14:45.600] The problem with that has been that the countries where those nurses are coming from, [14:45.600 --> 14:47.520] they decimate their own health systems. [14:47.520 --> 14:51.040] And so we create another problem in other parts of the world. [14:51.040 --> 14:53.760] The nursing immigration, again, like anything, [14:53.760 --> 14:58.320] picks up when the shortage in America becomes significant and critical. [14:58.320 --> 15:01.320] Then we ramp up our foreign recruitment of nurses. [15:01.320 --> 15:07.800] I've not really heard a lot about bringing young people in as an immigrant [15:07.800 --> 15:09.720] to become a nurse. [15:09.720 --> 15:13.120] That's not something I'm as familiar with, [15:13.120 --> 15:17.600] although I have heard about like someone who was a physician in Poland [15:17.600 --> 15:20.800] or a physician in Russia who comes to America [15:20.800 --> 15:24.680] and then can move through the nursing curriculum quickly. [15:24.680 --> 15:27.600] But I'm not familiar with just young people coming in [15:27.600 --> 15:29.720] from an immigration perspective. [15:29.720 --> 15:35.040] And it's unfortunate because we don't have enough bilingual health care providers, [15:35.040 --> 15:39.320] which impacts health care outcomes, which impacts health disparities. [15:39.320 --> 15:42.800] So if our nursing workforce, which is something we talk about, [15:42.800 --> 15:47.560] looked like the patients we serve, we would be in a much better place [15:47.560 --> 15:49.640] from a healthy nation perspective. [15:49.640 --> 15:54.440] But we don't have enough of those bilingual health care workers. [15:54.440 --> 15:58.040] And that would be a wonderful way to look at that. [15:58.040 --> 15:59.600] And the robots. [15:59.600 --> 16:00.600] Robots. [16:00.600 --> 16:01.800] It can speak all the languages if you want. [16:01.800 --> 16:04.840] Yeah, well, you know, that's, well, they already have those, you know, [16:04.840 --> 16:10.360] the translation little pods that they wheel around in hospitals around parts. [16:10.360 --> 16:16.880] I don't know that I see robots certainly not as care providers per se. [16:16.880 --> 16:20.800] But, and I don't know if you want to call, [16:20.800 --> 16:24.400] have you heard about the electronic EICUs? [16:24.400 --> 16:25.400] I don't. [16:25.400 --> 16:26.400] I have not. [16:26.400 --> 16:31.320] So there's technology where a nurse, usually it's a critical care certified nurse, [16:31.320 --> 16:37.960] is sitting in a call it a pod with three or four other critical care nurses. [16:37.960 --> 16:44.840] And they are monitoring an entire ICU three, three towns over at the EICU. [16:44.840 --> 16:52.840] So you have technology supporting remote monitoring, if you will, of hospitalized patients [16:52.840 --> 16:57.840] while there's someone in this headquarter pod. [16:57.840 --> 17:01.880] And for some reason, it's totally slipping my mind, but the name of the room, they call [17:01.880 --> 17:02.880] it. [17:02.880 --> 17:10.680] But we do see that as a way to not replace by enhanced, if you don't have enough of the [17:10.680 --> 17:16.440] right staff on the unit, you do have your EICU staff that can come into a patient's room. [17:16.440 --> 17:20.720] And the technology is such that that that camera in the patient's room can zoom right on [17:20.720 --> 17:27.160] to like an IV pump or an IV drip and see what's working and then communicate with the patient. [17:27.160 --> 17:29.000] So that is helping. [17:29.000 --> 17:34.160] And we have a lot of young nurses coming into nursing right now who need a backup, someone [17:34.160 --> 17:39.280] more experienced and they have that person, the remote ICU monitoring. [17:39.280 --> 17:44.600] The robots, I think, you know what you see now is robots delivering supplies, delivering [17:44.600 --> 17:48.480] meals, seeing robots in the pharmacy. [17:48.480 --> 17:53.640] So I won't be getting a colonoscopy from a robot any time soon, unfortunately. [17:53.640 --> 18:01.040] That's like his major 2024 wish bath that you really looking for a robot colonoscopy. [18:01.040 --> 18:07.280] So it's funny because what you're talking about, we've actually seen in like hotels where you [18:07.280 --> 18:09.440] come in, there's nobody at the front desk. [18:09.440 --> 18:11.080] There's an iPad that's there, right? [18:11.080 --> 18:13.640] And you're checking in through the front desk. [18:13.640 --> 18:18.800] Now this is how we fix a scale issue because humans don't scale well, right? [18:18.800 --> 18:25.160] We need that nurse in that room, but do we need that nurse in the room for all of the duties [18:25.160 --> 18:26.160] that the nurse has? [18:26.160 --> 18:30.320] Well, in this case, no, there's a command center and they check everything out. [18:30.320 --> 18:32.160] So I mean, it's very interesting. [18:32.160 --> 18:38.000] I mean, we're talking about hotels and then being able to, you know, to scale this way. [18:38.000 --> 18:40.000] Let me flip the script on you here for a minute. [18:40.000 --> 18:44.440] Now, I understand there's a myth that pay transparency in the health care system would [18:44.440 --> 18:47.480] create significant cultural changes. [18:47.480 --> 18:53.280] What exactly is meant by that cultural changes just by allowing everybody to know that they're [18:53.280 --> 18:54.600] getting paid fairly. [18:54.600 --> 18:58.680] Just so happens that I've written a couple of, I write a career coaching column for a nursing [18:58.680 --> 18:59.880] leadership journal. [18:59.880 --> 19:03.280] And one of the articles I wrote was about pay transparency. [19:03.280 --> 19:10.280] And one of the benefits of being very forthright with what the hourly pay is, what's the pay [19:10.280 --> 19:14.360] scale, what grade, what's the range, those kinds of things. [19:14.360 --> 19:17.920] There's three things that the science has said to us. [19:17.920 --> 19:22.760] One, it engenders more trust between the employee and the organization. [19:22.760 --> 19:26.400] Two, there's this feeling of distributive justice. [19:26.400 --> 19:31.040] Everyone's being treated fairly because we know what the compensation or what the ranges [19:31.120 --> 19:35.280] are and actually in one study, it impacted the turnover. [19:35.280 --> 19:36.960] The turnover went down. [19:36.960 --> 19:45.720] However, it has been challenging for hospitals to have that level of pay transparency. [19:45.720 --> 19:49.420] It's not something that they've ever done. [19:49.420 --> 19:50.420] You know what? [19:50.420 --> 19:55.600] I think it's the sacred cow, honestly, that probably should be slain. [19:55.600 --> 19:57.520] We've always done it this way, yeah. [19:57.520 --> 19:59.800] That's what it is, honestly. [19:59.800 --> 20:04.800] And honestly, and I don't think until me too, it really became an issue and there was a study [20:04.800 --> 20:11.840] that came out from UCSF like 2015, there was a $5,000 difference in compensation between [20:11.840 --> 20:16.160] men and women nurses, which got everybody. [20:16.160 --> 20:23.240] So that has begun to change, but then there's, you know, you're not supposed to talk about [20:23.240 --> 20:24.240] salary. [20:24.240 --> 20:25.960] It's illegal to talk about salary. [20:25.960 --> 20:30.600] Because all these perceptions like the employer say, you can't talk about that with your peer [20:30.600 --> 20:32.280] and that's not true. [20:32.280 --> 20:38.560] So where we do have really good pay transparency is in our hospitals that have collective bargaining [20:38.560 --> 20:39.560] units. [20:39.560 --> 20:40.560] Unions. [20:40.560 --> 20:41.560] Unions, baby. [20:41.560 --> 20:42.560] Unions. [20:42.560 --> 20:47.720] So, I mean, what it sounds like is literally, you know, we're trying to expand profits because [20:47.720 --> 20:55.640] the United States, as, you know, to the GDP, we spend more money than any other country [20:55.640 --> 20:56.640] that's out there. [20:56.640 --> 20:59.400] Although, well, nurses aren't seeing it. [20:59.400 --> 21:05.200] So where's that, where's that going and to be able to grow that trust, which we've lost [21:05.200 --> 21:10.680] over the last decades and we need, especially from our healthcare professionals, what do [21:10.680 --> 21:15.160] we have to change to make this actually work for our healthcare systems? [21:15.160 --> 21:19.120] Because again, Joel said, I mean, boomers are out there, we've