Nurse Engagement

Engagement isn’t a score on a dashboard; it’s how a shift feels when the work is heavy, and the support is real. We sit down with Dr. Katie Boston-Leary, Senior VP of Equity and Engagement at the American Nurses Enterprise, to unpack why retention lags when organizations chase surveys instead of fixing the work itself. From red-yellow-green mood checks that trigger real-time support to linking nurse well-being with patient “happiness,” we explore practical systems that help nurses show up ready and leave with energy to return.

We take on complexity creep—EHRs that promised simplicity but added clicks, protocols that squeeze critical thinking, and floating barriers that multiply friction across units. Katie names workload as the clearest love language leaders can speak: reduce physical strain, ease cognitive load, and design psychologically safe teams. We share strategies to personalize nurse residency through appreciative inquiry, train and evaluate preceptors for coaching excellence, and ensure the unit culture mirrors the care offered in the classroom. Because a strong residency can’t overcome a toxic environment, the day-to-day must change.

You’ll hear actionable ideas that boost nurse engagement and patient outcomes: real-time readiness signals, unit problem-solving boards, transparent internal mobility windows that keep talent in-house, and human-centered design that prioritizes patient time over screen time. If you’re a nurse leader, educator, or preceptor looking to make retention a byproduct of better work, this conversation offers a clear path forward. If it resonates, follow the show, share with a colleague, and leave a quick review telling us one change you’ll try first.

GUEST: Dr. Katie Boston-Leary is the Senior Vice President of Equity and Engagement at the American Nurses Association, addressing DEIAB and workforce challenges within the profession. Katie is an Adjunct Professor at the University of Maryland School of Nursing and the School of Nursing at Case Western Reserve University. She sits on numerous boards and national committees in nursing and healthcare and serves on the editorial advisory boards of Nursing Management, Nursing 2025, OADN, and ACHE. Katie leads the National Commission to Address Racism in Nursing Forum and organized ANA’s inaugural Equity Summit in Washington, DC. Katie is a 2024 ICN Global Nurse Leaders Institute Scholar and was previously identified by Health Leaders Media as “One of Five Chief Nursing Officers Changing Healthcare”. She also won the ICABA TD Bank 2023 Woman of Impact award, the 2024 Spectrum Circle Award for Innovation in Health, and the 2025 National Black Nurses Association (NBNA) President’s Trailblazer Award. She was inducted as a Distinguished Fellow at the Academy of Diversity Leaders in Nursing with the NBNA, is a Fellow with the American Organization of Nursing Leadership (AONL), the American Academy of Nursing (AAN), and the Faculty of Nursing and Midwifery with the Royal College of Surgeons in Ireland. She was recently named as an honored listee on Marquis’ Who’s Who in America. Katie authored two chapters in The Sage Encyclopedia of Multicultural Counseling, Social Justice, and Advocacy, the first encyclopedia focused on racism and Diversity, Equity, Inclusion, and Belonging. Katie was also featured in the award-winning documentary film, Everybody’s Work, funded by the Robert Wood Johnson Foundation. She recently co-authored a Sigma-published book titled Harmony by Design, Navigating Work and Life in Healthcare. 

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Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp to explore our resources for new graduate nurses and beyond.

Chapters

• 0:00 Welcome & Today’s Focus: Engagement
• 1:16 Meet Dr. Katie Boston-Leary
• 4:41 Redefining Engagement As Mutual And Dynamic
• 7:31 The Limits Of Surveys And Real-Time Signals
• 11:17 Patient Happiness Linked To Nurse Well-Being
• 16:06 Whole-Person Well-Being And Presenteeism
• 20:01 Entry Practices That Build Belonging
• 23:04 Culture, Softness, And Psychological Safety
• 26:07 Workload As Love Language: Fix The Work
• 30:05 Complexity Creep And EHR Broken Promises
• 35:12 Residency Gaps: Support Beyond Curriculum
• 39:42 Human-Centered Design Over Output Obsession
• 44:01 Retention Isn’t A Single Metric
• 46:30 What Works: Real-Time Mood Checks & Mobility
• 50:53 Closing Thoughts & Resource Suite

Transcript

00:00:01 Nicole Weathers
 
You're listening to the Beyond Nurse Residency Podcast, an educational series where we interview experts on all topics related to the transition of new graduate nurses into practice and beyond.
 
00:00:14 Nicole Weathers
 
I'm your host, Nicole Weathers, director of the Iowa Online Nurse Residency Program. Thanks for joining us. Let's jump in.
 
00:00:23 Nicole Weathers
 
As we step into the new year, many nurse leaders and nursing professional development practitioners are asking ourselves how can we improve retention, build stronger teams and create environments for nurses like to show up and work, and one word that keeps coming up in conversation as engagement. In my opinion, retention doesn't happen without engagement in fact.
 
00:00:42 Nicole Weathers
 
Study show that engaged nurses are significantly less likely to leave within that first year of practice. The challenge, though, is the recipe for engagement seems to be elusive for many.
 
00:00:53 Nicole Weathers
 
In today's episode, we're going to explore what engagement really means in nursing practice.
 
00:00:57 Nicole Weathers
 
We'll talk about.
 
00:00:57 Nicole Weathers
 
How it shows up in the first year, why it matters what gets in the way and what we can do to strengthen it. My hope is that you will walk away with practical strategies you can use to foster engagement in your own organization, especially for the newest nurses who need it most.
 
00:01:12 Nicole Weathers
 
So today, I'm thrilled to be back and talking about this topic, and I'm also very excited to welcome our guest, Dr. Katie Boston-Leary, to the conversation. So, I thought we could start off by having you just introduce yourself and share a little bit about your current work.
 
00:01:28 Dr. Katie Boston-Leary
 
Sure. Well, let me stop by saying I'm very honored to be on your platform, Nicole. I, I you know how I feel about you. So I I'm grateful to be in any space that you're in.
 
00:01:42 Nicole Weathers
 
Well, likewise. Right. So you just a quick little side note.
 
00:01:48 Nicole Weathers
 
Dr. Boston-Leary was kind enough to be a preceptor for me in my final semester of my DNP program. And.
 
00:01:58 Nicole Weathers
 
Worked with me for an entire semester and I learned so much from her and I continued to watch her do amazing things out there for the nursing profession and I am just beyond grateful that you're here with me today.
 
00:02:11 Dr. Katie Boston-Leary
 
Ah.
 
00:02:11 Dr. Katie Boston-Leary
 
Thank you. Well, it goes both ways, right? So I'm the senior VP of Equity engagement.
 
00:02:18 Dr. Katie Boston-Leary
 
At the American Nurses Enterprise and people always say what's this enterprise. And I thought this was the association. The enterprise includes the Association and ANCC that a number of people are very familiar with, with designations for Magnet and pathway and accreditation and excellence.
 
