[BEGIN_TRANSCRIPT]
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Welcome to this edition of AMC.

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Tell you how I got better. I'm glad to be

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here, but a mission

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to. Well, I think that we're, we're talking, we're gonna

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talk about everybody's Arkansas is

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the 2nd highest prescriber.

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Welcome to AMCTV. I'm Robin Ledbetter.

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Thank you for joining us today I have with me Stephanie

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Whittaker, and she's the chief nursing

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officer at Mercy Hospital Fort Smith

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Communities.

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Stephanie, thanks for being here.

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Thank you, Robin. I appreciate you having me on.

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So we're talking about nursing today in the workforce.

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Can you describe the current state of nursing

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at Mercy Hospital Fort Smith, and you're

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doing some really innovative things.

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Well thank you we are exciting you

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know nursing is

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um building a future uh here

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in the River Valley and it's a

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complex and challenging process with the nursing

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shortage across the nation,

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but we're navigating this with forward thinking,

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innovation and really engagement with

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our nursing community and with our

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students starting even at the 8th grade

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level to get them engaged in healthcare.

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So what do you believe are the primary factors

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contributing to the nursing shortage? Is it,

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it's not just local, right?

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No, it's not. We're still coming out

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of the pandemic from the the

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COVID pandemic and there's still some

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challenges related to that. We saw a lot

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of healthcare professionals that

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retired during that season and

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when. We're already in a shortage and then have

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early retirements or people

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make complete career changes based on the

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pandemic and the effects that it had on their

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well-being, mental health, and their financial

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situations, they left healthcare.

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So we're still moving forward

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out of that. We also have

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challenges with uh nursing

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schools.

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enough trained faculty

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to add students to their

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programs, which then in turn delays

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getting us new nurses at the hospital

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or clinics anywhere in

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across the nation. So really academic

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faculty and just

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really building that pipeline is what we need

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is the challenges of the shortages.

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And how has the shortage affected patient care

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and nurse workloads at your facilities?

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Coming straight out of the pandemic, the nurse workload

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I would say was much higher because of

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the challenge of uh that gap,

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and we had a lot of agency or contract

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labor

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and um those team members were traveling

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all across the country to help support patient

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care. So at that time there were a lot of

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stretched ratios, uh, meaning that

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nurses are taking care of more patients

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than than what they typically cared for, just

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to meet the needs of the patients in our community.

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Those have come back down, we've been very successful

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in bringing those back down.

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To normalizing ratios that are standards

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across the industry,

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but we still, the acuity of the patient

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is still very high because there are a lot

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of uh side effects from

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those who receive COVID and ongoing chronic

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illnesses and challenges. Our patients

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across the country just continue to

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get sicker when they're in the hospital and have

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more challenges.

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So we're here to meet those needs and that

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does bear a burden on the, on the healthcare

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workers, especially the nurses who are with the patients

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24/7.

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And you touched on this a little bit, but what are strategies

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that Mercy Hospitals implemented to attract

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new nursing talent?

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We, we have several strategies, so we

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um start very early in um

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elementary and middle school talking with students about healthcare,

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going to career fairs,

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trying to get them engaged in what an

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amazing profession healthcare is specifically

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nursing.

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Um, it's certainly a passion of mine. And

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then we have a middle school program,

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a health science middle school program with Darby,

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um, elementary, middle school, excuse me, that

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is here on campus, so they actually

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are immersed on the campus and do their

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education here when they're in 8th grade.

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So we have that, so we're able to engage them

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and take them,

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have them experience healthcare from a different

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lens while they're in school.

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And then we partner with many academic

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programs, whether it's our

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high school program PE where they train

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LPNs and CNAs

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that is a high school.

