Caring for Caregivers: How Healthcare Organizations Can Fully Support the Wellness and Wellbeing of Nurses

Podcast Transcript

Carol Pehotsky:

The healthcare workplace is definitely changing. It was already evolving pre-pandemic, and we've seen an acceleration in what that looks like. And no matter where you are in your career, you may be thinking, "How do I find an organization that takes care of me so I can take the best care of my patients?" We're joined today by Cleveland Clinic Chief Caregiver Officer, Dr. Kelly Hancock, to discuss this further.

Hi, and welcome to Nurse Essentials, a Cleveland Clinic podcast, where we discuss all things nursing. From patient care to advancing your career to navigating tough on-the-job issues. We're so glad you're here. I'm your host, Carol Pehotsky, associate chief nursing officer of surgical services nursing.

Well, hello, everyone. Welcome back. You reflect on that we were joined previously by Samantha Connelly, the director of Caregiver Wellness, and had a fantastic conversation with her about whether you're within the Cleveland Clinic or outside the Cleveland Clinic about resources that nurses can tap into or things that nurses need to consider taking care of themselves.

But in this day and age, it's reasonable for nurses to also look to their organization, to ask the organization they're in, or perhaps an organization they're considering joining, what sort of supports an organization has in terms of caregiver wellness, caregiver wellbeing, and caregiver support. So, you ask, and we answered. We have back with us today, chief caregiver officer and nursing extraordinaire, Dr. Kelly Hancock. And thrilled to have you back with us today to talk more about caregiver wellbeing. Thanks for joining me.

Kelly Hancock:

Thanks, Carol. I'm, I'm happy to be back.

Carol Pehotsky:

Excellent. So different topic but, um, more current to your current role. So, I believe we're the only organization in the country that has a chief caregiver officer role. Is that correct?

Kelly Hancock:

That is correct, yes.

Carol Pehotsky:

Would you mind telling our listeners a little bit more about that?

Kelly Hancock:

Sure. So, it's hard to believe it's been three years already. June, it'll be three years.

Carol Pehotsky:

Oh, my gosh.

Kelly Hancock:

Yes. So, this is a credit to Dr. Mihaljevic. So, three years ago, he had this vision, this idea to create the first ever chief caregiver officer and office with, really, the sole idea when you think about the depth and breadth of our organization in terms of our caregivers, and we know our caregivers are our greatest asset. He really wanted to be a differentiator, not only in healthcare but other industries.

Carol Pehotsky:

Yes.

Kelly Hancock:

And having an office that really looked at all aspects of our caregivers to ensure that there was equity, that there was support. And remember, Carol, this was right at the pandemic.

Carol Pehotsky:

Yeah.

Kelly Hancock:

I mean timing is everything.

Carol Pehotsky:

One could say, "We'll wait till the pandemic is done," and he didn't. That's amazing.

Kelly Hancock:

And he did not, and he really wanted to move at that time. You know, he's about two and a half years into his tenure as our CEO and president.

Carol Pehotsky:

Gosh, yeah.

Kelly Hancock:

And, you know, he said, "This is the vision." He says, "You know, Kelly," he said, "We've always been known in this organization for our team of teams approach to healthcare, and delivering that high quality care, which we'll always be known for. But we also, also have to be known for being the best place to work in healthcare. And I believe that this office will help support that and help support our leaders."

Carol Pehotsky:

Absolutely. Yes.

Kelly Hancock:

So, in a nutshell, the office is really the single resource for nearly 80,000 caregivers now.

Carol Pehotsky:

Wow.

Kelly Hancock:

It's hard to believe we keep growing.

Carol Pehotsky:

Yeah.

Kelly Hancock:

And so, it really aligns all aspects of human resources from Total Rewards to talent acquisition to our business partners. We created some new verticals. You know, one is a workforce strategy vertical, which is really looking at, and how pertinent it is now is we continued to work with our workforce challenges. But really, looking at how we can be more predictive in thinking about the workforce needs, not only of today but in the future.

