How Nursing Education is Meeting the Workforce Crisis

Podcast Transcript

Dr. James Stoller:

Hello, and welcome to MedEd Thread, a Cleveland Clinic Education Institute podcast that explores the latest innovations in medical education and amplifies the tremendous work of our educators across the enterprise.

Mari Knettle:

Hi, welcome to today's episode of MedEd Thread. I am your host, Mari Knettle, medical director of the Center for Health Professions Education here at Cleveland Clinic in Cleveland, Ohio. Today, I'm very pleased to have Dr. Lisa Baszynski, the associate chief nursing officer of nursing education and professional development at Cleveland Clinic join us. Dr. Baszynski, welcome to the podcast.

Dr. Baszynski:

Thank you very much, Mari, it's a pleasure to be here.

Mari Knettle:

Why don't we start out, can you tell us a little bit about yourself and where you're from?

Dr. Baszynski:

Oh, absolutely. I am from the Cleveland area and I have been at the Cleveland Clinic for the last almost 20 years. Um, been a nurse many, many decades, started with the Cleveland Clinic in about 2003. And that's really where my professional journey began. I like to say this was my roadmap for professional growth and development. In this time, I've been able to go from a diploma nurse to my doctorate, from an associate lead to an AM to associate chief nursing officer. So, I'm very proud to be here and share my story.

Mari Knettle:

We're so glad to have you. It sounds like you've made a lot of progress from the day that you started out as a brand-new nurse. What do you do here at Cleveland Clinic now?

Dr. Baszynski:

So as associate chief nursing officer of nursing education and professional development, that's really overseeing, directing, influencing education and professional development for nurses who report up through the Nursing Institute, and also for caregivers who report up through the Nursing Institute. So, it's all about competency, quality, growth, development and leadership in the nursing profession here at Cleveland Clinic.

Mari Knettle:

So, in that role, you obviously have a lot of insight about nursing and many different facets of nursing, including what it takes to become one. And what we're here to talk about today is really the nursing shortage, I think. And everybody knows there's a national shortage of workers across industries. What are some of the major factors that contribute specifically to the shortage in nursing?

Dr. Baszynski:

For decades, we've had a nursing shortage. But really when we talk about where we are with the healthcare crisis and the nursing shortage, I think we need to really talk about in the context of the pandemic. So, we've also had this nursing shortage, but what has happened, what we've been through in the last two and a half years, really has shed light on where we are. The profession of nursing has actually done a couple things. We are now in an illuminated state, where, you know, we are very valuable, and we should be proud. But what happened in the last two years, think about it, it's historic. There are not enough adjectives sometimes to describe it, the unknowns, caring for patients when, you know, we had no idea, there were no vaccines, we were worried about taking it home to our families. But, you know, nursing, physicians, healthcare workers, we all went in and we did what we needed to do to take care of our patients, our organization, our community, and I think that's something so special and something to be proud of. So even though we hear all about the crisis and the pipeline, and all those things are so true and so real and it's going to take a lot of work to solve these issues. You know, I like to put it in that context of being proud of what we do and proud of what we've accomplished.

So, you know, it's those things where we have an aging population, we have nurses who are over 50, we've nurses who wanted to retire post-pandemic or during the pandemic. It's not only nursing, it's the healthcare industry.

Mari Knettle:

Yeah, it's the healthcare industry and, and really all industries. But I think that you're right, the pandemic gave us a particular appreciation for the value of nurses. And I remember some very heartwarming scenes at the beginning of the pandemic and I think we need to remember that. What a wonderful career that means too much to everybody.

Dr. Baszynski:

You know, I appreciate you saying that because I think we need to change the context of, we hear a lot about burnout resilience, and I'll tell you what nursing education was able to accomplish, at the beginning of the pandemic we had to do skills refreshers for nurses who maybe had been away from the bedside, from our periop nurses it was all hands on deck. And you know, the overwhelming theme that I heard from these nurses it's, "I want to help my coworkers. I want to be there for patients." It was their due diligence, they were proud. And, you know, I don't think we can forget that, the true meaning. It's an honor, it's a privilege, we're in healthcare, to take care of patients, families, community, organization. It is precious, it's meaningful. Healthcare is human care and we can't forget that, and I love to see that context of where we are in nursing, that to be the main narrative of what nursing is.

