Salary Survey & Workplace Nursing Trends | July 2023

FOCUS: SALARY SURVEY/ WORKPLACE NURSING TRENDS

Louis Pilla

By Michele Wojciechowski

Julia Quinn-Szcesuil

Gay Landstrom, PhD, RN

Editor’s Notebook

The news is positive as nursing salaries are trending higher, but the salary is no longer the primary reason for staying in your nursing role. Nurses consistently cite work-life balance and other factors that lead them to one employer over another, including:

• Flexibility

• Support

• Opportunity for growth

• Job security

• Job passion

• Feeling valued

• Culture

Each of these factors is key for your engagement, fulfillment, and happiness at work and makes the difference in increasing the longevity of a fulfilling and meaningful nursing career. This month Minority Nurse explores the rise in nursing salaries and trends keeping nurses in the workplace.

• The news is good for nursing salaries as they trend higher, but minorities still struggle.

• Meet a nurse treating nurse burnout, trauma, and grief with dance.

• Nurses with disabilities are a skilled workforce performing meaningful work with a different approach.

• Empowering nurses. CNO says supporting our most essential workforce is the only way forward.

“For us who nurse, our nursing is a thing, which, unless in it we are making progress every year, every month, every week, take my word for it we are going back. The more experience we gain, the more progress we can make.” –Florence Nightingale

–Reneé

SPRINGER PUBLISHING COMPANY

CEO & Publisher Mary Gatsch

Vice President & CFO Jeffrey Meltzer

2023 Salary Survey/Workplace Nursing Trends

Editor-in-Chief Reneé Hewitt

Creative Director Kevin Kall

National Sales Manager Andrew Bennie

Sr. Sales Manager, Recruitment & Education Phone: 212-845-9933

Email: abennie@springerpub.com

Trend Higher The News Is Good, but Minorities Still Struggle

By Louis Pilla

If you’ve seen an increase in your paycheck in the past few years––and hopefully you have––you are part of an overall trend of increases in salaries for nurses. And, as you might expect, some of that has to do with the effects of the COVID pandemic.

“We’ve seen an increase in nursing salaries, particularly since the pandemic,” says Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, director of nursing programs and co-lead for Project Firstline at the American Nurses Association (ANA).

Registered Nurses (RNs) earned a  median salary of $81,220 in May 2022, according to the Occupational Employment and Wage Statistics (OEWS) program from the Bureau of Labor Statistics (BLS). That’s up from a median salary of $77,600 in 2021. The mean (as opposed to median) annual wage for RNs as of May 2022 was $89,010

$87,990 to $133,340. The toppaying states for RNs included California, Hawaii, Oregon, Massachusetts, and Alaska. The lowest salaries were clustered in the middle of the country, where the annual mean wage of $37,360 to $74,330 was indicated for nurses in states such as South Dakota, Missouri, Tennessee, and South Carolina.

Some 46% of surveyed nurses earned a salary between $80,000 and $139,999, according to the  2022 Nursing Trends and Salary Survey Results published in  American Nurse, the official journal of the ANA. Those figures were up from 39% in 2021 and 41% in 2020. Nearly half (47%), notes the report, earn less than $80,000, but 62% reported that their salary was higher than the prior year.

Pandemic Effects

Before the pandemic, health care organizations were moving away from merit increases for nurses and shifting more toward bonuses and cost of living increases, according to Boston-Leary. But that has been problematic, she notes, because a great deal of data indicates that, to a certain degree, nurses live barely above livable wage in some markets. As a result, some nurses work overtime or take on second jobs.

it’s always been a struggle for nurses to advocate for what they deserve in terms of their salaries. So I think some of that broke through with the pandemic.”

Not only were incumbent nurses in organizations making less than the staff they were training, notes Boston-Leary, but also agency nurses were making a lot more than they were. “That created this untenable situation where many nurses rallied,” some striking or entering new bargaining agreements.