Which has really been a wonderful vertical. It also includes the nursing institute, of course, you know, our focus on diversity, equity, and inclusion, and health and wellbeing of our caregivers. So, it's really the catch-all for all of our caregivers, which has really been fun to be a part of.

Carol Pehotsky:

Wow. What an amazing opportunity and an amazing vision. So, we know that we have hopefully lots of listeners coming to us from within the Cleveland Clinic but there's hopefully people listening outside. And so, we know no other organization has a caregiver office, but our nurses listening from outside the Cleveland Clinic. What sort of things are universal that, that the office delivers that, really, every organization should be thinking about in terms of their caregivers?

Kelly Hancock:

Sure. You know, we've learned some best practices from our other colleagues across the country as well. And to your point, it spans beyond nursing and across many industries. And really thinking about designing and supporting resources for every caregiver, every part of their journey within the organization from, from day one until, you know, hopefully their retirement and everywhere in between. But I think about coming out of the pandemic now and some of the aftermath that we're dealing with, as you know, we've been on this multi-year now for three years, strategy to look at caregiver engagement differently. And so, I would encourage others outside of our organization or out of healthcare to do the same if they're not doing so already.

Carol Pehotsky:

Sure, yeah.

Kelly Hancock:

As we know, engagement, so there's employee engagement, you know, all of our employees are called caregivers. Caregiver engagement in our case is not a one-day event.

Carol Pehotsky:

No.

Kelly Hancock:

It is a process.

Carol Pehotsky:

Not just a survey.

Kelly Hancock:

And it's just not a survey and it has to be ongoing. So, credit to our amazing team. And I was actually meeting with our engagement, what we call, squad this morning.

Carol Pehotsky:

Oh, okay.

Kelly Hancock:

So, this team has been in place, and this is really an example of a team of teams approach, and really looking at our engagement strategy and being very intentional. And I think that's what's key about it. So, as our workforces have changed over the years, we too must pivot the way we think about how we support caregivers and employees.

So, as I mentioned, everything from wellbeing to health and wellness to even looking at Total Rewards. An example would be this past fall. We administered a benefits preference survey, and we did that because we really wanted to hear part of this engagement strategy from our caregivers what they appreciated most about our offerings.

Carol Pehotsky:

Sure.

Kelly Hancock:

So, not only our employee health plan, but other benefits. But what more would you like to see?

Carol Pehotsky:

It's a different workforce than it was, even a handful of years ago. Yeah.

Kelly Hancock:

It's a different workforce, and they think about the different generations, right?

Carol Pehotsky:

Absolutely. Different workforce, different needs, different wants.

Kelly Hancock:

Yeah. And there's different needs where you're at personally and professionally. And so, we were delighted that 90 percent of our caregivers who participated in that survey really valued our employee health plan and the richness of it, and they wanted further benefits and offerings to support wellbeing, as well as financial health.

Carol Pehotsky:

Oh, interesting.

Kelly Hancock:

Yeah. And so that is an opportunity we're exploring right now, you're well aware. Because of the pandemic, and even before that, we had health and wellbeing offerings, but we really strengthened those initiatives and our programs based on feedback we were hearing from caregivers. And we'll continue to do that as we move forward, because it's a changing environment in terms of that workforce. And the landscape has changed, and we have to meet the needs. We heard from our caregivers loud and clear, they wanted flexibility. And so, from a clinical standpoint, we've offered many different shifts for people to work.

Carol Pehotsky:

Yes.

Kelly Hancock:

And from a nursing standpoint, we brought back the weekender program different types of parent shifts. And I'm doing the air quotes, y'all. You can't see me.

Carol Pehotsky:

Yes.

Kelly Hancock:

And, really, to meet them where they're at, knowing that there were some challenges perhaps with childcare, elder care, et cetera. Didn't it?

Carol Pehotsky:

Yeah. Yeah.

Kelly Hancock:

And so, we had to. We had to meet, be flexible.

Carol Pehotsky:

Yes.

