Abby Burns (00:08):
From Advisory Board, we are bringing you a radio advisory, your weekly download on how to untangle healthcare's most pressing challenges. I'm Abby Burns.

(00:18):
Anyone who works in healthcare knows that nurses are the lifeblood of care delivery. There are about four million nurses in the United States working in medical offices, post-acute sites, retail clinics, and most of all hospitals. Nurses make up the largest constituency in our clinician workforce. They've also been ranked the most trusted profession in the US for 24 of the last 25 years.

(00:44):
But before we were talking about a public health crisis, we were talking about a workforce crisis. Hospitals and post-acute sites were having trouble staffing their beds. Enter the pandemic, turnover among nurses shot up. It seems like things have somewhat stabilized over the past 18 months or so. So today I'm talking with Advisory Board nursing experts, Allyson Paiewonsky and Miles Cottier. Allyson and Miles are going to talk to us about the state of the nursing workforce in 2025 and how nursing leaders should be thinking about engaging and retaining their nurses. Hey Allyson. Hey Miles. Welcome to Radio Advisory.

Allyson Paiewonsky (01:20):
Hey, Abby.

Miles Cottier (01:21):
Hey Abby. Good to be back.

Abby Burns (01:26):
When we look at the past several years, workforce topped the list of health systems C-suite concerns for many years running, and it's because leaders recognize that care delivery simply doesn't happen without clinicians. Allyson, based on my conversations with health system leaders, it is certainly feeling like we're not in the same level of crisis that we were in a couple of years ago, I'm thinking early pandemic, but you've been looking at this more empirically. So catch us up. How would you describe the state of the nursing workforce as we wind down 2025?

Allyson Paiewonsky (02:03):
I think you're absolutely right, Abby. We are not in the same crisis mode that we were back in 2021 or back during the pandemic. Peak pandemic, we were seeing nurse turnover at 27%, and that was just completely unprecedented, but now we're seeing those numbers come back down. Turnover is about 16%, vacancy rates around 10%, time to fill around 83 days, so that's pretty close to where we were in 2019.

(02:28):
So we could say that things have maybe stabilized, but I would argue were things ever really stable? And when we think about pre-COVID, we were still dealing with things like burnout, staffing shortages, retention challenges. So while I think that the metrics are looking better on paper, the data shows us that things have maybe returned to normal, I don't think that we should think of this back to baseline as we have solved the problem.

Abby Burns (02:53):
That was going to be my question because we didn't enter the pandemic on stable footing when we think about the workforce. So I'm wondering as we return to that unstable baseline, what does that current status quo feel like to nursing leaders?

Allyson Paiewonsky (03:07):
I think there's a sense of relief that numbers have improved and that we're not putting out those fires that we once were, we can kind of return to some of those more pressing priorities that nurse leaders have to deal with. But I would kind of caution that this might be a false sense of relief because while we're seeing things like turnover and vacancy come down, we're also seeing intent to leave is rising, and I think that that is a red flag that we really need to pay attention to.

(03:34):
In the 2022 National Nursing Workforce Survey, we saw that intent to leave in the next five years among nurses was about 21%. In the most recent publication of that survey, it is now up to 40%. So that is a huge increase. So I think that we are at risk at looking at those surface level metrics like turnover, and we're missing these things like intent to leave. So we're potentially sitting on a slow burning workforce crisis. We can't celebrate this return to normal, we need to dig deeper and think about what are the root causes that are making nurses think about leaving their roles and the profession.

Abby Burns (04:10):
That 40% number is concerning on its face, but it's really concerning when we look at the projections for patient volumes. When we think about what hospital and patient beds look like right now, what censuses at hospitals look like right now, and then we project into the future, we're certainly going to need a stable and a well-staffed nursing workforce. That said, if nursing leaders feel like they do have a second to breathe and focus on, as you said, some of those strategic priorities when it comes to their nursing workforce, that list of priorities is still long. What is maybe coming to the top of the list as they have a little bit more bandwidth?

Allyson Paiewonsky (04:47):
I think there's a long list of things that they're thinking about tackling now. They're zeroing in on things like workplace violence prevention, flexibility, giving nurses that kind of work-life balance that they want, addressing things like workload, staffing concerns. And I would say that these are all not nice to have. They're foundational because if nurses don't feel safe, supported or like they have control over their work-life balance, it's going to be really hard to keep them at the bedside in the long term.