Mari Knettle:

And I think that everybody who is a nurse should be very proud of that role. specifically at Cleveland Clinic, what makes Cleveland Clinic a good place to be a nurse?

Dr. Baszynski:

You know, I often say this, you know, because I started my career at other organizations, there is no better place to be a nurse than here at the Cleveland Clinic, and I can say that from personal experience. It is the quality infrastructure; it is the executive leadership. We have a very strong Nursing Institute with very strong nursing leaders. We have a professional practice model that empowers us to make decisions, to have a team of teams. This practice model is focused around our four care priorities of the Cleveland Clinic and it gives it a more wholistic model when we talk about patients, organization, caregiver and community. And then in the context of nursing education, we have so much to offer nurses, whether you're a new graduate nurse, whether you're an experienced clinical bedside nurse, whether you're a specialty nurse, whether you want to go into formal nursing leadership or informal nursing leadership, there's so much opportunity for growth and development.

And, you know, we're one of the few hospitals in the nation that have an accredited new graduate nurse residency. And so less than four percent of hospitals have that. And, you know, we're very proud to be accredited. We follow our new graduate nurses for an entire year. And we also provide a caregiver support specialist that's there to help nurses through their first year of practice. So, these are such great foundations for education and growth and development, it makes me incredibly proud of what we have to offer nurses here at the Cleveland Clinic.

Mari Knettle:

That's so exciting. I know that Cleveland Clinic as an organization is very much founded on principles that relate to education, and we do support our caregivers, but it sounds like nurses have some special support directed at that profession particularly.

Dr. Baszynski:

You know, I often say that nursing education here at the Cleveland Clinic is just so positioned for the caregiver of the future. You know, we touch nursing caregivers and those that report up to the Nursing Institute at every level throughout the entire year. The opportunity and some of the foundational programs that we have, our pipeline programs at our residency, our leadership courses, this is where we make some innovate change where we get to touch caregivers, we have students, and, you know, it's just such a great opportunity. And I'm, I'm really proud of our educators and proud of what- the work that we do day after day.

Mari Knettle:

So, you bring up students, and obviously in your role, education and students are critical to what you do. And students are going to be critical to addressing our workforce shortage in the nursing profession. How do you think that hospitals and schools can work together to address the shortage and get more individuals to pursue nursing as a career?

Dr. Baszynski:

We are definitely partners. We're partners with the same goals. And, you know, I'm happy to say at the Cleveland Clinic we have robust collaborative relationships with our academic partners. So, we have worked with our academic partners for years on issues that affect nursing, that effect nursing graduates and students. For example, at the Cleveland Clinic, we have the Deans Roundtable, where we actually bring the deans together. Now we've incorporated program directors and managers and, you know, we're really working through issues such as getting students interested in nursing, pipeline programs, how do we recruit more faculty? So, all of those issues that we work collaboratively with our academic partners. You know, and there's also, Mari, you and I've been on the Workforce Sector Partnership, which is, again, I think the, the issues around healthcare and nursing, they're a heavy lift and it's going to take all of us to solve these problems. So, in the Healthcare Sector Partnership, we work within the community with our other hospital systems so that we can look at ways to solve the healthcare crisis, specifically to nursing and these critical job positions that we need to continue our healthcare environment.

Mari Knettle:

You're so right, and I'm so glad to hear you talk about the many different things you're doing, the innovative types of things that we're doing here at Cleveland Clinic and in partnership with others in our community about education for nurses. I know that in my view, I see a lot of individuals who talk about the partnership between hospitals and schools, and they're really talking about a one-dimensional type relationship. The nursing schools send nursing students to the hospitals and they call that a partnership. But you're really describing a more robust relationship that you facilitate.

