Dan:

Bonnie, welcome to the show.

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Bonnie:

Thanks, Dan.

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Dan:

What are some of the latest projects and innovations that you're working on?

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Bonnie:

There's a couple areas where there is such a need in organizations. One of them, because of the turnover that we're seeing among nurse leaders, CNOs, managers, and directors, is literally just some of that good old-fashioned leadership, transformation work, coaching, helping bring people up to speed. That's been kind of a busy book of work that I've been doing as of late.

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Bonnie:

Then coupled on top of that is some really neat transformation-related work around helping organizations explore new care delivery models, and whether that means changing the staffing model or whether that means exploring hospital at home or even looking at technology that is going to improve workflows and streamline the function, that task-based work of nursing. I've been doing a little bit of everything because the demand is just off the charts.

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Dan:

Let's dig into a couple of those things. One I know a passion of yours is the engagement and retention of nurses. So talk to me about what's going on in that space and where you think some of the latest innovations are.

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Bonnie:

Absolutely. You know I've been a chief nursing officer for over 20 years. So to me, there are some components that we just have to get right, and that's around how we staff and that is also around how we compensate. And throw your darts, get it out of your system now, but ratio is absolutely not the answer. There are too many assumptions there. We assume every nurse is the same kind of nurse and every patient is the same kind of patient. Not the answer.

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Bonnie:

I do believe we absolutely have to innovate and come up with new models that we can ascertain the level, the type, the quantity of care that a patient requires whether it's in home care, inpatient care, in an acute care setting, post-acute care. Whatever it is, we need to understand what that looks like and how we're going to deliver it. So I think that that's incredibly important, that we have technology to assist us. Then the other part of this is we have to make sure we compensate nurses appropriately.

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Bonnie:

I think that we actually have seen probably some of the largest pay increases to all nurses across the country over the last two years of the pandemic as we had probably in the last 15 to 20 years. Now, to be honest, some of this is economics, supply and demand. We know the answer is that a nurse should not be paid $27 an hour, maybe even $37 an hour. But we also know that on a sustainable, long-term basis, a nurse cannot be paid $175 an hour. So somewhere in the middle is where we have to do the work to figure out what is the right kind of compensation and how do we know that?

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Bonnie:

How do we measure the value of a nurse? We don't have a way to do that today. Then how can we actually make sure that comp is appropriate based on that? Once we fix some of those fundamentals, then we can go into some of the fun stuff. I think that's where we're really going to lean heavily on emerging technology to assist us in improving the practice of nursing.

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Dan:

Yeah. And one of the things on that technology front, I think... Like you said, the ratio piece is a linear solution to a very complex problem. It doesn't take in all those nuances. Now we have technology assessment and other ways to determine what the skill, competencies, and even career passions a nurse has and codify those. Then we have the electronic medical record and other things to show the needed care requirements for a patient, but we're not doing a good job of matching that.

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Dan:

I've been talking to CNOs and I'm like, why are you creating shift calendars with just random people, so you hope that that nurse that works on Tuesday has the skillset you need in order to take care of that patient that may show up on Tuesday? We could do a better job of connecting the skills and the patient needs in real time so that people can get the care they need and to break through some of these silos too. Why are we hiring people just into [inaudible 00:05:21] ICU and that's all they ever work for the rest of their lives? That doesn't make sense either. So what are the things that we need to disrupt in order to get to a place where we're actually matching skill to patient need?

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Bonnie:

Yeah, I think there are some amazing technologies out there. So there are a couple of different industry partners that actually have solutions in this space. What that looks like is coupling AI, so utilizing artificial intelligence and utilizing predictive analytics and interfacing with not only our EHR to understand who might be going home or being transferred to where and when, and even predicting when that looks like it will happen in that patient's journey. Then it can also interface with staff scheduling.

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Bonnie:

So when we can begin to have automated tools take away the workflows from humans, it means that it thinks better than we do. It doesn't get disrupted with a phone call that we have to answer or an email we have to respond to. So utilizing AI and predictive analytics in ways to actually predict our senses within 99 point something percent accuracy over four hours and 94 and 95% accuracy over seven days, to me, those things are almost stupid that we aren't using that and scaling that across organizations around the country, to take people away from the task-based activities and let computers that are generally smarter than us, let them begin to predict where we should be performing the work and what the work is that we should be performing.