Miles Cottier (05:14):
I would say it probably comes down to engagement more than anything else. That's an undercurrent that always exists and is going to greatly influence a nurse's decision to stay, to leave, how much they're going to apply themselves to their job, and all the things Allyson's just discussed can be linked back to engagement one way or another. So at the very least, it's worth thinking about. It's worth embedding more so into our decision-making, and then, of course, our investments down the line as well.

Abby Burns (05:36):
Where does engagement stand? So I mean, we understand intend to leave at 40%, I imagine that means nurse engagement is pretty low.

Allyson Paiewonsky (05:45):
Yeah, I think when we talk about engagement and thinking about the traditional playbook for engagement, there's a lot of focus on things like recognition programs or wellness initiatives, shared governance, and I think that those are really important, but they're not enough on their own to engage nurses today. And I think that there are things that nurses are looking for in their careers, in their profession, today that are missing.

Abby Burns (06:09):
Like what?

Miles Cottier (06:10):
The thing that came up the most over the past year or so, the thing that they're missing, or certainly that they're not prioritizing as a engagement lever is career-pathing, or they're doing it, but they're doing it in the wrong way. And that's been the focus of what a lot of our research has been on over the past of year.

(06:26):
This is not just in the US, this is internationally as well. Nursing leaders were coming up to us and saying, maybe we're getting a handle on various other elements of maybe flexibility or work-life balance or virtual care or whatever it may be that the nursing world is evolving into, but one thing that feels like it's stuck in the past is career-pathing. What career structures and opportunities we're offering our nurses as an organization?

Abby Burns (06:50):
Okay, this is interesting. Explain this for me Miles, because in my mind, nursing is actually a profession with a uniquely clear career ladder.

Miles Cottier (06:59):
No, you're right. It does. And it absolutely has been a career ladder historically. I think that's changed somewhat as the sector has changed, as the market's changed. From an organization's perspective, they are still going to be doing career-pathing. They're not going to stop doing it. But what did become clear early in the research is that almost everything is built for the organization, so for the health system, even if leaders think it's built for the nurse, and that mindset can actually be pretty detrimental to nurse engagement if you think about it. Essentially, if organizations are building the pathways, then the development opportunities that they're building are a way to retain nurses, specifically to retain them at the bedside. So everything that they do and everything they invest in and the decisions they make is in service of that goal.

Abby Burns (07:42):
I want to push on this a little bit because it makes sense to me that nursing leaders might design career ladders that keep nurses in the positions that the organization needs in order to treat patients, which ultimately is the end goal. Why is it a bad thing to do career-pathing in a way that is primarily organization-centric?

Miles Cottier (08:02):
That's kind of the crux of the research really. We should be pretty empathetic to nursing leaders here. We need nurses at the bedside. We're always going to need nurses at the bedside. So it makes sense that we do everything we can to keep nurses there. At the same time, I think what we hear a lot is that leaders are genuinely concerned, and understandably so, that if they offer more diverse pathways, more diverse opportunities, then that might pull nurses away from the bedside.

(08:28):
But when you look at survey data and you ask nurses, career-pathing is very, very rarely given as a major reason that people actually leave. It's usually 12th or 13th in the list. The other reason is the mindset and the actions that we're talking about here can be detrimental to retention. We're building pathways that prioritize the immediate staffing needs of the organization, sometimes, not always, sometimes at the expense of the nursing needs, about their career or development or their non-work commitments, whatever it may be. So everything's going to be bedside first, and it's all very rigid, it's all built for a time when nurses did stay in the same job for decades.

(09:07):
And a lot of that time, that's not what nurses want or not what they need. And I think they're certainly going to feel disengaged a lot of the time because they don't see any other options. And the result a lot of the time is that they're going to leave anyway if you're not offering what they need. So I'm not going to flip this totally. I'm not going to say, you a hundred percent always need to prioritize the needs of every single nurse over the staffing needs of your organization, but I think we've gone too far the other way, I like to think of it as like a Venn diagram, if you have nurse needs, organization needs, and then in the middle somewhere there's that sweet spot that we, as an industry, need to hone in on a little bit more than we are now.

Abby Burns (09:40):
Yeah. So essentially your engagement efforts should include career-pathing. Your career-pathing efforts should aim to improve nurse engagement. Do I have that right?

Miles Cottier (09:49):
Yeah.

Abby Burns (09:49):
So the natural question does follow. We still need to retain nurses. We still need to think about that 40% of nurses that intend to leave in the next five years. Does improving engagement improve nurse retention?

