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How nursing execs see the future

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And here you thought all we talked about at Union was vertical consolidation and AI. Well today we're taking a look at the future of nursing (and yes, AI is involved, OK, fine).

One thing that's been well-covered across our industry is the extreme stress the nursing workforce has endured over the past several years: from heroic sacrifices during the pandemic, to a staffing shortage leading to widespread burnout, to a resurgence in organized labor and huge spikes in wages—the nursing labor market has never seen such upheaval in such a short period of time.

For purchasers and patients, continued labor shortages have meant overstretched staff and increased costs. For nursing leaders, it's meant managing a workforce more activated than ever before. All of this has been well-reported, but we wanted to see how nursing executives and experts themselves see the future of nursing—and so we spoke to a wide swath of them and distilled those conversations down to four observations:

Observation #1: Retaining staff requires a whole lot more than cash, but cash definitely helps.

Healthcare has certainly seen some of the biggest compensation jumps over the past few years (and has been the slowest industry to moderate on wages), but CNOs increasingly realize two hard truths: (1) there isn't enough cash to compensate for the overall workforce shortage, and (2) money isn't sufficient anyway. Nurses have dealt with increased violence in the workplace, stresses from shortage, and mental health challenges that rival almost any other profession. Workforce demands increasingly call for more tools to extend nursing capabilities, support for mental health and family needs, and efforts to ensure a safe workplace.

Observation #2: Virtual nursing's benefits are far greater than just efficiency and throughput.

Virtual nursing has gotten a lot of attention lately as a tool for extending nursing capabilities without increasing the size of the workforce—and every organization we spoke with had deployed virtual nursing in some form. But as our nursing leaders and experts told us, efficiency and throughput are actually two of the least important benefits (and to be clear, efficiency and throughput are key metrics for CNOs). Most touted the improvements to nurse training (especially critical amid a widening experience gap), patient experience, and therefore quality and retention as well. These are tools whose merits go far beyond what a CFO would initially want to see.

Observation #3: When deployed well, AI can improve the lives of nurses, not replace their jobs.

Yes, yes, AI. Much of the discussion of AI's role in clinical care revolves around the potential threat AI poses to clinical decision-making. And indeed, that issue has popped up in a number of labor disputes recently. But when we dig into the real issues underlying most nursing labor strikes, they mostly comprise standard labor disputes: wages, benefits, working conditions, etc.—even if AI does get a good portion of the headlines. In contrast, most nursing leaders we've interviewed are remarkably bullish on AI's role in clinical care, as are we. As we've said before, AI's biggest near-term deployment is likely to be on the administrative side of care, along with life sciences. But it does present an opportunity to improve not only productivity but also quality of life for nurses when used to speed and improve documentation capture, patient triage, and offer suggestions for specific patients' care in urgent situations.

Observation #4: Restoration of revolution? Leaders are split on two different versions of the future of contract labor.

Contract labor was the area where we saw the greatest divergence in views. Some leaders are pushing for a restoration of the status quo pre-pandemic (or at least, a near-restoration), when contract labor was in use sparingly, not to mention expensively. Others see no choice but to embrace permanent shifts in the labor workforce, including chronic shortages and increasing preference for flexible working structures, and have made peace with leveraging gig work and more-flexible labor pools. For obvious reasons, which path leaders are striving for is highly market-specific. Regions with reasonably strong population and labor growth and low levels of labor organization are likely to push for restoration, while those suffering with continued labor shortages have embraced the revolution.

These conversations were one input into a larger research project on the state of the healthcare workforce. Members can download those research materials here and watch an on-demand recording of our live discussion topic (featuring workforce expert Steven Berkow) here.

Not a member, but interested in those materials? Learn more about membership (and schedule time with us to learn more) here.


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