Dr. Baszynski:

You're exactly right. It's more than just clinical placements and clinical rotations. We have really worked many years on our partnerships with our schools, and I think by doing that, you know, we're changing the way we provide healthcare, not only in Ohio, but nationally.

Mari Knettle:

Well, talking about the way we provide healthcare, that prompts me back to something you mentioned before. You mentioned the four care priorities at Cleveland Clinic. Can you talk a little bit more about those, what are they and how do they tie into being a nurse here?

Dr. Baszynski:

You know, one of the important things that we do, and I'm just incredible proud, is the Aspire Nurse Scholars Program. And that is really reaching out to our community and high school, juniors and seniors in our surrounding communities who are interested in a career of nursing. So that program really is a pipeline that starts early. And what we really want to do is offer the opportunity to become a nurse for those who need economic opportunities and minorities, it really opens up the door to bring nurses here as bachelors prepared, and coming back to work at the Cleveland Clinic. And then we've extended that program this year to three other roles in the Cleveland Clinic. It's called the Aspire Pathways. We want to offer that same opportunity but with respiratory therapy, surgical technologists, and our sterile processing. So, reaching out to the community, we've made so many partners and so many great relationships within school systems, guidance counselors, organizations. So, we're incredibly proud of what nursing education brings to that and the community piece of what education is about.

Mari Knettle:

So, do most people find themselves going directly into a nursing career? Or are there other pathways that people take to become a nurse?

Dr. Baszynski:

You know, one of the things that I- that we've realized when reaching out to the community is we need to get the word out to nursing much younger. Really, really the pipeline starts early, even as early as elementary school. It's important to introduce healthcare, nursing, but also to take the right academic pathway. So, what we've found is people are not prepared sometimes for the math, the chemistry, the sciences that are required to become a nurse or in the medical profession. So really, we have to start early. We really have to do that professional socialization and integration into nursing and healthcare. So, I think those are important. I, you know, people may start or want to become a nurse or want to become part of the medical profession., but they don't realize what goes into it. There's a lot of prerequisites before you get into the nursing school, and a lot of those are the anatomy, the sciences. So, I do think there's a lot of desire, um, but how do we make that pathway clearer, remove some of those barriers and get people really interested? And families, we find out especially with the Aspire Programs, bring the families in and letting them know what the careers are and letting them know the great things that we offer at the Cleveland Clinic. That has really been an important piece of the pipeline.

Mari Knettle:

If somebody's really not sure about a career in nursing, or maybe they can't commit to the extended time in school for nursing, do you think that there's any benefit to somebody maybe being a medical assistant or a phlebotomist or taking on a- a role that has less of an extended education and maybe using that as a stepping stone to becoming a nurse?

Dr. Baszynski:

I think that's a great point and that is something that we- I absolutely believe in. It's coming to the Cleveland Clinic and getting a career, it's a ladder and a lattice, so the most important thing is that we embrace you as a caregiver and then help you decide what pathway may be the best for you. Some people come to the Cleveland Clinic and aren't aware of all the resources, tuition reimbursement, flexible scheduling, things that we can help you find that career and help you get prepared for something that is a fit for you and a fit for the organization. You know, we talk about our nursing assistants, I think that's a wonderful way to start a career, to see what is important, coming into the hospital system, earning a good wage, and then deciding what career ladder or lattice is right for you.

Mari Knettle:

So, when we're thinking about that decision making process, what can we, and by we I mean all of healthcare, what can we do better to make nursing careers attractive to individuals who are making those career decisions? And I say all of healthcare, but really whose responsibility is it to do this?

Dr. Baszynski:

Well, that's a great question. It's everybody's responsibility. It is our professional organizations, it's our colleagues. You know, we do a lot of interprofessional education. How do we make that as a team? But the most important think is taking care of, of human beings and patients and families. And then legislatively, what can we do on the state, federal level? What can we do with our accrediting bodies, reimbursement, right? How do all those things tie into making this crisis something that we can tackle together? That it is so important, it's a big lift, and we need stakeholders and we need stakeholders to work together. It is not just nursing, it is all of us that, you know, if we keep that patient at the center and those four care priorities, it is everybody.