Miles Cottier (10:02):
It does, and this is kind of part of the mindset shift that we wanted to talk about in the research. Retention is naturally multifactorial, right? There are a load of things that influence retention, and I'd say engagement's very similar. Engagement is going to be one of the things that we know influences a nurse's decision to stay or to leave and likewise, we also know if you've moved kind of slightly further upstream in that pathway, we know that career-pathing is a big contributor to engagement and satisfaction. So we're not necessarily ripping everything up. We're not tearing up the rule book here. We're just saying move your focus maybe earlier in the journey. And the bonus about engagement is it can help a load of other metrics and things that healthcare leaders care about.

Abby Burns (10:45):
Tell me what some of those things are.

Miles Cottier (10:47):
We looked into studies that showed care quality increases with engagement, staff relationships improve, patient experience improves, the cost savings that you gain through reducing turnover as well. So there's a load of different things that impact different parts of the organization and different things the leaders care about as well.

Abby Burns (11:04):
That cost piece is huge. I hadn't even thought of that, but yeah, the cost of replacing, especially an experienced or a tenured nurse is quite high, and especially at this time where leaders are looking to avoid any cost possible, it's an important consideration. So it's important to the business that nurses be engaged. Nursing leaders actually have a second to think about and work on nurse engagement. They're missing an important opportunity, which is to think about nurse career-pathing in this way, not that they're not doing career-pathing, it's that they're not doing it in a way that engages nurses. How does career-pathing that's intended to engage nurses look different from career-pathing that's intended to retain them?

Miles Cottier (11:49):
I think this is inevitably going to look different in every organization. There is some kind of nuance here, and I think the simple answer is, and this is the simple answer to a lot of healthcare problems, is ask your nurses. Ask them all and ask them as frequently as you can.

Abby Burns (12:05):
Ask them what though?

Miles Cottier (12:06):
Ask them specifically what engages you or what disengages you. And we found that organizations that were continuously using workforce data and their nurse input, so you get both qualitative and quantitative side, to feed their decision-making around the career-pathing strategies they had, they were the ones who were building something which better matched what the nurses needed and also allowed them to meet their own needs in tandem as well. There is that middle of the Venn diagram we talked about.

Abby Burns (12:33):
So it sounds like some people have sort of figured out how to strike this balance a little bit more effectively. When you think of the mindset or the approaches that those organizations use to career-pathing, what is exportable about what you've observed?

Miles Cottier (12:47):
I apologize for the analogy here, but the most advanced organizations when it comes to career- pathing, they're not talking about ladders anymore, they're talking more so like river basins, if that makes sense. So if you think about a main river has the main stream, and we could probably call that the bedside, but then if you think about as it enters the basin, it'll form tributaries, offshoots, some of them come back, some of them feed back into the mainstream, some of them stay as small rivers, and then some of them become larger rivers and become their own kind of main stream, if you will, and that's the way I like to think about it. So things are moving from side to side. You can come back into a previous pathway, historically, we may be inadvertently unlocking nurses out of. So that's kind of the picture we wanted to paint, something more like a river basin and less like a career ladder is what we're talking about.

Abby Burns (13:36):
Moving from a career ladder to a career river basin. But I think that's actually, visually, a very helpful analogy. You also mentioned something that I have to come back to, which is if the core, let's say river, is the bedside, and we're creating opportunities to siphon some nurses off in tributaries for different opportunities. Let's say we're talking about reducing a bedside nurse FTE by 0.2. That might sound kind of small in conversation, but that could equate to a full day of a floor being one nurse down. Can health systems afford to do that?

Miles Cottier (14:11):
I'd say the simple answer is, can we afford not to do that, right? I mean, the honest and realist answer I guess would be if we don't offer this, will the nurse leave? Because if that happens, then that's going to be a whole lot worse than trying to backfill 0.2 FTE. So obviously we have to put guardrails in somewhere and find the right people that we're offering this to at the right time. But I think the answer is, can we afford not to do this?

Abby Burns (15:49):
One of the important points that I'm hearing that is kind of underlying this need for having tributaries for moving beyond the career ladder to a career river basin is the fact that nurses don't want the same things necessarily that they did 15, 10, maybe even five years ago.

Miles Cottier (16:08):
Yeah.