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Dan:

Yeah. And it takes the load off the nurse manager as well, which like 80% of their day is calling and staffing. They should be helping support nursing practice, not trying to find warm bodies to show up and care for patients. So I think if we can free up that role to be actually practice managers and practice support instead of transactional doers, that's also a piece of it.

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Bonnie:

It's a paradigm that we need to change as well, that you get hired for one unit, because we need to have flexibility. Of course, we need to have safety, of course we need to make sure you're trained and competent, but if one unit is going to be overstaffed several days a week and we're going to flex and float, why not begin to create units that look more like those old pod-based systems that we had years ago, where when you got hired, you have a first, second, and third choice of units, but that's the family or the pod.

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Bonnie:

And you may be working in any one of those places on any given shift on any given day and that's okay. It doesn't feel obtrusive, it doesn't piss you off, it's not like you're floating. It's that you know those people equally well, everyone treats each other with respect and value and kindness and gratitude, but you get along. So if I go to A, B, C, or D, it doesn't matter. I'm prepared and I'm ready to go and I can handle that work and I like those people.

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Dan:

Yeah. One of the things that we did here at Ascension in the OR model was that. What we found is everyone was cross-training across everything. So no one was an expert in anything, the teams were always flexing, and the surgeons didn't know who they were getting. So it just created a lot of actual chaos and frustration. We moved to that pod model where you have a primary specialty, you have a team that you work with most of the time, but you're also cross-trained to at least two other specialties so you can float across depending on staffing and need and demand and that kind of stuff.

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Dan:

The nurses loved it. I mean, they love it. They feel like they're part of something that they can gel as a group. And in the OR, you know how important that is. So it just changed the whole paradigm. Then we added some other things around what you mentioned to pay. So there's guaranteed hours that allow the nurses to, if they finish a case early, not having to use their PTO in order to get paid for the 40 hours that week, and a couple other things, and some metrics for them to get incentive pay if they meet some of these quality metrics and things.

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Dan:

I mean, the response was overwhelming. Nurses were leaving top tier academic medical centers across the street and coming over to this OR that had piloted this just because of some of those just basic fundamental things. It didn't have to take virtual care and robots and all kinds of stuff. It's just pay me what I'm worth, make sure I'm not using my PTO to just piece together a paycheck, and give me a team that's consistent in high performing. It seems really simple.

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Bonnie:

Well, it is simple, but there's so many feathers that we ruffle in doing these things. We have to have the courage to do them. And I think this is where nurses are going to have to lean hard into the space of discomfort to solve these problems ourselves. Otherwise, they will be solved and influenced by external parties that perhaps have different interests.

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Dan:

Yeah. So let's go down that rabbit hole now for a minute. There's a lot in the media, there's a lot of nurse Twitter and nurse Instagram and TikTok going on right now and there are a lot of competing stories. I'm not on all of the social networks anymore, I spend most of my time on LinkedIn, so I see the Nurse Leader piece because that's my community. But I'm seeing commercials with nurses crying. Even vendors creating commercials with nurses crying, saying, "You're too burned out, come be a travel nurse or come do this X, Y, Z thing."

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Dan:

Then nurses are angry and trying to petition the Joint Commission on different things related to staffing and there's a march coming and there's all kinds of stuff. In the back of my head, I don't feel like nurses are actually owning the narrative. I think there's an opportunity for us to step up and own it. I feel like we're getting taken advantage of as a profession where people are taking our angst and using it to some sort of financial benefit, whether that's labor unions in some capacity kind of taken advantage of the situation or it's a company taking advantage of situation to create growth. I don't know, but it just doesn't feel like nurses are leading the way in a lot of this stuff.

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Bonnie:

I would completely agree. I get emails regularly, and honestly, it makes my head want to explode because the degree of anger out there is just incredible. And I think a lot of it is probably well placed and deserved because there were a variety of complexities that arose during the pandemic that I think really, for all of the perhaps right and maybe wrong reasons, got nurses very, very riled up. We know that we did not receive the appropriate PPE, the appropriate safety equipment.