“Now we’re in this place where there’s a reckoning point, and there is some making up that’s happening,” says Boston-Leary.

Minority Challenges

Nurses of color face challenges when it comes to salaries. “The difference is that many nurses of color don’t get the opportunities to climb the career ladders as quickly as their white counterparts,” says BostonLeary. “That in itself presents a salary discrepancy. And there are many more minoritized nurses with multiple degrees and academic achievements that are not in leadership roles compared to their white counterparts with lesser credentials.”

Nurse Practitioners

As of May 2022, nurse practitioners earned a median salary of $121,610, some $40,000 higher than their RN counterparts, according to the Occupational Employment and Wage Statistics (OEWS) program from the Bureau of Labor Statistics (BLS). Top-paying states for these advanced practice providers included California, New Jersey, Massachusetts, Oregon, and Nevada. In 2021, NPs earned an annual median salary of $120,680, and notably, NPs have been forecast to have the highest growth rate (46%) of any profession between 2021 and 2031.

Nursing Educators

Although postsecondary nursing instructors and teachers play a vital role in preparing nurses for practice, their annual median salary is slightly below that for RNs, at $78,580. Top-paying states for these educators include Massachusetts, Nevada, California, New York, and the District of Columbia.

Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, is the director of nursing programs and co-lead for Project Firstline at the American Nurses Association (ANA).

Nurses on the West Coast and Northeast generally enjoy higher salaries than nurses in other areas of the country, with an annual mean wage of

The pandemic encouraged nurses to feel justified in asking for fair compensation. “It’s important to recognize also that, culturally, it has been taboo for nurses to raise the salary issue because the thinking around nursing has always been that it’s altruistic. It’s about serving others. It’s not about money. It’s true. Many of us didn’t get into nursing to get rich. But you hope you’ll get compensated appropriately, and

Organizations have had the reluctance to track such data as turnover for nurses of color and nurse satisfaction by race, notes Boston-Leary. “There’s been an unwillingness over the years to look at that because when you look at it, you must deal with it. That is starting to change, but we’re still not fully there.”

Louis Pilla is a seasoned publishing expert with over 20 years of experience providing content and digital products to health care audiences.

EXPAND Your Career Opportunities

On average, nurse practitioners earn 45% more than registered nurses.* Take your career and your earning opportunities to the next level with a graduate degree from Frances Payne Bolton School of Nursing.

#11 Master of Science in Nursing**

#15 Doctor of Nursing Practice**

Our highly ranked programs will give you the education and network you need to improve patient care, develop your management skills and become a leader in your field. Part-time and distance friendly options available.

The Best of Buckeye Spirit

We strive, through our values and our culture, to create a welcoming, inspiring environment for all students, faculty, staff, alumni and partners to succeed and thrive. We celebrate our progress and our continuing journey. But most importantly, we honor the people who bring our passion to life.

Doctoral:

• Doctor of Nursing Practice

(BSN to DNP and Post-master’s)*

• Doctor of Philosophy (PhD)

• Doctor of Nursing Education

(DNE – first in the country)*

Master’s:

• MS in Nursing^

• Master of Healthcare Innovation*

• Master of Clinical Research*

Bachelor’s:

• BS in Nursing

• RN to BSN*

Certificate offerings in areas such as:

• Palliative care, clinical research, healthcare leadership and innovation, primary care, health and wellness coaching, school nursing and more*

*Available online

^Some specialty tracks available online

Ready to transform the future of health? We’re ready for you. Learn more and join us: nursing.osu.edu/academics

Treating Burnout, Trauma, and Grief with Dance After Dealing with Her Tragedies, a Nurse Learned How to Help Other Nurses Process Theirs

By Michele Wojciechowski

Tara Rynders, RN, MFA, BSN, BA, admits she hasn’t had the easiest life. From when she was a child, though, she would heal from it through dance. In fact, she wanted to be a professional dancer before she thought about being a nurse.