00:02:36 Dr. Katie Boston-Leary
 
Programs and then we have the foundation. So the enterprise is the umbrella term for all those different entities. I'm a nurse. I've been a nurse for over 30 years. I've been with ANA for close to six. Prior to that I was a chief nursing officer at a few hospitals in the state of Maryland, but made the long leap from.
 
00:02:56 Dr. Katie Boston-Leary
 
Practice to policy it and it's been a very rewarding experience.
 
00:03:03 Dr. Katie Boston-Leary
 
Because I get to work on a number of things, including nursing programs, things that impacts nurses the most, a lot of people know me for the work I've done in staffing.
 
00:03:14 Dr. Katie Boston-Leary
 
Now the work I do in is relates to diversity, equity and inclusion, but also workforce, right, which is staffing because those two things feed into each other. You know, if we create an environment where inclusivity is promoted
 
00:03:28 Dr. Katie Boston-Leary
 
and everyone is able to be their authentic selves to perform optimally. That does in turn strengthen the workforce and you cannot have a sustained a strength in workforce without creating avenues for diversity, equity and inclusion. So that's what I do and that's who I am. I do a lot of research. I also go on Capitol Hill.
 
00:03:50 Dr. Katie Boston-Leary
 
I do a lot of speaking engagements. I write articles.
 
00:03:54 Dr. Katie Boston-Leary
 
And I try to mentor and support my fellow nurses and nurse leaders any.
 
00:04:00 Dr. Katie Boston-Leary
 
Way that I can.
 
00:04:01 Dr. Katie Boston-Leary
 
So that's me in a nutshell.
 
00:04:03 Nicole Weathers
 
Well, I appreciate that introduction and I'm really excited to jump into our conversation. So we hear this word engagement a lot. It's tossed around. I feel like in workforce conversations, but I think it does mean different things depending on maybe the setting, so.
 
00:04:19 Nicole Weathers
 
Engagement is one of those. I think concepts too that feel a little abstract until we really dig into you know what it means. So before we get into talking all about the challenges, I think it would be good to maybe.
 
00:04:32 Nicole Weathers
 
Start by just.
 
00:04:33 Nicole Weathers
 
Grounding us in your perspective on engagement. So how do you define it? And?
 
00:04:37 Nicole Weathers
 
What does it look like?
 
00:04:39 Nicole Weathers
 
In our day-to-day practice.
 
00:04:41 Dr. Katie Boston-Leary
 
The engagement in the traditional sense has been mostly very one sided.
 
00:04:47 Dr. Katie Boston-Leary
 
I think it's been mostly seen as what people or employees or individuals show that they're connected and within a system or an organization and things like that. It's always been seen to me as this transactional term in terms of.
 
00:05:08 Dr. Katie Boston-Leary
 
We do all these, so let's see what we're getting in return. And I really do think that it's mutual. It flows both ways. If you're in an institution or a part of a system.
 
00:05:20 Dr. Katie Boston-Leary
 
You want to make sure that they're doing everything they can to keep you engaged and to validate or support your engagement. That would also then in turn show that you are engaged at the same time. I've also heard things about how with newer generations that are coming into the profession.
 
00:05:39 Dr. Katie Boston-Leary
 
Especially this started with the millennial generation there. There was this saying about.
 
00:05:45 Dr. Katie Boston-Leary
 
How you can engage this group? But they're not necessarily loyal to you. And with engagement, people look for loyalty, which I think is also in the wrong way to look at things. I think it's more about it's very dynamic in terms of what you get from me today maybe different tomorrow what you get.
 
00:06:05 Dr. Katie Boston-Leary
 
May this hour may be different the next hour and it's really because there are so many different things because we are fully like the systems that we operate in. Humans are also open systems and we're easily influenced by the environment, which could change and impact how we're seen.
 
00:06:24 Dr. Katie Boston-Leary
 
In how we engage and whether we want to continue to be engaged. So that's the way I kind of say it, I think there needs to be revisiting of what engagement really is of what it means to benefit both sides. Yeah, I like that because I do.
 
00:06:42 Nicole Weathers
 
Think when we think of engagement.
 
00:06:45 Nicole Weathers
 
A lot of times, especially in the space of nurse residency, it's like, are we seeing engagement, What are we seeing that new nurse do for us that shows that they are engaged. And I do think I like it. That does seem very transactional. And so I do like the fact that you kind of brought.
 
00:07:03 Nicole Weathers
 
Emphasis to this idea that it's a mutual thing and that it's dynamic and continually changing because it's not like we're going to achieve engagement one day and then that's it, right? It's going to be a continuous process, a continuous working towards sort of improvement or retaining that engagement. I guess you would maybe say.
 
00:07:25 Nicole Weathers
 
And so I think those are important things to kind of set the stage as we talk.
 
00:07:28 Nicole Weathers
 
About kind of what comes next.
 
00:07:30 Dr. Katie Boston-Leary
 
Oh, absolutely. Because we know that a number of institutions do employee engagement surveys.
 
00:07:37 Dr. Katie Boston-Leary
 
And that's where the crazy making starts, right? Because these surveys are done, and then the results said a lot of organization leaders want are not necessarily reflected in the scores. And then here comes the work, right? Well, let's do some interviews. Let's do some action plans and
 
00:07:58 Dr. Katie Boston-Leary
 
The other thing that I recall again being and it happens also because we do engagement surveys at ANA.
 
00:08:05 Dr. Katie Boston-Leary
 
By the from the time you complete the survey, so it's time to get the results. You don't know what you were thinking back then, but then you.
 
00:08:11 Dr. Katie Boston-Leary
 
As a leader. Like, OK, so. So what happened? Why did you respond this way?
 
00:08:16 Dr. Katie Boston-Leary
 
I said well.
 
00:08:16 Dr. Katie Boston-Leary
 
I don't know. I mean, when was it again, what was happening during that time? So I.
 
00:08:23 Dr. Katie Boston-Leary
 
Really do think that we have to.
 
00:08:26 Dr. Katie Boston-Leary
 
Get out of the quicksand on this right and look at engagement as a very fluid dynamic term where it's really something that changes on a dime based on what people face. One of the best lines that I heard from a mentor of mine.
 
00:08:42 Dr. Katie Boston-Leary
 
Said this because I was in this place where I felt like I was doing everything and nothing mattered and she said something that I'll never forget. And she said this to me over 20 years ago, she said a nurse is as.
 
00:08:55 Dr. Katie Boston-Leary
 
Good as their last shift.
 
00:08:58 Dr. Katie Boston-Leary
 
So as good as their last shift, Katie and that really is so true because.
 
00:09:05 Dr. Katie Boston-Leary
 
I can do all the pizza parties and all the recognition things that I want, but how did that last shift go? How did nurses feel? Do they do they feel valued? There's a new nurse that shared about how a nurse is one of being a nurse is one of the only professions where you can move from saving a life.
 
