The story below is from our July/August 2023 issue. For more stories like it, Subscribe Today. Thank you!
As hard as it has been to work as a nurse the past few years, the public’s perception of those brave souls has been one of absolute respect and admiration. “Heroes,” some call them.
In 2022, the Gallup organization asked a lot of Americans to name their most trusted profession. It probably is of little surprise that nurses came out on top with 79% approval. That poll ranking maintained a 21-year winning streak, but of late, it has been especially gratifying to the medical profession (which held the top three positions) in light of the COVID experience, which presented an often-devastating test.
Dr. Phyllis Whitehead, who holds several titles (and jobs) with Carilion in Roanoke, including Clinical Nurse Specialist, boils that endearment down to its essence when she says, “It is always about the patients.”
Dan Smith
“It is always about the patients.” - Dr. Phyllis Whitehead
In fact, it is always about the patients, even when it isn’t. Keeping nurses healthy (mentally and physically), educated, alert, prepared, involved, rested, relieved of as much stress as possible and — vitally — employed, has become an urgent goal for hospital organizations.
Like many hospitals, new programs at Carilion have sprung up to take care of nurses’ needs, including “a collaboration of spiritual and emotional healing,” says Whitehead. Carilion, she insists, has seized the “opportunity to provide innovation” in securing the workplace since COVID’s opening blast of death in 2020 devastated much of the medical profession.
“Supporting staff well-being is a priority,” Carilion PR specialist Hannah Cline points out. “The pandemic underscored the stressors on clinical teams. The impact will be lasting, and there are plenty of lessons to be applied to approaching provider well-being. It’s critical that health care systems be nimble and continue to adapt, meeting teams where they are.”
It has been well-noted that a lot of nurses have left the profession since COVID and hospitals have had to respond in a number of ways. Whitehead says there is a broad effort “to build a healthier workplace” and deal with what she calls “compassion fatigue.” She says that “moral distress has gone down, but it stays with you and can be triggered.”
A wide variety of programs have been instituted to meet that end, and hospital organizations are offering incentives, including tuition assistance for nursing students. The American Nurses Association has estimated that 1.2 million new nurses will be needed in the U.S. by the end of this decade because of retirement and burnout.
The Virginia Healthcare and Hospital Association says that in early 2023, there were 4,510 openings for nurses in the Commonwealth, a few more than 500 of them in the Roanoke Valley. The Virginia Center for Assisted Living reported that 7,500 nurses have left their jobs in assisted living facilities in the past year.
A CNN report revealed that 610,388 registered nurses with at least 10 years of experience and an average age of 57, “said they planned to leave the workforce by 2027 because of stress, burnout or retirement. The same was true of 189,000 additional nurses with 10 or fewer years of experience and an average age of 36. The survey found that there were more than 5.2 million active registered nurses and 973,788 licensed practical nurses or vocational nurses in the US in 2022.”
Not all of COVID’s effects have been negative. “We are seeing innovation,” says Whitehead. “There are more options, more control [for nurses].” Collaboration in the medical community has intensified, says Whitehead, and “physicians are saying ‘I need my nurses.’”
Dan Smith
Barbara Wagnon surrounded by her daughters, Sarah Kinsley, Rachel Thomas and Abigail Jamison: “It was certainly hard. And when we did open back up, many of them no longer recognized their families. That was even harder.”
Why are nurses coming back? Whitehead says, with emphasis, “The possibilities are boundless. We need creative, innovative people to be trail blazers. This is a wonderful time and we need to be bold advocates for patients, families and ourselves.”
Says Cline, “While our recruitment efforts continue to evolve, a main priority remains retaining existing staff. The pandemic has allowed us to get creative with our approach to workforce development and consider new ways to help our teams excel professionally.”
Barbara Wagnon heard the call loud and clear. And so did her daughters. Wagnon is a nurse practitioner at the Center for Healthy Aging and a long-term care facility, and the mother of two nurses and a psychologist who just wrote her PhD dissertation on the nursing shortage. Daughter Dr. Abigail Jamison teaches at Ferrum college. Two other daughters are Rachel Thomas, a travel nurse, and Sarah Kinsley, a nurse practitioner, who graduated with her mother.
Wagnon gave daughter Abby a book called the “Nightingale Prescription,” and that was all it took for her to embark on her dissertation. Wagnon and Kinsley graduated nursing school in 2008 and “I had a blast with her in school and at times we were able to complete clinicals together.” Kinsley is a nurse practitioner in plastic surgery. Rachel has worked in cardiac critical intensive care and is on the road now (where pay is considerably more generous than on the hospital floor).
Wagnon was 61 when she was certified as a nurse practitioner and is considering working for a doctorate. “COVID changed everything and nothing about nursing,” she says. “Nursing is nursing. We love and care for our patients. Nothing changes that. The foundation of nursing remained the same.
“What COVID did change was our way of doing things and the stress level in the building. For me, it meant I went from being a facility nurse practitioner to functioning as a step-down nurse practitioner within a nursing facility.”
During the pandemic, hospitals basically closed to outsiders. “Everything was shut down, no families allowed, and we were locked in with residents who didn’t understand why they couldn’t come out of their rooms, or why there were all these aliens running around the place (us in our protective gear),” she says. “It was certainly hard. And when we did open back up, many of them no longer recognized their families. That was even harder.”
These days, “the stress is mostly gone and there is a lot of laughter. I would say that the nurses in the facility have grown immensely, and I am proud to work with them.”