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Bonnie:

We know that nurses have been told, "Just come in, we don't care if you have COVID. Come in, we don't care if we're super short staffed." Some of those decisions were not smart. We've done a couple of things in my opinion. We're trying to tell a profession... We've been working very hard on becoming a profession. So we're telling a profession, and the voices are coming from hospitals, health systems, organizations, and amongst our own colleagues, that, "Yes, you're a profession." However, we treat people very much like we're not, like we're clock punchers."

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Bonnie:

So either we're going to be hourly workers or we're going to be managed as a profession. But it seems to me that at some point we are not going to be able to do both of those things. So if we're treated like hourly workers and we're flexed and floated and sent home and done all those things, then why would we expect this group of people to act like professionals when they're treated like hourly workers? I think the corollary is, if we want professionals, then we have to look at different pay models. I think we have to look at things like salaried, guaranteed hour paychecks. I think we're going to have to do that.

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Bonnie:

Now, what's certainly not to like about that from a hospital and health system perspective, they're going to say, "Whoa! Whoa! Whoa! Breaks on. We don't have that kind of money. That is not a sustainable model." Look, you've been in nursing a long time. I've been a CNO for 20 plus years. I would say you're already spending the money, so figure out what's the smarter way to spend it. But in order to keep nursing in place as an important, a key, and integral part of the healthcare ecosystem, we have to be the ones that solve this.

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Bonnie:

And it means that we're going to have to work through all the crankiness and the anger and everything else and we're going to have to be the ones to solve it. We also have to not allow ourselves to be exploited by any side in this.

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Dan:

Yeah, I think that's the biggest concern for me. I think there are organizations that have our best interest in... In fact, I was just talking with this Alliance of Unions recently and they want to be aware of all these changes so they can make sure that they keep the profession a profession. It's a different conversation than that transactional thing that you have in your head around some other groups who are just going for pay and benefit sort of thing.

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Dan:

There are some organizations that have our best interests at heart as well and we're part of them, but there's others that are really trying to take advantage and get a message across or a policy agenda. I think the thing that frustrates me too is that I see those emails, I get those emails too, and it's like, "Yeah, we're going to go petition," whatever, "Joint Commission." Well Joint Commission has standards, but they basically just accredit for CMS.

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Dan:

So why don't we go upstream to the big dog and actually focus our energy as a coordinated voice towards the actual regulators, not the people that come in and tell you that you can't have your drink cup on the table. Let's go after the big stuff. That's what the profession does. That's what the American Medical Association does, that's what the lobbyists for staffing do. I think we're doing these one off things or these fragmented efforts. We need to come together as a profession and own this and use the power of four million people to make it happen.

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Bonnie:

Well, absolutely. What I think would be probably a little bit maddening yet also incredibly fun would be to get the ANA, AONL, AHA, AMA, IHI, get a ton of these organizations in a gigantic conference center over the weekend and say, "You're not going home for 72 hours until we figure some of these things out." Hell, I'll even order the pizza. But it's a matter of we got to figure out what is it we want to be as a profession? What is required for us to provide safe patient care, to protect our licenses?

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Bonnie:

To make sure that not only our patients getting what they want to, but also the other professions on the team, physicians and therapists. It isn't just a one discipline team that gets this work done anymore. So I think we have to take the gloves off and not play as nice as we did, but we also just can't plan to mow over everyone and every organization and say, "This is how we're doing it. Take it or leave it."

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Dan:

Yeah, everyone can't be our enemy for sure. I think we have to create strategic alliances. I know there's a lot of excitement around hackathons and things that are going on within nursing at the moment. I mean, you just described a hackathon I would attend, which is get the stakeholders in the room and hack through the policy issues and the competing demands and come up with some path forward instead of just skirting around the edges or complying with X, Y, Z person or X, Y, Z group. I think we need to have those hard conversations.

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Bonnie:

If we want to make this even more fun, let's add some legislators, let's add some lobbying groups that would lobby on our behalf, let's add the safe medical practices guys. Let's add all of those groups and say, "What's wrong with healthcare?" We could point at each other all day long, but we got to fix it collaboratively. Without strategic partnerships, it doesn't matter anymore. It's not going to work.

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Dan:

Yeah. I think there's opportunity in all of that. I look at the march coming up in May and some of these other events and things that are happening and I hope that it does at least bring up some of these concerns and it leads to some partnerships like that to push the walls because I think nursing needs help to do that.