got, we're going to have [21:19.120 --> 21:23.840] a bulging healthcare system and we're not going to have the staff to take care of it. [21:23.840 --> 21:25.240] So is that a piece of it? [21:25.240 --> 21:26.880] Is it pay transparency? [21:26.880 --> 21:27.960] Is it more pay? [21:27.960 --> 21:29.320] What do we, what do we have to do? [21:29.320 --> 21:30.520] What's the short-term fix? [21:30.520 --> 21:35.000] Well, you know, nurses would tell you they want more pay from hospital CFO, we'll tell [21:35.000 --> 21:36.400] you there's no more money. [21:36.400 --> 21:42.720] So there, there we go, right now, I don't want to bore your listeners over either of you [21:42.720 --> 21:47.160] with why nursing is on the wrong side of the ledger and on the P&L. [21:47.160 --> 21:53.560] But there is a problem with the way nursing care is invisible and is embedded into the room [21:53.560 --> 21:59.600] charge, which makes it look like nursing is a cost and not a revenue generator. [21:59.600 --> 22:05.600] So until we are shown as generating revenue, which we do, which is a whole nother conversation, [22:05.600 --> 22:11.280] I could go down that little rabbit hole, but until we show revenue in the hospital, because [22:11.280 --> 22:17.680] all the tasks we do that are coded in the computer or physicians get to build for, not [22:17.680 --> 22:18.680] the nurses. [22:18.680 --> 22:21.680] All mighty dollar, Cheeseman, it's the almighty dollar. [22:21.680 --> 22:27.200] There's no customers, if there's no nurses, I mean, there's no customers without nurses. [22:27.200 --> 22:30.320] I was going to say, no, they're going to be customers, they're just not going to get [22:30.320 --> 22:31.320] care. [22:31.320 --> 22:32.320] Yeah. [22:32.320 --> 22:33.600] That's the big, that's the big key there. [22:33.600 --> 22:36.000] The customers are not going away. [22:36.000 --> 22:37.000] Yeah. [22:37.000 --> 22:38.000] It's just whether they get care. [22:38.000 --> 22:39.000] Yeah. [22:39.000 --> 22:40.000] So it's, it's a money. [22:40.000 --> 22:43.560] I do think that, you know, you said, how do we build trust back into the system? [22:43.560 --> 22:47.480] A couple of things, one, better, healthier work environments. [22:47.480 --> 22:51.960] We know that burnout is not my problem. [22:51.960 --> 22:54.960] A burnout comes from a toxic work environment. [22:54.960 --> 22:56.800] So we've got to fix our work environment. [22:56.800 --> 23:02.400] We've got to have better listening by the senior team because nurses don't feel listened [23:02.400 --> 23:03.600] to. [23:03.600 --> 23:11.040] And I think that piece of autonomy and control over your practice, there, you know, that there's, [23:11.040 --> 23:14.400] you would never that my girl, my one of my colleagues gives this example. [23:14.400 --> 23:21.040] If you were a CFO and you walked in and they said to you, oh, Joel, today you're going [23:21.040 --> 23:26.640] to have to go work on five North rather than your nice office down in the, in that would [23:26.640 --> 23:29.080] never happen to a CFO. [23:29.080 --> 23:33.320] But if you're a nurse, you can show up at work and they'll say, oh, you're not working [23:33.320 --> 23:34.320] here today. [23:34.320 --> 23:35.680] You're going over to three South. [23:35.680 --> 23:36.680] See you later. [23:36.680 --> 23:37.680] Have fun. [23:37.680 --> 23:44.280] So you have no, you feel like you're this, just widget in a system and hospitals that [23:44.280 --> 23:51.400] have worked on their work environments, have leaders that listen and have nurses that have [23:51.400 --> 23:54.640] a voice and how care is provided. [23:54.640 --> 23:59.040] Those are the environments that still may have difficulty recruiting, but they have less [23:59.040 --> 24:00.360] difficulty. [24:00.360 --> 24:06.120] And what you're outlining is the recipe for a gig economy uprising because if that's the [24:06.120 --> 24:12.120] environment that nurses have, I would totally want to be, you know, a freelancer or a contract [24:12.120 --> 24:14.600] worker because I can tell you how much you're going to pay me. [24:14.600 --> 24:17.200] I can, I can just decide where I'm going to work. [24:17.200 --> 24:21.740] And I also