Abby Burns (16:09):
To that point, we know that the nursing workforce is diverse. It spans generations, even. That means, I'm guessing there is not a one-size-fits-all approach for creating this type of flexibility or for designing those tributaries. That feels pretty overwhelming, if I put on the nurse leader hat. How should nursing leaders make this problem feel more approachable?

Miles Cottier (16:33):
I think, honestly, like I mentioned earlier, we don't know if we don't ask, if we don't look at our own data. So my first push for anyone listening would always be, look at what is driving disengagement or flipping what's driving engagement? Who are we targeting here? The way that the research told us, organizations really should start is with larger cohorts. So probably tenures, because usually telling us similar things and it's aggregate your nursing workforce by tenure as well.

Abby Burns (16:59):
Meaning segment your nursing workforce by the tenure that they have at the organization to understand within these groups, what are their needs, what are their engagement and disengagement drivers.

Miles Cottier (17:11):
Absolutely. Yeah. And we're saying start with tenures. Don't finish with tenures, right? It's a good place to start because they're relatively large groups. Once we've identified the cohorts and we've asked them what's engaging you? What's disengaging you? Then we can target that, and they're going to tell you different things. Each tenure is going to tell you something different, and that's where you can get quite creative with the solutions you're offering.

Abby Burns (17:32):
What are some of the different things that you hear from nurses at different stages of their career?

Miles Cottier (17:38):
So I would say having spoken to nursing leaders pretty much everywhere around the world, they are targeting early career nurses more than any other cohort, highest headcount, the potential to stay in the career for a long time.

Allyson Paiewonsky (17:52):
The early career nurses have the highest turnover. So I think our nurse leaders tend to want to put the most resources into career- pathing and trying to engage these nurses and keep them at their organizations. But I think if we're looking at the research that Miles has done that this might not be the right approach and that there are other cohorts that we should be thinking about and targeting, and we might have a better return on investment.

Abby Burns (18:14):
Interesting. So based on your research, where is there the greatest untapped opportunity to improve maybe the effectiveness of career- pathing and engagement efforts?

Miles Cottier (18:23):
So the thing that came up, I would say, more than anything else in the research was mid-career nurses as kind of the most underappreciated or under-resourced cohort. Mid-career nurses is a pretty nebulous term, right? Four to 15 years, people take something in that ballpark, they've been historically thought of as career nurses. So they're more resilient to change, they're more resilient to stress, maybe they're likely to stay for a much longer period of employment in healthcare than other cohorts of nurses. So they tend to get less tailored support, less tailored pathways.

(18:52):
But that means that because we're not offering them enough, they a lot of the time feel like they get stuck or they feel unchallenged or they feel disengaged in what they're doing now. And this is a really, really important, really valuable and very experienced cohort. We absolutely cannot afford to lose any more of this cohort. So this was definitely the gap that the research surfaced.

Abby Burns (19:11):
What did you learn in your research about what mid-career nurses want?

Miles Cottier (19:16):
Many mid-career nurses are actually really looking for additional opportunities for development and growth without actually sacrificing a lot of their clinical work as well.

Abby Burns (19:25):
So they want to be at the bedside.

Miles Cottier (19:27):
Exactly. They've been there for a long time. Many of them do want to continue some of their bedside responsibilities, but they want something else. They want to scratch the itch of growth or development in other areas. One of the coolest examples I've seen in the research was from an organization in Ontario and Canada called CHEO, it's a pediatric hospital. They found that their mid-career nurses were feeling the strain, they felt like they weren't offered enough, and at the same time, in an unrelated survey, they found that nurses weren't really engaging with the EMR, the EHR, and kind of informatics engagement, so they developed a thing that would again meet the middle of that Venn diagram. They introduced a, I think it was called a clinical informatics champion, so this is for mid-career nurses, they have to be there for over three years, and basically they are boots on the ground leaders of EHR optimization projects.

(20:14):
They do a year of training into what the EHR is, how it works. They do Lean Sigma Six, all that kind of stuff. But importantly, they only dedicate 0.2 FTE to that core through that program. So yes, the organization is responsible for backfilling that, but they are retaining these nurses, and these nurses love it because their needs are being met. And it was successful enough that they rolled out a similar program for, I think it was best practice and for research as well. So again, asking nurses what they want and developing on top of that original blueprint.

Abby Burns (20:47):
I'm hearing a little bit of maybe it's really hard to build this new tributary the first time, figure out how do we create the kind of flexibility in a role to keep at least a few nurses engaged. You're not going to have half of your workforce serving as informatics officers, but it sounds like what they found is something that's actually replicable. We can do this and create other pathways for nurses.

