Luminis Health’s retiring VP of Nursing, CNO shares perspectives on nurses today

Barbara Jacobs played an instrumental role in HealthLeaders leadership events over the years.

HealthLeaders is sad to say goodbye to Barbara Jacobs, MSN, RN-BC, NEA-BC, who recently retired as VP of Nursing and CNO at Luminis Health Anne Arundel Medical Center in Annapolis, Maryland. Barb has been instrumental in our leadership events over the years and we have turned to her each time for her unique perspective and insight into nursing practice.

As a founding member of our HealthLeaders CNO Exchange, she has been instrumental in connecting professionals with this peer network as well as fostering new leaders. We spoke with her before she left Luminis Health to hear her advice for executives as the pandemic has changed the profession in unprecedented ways.

HealthLeaders: We have seen an exodus of nurses since the pandemic and now most healthcare organizations have a shortage of nurses. What do healthcare leaders need to understand about this profession to attract and maintain a stable workforce?

Barbara Jacobs: It is important for everyone to realize that nursing is not just a profession for nurses; rather, breastfeeding is who we are—it truly is part of our heart and soul. Nurses are incredibly positive and motivated by the relationships they have with patients and their families, as well as with each other, and these positives enable nurses to do this demanding job. The feeling that you have made a difference in another person’s life by using expert clinical skills and also expert people skills is an extremely powerful thing. These relationships are what matter to nurses, and healthcare institutions must create an environment that allows nurses to leave work feeling that they have made a difference to their patients, families and colleagues. If we don’t create this environment, we will continue to see nurses leave the bedside.

I often like to stop, day or night, and think about how at this very moment hundreds of patients and families are receiving care from a nurse in our system. We must work hard as healthcare leaders to recognize what is important to nurses.

HL: What factors during the pandemic led to nurse burnout?

Jacobs: The nursing workforce was strained before the pandemic with growing concerns about incivility, safety and equity of care. I was able to work with a group of nurse leaders who came together through the Beryl Institute to write a paper where we wrote about burnout and recovery. (Rushton CH, Wood LJ, Grimley K, Mansfield J, Jacobs B, Wolf JA. Restoring the foundation of trust: a call to action in creating safe environments for all. Journal of Patient Experience. 2021;8(3):5 – 12. doi: 10.35680/2372-0247.1651.)

The pandemic has created stress in the workplace, but in addition it has created significant stress in the home environment, causing nurses to rethink their work. These stresses, combined with the retirement of large numbers of highly experienced baby boomer nurses, contributed to burnout.

HL: How has burnout affected breastfeeding?

Jacobs: The pandemic has led to situations that have forced nurses to consider life choices as they try to balance home and work life. Most institutions have had to make dramatic changes in practice, often at an extremely rapid pace, requiring nurses to work in more uncomfortable situations. I believe that the combination of stress at home and at work at this time has affected the amount of energy and enthusiasm that nurses can bring to their workplace.

Time is challenging for leadership, as it is essential that front-line staff feel that they are considered and supported as they go through the necessary permanent change. Great leaders will be needed to lead the people in the coming years.

HL: What can leaders do to reverse the trend?

Jacobs: It is essential that healthcare leaders remember that the heart of healthcare is in the hands of the staff who touch the patient and family the most. These staff need to feel supported and that they are personally achieving what is most important to them. With the extraordinary financial issues affecting health care right now, every system is looking at how to change care models to provide care to patients in a more cost-effective manner.

We must proceed with caution as we recognize that there are large numbers of less experienced staff in the hospital workforce. As we work for efficiency, the burden of non-nursing activities cannot fall on these less experienced nursing teams. As new models emerge to retain nurses at the bedside, they must allow nurses to very concretely feel that they are making a difference in people’s lives. We are people care about people and we need to care about people on both sides of that statement to succeed.

Barbara Jacobs, MSN, RN-BC, NEA-BC

HL: What does today’s nursing workforce look like?

Jacobs: The workforce today is quite different than it was three years ago. With the retirement of the large group of baby boomer nurses and the loss of other experienced nurses, most systems are replacing this staff with newly graduated nurses. This experience gap requires us to support these staff in a variety of ways, including providing robust nursing and clinical resources for these staff. Additionally, systems are experimenting with adding different members to the care team, such as increased numbers of LPNs, additional foreign-trained staff, paramedics, and others.

HL: Can you cite an example of a patient that you particularly remember?

Jacobs: There are many patients to remember. One was a patient in my ward when I was a young ‘head nurse’. She was 57 years old with crippling rheumatoid arthritis that left her with limited use of her arms and required the use of a wheelchair. An experimental treatment had caused aplastic anemia, and in 1980 we just had to hope that her bone marrow would start producing white cells and that we could protect her from infections. She had many near-death experiences and was hospitalized for many months.

When she was finally getting ready to go home, she gave me two hand-knitted clothes hangers that she had made with her crippled hands. I still have them and every time I see them I think of her hands and how we both touched each other’s lives. It was because of patient experiences like these that I became a nurse.

HL: Given the opportunity to start in the profession today, is there anything you would do differently?

Jacobs: I think if I got out of nursing school today, I might be headed right into becoming a nurse. But I wonder if that might have prevented me from working in nursing management as much as I did.

As nurse leaders, I think there are many opportunities to make leadership roles more interesting and attractive to newer nurses. It’s an incredible feeling to think that you may have played a role as a leader in improving the care of many patients and impacted the environment and lives of many nurses. We need to better represent the leadership role to excite more young employees to follow this path of personal fulfillment.

Julie Outon is the Leadership Programs Editor for HealthLeaders.

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