00:09:26 Dr. Katie Boston-Leary
 
One minute to another minute someone asking.
 
00:09:28 Dr. Katie Boston-Leary
 
You for a sandwich.
 
00:09:30
 
Right.
 
00:09:31 Dr. Katie Boston-Leary
 
So we have to continue to figure out how we keep our fingers on the pulses of engagement and adjust accordingly and move away from these traditional approaches to measuring it and create all this back end work of action planning and all the other things that comes with employee engagement surveys.
 
00:09:48 Nicole Weathers
 
OK, so I think moving on to talking about now why engagement is such a critical factor and then sort of the positive and negative downstream effects when maybe engagement is present versus when it's missing.
 
00:10:01 Dr. Katie Boston-Leary
 
I and I think we're stuck with this because we don't have another term. I've heard satisfaction but.
 
00:10:12 Dr. Katie Boston-Leary
 
I don't know that that is the word. When I was in the Middle East on an assignment years ago, because we have to also look at.
 
00:10:21 Dr. Katie Boston-Leary
 
How and which is not typically done but
 
00:10:26 Dr. Katie Boston-Leary
 
How we measure patient engagement and patient satisfaction against nurse engagement nurse satisfaction, because those two are correlated, they really are. And I don't know that correlation is happening when reports come out to say, well, you know, we know that patient agent was here where was nursing because.
 
00:10:45 Dr. Katie Boston-Leary
 
There are a lot of organizations that would overlook nurse engagement scores or employee engagement scores and chase patient satisfaction patient engagement scores.
 
00:10:56 Dr. Katie Boston-Leary
 
And those who feed into each other, right. So we have to. That's one way of addressing it differently. But I remember in the Middle East back to that, I remember touring this hospital is Saha in Abu Dhabi and they had me look at their board.
 
00:11:17 Dr. Katie Boston-Leary
 
Where they put up all their wins for periods of time quarterly.
 
00:11:24 Dr. Katie Boston-Leary
 
And they had patient happiness and happy with a ‘y’.
 
00:11:30 Dr. Katie Boston-Leary
 
Right. And I thought that was interesting and I said why? Why did you? Why are you using that word? Was that a direct translation, which was a foolish thing to ask because most of the these institutions are? They're English speaking because they have a lot of nurses from other parts of the world that care for patients. So.
 
00:11:51 Dr. Katie Boston-Leary
 
A lot of the language that they use to communicate in institutions there is.
 
00:11:56 Dr. Katie Boston-Leary
 
English, but that of course could vary when you interact with patients, right? We'll use the language that people can respond to, but.
 
00:12:06 Dr. Katie Boston-Leary
 
I was curious so.
 
00:12:07 Dr. Katie Boston-Leary
 
You know why not engagement? Why not?
 
00:12:11 Dr. Katie Boston-Leary
 
Experience. Why not satisfaction? Why happiness that is. That is a long reach, like, because no one's happy coming into healthcare, right and.
 
00:12:21 Dr. Katie Boston-Leary
 
But the only groups that you can say that for of.
 
00:12:23 Dr. Katie Boston-Leary
 
Course if you.
 
00:12:25 Dr. Katie Boston-Leary
 
If the outcome is different, what you intended and you know what you didn't, what you expected did not happen and it's a better outcome, you're kind of happy, but maybe more relieved or the best example is having a baby. Of course people are happy, but then a whole new set of worries.
 
00:12:43 Dr. Katie Boston-Leary
 
Come to mind, right?
 
00:12:45 Dr. Katie Boston-Leary
 
So who is completely happy? So why would you choose that? And they?
 
00:12:50 Dr. Katie Boston-Leary
 
Said it was intentional.
 
00:12:52 Dr. Katie Boston-Leary
 
They said it was intentional because they felt that they have to set the bar for that being what they strive for, like we know that this is the last place you.
 
00:13:04 Dr. Katie Boston-Leary
 
Want to be?
 
00:13:05 Dr. Katie Boston-Leary
 
But we're going to do everything in our power.
 
00:13:07 Dr. Katie Boston-Leary
 
To seek your happiness.
 
00:13:10 Dr. Katie Boston-Leary
 
Happy in terms of how we care for you happiness, not the circumstances, but just being happy with how you were treated, how you would care for the compassion that we showed and all.
 
00:13:21 Dr. Katie Boston-Leary
 
That, and I was like.
 
00:13:23 Dr. Katie Boston-Leary
 
That was that was just.
 
00:13:24 Dr. Katie Boston-Leary
 
So mind blowing to me.
 
00:13:26 Dr. Katie Boston-Leary
 
And this is the same institution.
 
00:13:29 Dr. Katie Boston-Leary
 
That talk about with what we just discussed about engagement that uses color codes for nurses when they show up for work.
 
00:13:38 Dr. Katie Boston-Leary
 
They put a color code up on the board to show how they're feeling, you know, red for not so good. Yellow for I'm kind of the middle and green for. I'm really good.
 
00:13:49 Dr. Katie Boston-Leary
 
And they just put up these dots on this wall, and they had a process.
 
00:13:55 Dr. Katie Boston-Leary
 
For when leaders would ascend and support if they saw more Reds and yellows  than green.
 
00:14:03 Dr. Katie Boston-Leary
 
So to me, that's the correlation. I was just talking about like we care real time about how you're feeling. And our goal is to measure whether our patients are happy with facts. So I think that is some of the shifting in these to happen when it comes to engagement.
 
00:14:21 Dr. Katie Boston-Leary
 
Because it feels like currency feels like I give you this. So now you need to prove to me that.
 
00:14:29 Dr. Katie Boston-Leary
 
What I'm doing is working and logically that makes sense, but again, it just feels so transactional, especially since we don't measure it real time.
 
00:14:40 Dr. Katie Boston-Leary
 
So, I think there is another word that we could probably use, but I'm not sure. Engagement is the word, but until we figure that out, we're stuck with engagement. But what we can do is measure it differently.
 
00:14:53 Nicole Weathers
 
That's a really interesting way to kind of look at it. And you know, I mean, a lot of times.
 
00:14:56 Nicole Weathers
 
When we think.
 
00:14:57 Nicole Weathers
 
Of like, what does healthcare need in?
 
00:14:59 Nicole Weathers
 
Terms of improved patient.
 
00:15:01 Nicole Weathers
 
Outcomes, it does seem like it. It obviously comes back to the staff who are providing the care for the patients and what they can.
 
00:15:10 Nicole Weathers
 
Give to that patient care depends on sort of that yellow, red and green system that you were talking about, right? I can only give what I have and if I'm.
 
00:15:20 Nicole Weathers
 
Coming in to.
 
00:15:21 Nicole Weathers
 
Work.
 
00:15:21 Nicole Weathers
 
With not being maybe in that Green Zone, you know that means that I do need a little additional support and additional help. So that is such an interesting I think way to look at it.
 