think I would imagine that from a trade pay transparency perspective, the gig [24:21.740 --> 24:27.000] economy, assuming that you publicize what you want per hour or what you're going to pay [24:27.000 --> 24:31.280] a nurse per hour, then that sort of levels the playing field because I can go and say, [24:31.280 --> 24:35.680] look, the nurses that do exactly the same thing that I do are on this site and getting more than [24:35.680 --> 24:36.680] me. [24:36.680 --> 24:38.320] So I should be getting at least that. [24:38.320 --> 24:40.440] I mean, is that happening or should it happen? [24:40.440 --> 24:41.440] It is. [24:41.440 --> 24:43.360] So whether it should or not, it is happening. [24:43.360 --> 24:45.160] That's exactly what's going on. [24:45.160 --> 24:46.480] And I think it's, I think it's fine. [24:46.480 --> 24:52.520] I think nurses have always been a little bit shy about talking about money and, you know, [24:52.520 --> 24:56.400] we're all in it for, you know, to take care of patients and do the right thing. [24:56.400 --> 24:58.080] And absolutely that's true. [24:58.080 --> 25:05.240] But there's something about the work, the caring work of women that has never really been [25:05.240 --> 25:08.280] compensated appropriately. [25:08.280 --> 25:12.200] But there are nurses who bid on shifts all the time. [25:12.200 --> 25:13.760] There's shift bidding apps. [25:13.760 --> 25:19.240] We've got a shift over here at hospital A for $50 an hour and hospital B is going to [25:19.240 --> 25:26.160] pay 60 and you can, you as the nurse can bid on which shift you want and then go and do that. [25:26.160 --> 25:32.480] And really any nurse can do that as long as you have somewhere to hang your hat where you [25:32.480 --> 25:34.560] have benefits, right? [25:34.560 --> 25:41.280] It's hard to not have health insurance and it's hard to, that's a whole other podcast [25:41.280 --> 25:42.280] that we call. [25:42.280 --> 25:43.280] Yeah. [25:43.280 --> 25:46.640] But I mean, we just talked about the companies or the country who spends the most in GDP on [25:46.640 --> 25:53.640] healthcare and not all of our people are covered who that is another whole other podcast. [25:53.640 --> 25:59.560] But Dr. Beth a Brooks Beth, we appreciate you coming on the show. [25:59.560 --> 26:03.680] And if somebody wanted to reach out to you because they want to dig a little bit deeper into [26:03.680 --> 26:07.160] this conversation, where would you send them to connect with you? [26:07.160 --> 26:10.760] I would send a LinkedIn and just find my LinkedIn profile easy. [26:10.760 --> 26:11.760] It's right there. [26:11.760 --> 26:12.760] Easy peasy. [26:12.760 --> 26:13.760] Nacho cheesy. [26:13.760 --> 26:16.200] Another one in the can chat. [26:16.200 --> 26:18.160] We out. [26:18.160 --> 26:19.160] We out. [26:19.160 --> 26:22.640] Thank you for listening to what's it called? [26:22.640 --> 26:23.640] A podcast. [26:23.640 --> 26:24.640] The Chad. [26:24.640 --> 26:25.640] The cheese. [26:25.640 --> 26:26.640] Brilliant. [26:26.640 --> 26:28.600] They talk about recruiting. [26:28.600 --> 26:30.320] They talk about technology. [26:30.320 --> 26:33.280] But most of all, they talk about nothing. [26:33.280 --> 26:35.280] There's a lot of shout outs of people. [26:35.280 --> 26:36.560] You don't even know. [26:36.560 --> 26:37.960] And yet you're listening. [26:37.960 --> 26:38.960] It's incredible. [26:38.960 --> 26:47.800] And not one word about cheese, but one cheddar, blue, nacho, pepper jack, Swiss, so many [26:47.800 --> 26:51.200] cheeses and not one word. [26:51.200 --> 26:52.200] So weird. [26:52.200 --> 26:58.960] Anywho, you should have subscribed today on iTunes, Spotify, Google Play, or wherever you [26:58.960 --> 27:01.440] listen to your podcasts. [27:01.440 --> 27:04.080] That way you won't miss an episode. [27:04.080 --> 27:09.760] And while you're at it, visit www.chatcheese.com. [27:09.760 --> 27:14.760] Just don't expect to find any recipes for grilled cheese. [27:14.760 --> 27:15.760] So weird. [27:15.760 --> 27:16.600] We out. Transcription results written to '/home/forge/transcribe.sonicengage.com/releases/20240205231042' directory
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