“My earliest memory is of holding a neighborhood performance in my backyard—and it’s a lifeline that I’ve held on to through all of life’s highs and lows,” Rynders explains.

So Rynders graduated high school and headed to Hollywood. But she soon realized that the business was more focused on outward appearance rather than the inward healing dance provided.

“After my time in Hollywood, I realized that I wanted to be able to offer both emotional and physical healing. Nursing allowed me the entry point into that space. It’s a profession that offers flexibility to keep connected to my lifeline—dancing,” she says.

Trauma Hits Home Rynders came to embrace dance and bring it into the world of nursing after her tough times. She cared for her mother until she passed. Rynders says that losing her mother made her entire world fall apart. At the time, she was working as a nurse but decided to reach out again to what had always helped—dance. So, she cut down her nursing hours to earn a master’s degree in dance.

Her sister became ill during that time and went into a coma for months. Rynders took off a semester and went to live with her in rehab until she was transferred from California to Colorado, where Rynders was living.

“In my sister’s hospital room, my dance and nursing worlds began to collide,” recalls Rynders. “Every night, I would dance to Miley Cyrus’s ‘Party in the USA.’ And I discovered that although my sister couldn’t speak, she could  laugh. That became my goal—to make her laugh.”

When Rynders returned to school, she created an immersive theater performance called You & Me that was connected to her experience as her sister’s caretaker and her work as a charge nurse in the ER.

The show You & Me traveled nationally and internationally to more than five countries.

“What I realized when I cared for my sister was the gift that comes from having one-on-one intimate moments with another human being—to bathe her, feed her, and help be her voice,” says Rynders. “During the day, I would hold the suffering and loss with my sister, and at night we would hold the joy as I danced. It felt like I had both my joy and my grief coupled together in all that I did.”

One more scary experience brought Rynders to where she is today. When her twins were six months old, she learned she was pregnant again. But this time, it was an ectopic pregnancy.

“When I arrived at the hospital, things moved quickly. I remember the ER tech rolling me on the bed with too much force to start my IV; the ER physician and his caring face took extra time to see and listen to me. I remember feeling his compassion for my situation. I remember being transferred to a room when my fallopian tube burst and

my abdomen began to distend with blood,” says Rynders.

“They called a code yellow— the code they call before a code blue when your heart stops. My room was full of people,” she says. “I passed out, but I could still hear everything being said. I felt my nurse grab my hand. She leaned into my ear and said, ‘I am here, and you will be okay.’ I remember thanking her for remembering me because I was so scared and couldn’t speak.”

This experience caused Rynders to have an epiphany. “I realized that nurses are everything to their patients–their voices, their advocates, their support, their healing hands. I experienced this firsthand as a patient and realized how many opportunities I was missing as a nurse to connect and see my patients authentically. I became passionate about this in my practice as a nurse and began researching authentic connection in nursing,” she says. “Everything pointed to one thing: our nurses are tired, overworked, and our healthcare systems are not set up for them to thrive and successfully care for patients.”

Rynders decided she was going to change that.

Bringing Dance to the Nurses

Pre-COVID, Rynders says that nursing leadership was downplaying nurses burnout. And in 2017, nurses weren’t ready to talk about it openly.

But the CNO and CEO where she worked approved her creating a two-hour immersive theater experience at the hospital to raise awareness of compassion fatigue and burnout. She created the performance with artists Jadd Tank and

Lia Bonfilio and worked with playwright Edith Weiss.

“The 2-hour performance took place in the hospital and was open to the general public. The nurses, doctors, and other healthcare personnel testimonials were breathtaking. Most along the lines of ‘Thank you for giving us a language to understand the unrelenting grief and trauma we have been carrying with us,’” says Rynders.

After raising awareness about burnout, Rynders co-created, with Dr. Clare Hammoor, a six-week grief and trauma workshop series. The nurses connected with it so much that they began having monthly meetings post-workshop, which continued until COVID.