Miles Cottier (21:10):
Absolutely. Yeah. I mean, it's like that old change management mantra. It's like walk before you can run, which I'm sure listeners have heard thousands and thousands of times, but it still applies. And usually starting with smaller cohorts, pressure test what works, pressure test what doesn't work, and then start to slowly scale out and add more things is probably the way I'd go about it.

Abby Burns (21:27):
I think that's an awesome example. Are there others?

Allyson Paiewonsky (21:31):
Something that is interesting that I have also seen in the data is that mid-career nurses and also late-career nurses are feeling really energized and fulfilled by helping early tenure nurses grow. So I think that there's a really clear opportunity here to create roles that help tap into this desire that they have. So things like virtual expert nursing roles or models or hybrid clinical educator roles that can really meet the needs of the organization by supporting that skill building and retention of these new grad nurses, but also giving those experienced nurses who are later in their careers that sense of maybe a purpose or progression in their careers and that fulfillment.

Abby Burns (22:08):
Which I imagine also has benefits for the earlier career staff that are being mentored in terms of driving their own engagement, they feel invested in, they feel like they're being supported in a new role.

Allyson Paiewonsky (22:19):
I think it's a win-win all around, and it probably helps the early nurses' career-pathing in a way too, to see all of the different possibilities that are available.

Abby Burns (22:26):
One thing that I want to emphasize, Allyson, in what you said is this is not mentorship that's happening off the side of these nurses' desks, this is actually built into their FTE right?

Allyson Paiewonsky (22:37):
Exactly.

Abby Burns (22:38):
Are there any examples of organizations that you've seen do this really well where they've built it into a mid-career or late-career nurse's role?

Allyson Paiewonsky (22:45):
We have a couple examples of virtual nursing experts. One comes from CHI that we have in our Advisory Board library where a virtual expert nurse oversees nurses who are on the floor and serving patients. So they're able to provide assistance if they have questions and help provide that guidance and skill support to nurses who are still learning. And we've also seen being able to give that flexibility to nurses who are maybe later in their careers and don't necessarily want to be doing that hard physical labor that comes with being a nurse.

Abby Burns (23:14):
Right, walking miles every day across the hospital.

Allyson Paiewonsky (23:16):
Right, exactly. Being on your feet for 12 hours a day. So how do we add that flexibility into the role where maybe you're able to work from home part-time or be a virtual nurse for part of your shift and be on the floor for the other part of your shift so that we're able to keep nurses who have that experience that we need in the profession and at the bedside for longer?

Abby Burns (23:35):
Yeah. I think the common denominator that I'm hearing here really is flexibility and nimbleness. There is an elephant in the room that I do want to name, which is that healthcare is a pretty heavily regulated industry, and nursing itself can be a pretty heavily regulated profession, especially depending on what state you're operating within. How big of a barrier is the regulatory environment to the sort of career optionality that we've been talking about?

Allyson Paiewonsky (24:05):
I think things like mandated ratios, union contracts, and even sometimes internal policies, they can make it difficult to innovate on things, whether that's creating new roles or offering flexible career paths, rethinking how we're deploying nurses. But I'll let Miles jump in here too, I know that a lot of the examples that he has found internationally come from unionized environments.

Abby Burns (24:29):
Oh, wow.

Miles Cottier (24:30):
Yeah, absolutely. I would say for the most part, actually, in countries outside of the US that we spoke to, they're all pretty heavily unionized. So talking the UK, Canada, Australia, they all worked with unions to keep them happy along the way. And part of the research process, we actually spoke to a couple of unions and they actually told us that this was at the top of their agenda as well. And they're actually leading and spearheading a lot of the work, because if you think about it, career-pathing is as much of a working right as something like flexibility, which is very high on their list as well. So I think you'd probably be surprised with how many unions are actually on board with talking about this and instilling more and more innovations in the career-pathing world. But as long as you work with them to do it, I think there's definitely, definitely a middle ground there.

Abby Burns (25:14):
As we come to a close here, Miles, where do you want nursing leaders to start? What's the first thing they should do as soon as they finish listening to this conversation?

