What’s Trending Now

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

This week marks the mid-point of the calendar year 2023.  Most healthcare leaders had hoped that 2023 would be less turbulent, but most of the previous three years’ challenges continue. Here is what nurse leaders are talking about now:

1. The financial margins for for-profit systems are improving. Still, non-profit systems report financial losses and bond downgrades as inflation and labor costs continue to impact the bottom line.
2. Patient volumes are up in most but not all parts of the country, and nurse leaders see less fluctuation as their censuses remain high.
3. Health systems strategically plan to expand services to grow revenue while clinical leaders watch with increasing frustration, unable to staff the services already in place.
4. Travel nurses remain important to core staffing in most health systems, although travel pay has declined.
5. Nurse leaders now report fewer nurses who will volunteer to precept new staff telling their leaders they are exhausted with the endless cycle of onboard, rinse, repeat. 
6. Many health systems have eliminated leadership positions outside direct patient operations to maintain financial stability.
7. Moving patients across the continuum of care remains challenging as health services in the community decline resulting in increases in lengths of stay.
8. Recruitment and retention remain nationwide challenges as the shortage of nurses and growing vacancies now impact almost all health systems.
9. Where are the new graduates? There was intense competition for this year’s class of nursing graduates, and many hospitals could not fill all their projected residency positions.
10. Some nursing leadership teams are making the tough decision not to seek Magnet redesignation as they continue to work to improve their metrics and work environments.
11. Nurse turnover remains high as nurses will quickly change jobs for higher pay, travel positions, and remote work.
12. Physician-nurse relationships are deteriorating in acute care as doctors express concern about the quality of care and lack of staff tenure.
13. Nurses are in the driver’s seat relative to employment and increasingly refuse to work nights, weekends, or take call.
14. Safety at work is a key concern among nurses, as verbal and physical assaults from patients and families escalate. Health systems grapple with balancing the customer experience versus challenging customer behaviors. Nurses report anxiety as many states now allow concealed weapons, and few hospitals have metal detectors or permit a belongings search.
15. Younger nurses seek part-time and fewer hours to maintain their mental health and well-being.
16. Nurse leaders are navigating the balance between leader coach and therapist as more staff openly discuss their mental health issues.
17. Nurse leaders grow increasingly more anxious as states consider mandated staffing ratios when current RN vacancies go unfilled.
18. More new graduates seek and successfully get positions outside acute care environments.
19. Enrollments in nursing programs are beginning to decline in private universities.
20. Health systems struggle to provide unprepared new graduates with the extended orientation they need to function in high-acuity environments.
21. Younger nurses resist getting specialty certification and are less interested in clinical ladders.
22. Nurses want more scheduling flexibility, yet most health systems are behind in innovating around staffing and scheduling.
23. Nurse managers want executive leaders to spend more time with frontline staff so they can better understand the seismic shifts in what contemporary staff wants versus what organizations provide.
24. Younger nurses turn to TikTok, Instagram, and YouTube to voice their frustrations about the profession, workplace, and nurse leaders. Seasoned nurses, once critical of these behaviors, increasingly communicate their support for the efforts of their younger colleagues to improve working conditions.
25. There is a growing recognition that nursing care delivery needs to be redesigned, but health systems struggle with innovation and worry about unionization threats.

© emergingrnleader.com 2023

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