“At the height of COVID, my CEO asked me if I would come off the floor and focus on caring for our nurses as they cared for our COVID patients. This told me he also saw that our staff would need ongoing support,” says Rynders. The position was temporary, though; she would eventually work as a clinical nurse educator at another health care system.

Today, Rynders is also an advanced grief recovery specialist and a RESTORE (Resiliency and Equity Support and Training for Organizational Renewal) peer responder who is on call for health care personnel when they need immediate support.

“I help teach resilience, equity, and anti-racism courses for our entire system. I do this alongside my position as executive director of The Clinic Performance. I see both of these roles mutually honoring each other as I bring my whole self into all my experiences,” she

says. “We dance in the hospital at our meetings, and having a pulse on nursing in the hospital setting is vital to creating workshops that tend to our nurses—meeting them where they are emotionally.”

Dance Workshops

Rynders workshops touched many people and were so effective that Kaiser Permanente

asked her to bring them to nurses across California. These six eight-hour workshops with up to 600 nurses began in April and will run through September.

“Our workshops are now titled  (Re)Brilliancy, a play on the word resiliency. I was tired of hearing everyone tell us to be more resilient during the pandemic. Nurses are some

of the most resilient humans I know. We need resilient systems that reflect the brilliant and resilient humans we already are. (Re)Brilliancy workshops help us reflect on and honor the brilliant and resilient humans we already are,” says Rynders.

Until they experience the workshops, nurses often don’t even realize that their stories

or experiences have continued to both of them.

Rynders knows that her workshops are keeping nurses from leaving the profession.

“I have seen firsthand nurses ready to leave—completely burned out and done with the profession. [They’ve] attended our workshops on an ongoing basis and have a rekindled joy and fervor for caring for themselves and their patients,” she says.

But more needs to be done.

“Nurses go into this field to make a difference in the lives of others. At some point, we begin sacrificing ourselves to do this. We don’t have to sacrifice our mental well-being. These workshops help us disentangle our worth and identity as caregivers from being directly related to how much we can sacrifice our well-being. Our workshops help remind us what we love, what we are passionate about, and what we need to feel seen, heard, and cared for,” says Rynders.

“If healthcare systems want to retain their nurses, they need to start thinking creatively and bringing in non-traditional and innovative ways to care for their teams. Wellness must be embedded as a cornerstone that everything else builds upon.”

Michele Wojciechowski is a national award-winning freelance writer based in Baltimore, Maryland. She loves writing about nursing but comes close to fainting when she sees blood. She’s also the author of the humor book, Next Time I Move, They’ll Carry Me Out in a Box

Tara Rynders in her dance workshop

Nurses with Disabilities: A Skilled Workforce Meaningful Work with a Different Approach

By Julia Quinn-Szcesuil

Nurses with disabilities find the nursing industry offers excellent career paths that help them fulfill their goals, regardless of disability. Whether nurses have a disability before they enter the workforce or become disabled after their licensure, they are needed to fill jobs and help broaden the diversity of the nursing workforce, says Karen McCulloh RN, BS, co-founder and co-director of the National Organization of Nurses with Disabilities (NOND).

Working with a disability or an open approach to different specialties might require accommodations to help you perform your job better. “Being honest with yourself regarding your strengths and weaknesses will go a long way toward facilitating success,” says  Donna C. Maheady, EdD, APRN-BC, founder of  ExceptionalNurse. com.

there,” she says. But for nurses who become disabled while already working as a nurse, McCulloh says there’s often an adjustment phase. “You think about, ‘who am I now? What about my self-esteem, self-identity, self-worth, and self-confidence? Am I still the same person?’”

