Dan:

Krista, welcome to the show.

Krista:

Thank you for having me, Dan.

Dan:

Yeah, no, this is great. I told you before the show, I'm a LinkedIn stalker of yours because I just really enjoy your content, the karaoke, which we'll talk about later, and just all of your advice for healthcare leaders and nurses and really anyone in this space on how they can be better prepared to find roles. So before we jump into some of the questions, would love to hear sort of what are you up to lately? What's the latest project on Krista's docket?

Krista:

Lots of projects, Dan, focusing on the recruiting industry, educating the hiring authorities on how to more effectively find the talent that they're so desperately asking for but it seems the recruiting process is broken. So I don't mind leaning into uncomfortable truths for how to fix it. And it might not be what hiring authorities want to hear, but it's what we need to do in order to fix this process and make it better and more efficient for everyone. So that's first and foremost. Second, Karaoke for a Cause is coming up next week, so I'm very excited about that.

Dan:

I love both of those. And I know you're vocal about both, literally vocal in the karaoke side and some of your songs, it's so good. And your memes are also amazing. So before we dive into some of the specific tactics, I would love your take on just the industry as a whole. So where are we at with supply and demand, is it an employer or an employee market? So what is your view of the job market in healthcare at the moment?

Krista:

Right now, we're certainly in a candidate driven market. For every one candidate speaking to your hospital, most likely they're speaking to three others. And so the name of the game is making decisions quickly on hires, get them the best comp package that you can, interview quickly and efficiently. But most importantly, just give people closure if they don't get the job. People won't shatter from a no but I think false hope is unkind because candidates are looking for that right fit. And so that's what I'm trying to educate folks on in the interview process is let's get to answers faster. Let's recalibrate what we're looking for in terms of the candidate market, and you have to roll out the red carpet for these candidates, otherwise they will not choose you as the employer. They have several other choices. So we have to be proactive in our marketing strategies to get the talent that we want.

Dan:

And how do you source that talent? So obviously you're on the platforms and can reach out and share content and build that network that way, but how are you finding some of the top talent in other ways?

Krista:

Well, luckily most people put their lives online. So LinkedIn is one of the largest professional sources of healthcare professionals. I can go and see someone's profile, but also just the internet's a beautiful way to research other folks. It's all too easy to say, well, who's the surgical director at NYU? Oh, it's blankety blank. And so we have an internet resourcer that sources those candidates for me. And I do it old school style. I will just call people and initiate a conversation because no matter what, my interview process has to start in trust and relationship building.

Dan:

I love that. I was just thinking as you were saying that if you called me, would I actually answer the phone or not? Or would I let it go to voicemail and then I'd text you back that I don't want to talk to you? Anyway-

Krista:

[inaudible 00:03:16].

Dan:

That's the borderline millennial in me, I think. But I love that approach. It's not just one. One of the things, and actually this dives into one of the questions I want to ask you, which is what's your advice for candidates in order to set themselves apart? And one thing that we teach in the Masters in Innovation Program at Ohio State, and I've told to many of my other colleagues, is LinkedIn is probably one of the best investments I've ever made in my career. And it's led to so many opportunities, whether that's just networking or jobs or consulting work or just a connection to ask a question. I really think that that is the new resume. What are some of those things in addition to LinkedIn that candidates can do to really set themselves apart as they're applying for roles?

Krista:

Absolutely. So preparation is key. I've seen strong leaders on paper at least get passed over by candidates with less tenure simply because of how well they present themselves in the interview. So I give people three homework assignments when they're preparing for that job interview, they have to research the organization they're going to speak with, they need to know their metrics and be the most personalized version of their professional self. As you mentioned, LinkedIn is a great tool to find out information about the people you're going to be interviewing with. Look them up, see where they went to college, see what projects they're rolling out with their hospitals. Also remember, companies are looking for the following traits in high potential healthcare leaders, they're looking for someone with high energy, passion for what they do, knowledge of who they are, and candidates that are running to them and not away from something else.

That's a big red flag. If you talk a lot of smack about the hospital you're about to leave. So I always tell folks, treat it like a date and personalize your answers to that specific hospital. Now, Dan, you wouldn't go on a date and say, well, I'm looking for a girl with pretty eyes. That sounds weird. So you'd [inaudible 00:05:14] tell that girl, oh Sally, your eyes are gorgeous. You need to personalize your answers this way in the interview process as well. I'm interested in your hospital because of something specific about them, either as a leader or a system.