00:15:32 Nicole Weathers
 
And a really interesting way to do something more in real time. So you talked about like our engagement scores.
 
00:15:39 Nicole Weathers
 
And how? That's like one point in time. We capture it, we look at it, maybe finally three months 6.
 
00:15:44 Nicole Weathers
 
Months later and.
 
00:15:45 Nicole Weathers
 
You know, at that time is fleeting and it's gone and we can't do anything about it anyway. So that's a really, I think, just interesting idea of how you might be able to capture some of that a little bit better in real time. And this idea that maybe it's not engagement that.
 
00:15:59 Nicole Weathers
 
We need to be measuring.
 
00:16:01 Nicole Weathers
 
But it's these underlying.
 
00:16:02 Nicole Weathers
 
Ingredients, if you will, to what helps me.
 
00:16:04 Nicole Weathers
 
Show up and be engaged.
 
00:16:06 Dr. Katie Boston-Leary
 
Right. And.
 
00:16:07 Dr. Katie Boston-Leary
 
I think again, going back to being open systems.
 
00:16:12 Dr. Katie Boston-Leary
 
If I'm not doing well at home.
 
00:16:15 Dr. Katie Boston-Leary
 
You're not gonna get the you're. You're gonna get something from me, and some people are able to compartmentalize and shut things off when they get to the institution. But I bet you that and we rise to the occasion because of who we are. We're nurses when we're in the care setting. But if I'm not doing well.
 
00:16:35 Dr. Katie Boston-Leary
 
At home, if I'm barely making ends meet.
 
00:16:39 Dr. Katie Boston-Leary
 
I'm having issues with my within my family unit. The neighborhood that I live in isn't safe.
 
00:16:47 Dr. Katie Boston-Leary
 
Having car trouble?
 
00:16:49 Dr. Katie Boston-Leary
 
That is going to affect those scores.
 
00:16:52 Dr. Katie Boston-Leary
 
Now, I'm not suggesting that organizations be the are the ones to fix all the personal issues that nurses have, but there's an opportunity to show that you're open to and care enough where there's a place for that. If you want to bring it.
 
00:17:09 Dr. Katie Boston-Leary
 
Here.
 
00:17:10 Dr. Katie Boston-Leary
 
In the professional setting.
 
00:17:13 Dr. Katie Boston-Leary
 
I love work that Gallup did on this a few years ago.
 
00:17:19 Dr. Katie Boston-Leary
 
And there there's this book by Jim Clifton called, Well-Being at Work. And he talks about how his leaders.

00:17:27 Dr. Katie Boston-Leary

We have to care about all the various facets of well-being.

00:17:33 Dr. Katie Boston-Leary

For us to be able to move the dial on the relationship that we have with the people that we lead, so he talks about how we should care about social well-being, community, well-being, financial, well-being, fiscal well-being.

00:17:51 Dr. Katie Boston-Leary

Social well-being like all the different aspects of a person and the example they gave was you're not going to get high engagement from someone who dodges bullets to come to work every day or has to worry about their children.

00:18:07 Dr. Katie Boston-Leary

Dodging bullets to get home from school.

00:18:11 Dr. Katie Boston-Leary

And we have to create openings for us to assess the full well-being of the people that we employ or the people that we lead to make sure that we understand fully who's in front of.

00:18:26 Dr. Katie Boston-Leary

Us.

00:18:27 Dr. Katie Boston-Leary

Because we focus a lot more on absenteeism.

00:18:30 Dr. Katie Boston-Leary

From a.

00:18:32 Dr. Katie Boston-Leary

Human resources, perspective and.

00:18:35 Dr. Katie Boston-Leary

Managing a people perspective, but the presenteeism piece is real too. Where you are here, but not really because of all the other things that you face. So how do we shine a light on the presenteeism piece of the people we lead.

00:18:52 Dr. Katie Boston-Leary

Not necessarily. Presenting ourselves as a fixer of all their issues.

00:18:58 Dr. Katie Boston-Leary

But to at least show that we care, how do we do that?

00:19:02 Nicole Weathers

I think there's two things that kind of come to mind. So, one is we had Dr. Rose Sherman on a podcast, but she talked about kind of the same idea and she kind of used the term like social determinants of work health. So, these aren't things that work can necessarily fix for you, but they are things that impact your ability to work, right your ability.

00:19:22 Nicole Weathers

To show up.

00:19:23 Nicole Weathers

And get “ engaged.”

00:19:26 Nicole Weathers

And the other thing I always think about when we talk about this is that, and I'm sure you've seen this, that video that Cleveland Clinic put out years ago around like human empathy, right and the.

00:19:37 Nicole Weathers

People walking down.

00:19:38 Nicole Weathers

The hall and you don't know what their story is, and I think you know the same holds true when you have an employee coming into your organization. Like you don't know what they're bringing with you.

00:19:46 Nicole Weathers

So having that.

00:19:47 Nicole Weathers

Level of understanding and compassion that everybody has something, can really, I think, go a long ways and just making employees feel a little bit more. You didn't care about absolutely.

00:19:59 Nicole Weathers

How do we do this? Like, are there things that we can do to foster stronger engagement? What are maybe the big key ingredients that you see that that maybe organizations need to think a little bit more about?

00:20:14 Dr. Katie Boston-Leary

So, I think it starts on entry initial employment.

00:20:17 Dr. Katie Boston-Leary

And asking questions beyond what we hope to get from people in terms of their skill set. And I think this was an example from the Well-Being at Work book. It really requires us to understand other than the skills that's required of you to perform in this role.

00:20:37 Dr. Katie Boston-Leary

What other abilities do you have? What other things that are present that could impact your ability to

00:20:46 Dr. Katie Boston-Leary

Be 100% productive and effective at work. What motivates you when are you?

00:20:52 Dr. Katie Boston-Leary

At your best.

00:20:54 Dr. Katie Boston-Leary

When are you at your worst? What can your team count on you for?

00:20:59 Dr. Katie Boston-Leary

I think setting that up at the start, there's the institution level, but then there's also the department level.

00:21:08 Dr. Katie Boston-Leary

That's what starts to build this sense of someone feeling that you really do care about me and if you care about me with what you get back is all that you can get from me.

00:21:23 Dr. Katie Boston-Leary

Not just from the skill sets that I have, but you're going to have. You're going to have my heart too.

00:21:29 Dr. Katie Boston-Leary

In everything that I do, and I think for any leader, it's a great team exercise.

00:21:37 Dr. Katie Boston-Leary

It's kind of like that show on NBC, The Story of Us.

00:21:41 Dr. Katie Boston-Leary

Like. How do you build a Story of Us through your team so everyone knows where everybody is and what they bring to the table, and not just from a nursing skills perspective, but everything else. Because nurses are so multi-layered, it's hard to find a nurse that.