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Bonnie:

Let's also be honest, nursing is not the same profession it was when you and I joined these ranks. It's a very different group of people that do things differently. It isn't bad, it isn't worse, it's different. So I think trying to apply value sets from different generations from Xers or millennials aren't going to work for Zers. So I think we're going to have to figure out, how do we cross all of those lines and span all these boundaries and come up with something that works? Because patients aren't going away, someone's going to have to continue to provide care. Whether in a hospital, in a skilled care facility, or in a home, someone's going to have to do that. And I sure as hell would like that to be nurses, but we got to work our way through this time right now.

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Dan:

Yeah. One of the things that I've been talking about too as I go around is nursing's not invincible. We are definitely as apt to be removed as any other profession within healthcare. The more that we are fragmented and the less of us there are, the easier that is to accomplish. So I think we have to think about it as this is our survival as a profession. And how do we be bold, but also compromise and figure out solutions that are sustainable? That's why I'm not a big fan of these kind of outward things of $200 an hour, whatever the topic is, doesn't have to be pay.

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Dan:

But we have to think of it in the context of healthcare in the US as a business. We don't like that in some cases, but it is, and the only way to get the ear of people with the finance and the checkbooks is to make that business case a little bit different. I think nursing has the skillset to actually transform healthcare, to make it cheaper, make it safer, but that doesn't seem to be the conversation at the moment.

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Bonnie:

No, it doesn't. And I think perhaps in an over simplistic way, there are lessons we can learn from a lot of the large tech employers who seem to be doing better when it comes to employing younger generation workforce. I mean, you look at organizations, whether it's Google or Facebook, or whomever, they've done a good thing in that their hires don't pay for parking, their hires get free food and drink all shift all day long.

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Bonnie:

So even things like that, you might say, "Wait a minute, that doesn't matter to me. I want a better paycheck. I want my $200 an hour." Okay, we'll see how that works for you. However, if we could also remove some of those silly barriers like having to pay for parking or having to pay for your food in the cafeteria or things such as that, it becomes a little bit less of just one more issue that gnawers away at you.

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Dan:

Yeah, no, I was just actually yesterday talking to a colleague who used to work at YouTube and she's like, "I was able to show up early. I'd work a certain number of hours. I'd go down and get a snack. I could get a 15-minute back massage and I'd go back into my office and work." And she's like, "I'd work a 14-hour day, but it didn't feel like it. I felt rested and excited and I felt taken care of." Not that we have to make the Googleplex in every hospital, but I think you're right, there are some of these basic things where... Our nurses aren't even going to the bathroom half the shift. So why would you show up? It's amazing-

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Bonnie:

Yeah, and that's not okay.

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Dan:

... that we do it, we take that on our shoulder. Yeah, that's not the pay at all.

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Bonnie:

No. So if you're making 200 bucks an hour and you can't even go to the bathroom or can't eat, is that really the trade off that you want? I don't think so. I think it's a matter of the and game, not the either or game.

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Dan:

Yeah. Agreed. Agreed. That brings us into the nursing workforce piece. We talked a lot about the gaps and the messaging and those type of things. I'd love to hear, what do you think the path forward is? The provocation I have is you'll never ever be fully staffed again, so you have to think of this flexible labor, different shifts, those type of things, but would love to hear your take on where the nursing workforce needs to go.

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Bonnie:

Now you're really going to throw me into it. Yeah. You know what? I think that technology coupled with the workforce is the only path forward. Things for me that make a tremendous amount of sense are we should not be having nurses nor even PCTs or CNAs or any of those folks doing stupid, silly task-based running and fetching. I want to be tripping over a robot because it's running down the hall carrying linen or a dressing tray that I just dropped on the floor instead of having a human being doing that.

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Bonnie:

I want to make sure that AI is embedded in my EHR and telling me, "Jeepers, nurse, ding, ding, ding, ding, ding. Based on the meds this patient is on and the vitals and the fact that they had this lab drawn, I think you should look at this thing." Because we're going to keep running in a million directions. Let's use AI, let's use the predictive analytics that are on the market today that can tell you if your patient's going to have a lethal arrhythmia in four hours. Let's use the AI that's on the market today that will tell you if your patient is pre-septic 24 hours before they become septic.