Secondly, I tell people they need to know their numbers. You'd be shocked at how many resumes I see that don't tell me how many beds your hospital has, let alone FTE's or patient satisfaction scores. If these numbers are not included in your interview or on your resume, how can someone differentiate your hospital from a Level I trauma center versus a Critical Access? But last but not least, remember that hiring authorities want to hear the reason you want to be in healthcare in the first place. What personal experience led you down this path? They want to hear your passion for helping other people. And this authentic approach can humanize you and is the difference between someone that wants a job and someone that's answering a calling. Ultimately people hire people that they like so that genuine conversation with the interviewer can set you apart from the rest of the competition.

Dan:

Yeah, that's such great advice. And similar things when I'm looking at colleagues and they're sharing that they're searching for roles and things, and I really try and say in those bullet points on your resume, not only quantitative number of beds, impact dollars, staff count, reports, those type of things. But also the qualitative piece, if you can pull in a story or bullets around a story and then use that to tell that story in the interview, I think those are the things that make connections and the stories really speak to your passion and really prepare some of those key stories because you're going to get asked that, tell me about a time, blah, blah, blah. And so have some of those queued up with numbers, quantitative and qualitative that allow you to connect with the hiring manager.

Krista:

Absolutely. Let me tell you, my favorite interview story was with a surgical director named Becky from Pennsylvania. She was interviewing down here in Texas, and she shared with me about a time she had a contest with her staff. She promised if they can make their patient satisfaction scores go to the 95th percentile by November, she would come to work the week of Thanksgiving dressed as a Turkey. So they did it and she did just that. Of course, I asked if she had pictures and she did, and I urged her to bring them to the interview and she was like, "No." And I just insisted. I insisted because this incredibly fun quality about her shows the soft skills my clients are wanting to hire for, not only that she was a team player, but a team leader that got buy-in from her staff. And I kid you not Dan, 30 minutes after her interview, they made her an offer and she got the job.

Dan:

Wow, that's amazing. But that shows her commitment. Follow through, engagement, making life fun. Those are the stories that I think, like you said, they resonate and people can see in that one action, your commitment to your team and that sets you way apart than just putting a bunch of bullet points on a piece of paper.

Krista:

Absolutely.

Dan:

One of the other things that I get asked a lot, I'd love your opinion on this and especially in the innovation space in my network, are people that take the non-traditional path. They don't necessarily go from charge nurse to manager to director to CNO or any iteration of that, to academia and go up the tenured kind of direction, or they've sort of bounced around within healthcare all for good reason because they're interested in other things. So when you have that non-traditional candidate, what is some advice for them to of relate to the role even though they may not have had that exact role, but they have the skill set that the hiring manager is asking for? How do they present themselves when they don't have that linear path that many hiring managers write off when they're looking through resume packages?

Krista:

So one thing I want candidates to understand is that the top two requested skill sets I'm asked of have nothing to do with clinical competencies. So if you have a non-traditional healthcare pathway in your career, that's okay because you have transferable skill sets with leadership, with business making decisions, being an effective communicator in other areas of healthcare that you can thrive in as long as healthcare leaders give you the opportunity to shine and do so. And so those top two things being effective communicator and having a business mindset, those can go into all facets of healthcare. Whether you're at surgical services, critical care, informatics, great leaders have mastered the art of persuading others into action. So if you want your employers to be receptive of your vision, they need to be attentive of what you have to say, and more importantly, they should like and trust you.

Dan:

And I think you hit on the key point that is really great, which is leadership in all its forms is persuading people and-

Krista:

Yes.

Dan:

Building relationships, having those connections and influencing decision making. And so whether you are an informatics nurse trying to look at a management role or you're a manager looking for a innovation role, it really is the same skill set in a different context. And so really telling stories about that and showing impact about influencing people, I think some of the other pieces of those roles you can learn, anyone can get online and figure out how to do a budget and those are of things that are sometimes over weighted versus that personal relationship skill that you can really learn in any role.

Krista:

Absolutely. I always tell hiring authorities hire someone that's at 80% skill set fit if they are 100% culture fit.

Dan:

Love that. All right. So I want to switch us over into the hiring manager advice section now as well. So before we started recording, you mentioned it takes up to 90 days or a little bit over 90 days in order to have a surgical services professional hired onto the team. So that time to hire, three months, that to me is ridiculous. If you have an open role and you can interview X many candidates in a couple weeks, you should be making decisions much faster. So would love to hear the state of the industry on the time to hire side and maybe we can dive into some of the recommendations on how do we speed that up?