Kelly Hancock:

For some of our other colleagues, the ability to have a hybrid situation or remote if their work allows for that flexibility. And providing that space and education in how to manage through that was important for us to do that, and we'll continue to support that.

Carol Pehotsky:

Lots of great things are in, I found myself reflecting on a couple things. You know, we talked about wellbeing and our brains often go right to our diet and our exercise and our health plans, but to think about financial wellbeing and other things that's really innovative to think about how we can really take care of the full caregiver's wellbeing.

Kelly Hancock:

Exactly. So, when you think, I'll start with the emotional wellbeing.

Carol Pehotsky:

Yes.

Kelly Hancock:

As you know, we had so many programs in place for our caregivers, particularly during the pandemic, because they've endured a lot personally and professionally. And what we've learned and evolved over these past three years is that it's clearly not a one-size-fits-all. So, there are some that really enjoyed the benefit of that one-on-one conversation with our teams from Caring for Caregivers, and they appreciate that support and that added benefit, while others really enjoyed being amongst their peers.

Carol Pehotsky:

Yes.

Kelly Hancock:

And so, when you think about programs, Emerge Stronger which is a program designed with your peer groups just to have conversations about what you're experiencing from emotional standpoint and how you have those meaningful conversations, and more importantly, a solution-oriented, and where they share some different best practices. So, it can be anything from meditation and how you practice that, or you practice gratitude, journaling, I mean, the list goes on and on because so many best practices are shared about your emotional health and wellbeing in, in those different programs that it really benefits all of our caregivers no matter what they're going through. And I think organizations need to continue to think strategically in that manner, if that makes sense.

Carol Pehotsky:

It does. And if I'm struggling, I'm not necessarily going to go out and seek those resources. But if they're all around me they present themselves hopefully when I need them the most.

Kelly Hancock:

And so, when we dug a little deeper about the financial you know, health and how do you support my financial health, our caregivers wanted additional support and resources about planning, so planning for retirement my gosh. It is so complicated.

Carol Pehotsky:

And just getting worse, I think.

Kelly Hancock:

And, and how do you manage day-to-day now?

Carol Pehotsky:

Yeah.

Kelly Hancock:

As we know, people struggled whether they had spouses, significant others who perhaps had their employment impacted because of the pandemic and haven't quite recovered yet. Some folks have lost childcare, elder care, and then the subsidies have gone to support that as well. And so, they just wanted additional support, so we have those resources internally. We have some subject matter experts that we utilize through our Total Rewards program to help our caregivers, and it's met with much enthusiasm.

Carol Pehotsky:

It's wonderful.

Kelly Hancock:

Yeah. Yeah.

Carol Pehotsky:

Yeah. So, listeners, if you're, especially if you're a leader at a different organization, it's time to start thinking differently about what your employees program looks like, about... Yes, of course, everybody loves getting a raise every now and then but how are we helping any organization helping their caregivers manage that money? Knowing that inflation probably isn't going anywhere and all the other things that we're all managing through. That's really fantastic. We're seeing all sorts of interesting work practices and HR benefits coming from outside of healthcare. You've mentioned a few of them that the clinic is already considering, but what are some practices that you're starting to see work their way into either organization or healthcare at large in terms of offerings for their caregivers?

Kelly Hancock:

Sure. So, I already mentioned that many Fortune 500 companies had a dedicated team, like the strategic workforce planning team that we put in place, because the idea is to be more proactive about the needs of your organization. And so really analyzing your current workforce, ensuring, you know, looking at how many people could retire.

Carol Pehotsky:

Gosh, yeah.

Kelly Hancock:

You know, and so we enjoy, as you know Carol longevity in our organization.

Carol Pehotsky:

Yes.

Kelly Hancock:

But also, it's great until everybody decides to retire in the same year.

Carol Pehotsky:

Yes.

Kelly Hancock:

And so, being really proactive about how do we plan for the future not only with people who are retiring, but what other skillsets and competencies are needed? And how do we think about redesigning different roles?

Carol Pehotsky:

Right.