Every Path Is Different

Sandra Nosek, MSN, RN, has been a nurse for over 30 years with experience in management, staff development, QA wound care, long-term critical acute care, hospice, and skilled nursing facilities. She had a hearing aid in her right ear but woke up with sudden bilateral deafness in 2015. “It rocked my world and was very scary,” she says. Navigating without her hearing proved exceedingly challenging.

she eventually began working in hospice, a nursing specialty she loves. She recently obtained an RN case manager position with a small hospice in her community. “To other nurses with disabilities, don’t give up,” she says. “Continue to pursue options in your career.”

Kim Hickman, DNP, APRN, Adult PMHNP-BC , works as an adult psychiatric mental health nurse practitioner with the VA Health Care System and has more than 36 years of nursing experience, including in the Army Nurse Corp, as a lieutenant stationed at Walter Reed Army Medical Center (three years on active duty), and roles in medical surgical nursing, home health nursing, occupational health nursing, and volunteer work as a faith community nurse. But Hickman, who has a speech impediment of a stutter/ stammer, almost didn’t pursue this career.

“I was unsure if I would be an effective nurse,” she says. “I shared my concerns with my mother, an ICU nurse at the VA then. My mother paused for a few minutes before answering. She looked at me and said, ‘Remember, it’s more

important what you say than how you say it.’ Her confidence in me encouraged me to continue pursuing my nursing degree. From that point on, I focused on the content of my speech, making sure the information was accurate and relevant.”

Hickman says her stutter/ stammer can fluctuate depending on the situation and her stress level. “Learning to be patient with myself has been a tremendous achievement. I am learning to accept that my stutter/stammer is a part of who I am,” she says, noting that it has positive impacts. “Stutter/stammering has allowed me to actively listen to others, to be patient with others, to be present, and to be compassionate and empathetic toward the suffering of others. It has also helped me recognize and value words’ power and importance. It has given me a chance to pause and decide if I want to say what I intended and time to decide if my comments add value or take away value to the conversation.”

McCulloh, who lost her vision over a 24-hour span, says her nursing skills were enhanced. “We’ve found that nurses with disabilities have a sense of compassion for patients and what they are going through because they’ve been

Nosek thought she’d have surgery and be able to return to work quickly, but her path proved challenging. She obtained her MSN in nursing education (with a 4.0 GPA) in 2019 and, after receiving improved Bluetooth processors in 2021, sent out more than 400 applications with little result.

She landed a job at a skilled nursing facility that restored some of her self-confidence lost in the job search process, and

Lois Taurman (who has a nursing degree,  national certification as a poison information specialist, a master’s in educational counseling, a jurist doctorate, and also represented the United States as a wheelchair athlete in the Paralympics Games in Seoul) had plans to work in the Navy as a nurse or as a pediatric nurse when a fall from a ladder just before graduation paralyzed her (she can move her arms, but has no finger movement). Taurman, who now works in America’s Poison Centers, a poison specialist in the Kentucky Poison Control Center of Norton Children’s

Karen McCulloh, RN, BS, co-founder and co-director of the National Organization of Nurses with Disabilities (NOND)

Sandra Nosek, MSN, RN

Kim Hickman, DNP, APRN, Adult PMHNP-BC, is an adult psychiatric mental health nurse practitioner with the VA Health Care System.

Hospital, says that while she isn’t doing hands-on nursing, her work fulfills her drive to help children.

opportunities there. Always keep the Poison Help number 1-800-222-1222 with you.

Work Options

Nurses must assess their interests and how they work when thinking about a nursing path. Consider the specialties you enjoy working in, determine how fast you can work or prefer, and what accommodations you’ll need to know what’s possible.

According to Maheady, the career options available for nurses with disabilities are very wide and include the following partial list:   Teaching nursing online

• Parish/faith-based nursing

• Case management

• Quality assurance

• Telephone triage

• Diabetes nurse educator

• Nursing informatics

organization already employs could become disabled and will need to determine the next steps.