Krista:

I mean, you said it right there, just speed it up. Come to a decision quickly. So I'm quite vocal online about how to fix the recruiting process because it's broken, it's convoluted, it's exhausting. So in my personal opinion, not biased at all, if you have a trusted recruiting partner to vet candidates and tell your hospital story on a large marketing scale, you can decrease this fill time exponentially as long as you make decisions quickly. So in my opinion, Lean Six Sigma is the most effective way to hire in today's job market. In recruiting, that means eliminating unnecessary steps in the interview process to get the right hire as efficiently as possible. It's tedious, it's exhausting, and if it takes too long, a candidate can flame out on their interest anyway. So let's untangle it. Stop wearing people out.

Dan:

Exactly. And I've experienced that where there's this hope and that the email comes across, "I need more time. We're figuring some stuff out, I need more time." And you're like, "okay, more time sounds good." Maybe that's a week or two weeks and then three weeks and then a month and then two months and you're emailing back, "Hey, how's that time coming?" "Oh no, we need a little bit more time." And then it of feels like they're waiting for somebody better or different from the candidate side, and so you're just like, maybe this isn't the right fit. So if the client needs more time, what are some tips on communicating and keeping someone interested and engaged in the job? Because there are real whatever approvals or budget things that need to occur in some timeframe. But how do you keep that candidate warm?

Krista:

My philosophy is that clear is kind and unclear is unkind. So if you align time expectations on both sides, both people aren't left waiting and both people aren't left anxious. So let's say, Dan, I interviewed you for a job this Friday and I know that there are other candidates in process, that's okay for you to know that, but what's not okay is to leave you hanging on when you'll hear about closure for the next step. So myself as a hiring authority, Dan, it was great to speak with you today. I have to talk to my partners within the unit to see what next steps are going to be. You will have an answer from that within two weeks. So until then, I wish you a great day.

Because that way at least people know what to expect. But again, I urge people, if someone's a no, tell them no now so they can move on and find a potential organization they would work for. It's not fair to keep candidates warm if you know you're not going to hire them. I once had a client wait two months to tell me someone was a no. What's the point in that? And quite frankly, now that candidate will never speak to that organization again.

Dan:

Yeah, and I think that's the key is the perception of that candidate is key, especially as you move up into higher profile roles. And this is so true in nursing. I was just at the American Academy of Nursing conference and everyone knows everybody, especially in nursing. And so one bad interaction gets around real quick. And so to really know that it's not just the candidate you're managing, but it's also your brand image, which is a big piece of this. And so like you said, be clear, be kind, and set those timelines. Even if it comes that two weeks and you need more time. Just communicate. I just feel like there's this weird, I'm afraid to talk to the person mentality. So one other thing I wanted to ask you is what do you think drives that 90 day plus timeframe? Is it really just decision making or are there processes that are so ingrained in healthcare that we just follow because we follow them that are causing this that we may need to call out and really truly disrupt?

Krista:

I mean, I think that the biggest mistake is that people are waiting for that 100% fit. Even if they just interviewed someone that is a 98% fit for that role. In your time vetting that 100%, you're going to lose out on talent that could grow into that gap. Perfection doesn't exist, but career development program should, and like I said earlier, hire someone that's an 80% skill set if they are 100% culture fit every time. So what needs to be disrupted is again, getting over the fear of telling someone no, it won't break them, but it will at least say, okay, they did it in a respectful way. How you say no is just important is how you say yes. And hiring authority and people in general need to learn that just because you might not come to an agreement, it doesn't mean it has to be disrespectful. You can respectfully walk away from something that doesn't work out.

Dan:

Yeah, agreed. And I think from a hiring manager perspective, it's freeing to tell someone no because it's one less person you have to communicate with over time it sort of lowers your workload and it's making a decision. When I was hiring in my last role, I was hiring a whole team in and I would try and communicate as early as possible, tell them no, at least give them some reason why there wasn't that fit. Wish them well. Tell them I'm happy to help in any other way. And then it was freeing, it's like, okay, I'm on to the next thing, we're getting down to the top two or one or whatever and it sort of felt like I was moving the process along.

So that was the hiring manager experience. And then from a candidate being told no, it's sort of freeing as well. You're like, all right, I can move on now. I don't have to hold onto this thing and hope and wait and wake up wondering if I'm going to get that email today and release the stress and energy around that piece and move to the next thing. So I think just in general we just... Maybe that should be one that we should do a class together on, 101, communication 101.

Krista:

Gladly. I will get on the tallest pedestal and teach that all day long. That's honestly, as a recruiter, that's my biggest ask the clients, just give us an answer as fast as you possibly can so we can move forward together.

Dan:

Yeah. So you mentioned that it's a candidate market at the moment, so each candidate's probably talking to two or three organizations for every role they've applied at yours. What's the best way for hospitals to... Or I should say hospitals, health systems, how can they attract the top talent? What are some of those key things that candidates are looking for?