00:21:57 Dr. Katie Boston-Leary

Only, like all I do is nursing. There's nothing else other than care for my family. Like there's so many other things they bring to skill sets, experiences, passions.

00:22:08 Dr. Katie Boston-Leary

And I think it's that is something that could be that should be extracted and understood and leverage appropriately. So, people do feel like, Oh my gosh, OK, do you know that I love crocheting in the break room. There's a basket of materials for me to crochet or during my break like.

00:22:28

Like how do.

00:22:29 Dr. Katie Boston-Leary

We unearth.

00:22:30 Dr. Katie Boston-Leary

Those things.

00:22:31 Dr. Katie Boston-Leary

So that that sets up an environment, people feel that you care, that then turns into people. You give people giving you their all.

00:22:38 Nicole Weathers

Yeah, absolutely. And I think I always think about this, especially from a nursing perspective. So, we've figured out that that's how we need to treat our patients, right. This holistic view of the patient, not just the disease that they present with, but all the other things that they need.

00:22:53 Nicole Weathers

To be to live a healthy.

00:22:54 Nicole Weathers

Life. And so why is it?

00:22:55 Nicole Weathers

So hard do you think?

00:22:57 Nicole Weathers

For us to do the same.

00:22:59 Nicole Weathers

For our employees.

00:23:00 Dr. Katie Boston-Leary

Oh, it's because of the culture and traditional sense of what nursing is supposed to be. That still reigns through today. We've been conditioned to believe that nursing is tough. And for you to be in it, you have to be tough and you have to weather the storms. And that's true to a certain extent, but.

00:23:19 Dr. Katie Boston-Leary

There's a softness that we always want nurses to exude when they're in front of patients, but we don't build it into the systems where people work, where it changes, how we address and deal with, interact with each other.

00:23:35 Dr. Katie Boston-Leary

How leaders also support their teams and vice versa, there's this.

00:23:40 Dr. Katie Boston-Leary

Constant play of hardness and softness that is OK here, but it's not in within the patients confines. But outside of that it's not. And I think that is part of what his made it so hard for people to flip the switch. Now some organizations and some leaders are doing really great.

00:24:00 Dr. Katie Boston-Leary

Things I remember reading this article, I think there was this nurse.

00:24:04 Dr. Katie Boston-Leary

That won the Nurse Leader award, Daisy Nurse Leadership Award, and she made it her goal. One of her staff said that she stated that her goal is to make the workplace or the environment feel like Disney. That's a yeah. Wow, exactly. So how do we?

00:24:25 Dr. Katie Boston-Leary

And doing that doesn't mean that you don't take the work seriously. It just means that you care about everything you care about patient care but patient, but you care about the.

00:24:33 Dr. Katie Boston-Leary

Care of your nurses too?

00:24:34 Dr. Katie Boston-Leary

So I think that is the thinking. It's a lot of what we've only reserved for patients should be turned inward for us to care for ourselves better and it's going to take some structural systemic and psychological shifts for us to start thinking and acting that way.

00:24:55 Nicole Weathers

So definitely this.

00:24:56 Nicole Weathers

Give organizations or leaders valuing kind of the whole nurse is what I'm hearing you say. You know one of the maybe key ingredients to engagement are there other things that you've identified that you know must be present for a nurse to be engaged from like the organizational standpoint? Yeah.

00:25:16 Dr. Katie Boston-Leary

Address their issues.

00:25:18 Dr. Katie Boston-Leary

Address their concerns and we know that a lot of the concerns and issues that nurses have to practice today.

00:25:26 Dr. Katie Boston-Leary

A multi so multifaceted and layered, but at least make an attempt to work on it with them. I engage them in that process to address those issues and keep track of them so that they see that you know, we remember we started here, this is where we are now. We're making progress.

00:25:47 Dr. Katie Boston-Leary

Cause it's hard.

00:25:47 Dr. Katie Boston-Leary

To see it when you're in it.

00:25:50 Dr. Katie Boston-Leary

So, workload has been one of the things that we have not dealt with enough in nursing as a major issue for nurses. And if we start really addressing the workload issue and not just the physical workload, but it's the cognitive workload, it's the psychological workload, it's the.

00:26:10 Dr. Katie Boston-Leary

Physical I already said that, but all the different aspects of workload.

00:26:14 Dr. Katie Boston-Leary

That makes it hard for people to want to stay.

00:26:18 Dr. Katie Boston-Leary

In the profession.

00:26:20 Dr. Katie Boston-Leary

Needs to be addressed and I think once those things are addressed, that is a love language that nurse leaders can have for the teams that they lead.

00:26:27 Dr. Katie Boston-Leary

Like show me you care about addressing my issues and once you address my issues and have me at the table with you to address those issues, that is a big-time way of showing me that you care about me.

00:26:40 Dr. Katie Boston-Leary

Even the personal relationships, right, that's the currency.

00:26:44 Dr. Katie Boston-Leary

Why is it different in the professional setting?

00:26:47 Nicole Weathers

Absolutely. Like I, I mean, as you're talking about this in my brain, I'm thinking like physical safety. And do I feel safe at work, professional safety. So that's where, you know, safe staffing and things like that come into place. But also, this idea maybe too of psychological safety. And do I feel comfortable speaking up about my issues and concerns that they are going to be heard?

00:27:09 Nicole Weathers

And dealt with, and that it's not going to be two fingers pointing back at me that say that I'm the reason that this is an issue, but that they will actually hear, and act, and do something.

00:27:22 Dr. Katie Boston-Leary

Right. Because all those things lead to well-being continuum for nurses, where if you're not addressing my issues and every day I come in, it feels like it's becoming harder and harder for me to do the simplest things, the simplest things.

00:27:38 Dr. Katie Boston-Leary

Then I'm stressed. Then I feel burnt out.

00:27:43 Dr. Katie Boston-Leary

Then the apathy sets in.

00:27:46 Dr. Katie Boston-Leary

Then depression comes.

00:27:48 Dr. Katie Boston-Leary

And then in some cases, worst case scenarios, suicidal ideation. So we have to connect all these things. We can't say that we care about nurses well-being and by and not address their issues or say or brush it off to say well, because that's what's required because you signed up to be a nurse.

00:28:09 Dr. Katie Boston-Leary

This is what it is. This is the nature of the beast. Take it.

00:28:13 Dr. Katie Boston-Leary

Or leave it.

00:28:14 Dr. Katie Boston-Leary

That's part of the reason why we're still here, because that mentality still exists in a number of institutions and people that.

00:28:23

Need.

00:28:24 Dr. Katie Boston-Leary

Those institutions, so we have to disrupt that.

00:28:27 Nicole Weathers

Because you can know what you signed up for and it still for a lot of human beings. I mean, you can't continually take that right. Like you can know that the work that you signed up for was going to be hard. They were going to have to work odd shifts that.