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Bonnie:

Not only is it good for patients and it's going to improve literally mortality, it's going to be better for the nurses that are running in a million directions. I'm a huge fan of putting in place in the inpatient rooms remote patient monitoring. Let's make sure we can pull up on the TV screen, you can see the nurse on the other end of that, and that person's going to interact with you. They're going to make sure what medications you're on and why you're taking them, they're going to round with the providers, they're going to answer your call lights.

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Bonnie:

This in my opinion is going to be a great way to bring back out of retirement nurses who said, "You know what? I can't do 12-hour shifts running these long hauls anymore," but they certainly would be brilliant to be working in a command center or a call center watching RPM, watching remote patient monitoring, and talking to patients.

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Dan:

Yeah. And we've seen that too. We have a virtual surveillance piece here and we actually are recruiting nurses who are choosing to move away from the bedside who have worked there a long time and the physical, emotional stress of it is not sustainable for them in their life moment and they're joining virtual surveillance pieces, monitoring eICU or remote patient monitoring, or even just coaching newer nurses when they have questions across the system.

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Dan:

I think that expands our workforce, it expands our reach, it keeps that brain trust that the experienced nurses have in the system, and is a great path for us to continue to go down. It provides superpowers to the nurses directly in the rooms. It has this backup system that just... Why wouldn't we do that?

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Bonnie:

Absolutely. It's the extra eyes and ears for the nurse. For me, that's why ratios no longer make sense, because in a world where we can adopt technology, I'm going to say this out loud, but we can even have an RN that has a broader patient load because they would have eyes and ears on every one of those patients and a team that's comprised of LVNs, EMTs, paramedics, CNAs, and even having the old fashioned model of a PharmD roaming the unit. So in that kind of a situation, we can leverage our nurses, our registered nurses, over more patients because we actually will be providing them with the eyes and ears to help them. Now, the corollary is, we sure as heck need the good old-fashioned boards of nursing, licensing bodies, and regulatory bodies to catch up to that.

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Dan:

Yeah. And make sure it's safe. We need to test some of these models too and try it out. But yeah, I think that's our future because ultimately there's not enough nurses and there's no way in the near future that we'll train enough to fill the gap. It's the same with physicians, it's the same with physical therapists. There's just not enough bodies to care for the influx of people, and especially if another pandemic comes along, which it will.

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Dan:

So I think we just fundamentally have to rethink how care is delivered in a safe, effective way, and not to move everything to robots and virtual care, but to make sure that we augment and superpower our nurses with clinical decision support, AI, people behind the scenes. I think that's what we need to do. If you look at the military, that's what they do. They augment their soldiers on the ground with all kinds of tools. Here we're like, "Well, you can't use your phone. Don't look, Google anything, and don't ask your friend because they don't know." We make nurses just this island and we could leverage this system to allow them to practice just at such a higher level.

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Bonnie:

Well, and I would tell you, I've heard so much about Florence Nightingale that I'm almost becoming an unfan. Because yay! Great. However, that was a really long time ago. So it's not like we can pretend to practice that way anymore. That door's been closed. What's important to us is to think about how do we continue in a profession that is... In my opinion, we're at a little bit of a crossroads here and we need to make some decisions.

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Bonnie:

We also have to learn to adopt technology. We can determine how we want to be involved with the design and development, we can determine how it's going to work with us in our workflows, how it's going to help us streamline things. So I think we have to be involved in that. We do not want to make the binary choice of high touch or high tech. It has to be both and it can be both. Just because we use technology does not mean we are no longer compassionate beings.

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Dan:

Right. Even fundamental nursing theories, there's books on this about how do you care through technology. Again, like you said, it's not either or. We can go back to our roots of theory-based practice and actually do these things. And we talked about this pre-show, it takes us as an individual professional, as a nurse, not to wait, not to complain about it and make a TikTok about how funny it is that we can't use any technology and we're in the 1930s as far as tech goes in nursing.

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Dan:

But it takes us to demand a seat at the table, it takes us to make the table ourselves. It demands us to go to the... not the administrators, but to the tech companies and say, "You don't know what you're doing. This doesn't work. I will help you." I think we need more of that energy within the profession. Otherwise, we'll just continue to wait and wait and wait and complain and it'll never get fixed.