Krista:

So consumers buy products from brands that they like and trust. And employees interview and work the same way. Like you mentioned earlier, brand reputation of a company is everything and it will dictate candidate flow. So articulating that includes not just talking about compensation, but the culture, the mission, the values of a hospital. So sure, competitive salary is a given, but compensation is not the main motivator for a candidate seeking employment elsewhere. People are looking for a new challenge, advancement opportunities, a purpose, and a stable organization to join. The marketing strategy needs to focus on not just what a hospital does, but what do the leaders practice?

Those values can define organizational culture. And when hospitals lean into that and can advertise the human story of these healthcare heroes, potential hires will say yes, that is the kind of system, boss, person I want to work for. And my job as a recruiter, that's all I do is I tell the story of a company on a national level, why would someone else want to work there? And I never start with compensation. I start with what the company believes in. So if a hospital can tell their story everywhere to get their audience to like you, that's how they'll attract top talent.

Dan:

That's great advice. And something in my career too, I've learned the hard way, which is there's jobs that pay a lot that could be horrible and there's jobs that pay well and could be awesome. And sometimes it's easy to go for the shiny pay package and it blinds you to the core values of the organization. And I've found if your values as a candidate don't match up with the values of the organization, it's a slog no matter how much they're paying you. And so to really do that assessment and to understand the story and understand the philosophy of the leaders, because when it gets hard, like in COVID, all of those true colors come out very clearly. And when times are hard, you want to be aligned with the mission of the people and the organization not slogging through and hating every minute but collecting a paycheck. So I think it's wonderful advice.

So I've been talking to colleagues and there's a lot of focus on recruit and retain, which I'm sure you're very well aware of. And some of these ideas that I'm hearing come out of these recruit and retain sessions are like, well, we need to offer nurses back massages during their shift. And what if we could provide the pizza cart every Thursday? Or what if we gave them gift cards to the Starbucks if they did XYZ thing? Do you find candidates are looking for those sort of startupy, Silicon Valley perks and that pulls them across the finish line? Or are they looking at that stuff... Because my bias is that nurses look at that stuff like I don't even have time to pee. How the heck am I getting a back massage in my 12 hour shifts? So I would love to hear your thoughts on this.

Krista:

My thoughts might be conceived as pretty harsh, but I don't mind that. Those startup incentives like pizza parties and gift cards and insane sign on bonuses that will attract your short term candidates, that is not a long term solution to this unsustainable healthcare market that we're currently in. The average turnover for nursing leaders is two and a half years. That's for leaders, for staff RNs, 70% of first year staff RNs quit after the first year. So we need to find ways to retain these people. And it's not monetarily based every time. Again, is it part of it? Sure. But people stay with organizations where they feel valued, where their voice is heard, and there is a chance to make a difference not only in their personal world, but their professional one. Can this program develop me to become a leader and continue in this process? It broke my heart during COVID because so many healthcare leaders are burnt out, not just from their job but from nursing as a whole.

And so we can't just remind people that they're appreciated and valued when things are hard, we need to remind them every day. So my advice to nursing leaders is create that culture of letting people know how much you appreciate them by including them in meetings with hard decisions, by including them in projects where their say could feel very valued. Shared governance practices, including everyone. That's how you create a culture of retention. And unfortunately until the retention budget is higher than your recruitment budget, I'm always going to have a job as a recruiter in this marketplace.

Dan:

Well Krista, so you're always going to have a job because you get it. But yes, agree. But yes, and it comes down to, and this is where I get on my pedestal too, which is the science of incentive and motivation. And you know can read popular books like Dan Pink's book around motivation, Drive. And what they found is it's intrinsic, not extrinsic. So it's extrinsic motivators, like a $10,000 sign on bonus, awesome, how long do I have to work there to get that? Okay, a year, fine, I'll sign on for a year. That's easy for me to do, collect $10,000 more and then go to the next sign on bonus. There's no engagement in the organization necessarily with those type of things. So I think we really have to weigh that as hiring managers. There is something to kind of pull people out of the woodwork to get interested, but what's the long term sustainability of that?

And it's gone up and down in healthcare and throughout the ages and it's just interesting to see we sort of pull these old tricks out and not really think about the fundamental system changes that need to happen because there's a lot of science on this stuff, why people stay and how they are motivated and what they look for and how they engage and that kind of stuff. And we skip over that and say we'll just pay them more and survey after survey just shows that that's not always the top driver for these decisions.