Despite the tendency for some nurses to not want to reveal any disability for fear it could impact their job, Maheady says sometimes that approach backfires. “Undisclosed invisible disabilities can provide a privacy shelter for some nurses,” she says. “However, it may not serve the nurse or institution well.” Colleagues and supervisors might not know about the disability and could make hurtful comments about not looking sick or faking symptoms to struggling nurses.

better your chances for getting the accommodations you need, says Maheady. “Do you need a sign language interpreter?

If so, provide your employer with a list of resources in your community that provide sign language interpreters,” she says. “Offer to start a sign language club for staff to help staff learn basic sign language to work better with you and patients with hearing loss.”

That doesn’t mean the role was anywhere on Taurman’s radar. “I didn’t know poison center nursing even existed,” she says. “This is a blessing for my career, but also to feel like I have valuable nursing skills.” Her employer has made adjustments and accommodations so Taurman can work, including adaptive technology and spaces. Still, she knows not all nurses have such proactive employers and may feel like they can’t reach their dreams. “Be persistent in looking for jobs,” she advises. “Your skills may differ, but you can show them how to accomplish the job. It may not be how you envisioned it, but it is still possible. Disability isn’t something that should hinder someone.”

PoisonCenters.org is available for all health care professionals to access assistance during a poisoning emergency, and nurses can also find job

• Pharmaceutical or insurance company (Nurse Line)

• Legal nurse consultant

• Home health nurse

• Infection control

• Poison control hotline Technology is changing the options available to nurses with disabilities. Some apps help nurses with color blindness, and assistive technology will read out information for those who can’t see it.

Accommodations

As a nurse with a disability, the Americans with Disabilities Act protects you from having to disclose your disability, but if you need accommodations, then you will need to disclose. Nurses with visible disabilities (such as amputation or paralysis) will likely address their needs earlier in a job search than those with invisible disabilities (such as anxiety or fibromyalgia). Nurses who an

So, when is a good time? McCulloh says once you have a job offer, you should consider the need for any accommodations. But before that even happens, you’ll want to think about precisely what you’ll need to do the job best. Even the most accommodating human resources department can’t guess your needs, so having a detailed plan will help get you what you need and help human resources make the best plan.

When you have the job offer, approach the topic with your natural enthusiasm for the position, the new opportunity, and the skills you’ll bring. And then relay having a disability and needing specific accommodations to perform the job. Put everything in writing, says Maheady. See this Sample Language for Accommodation Request Letters from JAN - Job Accommodation Network.

Work with HR

The more specific you can be and the more resources and examples you can offer, the

She says that if you need frequent breaks, be specific about how often you need a break and for how long. Suggest to your employer ways you could be covered for breaks specific to your clinical setting/area of practice.

Nurses with mobility issues might need a scooter to navigate long hallways, so they can help their employer by providing resources for purchasing new and used scooters. “Show the cost-benefit of purchasing a scooter compared to the cost of hiring a new nurse or travel nurse for your position,” says Maheady.

Despite awareness around nurses working with disabilities and the protections of the ADA, not all employers are receptive. “If you are met with a negative response, don’t take no for an answer,” says Maheady. “Ask, ‘Who else can I talk to?’ ‘What else can I provide you with to help me be successful?’”

Role Modeling

Nurses with disabilities also reflect the diversity in a patient population and can show people that their life doesn’t stop after a disability. Nurses can share resources with patients and act as important mentors to other nurses. “I can share

Lois Taurman is a poison specialist in the Kentucky Poison Control Center of Norton Children’s Hospital.

in an hour what took me ten years to learn,” says McCulloh.

Nurses are needed to help guide policy, and the information is particularly validating to listeners when it comes from a nurse with a disability. “Nurses with disabilities are transforming healthcare and patient care practices,” says McCulloh. “The priority with every nurse is to ensure patient safety. And because of the critical eye toward us, we have direct awareness of that requirement.”