00:28:40 Nicole Weathers

You were going?

00:28:40 Nicole Weathers

To have to be away from your family on holidays. That.

00:28:43 Nicole Weathers

You know, patients.

00:28:45 Nicole Weathers

Needs often come first. You can know all of that going into nursing, but that doesn't make it any easier.

00:28:51 Dr. Katie Boston-Leary

It doesn't, and there's this belief that, you know, I'm dating. I'm dating myself. But you know, there used to be the Road Runner cartoon where he will clock in every day. Him and Wild E. Coyote.

00:29:02 Dr. Katie Boston-Leary

The clock in every day, and then they'll chase each other all day, and then they'll clock out.

00:29:09 Dr. Katie Boston-Leary

We'll see you tomorrow. There is no real reset.

00:29:12 Dr. Katie Boston-Leary

In nursing, where I have a horrible day today, I go home, I sleep it off, spend time my family, sleep it off and come back the next day. And you know it's a clean slate again. No such thing. The body keeps score, right? This is one encasement. And this is all compounding.

00:29:32 Dr. Katie Boston-Leary

And accretive. So, after a while to your point, Nicole, it gets to this point where you say I can't do this anymore.

00:29:42 Dr. Katie Boston-Leary

And it could happen the and it could be one little thing that can get you to that place of saying I'm done.

00:29:49 Dr. Katie Boston-Leary

And people wonder why it's just this little thing that happened. No, it's not. It's the accumulation of all the things that I've been housing in this encasement all this time that has not been dealt with. That has caused me to say I'm good now. I'm going to go pursue something else.

00:30:07 Nicole Weathers

Talking to a lot of people and this comes up a lot, wonder if you would speak to this a little bit so you.

00:30:12 Nicole Weathers

Know this whole.

00:30:14 Nicole Weathers

This whole mentality sometimes too of like, well, I mean, I came up as a nurse and, you know, 20 years ago, we just put on our big girl panties and we dealt with it right, like, or we just like.

00:30:25 Nicole Weathers

We just got through it.

00:30:26 Nicole Weathers

Kind of that toughness mentality.

00:30:28 Nicole Weathers

And that's just not happening today and maybe you could speak a little bit to what's changed and why maybe it's not happening the same way today.

00:30:39 Dr. Katie Boston-Leary

Well, I just likens to the conversations that we'll have with our parents and grandparents.

00:30:44 Dr. Katie Boston-Leary

Will say you know you don't you we.

00:30:47 Dr. Katie Boston-Leary

Had it worse than you?

00:30:48 Dr. Katie Boston-Leary

You didn't have shoes.

00:30:49 Dr. Katie Boston-Leary

We tied bread bags around our feet. We didn't have cars. We walked everywhere like and we know how off putting that is.

00:30:58 Dr. Katie Boston-Leary

And yes, that does play out in nursing, where it's like, well, you know, I deliver care during a time where we had 10 patients, 12 patients at a time and you just guys just have 6.

00:31:10 Dr. Katie Boston-Leary

I think what people tend to be missing when they say that is they're not taking everything into account. The work may have been harder then, but it was a lot simpler.

00:31:18 Dr. Katie Boston-Leary

Even though the workload supposedly is not hard, but again we just went through the different layers of workload. It's not just physical and there's so many other things that nurses have to contend with to practice.

00:31:32 Dr. Katie Boston-Leary

So, when you think about all the complexities, there's nothing simple anymore. Complexity seems to be sexy. Like, let's make it hard for you and you're going to really like it because it requires you to really twist your brain to use it. It's not as intuitive. Like, why is that? OK, so I think there's simplicity piece that we're not seeing.

00:31:53 Dr. Katie Boston-Leary

To you know, with the then to now where?

00:31:56 Dr. Katie Boston-Leary

It's everything. It's about everything that I have to do, care for, address, manage.

00:32:03 Dr. Katie Boston-Leary

That should make me want to be able to give the care that a patient deserves compared to then where it was physically more physically taxing, but they didn't have to deal with computers.

00:32:14 Dr. Katie Boston-Leary

They didn't have to deal with all these different subspecialty docs where you don't know who the attending is. They didn't have to deal with polypharmacy in all these different ailments. The patients come to the door. It's like there's no easy patient.

00:32:28 Dr. Katie Boston-Leary

Anymore it there's so much complexity now in the world compared to back then, and that's what tends to be missing.

00:32:38 Dr. Katie Boston-Leary

You know, in these arguments and when you talk to folks, they'll say, well, yeah, what's complex? Yes. But we're talking about a continuum of complexity, too. And I think that is the difference with this time vs. “Back Then”.

00:32:53 Nicole Weathers

Right, right. I mean, I think about.

00:32:56 Nicole Weathers

Very first year in nursing like hand, you know writing patient documentation and like checking boxes that this med was given or you know very simple. Not like I have to navigate through these 17 screens to find the place where I can now document care. And I have to do it here and there and everywhere. So, there's just so much more I think in terms of.

00:33:16 Nicole Weathers

Complexity that factors in.

00:33:19 Dr. Katie Boston-Leary

I mean if you think about, there is this whole thing about, Why don’t nurses float? We all know what that comes with. When you float to another unit, all the permissions are new.

00:33:32 Dr. Katie Boston-Leary

Like all the access that you had in.

00:33:34 Dr. Katie Boston-Leary

This one place.

00:33:35 Dr. Katie Boston-Leary

Is not in this other place. Phone calls has to be made and it's not just accessing the documentation. The supply rooms have different codes and you know it's like all like even the bathrooms have codes and it's so. So the complexities is what it's what makes it harder now than it was even.

00:33:55 Dr. Katie Boston-Leary

A couple of years ago and I say that the EHR in Healthcare is one of the most, the biggest broken promises because there was a promise of simplicity.

00:34:08 Dr. Katie Boston-Leary

With EHR’s that never came, there was also a promise that the physical chart will be gone. That hasn't happened. So now I gotta look at two things. I gotta find things in the chart physical chart. And I got to.

00:34:20 Dr. Katie Boston-Leary

Look at things in the computer.

00:34:22 Dr. Katie Boston-Leary

Right. And I gotta look at my patient and I gotta deal with the family.

00:34:25 Dr. Katie Boston-Leary

And all these other disciplines that contribute to care. So it's just all of those things. What's that movie? Everything Everywhere All at Once. It's Everything Everywhere All at Once right now. And it's getting worse.

00:34:41 Dr. Katie Boston-Leary

We've subconsciously built a system for nurses to spend less time with their patients.

00:34:49 Nicole Weathers

Oh, absolutely. I think if nurses could just.

00:34:52 Nicole Weathers

Go and do.

00:34:54 Nicole Weathers

Their patient care, satisfaction and engagement would probably skyrocket, right? It's all the other things that make it.