Miles Cottier (25:25):
The first thing I would tell any of your nursing listeners to go and do is find, collect, and analyze the data they have around the disengagement drivers and the engagement drivers of specific cohorts within their nursing workforce. So you probably have the data, I'd guarantee almost everyone who's listening has the data, my direction would be use it. And speak to nurses, right? It's not just a quantitative thing, this is qualitative as well, and there's going to be a lot of nuance there that won't come out in the numbers. And I think a really important and underrepresented point here as well is find out who isn't being represented. So where are the empty seats in the room? And then go seek them out and find out why they're not being listened to or feel that they're not being listened to and find out what they need as well. Because there's no point in making decisions to build engaging pathways if we're not engaging our nurses in those decisions as well.

Abby Burns (26:14):
Who does this work? Who should be involved in doing this work?

Allyson Paiewonsky (26:18):
I think you probably will want to partner as a nurse leader with your HR leaders as well. And I think adding to Miles, it's probably important too to have a clear understanding of why are your nurses leaving? What are the career opportunities that they're not finding at your organization? Because if they can't find a future with your organization, where are they going elsewhere to find it and why are they potentially leaving the profession entirely? And I think those are important things to have an understanding of so that you're able to build better career paths and fill some of those gaps that nurses aren't getting at your organization as well.

Miles Cottier (26:51):
And to that point, looking into the nuance a little bit more here, and this is what we're talking about when we're saying try and better understand the engagement and this engagement drivers, if you think about travel nurses, a lot of organizations would probably go, well, they're not really part of our core group that exists in this center, in this hospital, for example. If you ask them what they need, I guarantee a lot of those travel nurses would actually say, well, I was after flexibility the whole time. So granted, that's not going to be true for all of them, but if we can say, okay, we better understand your needs and we can offer something that's slightly more targeted toward them, then maybe you are giving them a bit more flexibility. Then they'll come and work at the bedside in your organization without moving around as much. So again, it comes down to really, really asking and trying to get a deeper understanding of what people want.

Abby Burns (27:41):
We know that nursing leaders are extremely capable as leaders, right? They have to flex clinical, administrative, people leadership among other things. What are the attributes, the skill sets, that are most important for them to tap into, to be successful in the type of work that we're talking about today?

Miles Cottier (28:01):
The thing I'm going to point to is, again, something that came up an awful lot, pretty much every conversation, and the attributes I would point to would be transparency, openness, listening, right? And being honest with what can and can't be done. So I think one of the biggest drivers of dissatisfaction is when maybe we are not being as honest as we can with nurses. The thing that came up huge amounts in the calls was that regular communication being a big issue.

(28:23):
So nurses actually have more opportunities and options and things to do than they've ever had before in healthcare, but we are doing a pretty poor job of communicating those options and the variability. So finding ways to broadcast everything that we have to offer as often as we can to as many people as we can, and through as many channels as we can, which I know is a lot of work, but it'll pay dividends in terms of the amount of people that are utilizing those resources and those pathways.

Allyson Paiewonsky (28:49):
Yeah. I think also to be successful here, you have to maybe lean into the discomfort of doing things differently. I think that we have to let go of the idea that there is a right way to build a nursing career, or that there is a single ladder that every nurse is supposed to climb. I think that this mindset doesn't reflect the reality of what nurses want today or what the next generation is going to need. So if we want to and need to meet them where they are, we need to be open to re-imagining what growth development and success can look like in this profession.

Abby Burns (29:20):
And looking at it through an engagement lens.

Allyson Paiewonsky (29:23):
Right. Exactly.

Miles Cottier (29:24):
Absolutely.

Abby Burns (29:26):
Well, Miles, Allyson, thank you for coming on Radio Advisory.

Allyson Paiewonsky (29:29):
Thanks for having us.

Miles Cottier (29:30):
Thank you for having us.

Abby Burns (29:38):
It makes sense that nursing leaders are focused on trying to retain their people, but what I heard from Miles and Allyson is the best way to do that is by looking upstream and finding out what engages them. Bonus, high nurse engagement actually serves the other business imperatives that are at the top of leaders' priority list. The best way to figure out how to engage your nurses across the span of their career, simply ask them. And remember, as always, we're here to help.

(30:33):
New episodes drop every Tuesday. If you like Radio Advisory, please share it with your networks, subscribe wherever you get your podcasts, and leave a rating and a review. Radio Advisory is a production of Advice Report. This episode was produced by me, Abby Burns, as well as Rae Woods, Chloe Bakst and Atticus Raasch. The episode was edited by Katy Anderson with technical support provided by Dan Tayag, Chris Phelps, and Joe Shrum. Additional support was provided by Leanne Elston and Erin Collins. We'll see you next week.