Nosek, who eventually found a role in a specialty that

is meaningful to her, says that all nurses must realize that no one is protected from having or developing a disability. “To all nurses, I strongly suggest obtaining some experience in an office-type position at some point in your career to be able to fall back on if you were to become disabled,” she says, noting that her extensive education and management experience wasn’t enough of a buffer to prevent roadblocks in her path to finding a job that would fit her needs.

“There should be more care and compassion by

healthcare administrators to ensure healthcare staff can continue to work no matter their disability,” she says, noting industry-wide changes for additional skills training and compassion from health care administration when faced with a nurse’s disability are needed. “I would have gone right back to work had I had the support and training to do another job within nursing,” says Nosek. Hickman advises nurses to embrace their differences, acknowledge their strengths, work on their weaknesses, and not hide behind

a disability. “You are more than your stutter/stammer or any other disability you may have,” she says. “Above all, love, respect, and be patient with yourself and teach others to love, respect, and be patient with you. You truly are unique! You inspire and motivate someone because you have decided to be courageous, present, and speak up!”

Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.

Empower Nurses––They Will Lead the Way

Providing Essential Support for Our Most Essential Workforce Is the Only Way Forward

By Gay Landstrom, PhD, RN

Nursing is more than a profession. It’s a calling. And those who answer the call become the backbone of a high-functioning, compassionate health care system. People who become nurses are capable, compassionate, and strong scientists and clinicians who have worked hard to start their careers. Their expertise, patient care delivery, and commitment to the profession contribute a distinct perspective on how health care should be managed and delivered.

While nurses are strong and resilient, they can’t fix their biggest problem: a dire nursing shortage. A decade in the making, our national nursing shortage threatens our already struggling health care infrastructure. Studies have long predicted that the demand for nurses would intensify as the US population aged. And just like the trends in general higher education, nursing schools have become less accessible, as many face faculty shortages, limits on enrollment, and limited space for clinical training at teaching hospitals.

And, of course, the COVID19 pandemic only accelerated these trends. Nurses came under incredible pressure from the increase in patient numbers and acuity, and public distrust surrounding politicized vaccines and treatments, with a large number of their peers opting to leave the field due to these pandemic stressors. The nurses who remain find themselves in professional limbo, looking for ways to squeeze in continued education and professional development, manage work demands and challenges, and find a healthy work-life balance.

And that is if they chose to stay. A staggering number of nurses have decided to leave. The total number of registered nurses in the workplace  decreased by more than 100,000 in 2021, the most significant drop observed in four decades. The largest group to depart was nurses under 35.

We need to do everything in our power to create sustainable solutions that don’t simply “put nurses on floors” but will provide our nurses with the best possible experience, one that allows them to practice at the top of their license. The circumstances are challenging, and there’s no quick fix, but our patients, our communities, our health systems––health care itself can’t afford to continue in this direction.

support their work and provide opportunities for professional development, continuing education, and alternative career pathways work.

Supporting Education and Career Advancement

Starting a career in nursing is no simple endeavor. So, when entry-level nurses are just beginning, it’s critical to jump on the moment’s excitement and encourage them to dive as deep into their new role as possible. In 2014 we collaborated with Vizient, the country’s largest member-owned health care services company, to create our Nurse Residency Program. This program helps orient entry-level nurses as they transition into practice. The evidence-based curriculum incorporates three key areas: patient outcomes, leadership, and professional development.

For experienced nurses, we provide a robust system-wide learning platform for those interested in advancing their skills in various areas of practice specialization. Obtaining the highest level of education doesn’t just support their careers and livelihoods, but it helps us ensure we provide the best patient care possible.

on-the-job training, and career advancement programs to help level the playing field for nurses from diverse backgrounds. This is crucial for delivering health care that is representative of the populations we serve.

Multiple Options to Support Work-Life Balance

Nurses especially need worklife balance. Options for flexibility and roles that match their needs and goals are essential to increasing the longevity of a fulfilling and meaningful career.