Krista:

Well, and paying them more is the easy solution. The hard solution is changing the culture. That's the actual hard work. Do nurses need to be paid more? Absolutely. But as leaders, we also need to do the hard work of how are we engaging our staff? Are they on a development program? Do they feel valued? Do you give them praise only on their performance report or just out of the blue. Hey, I noticed you had a tough day yesterday. I appreciate how you handled that. That can make or break someone's day. And also when I talk to candidates that are having a bad day, nine times out of 10, it's because at their work they're either feeling ignored or they're feeling bullied by their boss.

And so that's when folks like myself swoop in, hey, how's it going? Oh, well I'm not really liking this new leadership. I'm wondering what else is out there. Well, by golly, I'll tell you what, it's a good thing that I called because I have another opportunity and people don't just talk to me when they're dissatisfied, but when they think the grass is greener, unfortunately it probably is. And that's where I come in.

Dan:

I love that. And I will just reinforce that with my personal experience that almost every single one of my job changes was because of a leader that I couldn't believe in or resonate with. And so I think that's a huge piece. And I healthcare's very bad about removing bad leaders. We sort of let people fester and don't understand the total impact of that festering. So we're getting to the end of our time, but I want to ask you one more question because we have listeners from staff nurse, student nurse, healthcare leader, the whole gamut. But when it comes down to nursing leaders and nursing leader roles, what are some of the skill sets that employers are looking for over the last year or so coming out of the pandemic?

Krista:

Well, as I mentioned at the top, the top two requested skill sets, again, have nothing to do with competencies. It is effective communicators and healthcare leaders with a business mindset. Effective communicators can make or break the cohesiveness on a nursing team. How well does that unit leader address conflict or concerns? Can this leader teach project implementation or lean into uncomfortable coaching moments? Now I know that clinical competencies within the specialization are given, but the ability to clearly explain your key performance indicators in a way that showcases increased patient satisfaction or revenue generation or conflict resolution can make or break if someone is selected for a job. Now, as for the business minded healthcare leaders, I'd recommend those who are undecided about their master's programs to choose continuing their education with an MBA versus a Master's in Nursing.

Because healthcare is a business, it's a business of people and hiring authorities are asking for clinicians that can apply a collaborative management style and leverage those skills to achieve business goals. So know that it takes a certain executive skill set to drive a strategic organizational vision, but it takes an effective communicator to execute that vision by getting buy-in for the leaders around them.

Dan:

Yeah, that's great advice. And I would even add onto the MBA side, which I think is valuable in many cases, especially if you're going into operations degrees like the Master's in Innovation, I'm just plugging because it's awesome. But the Master's in Healthcare Innovation at Ohio State, which also has business design thinking, leadership, communication, influence, and so those masters roles that are focused on that, clinical nurse leader roles is another one where it's focused on that relationship between people and the business side of healthcare I think are always level ups that if you're going to go back to formal education, would be great to consider. So Krista, thank you so much for being on the show. This has been awesome. I want to invite you back because I want to challenge all of the recruiting and retention dogmas that we have in the healthcare system, but we like to leave the show with one thing you'd like to hand off. And so what is that one nugget you want to hand off to our listeners as we wrap up?

Krista:

Sure. So if you're a candidate interviewing in today's market, do it with intention. Find a company that aligns with your personal and professional values, and I guarantee you that you'll be happier if you just chose the location with the best compensation plan. But also remember that people just hire people they like. If you have the skills on the job description, but you're not a culture fit, they're going to pass. But if you don't have the skills, they can teach you those if you are a culture fit, we just can't teach people to change their personality. And if you're a hospital interviewing for a tough to fill role, untangle your recruiting process, make it efficient with fewer pit stops and your fill rate will increase. My job's to recruit people for you, but your job is to keep them feeling valued and appreciated.

Dan:

Great advice. Krista, thanks so much for being on the show. I know our listeners are going to be contacting you and finding you. So other than LinkedIn, which you're like queen of healthcare LinkedIn, where else can they find you if they want to reach out and connect with you about roles or just learn more about you?

Krista:

Absolutely. They can look me up on ParkwoodInternational.com so they can look at my firm and my agency and they can reach out anytime.

Dan:

I love it. And follow Krista on LinkedIn. She's hilarious. I don't know when the episode's going to drop, but in the beginning of November is her karaoke work, which you can't miss, and it raises money for great organizations and she's hilarious at doing it. And you can submit songs for her to sing, she'll do them, record them, throw them on LinkedIn, and so check that out. Krista, just thank you so much for the real conversation around recruiting and look forward to continuing to banter back and forth on social media.

Krista:

Absolutely. Thank you so much for having me, Dan. It's been a pleasure.

‍