00:35:00 Dr. Katie Boston-Leary

That's where the joy is, right? And that is becoming more and more a lost art.

00:35:07 Dr. Katie Boston-Leary

Everything that we're building in these systems is making you spend less time like I'm being willed by systems and technology more than what my patients telling me and their families.

00:35:20 Nicole Weathers

So we talk a lot with new nurses. We work with organizations of course in this program related to nurse residency programs. Nurse residency programs I think for a lot of organizations.

00:35:33 Nicole Weathers

Are a really good tool to begin to engage nurses from day one when they're starting at the organization, right. We're working on competency. We're working on giving them the safe space to learn to develop those relationships. A lot of the things that maybe we've talked about today in terms of key drivers of.

00:35:53 Nicole Weathers

You know, getting an engaged.

00:35:55 Nicole Weathers

Nurse. However, they don't always.

00:35:57 Nicole Weathers

Equal retention. So just because maybe I've put this residency program into place, we still might be losing nurses, right? They might be leaving. Do you have any thoughts around that and maybe what leaders are, maybe it's the way they're looking at nurse residency programs, how they're hoping nurse residency programs maybe solve

00:36:18 Nicole Weathers

all of their challenges, maybe you could talk to us a little bit about that, especially when it comes to first year nurses and engaging first year nurses and retaining those first year nurses.

00:36:28 Dr. Katie Boston-Leary

The one of the toughest transitions to make in life, actually, because especially lately we just talked about the current day

00:36:38 Dr. Katie Boston-Leary

nursing practice, you have to go from.

00:36:43 Dr. Katie Boston-Leary

Being in this somewhat protected environment to now everything that you do could be the difference between life and death. And then that is all contingent on you having a great support system in the institution with a good preceptor, mentor, coach, what have you.

00:37:03 Dr. Katie Boston-Leary

And we know that in a lot of institutions that's lacking. So, I think there's a lot of stock being put into well we have this residency program.

00:37:13 Dr. Katie Boston-Leary

And I was one of those CNO's. But we don't take a good enough look at what

00:37:19 Dr. Katie Boston-Leary

also, is the wrap around that program to make it successful?

00:37:24 Dr. Katie Boston-Leary

And I remember having a nurse residency program where it really became a place for nurses to come and cry because there was no room for that, a space for that with their preceptors and rather than a lot of times, we'll have the curriculum set up where we're going to go over delegation and.

00:37:44 Dr. Katie Boston-Leary

And the, you know, the gender into the multi-generational workforce, you know you have your curriculum and you go, we can't do this today. We got to deal with this issue like because once one person starts crying and just sets off this domino effect. So, the support then tends to fall on the people running those programs who have not received any

00:38:04 Dr. Katie Boston-Leary

coaching or training to deal with those emotions and some people do a decent job. Some people don't manage it.

00:38:14 Dr. Katie Boston-Leary

At all and some people.

00:38:16 Dr. Katie Boston-Leary

Do a great job, but I think it's more. There are more instances of people not doing dealing with it that well because again, we've been conditioned to believe that the emotions don't belong here unless you're truly happy. Right? And that's the only emotion we want to see.

00:38:33 Dr. Katie Boston-Leary

So we have to really think about how we create room for understanding fully. I have this program and I have invested in this program, but

00:38:43 Dr. Katie Boston-Leary

Do we have receptors that are supportive and strong and they're not subjecting people to what they probably went through the trial by fire they went through to get on the other side, do we have a place for nurses to be able to rate their preceptors?

00:39:02 Dr. Katie Boston-Leary

And not have it be a one-sided affair where it's the preceptors rating the residents do we have a way of them also assessing who they report to the charge nurse, the manager in terms of providing them that support.

00:39:16 Dr. Katie Boston-Leary

How do we also bridge them in terms of their skill sets? Because we know that more and more the programs are not able to give them the hands-on clinical skills that they need. So, they're coming in less and less prepared around the time the patients are becoming sicker and sicker. What does that bridge?

00:39:36 Dr. Katie Boston-Leary

Look like to make sure we shore up those skill sets and what and are we assessing truly assessing the skill sets that they're coming to the table with when they are hired on.

00:39:47 Dr. Katie Boston-Leary

Rather than the typical, well you know, we're going to do an IV skills day and you know, I mean, like, how do we really understand when the nurse leaders bring in agency nurses. There's a skills checklist that they have to do that checks through not just what you've done but what equipment you've touched.

00:40:07 Dr. Katie Boston-Leary

What you've been exposed to in terms of care methodologies and things like that, we have to have that for these nurses too.

00:40:16 Dr. Katie Boston-Leary

Because some of them do come to the table with some more than others may come in because they probably have experience in a hospital setting as a patient care tech or what have you. They may need less, but there might be some folks that are making a complete switch from working the bank to being in nursing.

00:40:35 Dr. Katie Boston-Leary

And I just went to this program and I'm supposed to have these skill sets, and no one's really doing taking the time to assess what you bring to the table on the front end. So, we usually are not using appreciative inquiry to understand what they bring to the table we're actually.

00:40:52 Dr. Katie Boston-Leary

Assessing them from a place of lack. Like what skills do you lack?

00:40:57 Dr. Katie Boston-Leary

And we'll figure out whether we can meet those skills and what you're under the gun because you're supposed to be done in X amount.

00:41:04 Nicole Weathers

Of time and this is our standard program. So this is what we're going to do, because this is how we built it. Yeah, that's something we've been talking a lot about as a team is how can we, how can we better personalize this experience? I mean, we know that research shows that these are the skills that are often lacking. These are the things that we can work on.

00:41:20 Nicole Weathers

But that isn't necessarily maybe true anymore, because, as you said, people are coming in from very different backgrounds. They bring a lot of unique things with them. And I think taking that into consideration.

00:41:31 Nicole Weathers

One of the things I want to just back up to and you were kind of talking about this as far as you know, we put this residency program into place.

00:41:40 Nicole Weathers

We are providing them with the competencies and the skills and the maybe even the preceptor connection. Hopefully all preceptors are trained and they're doing a good job, but I sometimes think or wonder, I guess if some of our retention issues are not necessarily from the residency program or.

00:41:59 Nicole Weathers

For what it's maybe missing, but the fact that our work environments don't necessarily mimic the kind of you know, care and support if you will, that they're getting in this residency program. So, they go to the residency program, they talk about the skills they have this great person who's working with them through some of their experiences, and then they go out into the work environment.

00:42:19 Nicole Weathers

And.

00:42:20 Nicole Weathers

It's kind of can feel like a battleground sometimes, and so sometimes it's maybe that discrepancy that is also challenging for building engagement retention.

00:42:31 Dr. Katie Boston-Leary

Yeah. I think the because there's a need for there to, for human centered design, like we're working a lot of systems that were designed by humans, but they're not for humans.

00:42:42 Dr. Katie Boston-Leary

Like they're really set up for superhumans. And I remember listening to this podcast with this, this leader of his tech company.