Mari Knettle:

Absolutely. When we talk about making it- the career attractive, I think part of that is gonna be clearing up misperceptions about what does it mean to be a nurse. What are some of the misperceptions that you can think of in terms of what a nursing career is?

Dr. Baszynski:

You know what I don't hear enough of is what you get back both professionally and personally. There is no greater privilege than to take care of a human being at their most vulnerable. And what you take away from that is something that, you know, it's really hard to define. It is something that you take personally and professionally. And I think getting that narrative of what you do to impact lives, that is so precious and so important. And when you- when I speak to my colleagues, they're proud to be here, they're proud to work here. Yes, the work is hard, but you know what they talk about? Their teams, those colleagues that they work with, that they wouldn't give that away for anything, like those things that keep them caring for patients keep them at the bedside.

And another thing that I think that we need to keep reminding nurses is that they are leaders, they are leaders at this level of their career, whether they're a new graduate, experienced clinical, an informal leader, a formal leader, a specialty, your voice matters. And that's why nursing education is so important. That's what drives me to make confident, confident nurses so that they have an equal voice at the table. They're a stakeholder. When decisions are being made about healthcare or practice, that is what drives me. And I think that is an important message to get out to nursing. Their voices matter. They will make a difference. So that's really so important, and I think that narrative needs to be out there more. It's out there, we just need to get it out there more.

Mari Knettle:

I can definitely hear your passion for empower others in your answer there. And that, that's so important I think to help, especially as you mentioned, those new grads to really see themselves as leaders. But really people who are at all stages of their career may not realize their potential and, and what they're already doing for leadership. Is there anything else that we've not talked about that you really want to make sure you have a chance to share with our listeners?

Dr. Baszynski:

I think I just want to, again, reiterate that nursing is, it's more than a career, it is a privilege, it's an honor, it becomes part of who you are. And what you get out of it professionally and personally far outweighs and hard work. I've never regretted, not one day of my many, many, many decades of being a nurse. Was it hard? Of course. But the end result was so much more. I've never re retted one day of leadership, I've never regretted one day of being in nursing education because it's impactful, it's important, and again, I want nurses to know they're leaders, their voice matters. Continue to have growth and development with your career, with your academic journey, this is how we become confidence and competent and stakeholders at the table. So, I just, again, want to reiterate those important concepts of nursing.

Mari Knettle:

That's wonderful. And you've given so much good advice from your experience. I'm wondering, as we wrap, could you maybe share a good piece of advice that you have gotten along the way?

Dr. Baszynski:

Oh, absolutely. I think this put it in perspective for me that leadership is also influence, whether it's through data, through networking, through emotion. And we influence at every level with every person that we meet, and it's really important to practice that, know your audience, know who you're speaking to, be confident, find yourself a mentor, reach out to resources. I was very fortunate in my career that I've had mentors to help guide me along the way, and I would be more than happy to do that to any nurses who, who needs that guidance, because it's so important that we hold each other up, especially in these times, you know, it's uncertain. We have to kind of build the airplane as we're flying, right? We don't know what's coming. Change is here. We have to be bold. I say this all the time, we have to be bold, not reckless, innovate but not forgetting what has gotten us here with our expertise, and then continuing to be fluid because change is here.

Mari Knettle:

Well, thank you so much, Dr. Baszynski, it's been an absolute pleasure to have this conversation with you. And this has been a great podcast.

Dr. Baszynski:

Thank you.

Mari Knettle:

To our listeners, thank you very much. And we will see you on our next podcast. Have a wonderful day.

Dr. James Stoller:

This concludes this episode of MedEd Thread, a Cleveland Clinic Education Institute Podcast. Be sure to subscribe to hear new episodes via iTunes, Google Play, SoundCloud, Stitcher, Spotify or wherever you get your podcasts. Until next time, thanks for listening to MedEd Thread, and please join us again soon.