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Bonnie:

Yeah. I think to a large degree, what's important is that we don't want to make fun of ourselves anymore than we have to publicly. I can't tell you how many times I've had friends and family and even my kids show me things on TikTok about what nurses are saying or doing or wearing. I'm like, "Oh, jeepers!" Yeah, I get it, we can make fun of ourselves, but it feels as though there's a whole industry that has been born out of influencers that are actually now making a lot of money just by making fun of us. So for me, that rubs me a little bit wrong in terms of what we're trying to convey as a profession.

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Dan:

Yeah. We just need to be cognizant of our image. There's a place for funny and comedy and... Nurse humor is probably the funniest humor on the planet. But at the same time, if you look at the media, they see that and they portray us in that same way to the public. So then the public starts laughing at us and they don't understand the inside joke. So I think we have to just be ready for that because that lesson's our impact when we're at the table. It's like, "Oh, you're nursing. Oh, you guys are just that thing. You do that funny thing all the time." No, we're professionals, we're doctorly-prepared people. We just have to be cognizant that what the public perceives us as impacts how we can influence policy that we want changed.

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Bonnie:

Well, we know we can't push you too hard or you're going to cry.

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Dan:

Right. Exactly. Yeah. If I see another commercial with a nurse crying, I'm going to send a letter to the editor or something. I mean, I get that it's happening and we should be real about that thing, but that shouldn't be the only perception that people have that nurses are just sad and depressed and falling asleep in their car in the parking lot. I forget which company it was, but I saw it the other day and it was a nurse getting off night shift, she falls asleep in her car, and then she gets a text message saying, "Here's five jobs that a recruiter found for you. Go travel." Or something like that. And I'm like, "Wow! What is this?" I can't stand it anymore. We're more than a crying nurse on a night shift.

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Bonnie:

Well, yeah, I'm sure she woke up long enough to apply for the jobs, right?

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Dan:

Yeah, exactly. Well, and I think what I do appreciate about the newer nurses coming in the profession is they're voting with their feet. They're not afraid to say, "This organization's not for me," and three months later go somewhere else because it doesn't fit with their values. I think if we can own our values like that and vote with our feet, eventually people are going to have to figure it out.

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Bonnie:

Do it. I love that and I've said that for years. When nurses vote with their feet, that sends a very strong message. I think we continue to have a lot of leaders and, I will say, lots of CEOs that haven't really believed that the problems are the problems. So when nurses vote with their feet, I think that gets people's attention. After you do that though, we have to fix the problems.

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Dan:

Exactly. Yeah. We can't just bounce around until you find someone that may listen to you for five minutes. I think we have to own it too. There's three phases of it. You yourself can try and influence the situation. If that doesn't work, then you need to bring a cohort of your co-conspirators and try and influence the situation. Then if that doesn't work, then you can decide to vote with your feet. But if you're not giving it a try, you're just moving around and not giving your feedback or you're not giving it directly, you're not helping the problem either. So I think raising that and having that professional obligation to fix the issues is going to be something we got to focus on.

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Bonnie:

Absolutely. I like to say proceed until apprehended, right?

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Dan:

That's right. Ask forgiveness, not permission. So what are some of the tactics that healthcare systems can do in the short-term to ensure that they support the nursing profession? I'll just caveat that with, the organizations that are divesting in nursing after the pandemic will 100% fail. So what are some of the ways that healthcare systems can invest in the profession and get to the innovation and the retention and the engagement that we talked about today?

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Bonnie:

Yeah. So again, for me, it's going to be some of those simple fundamentals. Proactively evaluate your pay structure. We used to do these things on an annual basis, do it every six months and adjust where you need to make adjustments. Also, be the first ones out of the gate. Be very proactive and say you're doing it and why. I think that's really important. Staffing and resources. Explore a multitude of staffing models, care delivery models, and get out there and lead.

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Bonnie:

Also, get your nurses involved with problem resolution in advance to start exploring new technologies and new models. I think where we can start to do those things and lead that work instead of being caught flat footed, I think that goes a long way. The other thing I'm going to say is that there is so much turnover in nurse managers right now. We have to support our leaders. Years and years ago, we looked at our structures and we said, "Oh, we have too many nurse leaders. We're going to cut managers and cut directors and increase their span of control." Terrible move.