At Trinity Health, we started developing solutions well before the pandemic and have seen first-hand how thoughtful solutions, informed and led by nurses, impact job satisfaction most. Programs that give nurses greater flexibility and options based on where they are in their career and what they want to do, innovative care delivery models that

Opportunity must be equitable, and we are committed to living Trinity Health’s values of equity, diversity, and inclusion in everything we do. Unequal access to education, specifically for underrepresented communities, is a well-documented barrier for students who wish to pursue a nursing degree. To that end, we provide tuition assistance, flexible online programming through our nursing schools and seven academic partner schools, scholarships,

Nurses at Trinity Health led the development of FirstChoice, our internal staffing agency that offers flexible scheduling and travel opportunities for nurses and clinical staff. Having our pool of travel nurses helps prevent colleague burnout and maintains continuity in patient care. In addition to FirstChoice, we’ve introduced a new care delivery model to improve patient care, experience, and nurse satisfaction. The delivery model has been well-received by nurses who are early in their careers and benefit from the unique mentoring experience and from more tenured nurses who can continue to work in a less physically demanding but gratifying capacity.

Beyond flexibility, we must provide other ways to support nurses’ well-being and resilience. A  recent study reports that a quarter to half of the nurses reported feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%), or at the end of the rope (29.4%) multiple times a week. Mental health benefits are an essential

Gay Landstrom, PhD, RN, is the senior vice president and chief nursing officer at Trinity Health.

requirement once considered a luxury perk or not considered at all. We began offering Colleague Care Resiliency Rounding, a real-time, oneon-one, human connection for colleagues in high-volume, highly demanding areas within the hospital setting. The program’s goal is to address mental health proactively and sustain their mental well-being in the face of the inevitable stress of the job.

To ensure that there are no barriers to mental health support, we offer six free therapy sessions and six free coaching sessions per calendar year, as well as options for personalized care, access to diverse providers, self-guided wellness exercises, personal medication management training, substance use support, worklife services, and more.

When someone is a nurse, their career can easily become their identity. Nurses love their job, and we love them for that. But we must recognize that

every nurse is more than the exceptional care they give to patients. They are whole humans with lives away from the bedside. They need support that is designed with that in mind.

Empowering Nurses

Nurses have long been renowned for confidently taking control of situations many shy away from. While I firmly believe it’s up to administrators and health systems to provide the essential support nurses need to thrive, I also know nurses must have a hand shaping their work lives. From my 40 years of experience as a nurse, with nearly 30 of those as a chief administrator, here is my advice to nurses searching for a career that will meet their personal and professional needs and goals.

Find an organization that shares your values. Look at the organization’s mission, vision, and values. Does it align with your own? Can you

see evidence of their commitment to these values? Make sure the operational structure meets your needs. Does flexibility matter? Ask about shift offerings, virtual opportunities, or options to work in multiple locations. Do you care about mental health access? See what benefits they offer from day one.

Make sure the organization will truly see you and hear you. Your input is key to creating improved work environments and patient care. You must feel nothing less than supported in asking questions and contributing your voice to the conversation.

Whatever stage of your career––recently graduated or 20 years in––make sure an employer is willing to support your professional development. Opportunities for a new nurse should look vastly different than those for someone who has spent decades in a specialized unit. Ensure you can access individualized

educational opportunities that impact your career trajectory and help you meet your goals. I can only speak for myself and my team, but until all nurses feel adequately supported, I won’t rest my case that urgent action needs to be taken. Patients’ lives depend on our ability to care for and empower the people who care for them.

I am encouraged by my colleagues who have taken notice and have started to make meaningful changes. Nurses have been through a lot in the past few years, and we never know what awaits around the corner. But a positive shift is coming. The momentum we’ve built so far must continue so that the next generation of nurses feels more supported, better equipped, and more passionate about their calling than they ever dreamed possible.

Gay Landstrom, PhD, RN, is the senior vice president and chief nursing officer at Trinity Health.