Wagnon says the primary reason her unit lost nurses was, “because the nurses did not want to get the vaccination. There are currently only three or four remaining original nurses and nursing assistants [in her area]. The rest came in and worked incredibly hard to take care of the patients, even when very short-handed. I don’t hear many complaints.”
Sarah Kinsley has found that “nursing itself has changed, but we’re still doing the same things always done. I feel a little more cautious that our jobs aren’t secure, [even though she doesn’t] expect to be furloughed. That was a reality shock for us. I think [nursing has] returned to what it was before. We all learned things can change overnight and just because we work in health care doesn’t mean safe as far as health goes.”
Abigail Jamison, who is an industrial organizational psychologist, wrote “Leadership in Nursing: Examining the Role of Authentic Leadership in Job Embeddedness and Turnover Intent” for her doctorate. Essentially, she found that “authentic leadership behavior” is elementary in retaining nurses. That includes “self-awareness; internalized moral perspective; relational transparency (communication styles); balanced processing; caring.”
Dan Smith
Dawn Sullivan: “I saw a lot of nurses leaving, scared.”
Now that she has identified the problems, she plans “another [hospital] study, looking at where there are areas that can be built on, so we know how to train leaders.”
The primary stressors include “unexpected working hours; work-family imbalance; stress; different leaders with different shifts (expecting different things). 96.1% of hospitals view retention as key, but they are still losing nurses … Some hospitals are at a 70% vacancy rate and over 80% of hospitals have a greater than 10% vacancy rate. … The exodus from hospitals has not stopped.”
For a year, Rachel Thomas has been a traveling nurse for Wake Forest Baptist Hospital, living in Stuart. She works on the renal special medical floor in various hospitals, generally within a couple of hours of her home. Even in the wake of COVID, she says, “My job has remained in a constant state of change. Initially, the unknowns surrounding almost every aspect of the virus caused fear of how it was transmitted, how to treat this virus, of being the nurse assigned to the patient who was sick” with COVID.
Thomas began her nursing career at LewisGale Medical Center and was in her third year in the “float pool” when COVID emerged. “For two months I was sent to the designated COVID floor. I sent many to [intensive care], some who survived, some who did not.” She saw “constant changes [that] maintained a level of fear.” Change has been the rule since. “We have now adjusted to the fact that COVID-19 is a virus that will not entirely go away but is manageable. Fear is not the dominant factor leading to decisions. Fear has evolved into respect.”
Having now lived through a pandemic and surviving, she has developed a new respect for life. “I have developed a renewed approach filled with empathy. This whole experience has made me not just a more compassionate healthcare provider, but it has touched every area of my life.”
Dawn Sullivan, a nurse at adult day care specialist Innovage in Roanoke, says that “when COVID hit, I jumped at the chance at nursing [with Carilion Pediatrics]. I saw a lot of nurses leaving, scared. Our workload doubled.”
She wasn’t scared because “I’ve always gone above and beyond with precautions and I still feel that way, even without COVID.” At Innovage, “it is like an eldercare facility and in general it can be stressful. We are still short-handed.”
“Nurses are there when you’re born, nurses are there when you die and everywhere in between,” says Jennifer M. Kennedy, president of the American Nurses Association. “Individually and collectively, we’re making a difference in people’s lives in the worst and the best times.”
Nursing remains at the top of the respect gauge for good reason. And with COVID in the rearview mirror, it is taking the opportunity to widen the gap.
Easy Segue: Banker to Nurse
Andrea Gee burned out at the bank but found new life in a profession known for its high stress, especially in the wake of COVID.
Dan Smith
Talk about moving against the grain. Andrea Gee, 34, has just finished earning her registered nurse designation with her bachelor’s degree from Radford University and is now working as an RN at Carilion Clinic. Not long ago, this mother of a young child was a bank executive in Roanoke. The burnout occurred in the latter, not the former, where it might have been expected.
Gee, a Navajo Indian transplant from the Phoenix area, earned her first bachelor’s degree in business from DeVry University before moving into banking at a low level. She emerged as a bank manager at Wells Fargo in Roanoke. Then, COVID changed everything, including her bank job.
“I fell into [banking] after graduation and worked my way up [in] six years,” she says. But banking changed “a lot,” she says, “because of the pandemic.” Increased working hours and responsibility, stress and a feeling of not being appreciated preceded her decision to drop out of the banking world.
Meanwhile, because of COVID, nursing was under siege. “I took a pay cut and started working as a nursing assistant,” she says. She loved the profession and decided to “go to school for my RN to help people. It was a crazy time to start.” She enrolled at Virginia Western Community College for a year and became a nursing assistant.
Carilion sponsored her in an accelerated 15-month program at Radford. That program “is madness,” she says, but “I am glad I made it. I would do it over again, in spite of all the tears … because the program is great, the leadership just amazing.” Raising a small child while studying intensified the work.
An important benefit of getting help from Carilion is that she had a job upon graduation, “giving [Carilion] time back for tuition.”
She is philosophical about her new career: “I get to come in at a hard, but amazing time. Things are constantly changing. At the beginning of COVID, I was reactive to everything and had no time to be proactive. Now, I really get to connect with our patients.”
Gee grew up steeped in Navajo culture where it was “hard to get out and find opportunities.” With the new RN designation, “I get to show my brothers and sisters that with hard work and help we can make anything happen. I want to go back and serve my community because they are underserved.
“I’m happy with it all. So thankful for the resources Carilion has given me.”
The story above is from our July/August 2023 issue. For more stories like it, Subscribe Today. Thank you!