Kelly Hancock:

An example would be, I think it was a really great example. Even before the pandemic a much critical role, much needed role in the organization is a medical assistant.

Carol Pehotsky:

Mm-hmm. Yes.

Kelly Hancock:

And we know how valuable that is particularly in our ambulatory setting. And we know there's a shortage that's existed across the country and it just got exacerbated similar to nursing shortage during the pandemic. And so, what this team and strategic workforce planning did is they partnered without clinical colleagues to see, "Let's look at every task and assign a time that a medical assistant does during the day."

And it was interesting, some of the learnings. I mean, some of the learnings were that 11 of these 47 tasks that they discovered really didn't have to be done by a medical assistant. They could've been done by somebody else.

Carol Pehotsky:

Oh, my.

Kelly Hancock:

Yes. That didn't need that certification or that training. Certain percentage of the task that they have done could be done remotely so, when you think about scheduling appointment afterwards MyChart messaging, et cetera. And so, the idea behind this is really looking at roles in how you can redesign them for the future, not to eliminate them because it's very critical, but really provide some enhancements as you move forward. And I know that there's organizations who have done this already, and that's where we've learned some of these best practices.

Carol Pehotsky:

Across your career. You've always been so great at articulating top of scope or top of license and so, yeah, if, if you're not already doing that, it's well past time to think about you know, how the role looked in 2019 or even mid-pandemic is not necessarily how these roles need to look now.

Kelly Hancock:

Exactly. You know, another example would be our work with OneTen.

Carol Pehotsky:

Yes, please.

Kelly Hancock:

And so OneTen is a coalition, which we're a founding member, dedicated to hiring and promoting 1 million Black Americans over the next 10 years. There's, like, 67 members now and some major players such as us, Delta, Target. So, it spans many industries. And what I really love about our involvement in this program, it's really helped us transform as an organization in our thinking about hiring talent into certain roles that meet a family-sustaining wage. And so, what I mean by that is that, because of this work, it made us take a step back and look at our job descriptions of roles in the organization that met a certain wage threshold to see what some of the requirements are. What were some of the educational requirements or certifications? And, really, was there a value add for that role?

Carol Pehotsky:

The why behind it, yeah.

Kelly Hancock:

And we clearly value education, and we know that so, that's not what I'm saying, but is that really a barrier to getting talent into your organization?

Carol Pehotsky:

Sure.

Kelly Hancock:

And the answer was yes, it is.

Carol Pehotsky:

Of course.

Kelly Hancock:

And as a result of that, we were able to evolve 260 job descriptions in the organization that represents about 20,000 caregivers.

Carol Pehotsky:

Oh, my gosh. Wow.

Kelly Hancock:

And so really focusing, going back, to skills and competencies that are needed for that role and designing apprenticeships. So, we have mentee apprenticeships in IT, in pharmacy, in finance, and ophthalmology that bring talent into our organization. They can kind of earn while they learn, right?

And they have the skills and competencies to fulfill those roles. And so that's a different way of thinking that many organizations have to do as we think about the future, particularly with the labor shortage, and I'm just excited that we're a part of that.

Carol Pehotsky:

Yeah. It's, it's removing those barriers, because once somebody gets into any type of organization, the sky is the limit. But if the barrier to entry is a degree, then no wonder people are intimated by it.

Kelly Hancock:

Exactly.

Carol Pehotsky:

It's really, it's really opening those doors. That's wonderful.

Kelly Hancock:

The other important piece of this work, and this really applies to all of our caregivers, is ensuring that people have professional career pathways so they can see a trajectory for their professional career here at the Cleveland Clinic. And so, we've designed some of the subject matter experts what they may look like, and it's really exciting.

Carol Pehotsky:

Absolutely.

Kelly Hancock:

It's exciting for our caregivers.

Carol Pehotsky:

Yes. So, we've talked a lot about the evolving landscape of the workforce and the market. And so probably some of our listeners are thinking about either what their next role will be or they're getting ready to graduate from nursing school. And so, nurses are in a different place than they were one, two, five years ago in terms of what questions they should be asking in an interview, for example. So, what should a nurse be looking for from their organization in terms of wellbeing, how they're cared for? What are questions you'd advise somebody to ask during the interview process to learn more?