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that we engaged so when they graduate from high school, they

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can actually have a licensed practical

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nurse degree. They can also have a certified

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nurse degree or an EMT degree. So

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those are some ways that Mercy partners

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with our public Fort Smith public

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schools,

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then move to the academic level and

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so we have multiple academic partners, whether

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it's the University of Arkansas, Fort Smith,

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 uh, Arkansas Tech,

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Carl Albert in Oklahoma, and

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many other partners that we, uh,

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allow. And invite

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really not just a lab, but we really welcome

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them to come to our facility and do their clinical rotations

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here. That gives us an opportunity to

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engage, train those nursing students,

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and really invest in them.

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One specific program we have

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to address these needs is we have a dedicated

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education unit, and that's for nursing students

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to work on a unit

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side by side with a mercy nurse,

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the two of the student and the.

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And the mercy nurse takes care of 4

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patients

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together, 2 students, 1 mercy

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nurse, 4 patients.

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So each nursing student really has 2 patients

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that they can really focus on

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and and learn all of their skills

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and assessments at the

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elbow with that nurcy nurse leading them, and

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it's been very successful in helping them

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become more practice ready. Yeah,

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what incredible experience and and

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starting at such a young age.

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Yeah. So how are you working to retain

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experienced nurses and reduce turnover?

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Is that something that you're seeing?

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Absolutely, it's something we're very focused on

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because we, we have to retain

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our top talent, our caregivers are essential,

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and they're with the patient 24/7.

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So we want to make sure that we give them all

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the resources they need to do their job as easily

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and efficiently as possible.

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We also work on, uh, focused,

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 uh, focus groups to find out what their needs.

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and what changes. Each generation

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has some different needs and different focus

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and so we have to adapt at mercy

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to try to meet those needs. So we have

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some flexible scheduling, different workforce

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layers, and we, um,

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also try to give creative ways like

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on our dedicated education unit

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that experienced nurse is

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training. New nurses, so they have a lower

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workload,

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 uh, less patients, so it gives them

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some fulfillment to give back and

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train nurses, and that's helping with

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some of that resiliency and reduced burnout

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because they can pay it forward and

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invest in these students and

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get some joy back in why they went into nursing.

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that's, those are just a few of the strategies we're

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using.

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And it sounds like mentorship, support

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programs, um, are play a vital role

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in that. Absolutely,

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that's that's essential and so we have a

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mentorship program which is a part of our residency

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program that as you start,

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when you're on board as a mercy nurse, you're placed

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into a nurse residency program that is 12

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months.

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And so you are with a with a cohort,

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a group of nurse like nurses

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like you, maybe not in the same department,

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but experiencing the same things and then you have to

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Points all throughout that year with multiple

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different nurse leaders and support. You have a preceptor

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program,

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you have a charge nurse, a

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supervisor, a manager, a director,

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and even myself that engage with you

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throughout your journey, uh, becoming a new

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nurse.

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So those and then those mentorships don't start

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there, we connect you and move you

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forward with that growth and opportunities.

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Have you adopted any technological solutions?

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Like, is virtual nursing, telehealth,

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all of those things to alleviate staffing challenges

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too? Absolutely. So,

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 uh, Mercy has a virtual care

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center in Saint Louis

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that there are nurses there that help support

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us, actually here in Fort Smith

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with things like sepsis alerts

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and critical care, um,

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monitoring, things like that, that help

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us. We also have

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a partnership with Epic and

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Microsoft

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to bring ambient technology to

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the bedside to the frontline caregiver,

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where the nurse can really focus in on.

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On that patient care. They have

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a device that actually helps

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hear the conversation between the nurse

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and the patient. Of course it's pre-approved with the

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patient's permission, but it's hearing

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the conversation, so you and I can have a

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conversation about your assessment

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and in the background, this AI technology

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with Microsoft and Epic is pulling

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those key information in, pulling it

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into your chart. We can talk

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about our favorite football team or basketball

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team. It will not pull that information in

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the. Chart so we can have a conversation that's

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very meaningful while also getting the

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very detailed clinical information

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that we need to be successful in your care

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and in care planning.