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Bonnie:

So I think we need to go back, we need to create smaller cohorts, probably more nurse managers, more nurse leaders, give them the tools, set them up to be successful, make those jobs doable. We shouldn't be hiring nurse managers at pay that's less than bedside nurses and say, "By the way, you own all these problems. Now go staff your unit." We have to come up with ways to actually make those jobs doable. Explore some of the things we had in the '80s, it's silly and old school. What about job sharing for managers and directors? Things that look different.

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Bonnie:

I know there are organizations that are actually exploring daycare on site again, or some of those amenity-based programs again, whether it's oil change, car wash, food delivery, pick it up out of the cafeteria on your way home. You know what? I don't think anything's off the table anymore, Dan.

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Dan:

Yeah, I think so too. I think it's a new world of work and we have to update our policies. I think from a nursing professional standpoint, we need to start asking for these things. So in times of change and frustration, don't recoil. Step up and ask for these things. I've seen groups of nurses be able to raise issues and have things solved. I was just talking with Karen Grimley at UCLA recently and she mentioned nurses in the pandemic were getting pressure ulcers on their heads from the face shields.

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Dan:

So they went to the College of Engineering and created in a matter of days a 3D-printed case that stopped the pressure ulcers and was much more comfortable and they implemented that across a whole academic medical center. Those are the things that we need to be doing. Not waiting for someone else to fix it, but to stand up and demand it and find the partnerships that allow us to create the future.

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Bonnie:

Well, and strategic partnerships are something that we haven't always done well in nursing. Now is the time that we have to go outside of our silo of nursing and talk to the IT people, the tech people, the informaticists, the engineers. This is our time to go out there and talk to them and begin to build these more broad coalitions of problem solvers that can help us think in ways that we might not always be able to think about.

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Dan:

I agree. Unless we fix the system, we're going to end up with more [inaudible 00:34:01] and more errs and blame and other things. So it's on us to do that. We can either recoil and wait for someone else to fix it and complain about it or we can jump up and demand a better system and make it happen ourselves. We can do that through voting with our feet or problem solving in the moment. Like I said, nursing's not anti-Titanic. We could sink just like they did, and so we have to step up and make the future that we desire.

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Bonnie:

Yeah. I think the future's bright. We just really need to go after it instead of waiting to be asked.

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Dan:

Yeah. I think this is the decade of the nurse now. So let's own it. There's 18,000, 20,000 open jobs out there for nurses at the moment. We have the cards in our favor and let's do something about it. So Bonnie, really appreciate you being on the show today. One of the things we like to do is hand off that one nugget or that provocation to energize people as they listen and go into their day. So what would you like to hand off to our listeners?

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Bonnie:

You know what? I would love people just to stop and think a minute and be grateful about anything. It matters not to me if it's something on your unit, but just pause for a second and give that gift someone else. Just give them 30 or 60 seconds to just stop and think. We're all grateful for something, right? So it's a matter of what are we going to do with that? How are we going to use that vibe, that energy in our workplace, around our coworkers, around our families just to do something that feels good?

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Dan:

Yeah. I love that. And I'm grateful for you, Bonnie, and our connection and our provocation to the profession. I hope that this inspires people to think about it, to always ask questions. You can be passionate and angry about something, but always look behind the system and see what's feeding it and make sure that it's aligned with your values and then go after it. I can't tell you what the solution is, I don't know what the solution is, and you can believe in a lot of stuff, but make sure that you're just aware of all those things. And be grateful for being a nurse because it is one of the greatest gifts, greatest professions there is. We can literally change healthcare and the way people seek health. So Bonnie, thanks so much for being on the show.

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Bonnie:

We can change the world, Dan. Let's aim high.

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Dan:

That's right. That's right. We can change the world. Nurses can do it. So Bonnie, where's the best place to find you? We're both LinkedIn influencers, so we spend a lot of time there. But where are some other places that you hang out that people might be able to find you?

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Bonnie:

I am on Twitter, I am on Insta as well. LinkedIn's probably your safest bet. I actually respond a hell of a lot faster out there.

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Dan:

Awesome. Well, we talked about a lot and I just really appreciate the provocation and the conversation. Let's go after this and change the world.

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Bonnie:

Absolutely. We can do this.

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Dan:

Thank you so much for tuning into today's episode of The Handoff. If you liked what you heard, please consider leaving us a review on Apple Podcast, wherever you listen to podcasts. You can also subscribe and receive new episodes at www.thehandoffpodcast.com.

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