Kelly Hancock:

You're right. I mean, they definitely have many opportunities in front of them.

Carol Pehotsky:

Yes. Yes.

Kelly Hancock:

And so, if you're really looking to see, "What organization do I align with? Where do I fit in?" A couple things I would advocate for. When you're thinking about being employed in an organization, ask about the mission statement, ask about the vision, ask about the values.

Carol Pehotsky:

Sure, what matters most to them. Yeah.

Kelly Hancock:

See if it aligns with your values. Does the mission attract your attention? Do you see this shared vision? I think that would be the first thing in terms of shared governance. As you know, Carol, we have many of our applicants seeking employment here, asking if we have shared governance.

Carol Pehotsky:

It's so exciting that, that we're getting these questions.

Kelly Hancock:

They do.

Carol Pehotsky:

It's wonderful, yes.

Kelly Hancock:

And they, and I only ask, do we have it, but is it very active? And what impact does it have?

Carol Pehotsky:

Mm-hmm. Yeah.

Kelly Hancock:

And so, they want to see how they can measure the impact of what we've created here and how I can be a part of it? I would also like to ask about engagement scores. You know, tell me about your engagement scores. Tell me about your, you know, planning efforts. How do you include the nursing voice in those efforts? And then, I think, ask about growth opportunities.

So, if I come in here on a, a medical surgical unit, you know, what can I expect in terms of a career pathway? Is there an opportunity for me to go to the ICU if I want or to the OR or to pediatrics? Ask about what opportunities or pathways we have. Certifications we hear that a lot from these applicants. They want to know about tuition reimbursement.

And will we pay for, you know, the certification, educational review courses? I think those are all top of mind in thinking about, is this organization one for me that focuses on my future growth and development so I could be my true best self when I come to work every day?

Carol Pehotsky:

And then you give superior care to patients because you're educated, you're supported. You can be fully present in what you're doing because you know that you have your direct leaders but also organizational support behind you.

Kelly Hancock:

Mm-hmm. Good.

Carol Pehotsky:

Well, unbelievably, we're running out of time.

Kelly Hancock:

Oh, my gosh.

Carol Pehotsky:

But I was hoping to wrap it up with sort of a big question.

Kelly Hancock:

Sure.

Carol Pehotsky:

If you'd like to focus either on nursing or in healthcare in general, but what excites you about our future?

Kelly Hancock:

Well, I think, from a nursing standpoint, it's an exciting time to be a nurse. So many organizations are prioritizing nursing like never before, as we know. We know that the impact nurses can have on this very complex healthcare system across the country. And I think, really, it's our time to shine. There are so many different avenues that a nurse can pursue professionally. They can excel at the bedside; they can go into education within an academic organization or within a healthcare organization. And so, I would just say embrace those opportunities from a nursing standpoint and really make the most of them. So, that's what really excites me about the nursing profession.

Carol Pehotsky:

Wonderful. Well, listeners, you have an assignment. So, if you're in a role already, start looking around. If you don't already, what sort of support does your organization give you? If you're considering a change or you're getting ready to graduate nursing school, think about, "How do I want to be part of that solution and how do I find the organization where I feel like they treat me like family?" Excellent, Kelly. Thank you so much for joining me today.

Kelly Hancock:

Thank you, Carol. It's been great.

Carol Pehotsky:

As always, thanks so much for joining us for today's discussion. Don't miss out. Subscribe to hear new episodes wherever you get your podcasts. And remember, we want to hear from you. Do you have ideas for future podcasts or want to share your stories? Email us at nurseessentials@ccf.org. To learn more about nursing at Cleveland Clinic, please check us out at clevelandclinic.org/nursing. Until next time. Take care of yourselves and take care of each other.

The information in this podcast is for educational and entertainment purposes only and does not constitute medical or legal advice. Consult your local State Boards of Nursing for any specific practice questions.