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Pulls that information in and then the nurse

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goes back and validates that

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that information is correct,

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which is amazing. It shaves off about

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2 hours of that nurse's time

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of their of their 12 hour shift. So

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it's taking that cognitive burden off

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the nurse so they can really provide that compassionate

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care. An exceptional service, while

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at the same time having a

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better

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quality documentation

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for our other caregivers, our physicians, our

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case managers, our physical therapists, our respiratory

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therapists. They can immediately see the

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documentation. They don't have to wait for me to go

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back to a computer,

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find a desk, sit down,

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remember everything we just talked about, or

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take something from my notes and put in it automatically

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goes in. So it also gains efficiency

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with our other caregivers, not just the bedside

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nurse. Well, that's a game changer,

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 um, in a number of ways. It's really incredible.

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Yeah, we're piloting it, so we're excited

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to see, so we'll be starting

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that. We've we've started it in Saint Louis,

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we'll be bringing it to Fort Smith in the next

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few weeks and pilot it on units and

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then we hope to

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have it successfully disseminated

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through all of our nursing units.

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So is, is Mercy Hospital also

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exploring flexible scheduling like part-time

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opportunities to accommodate diverse workforce

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needs? Is that something that you see in

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demand as well?

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Absolutely, as we talked about the generations,

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everyone has different needs and seasons in

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their life based on what they're what's

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happening. So we've created multiple workforce

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layers. One of those is called a gig

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workforce layer, and it's through Mercy

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Works on Demand, which is an app

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that we have and so if I'm

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a gig nurse, that means I'm not required to

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work. a specific

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amount of hours in a week, I can pick up up

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to 30 hours a week or I can pick up no

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hours based on what's going on. If I have childcare

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challenges or if I have an aging

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parent that I'm trying to care for, or if I

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want to go on a vacation and and I don't need

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to be I can be a gig nurse,

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pick up those shifts in the app

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immediately and then come to work.

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And that is for experienced nurses,

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 uh, our new graduate nurses, we, we work

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with you on what the track is and what

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you need and kind of work on

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what are the best needs to meet our

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patients and what, what

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to get you trained and practice ready

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to the best of your ability to move from that novice nurse

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to that expert as quickly as possible.

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So it's so many innovative programming

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starting from education um at

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really young ages and even like middle school,

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junior high

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up to now, partnerships with

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schools,

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education and mentoring, so many pro

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programs that really sound like they're

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making a difference within your within your

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hospitals for sure. So

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what are you hearing from new nurses about their

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experience starting their careers at Mercy

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and how is that feedback kind of shaped your

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approach?

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Absolutely. So we, uh, we

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absolutely survey our nurses

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and we have the conversations of what's

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working well, what's not working well, how can we better

[00:11:38.048]
meet your needs. And as we get that feedback,

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we continually adjust our residency

[00:11:42.599]
program, our orientation, our preceptor

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programs, our mentorship.

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We take that and feedback.

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Right now I would say

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we're like I said, we're still coming out of COVID.

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There's some nurses that during COVID.

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They didn't get a lot of hands-on with patients

[00:11:55.844]
because the schools were closed

[00:11:57.923]
down and so they were doing a lot of virtual learning. They

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were doing a lot of SEM learning with mannequins

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and so we're still partnering

[00:12:04.644]
with those new nurses to get them

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more hands-on experience and help build their confidence

[00:12:09.514]
and and skill level to

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care for those more complex patients.

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So that's an ongoing approach to

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those nurses and and their needs.

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Well, Stephanie, thank you so much for talking

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about this important work, and I

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appreciate you being here today and sharing the

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future of nursing at Mercy Health. Thank you.

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Thank you so much. We couldn't do what we

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have done with these innovative programs

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without the support of the Arkansas legislation

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and the aligned grant and support that we

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received that has been.

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So beneficial in helping us increase

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our nursing pipeline and we were very

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thankful for to receive those funds from

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the state government. Thank you for

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your time. I appreciate being with you. Yes,

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thank you. Thanks so much for being here.

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And that's it for AFMCTV. Have a great

[00:12:53.700]
day. Thanks for watching.
[END_TRANSCRIPT]