00:42:54 Dr. Katie Boston-Leary

Who had to will her team to understand that

00:42:59 Dr. Katie Boston-Leary

They need to listen to people in building these systems and they were annoyed at that because it's really more about the sterile environment of, well, it's the outcome that matters. A lot of the steps in between don’t.

00:43:16 Dr. Katie Boston-Leary

We just need to train them to do it.

00:43:18 Dr. Katie Boston-Leary

And that's the case for a lot of systems that we.

00:43:20 Dr. Katie Boston-Leary

Use in healthcare.

00:43:23 Dr. Katie Boston-Leary

The output is more like EHR as I remember when we went live with the new EHR system. I remember hearing this loud and clear from people at high level saying, “We’ll know everything's working when we drop a bill.”

00:43:38 Dr. Katie Boston-Leary

Like, What? What about all the other things in between? And they would say that.

00:43:44 Dr. Katie Boston-Leary

Constantly. When we know we can drop a bill, we know that we've had a successful go live.

00:43:48 Dr. Katie Boston-Leary

Like no, you can still drop a bill, and people would be suffering in the middle? So, are we looking at the right things and what we design because we assume that just because humans design something means that it's being designed for humans? No, it's actually being designed for the output that's intended.

00:44:08 Dr. Katie Boston-Leary

And sometimes the output that was intended is not even met. It creates something else, right? So there has to be attention paid to the true outcome of what's being built and the fact that everything should be centered around humans, human centered design. And I hate saying this, but for the most part, for a lot of things of use,

00:44:28 Nicole Weathers

It's loss.

00:44:31 Dr. Katie Boston-Leary

In our systems.

00:44:33 Dr. Katie Boston-Leary

Or even if it was built initially, by the time we continue to tweak it and set up like how heavily look at how.

00:44:40 Dr. Katie Boston-Leary

Heavily protocolized nursing is.

00:44:43 Dr. Katie Boston-Leary

And we talked for years and continue to talk about how, you know, we want people to bring in their critical thinking to.

00:44:51 Dr. Katie Boston-Leary

What they do?

00:44:52 Dr. Katie Boston-Leary

And how they practice. But because of fear based thinking and how litigious and risky our environments are.

00:45:00 Dr. Katie Boston-Leary

It’s heavily protocolized and the systems then that you have to work with in a very unforgiving. Like if it doesn't allow you to color outside the.

00:45:10 Dr. Katie Boston-Leary

Lines a little.

00:45:11 Dr. Katie Boston-Leary

Bit based on what you see, what your patient is presenting.

00:45:16 Dr. Katie Boston-Leary

So, all those things need to be looked at for us to get on the other side of where we are so that we can have retention and engagement and people would feel happiness to a certain degree when they enter into these spaces to practice as a nurse.
 
00:45:34 Nicole Weathers
 
I mean I think you know what you said about, We'll know that EHR is working when we drop a bill. I feel like that same mentality is applied to nurse residency. We'll know our nurse residency program is working when we retain our staff. But there's so many. Like you said, there's so much more kind of in the middle of that that we aren't considering.
 
00:45:52 Dr. Katie Boston-Leary
 
Right. Because we don't take into account.
 
00:45:54 Dr. Katie Boston-Leary
 
Why they're staying?
 
00:45:55 Dr. Katie Boston-Leary
 
We just care about the fact that they're staying. They could be staying because they don't want to disrupt their benefits. They could be staying because they're waiting for another year or two to make sure that it doesn't look on their resume as if they're job hopping, right. There's so many reasons people may be staying, not necessarily because.
 
00:46:15 Dr. Katie Boston-Leary
 
The system's working, they just did the math and said this is where I am for now.
 
00:46:23 Dr. Katie Boston-Leary
 
But eventually I may be over here because I need to continue to pursue happiness. A lot of nurses throughout their careers are pursuing that.
 
00:46:34 Dr. Katie Boston-Leary
 
And unfortunately, some towards the end of their careers never get that because we haven't zoomed in on the fact that this is an important thing that we have to address in the profession and it's sad. 

00:46:50 Nicole Weathers
 
It is absolutely. Well, Katie, we've talked about so many great things today. We've talked about engagement, why it's important, some ingredients for success. We talked about, you know how this looks in nurwe residency, but before we go, I have one last question I want to ask you when it comes to nurse engagement, what's one thing you've seen an organization do that you think has made a significant difference?
 
00:47:10 Nicole Weathers
 
Something we wish maybe more organizations would adopt as we enter 2026.
 
00:47:15 Dr. Katie Boston-Leary
 
Well, I gave you an example earlier with what I saw in Abu Dhabi, right where they had this continuous effort to assess where their nurses are.
 
00:47:25 Dr. Katie Boston-Leary
 
And they are striving for to find a place of happiness at work, for their patients and for their patients. And I think that that correlation is important. The other example is that, you know, with the nurse that I mentioned that won the Daisy Award like.
 
00:47:45 Dr. Katie Boston-Leary
 
My job, beyond the typical things that I have to do from a human resource perspective, but my job is also to make this environment conducive for you.
 
00:47:56 Dr. Katie Boston-Leary
 
To be able to function optimally.
 
00:48:00 Dr. Katie Boston-Leary
 
So Disney-ing up.
 
00:48:02 Dr. Katie Boston-Leary
 
My department is another example too, so I've seen both examples amount to longevity, retention, engagement, even for nurses because people tend to leave for various reasons, not necessarily because you know they're not happy with their workplace or their manager.
 
00:48:24 Dr. Katie Boston-Leary
 
But people may leave for whatever reason, but I've also seen examples where people so love where they are, they make it their job and their duty.
 
00:48:32 Dr. Katie Boston-Leary
 
To find their replacement before they leave, like they'll go out and recruit someone else from another department. Say you sure don't wanna work in my department if I'm leaving, but it would be great for you.
 
00:48:41 Dr. Katie Boston-Leary
 
To come here, I've.
 
00:48:42 Dr. Katie Boston-Leary
 
Also seen examples where because people move for different reasons because they want to change specialties and things like that and their specialty areas.
 
00:48:52 Dr. Katie Boston-Leary
 
I've seen organizations embrace that.
 
00:48:55 Dr. Katie Boston-Leary
 
And take remove the fear from that by setting up a period of time for people to put in systematically, you know? OK, like draft day in sports. Right. Like, I'm in Med surg today and I want to be in.
 
00:49:09 Dr. Katie Boston-Leary
 
L&D.
 
00:49:11 Dr. Katie Boston-Leary
 
I'm going to without any fear, without any.
 
00:49:15 Dr. Katie Boston-Leary
 
Repercussions or guilt and shaming for wanting to leave? I'm going to create this space for people to just say, OK, I have this skill set and because of my passion I will not work here.
 
00:49:26 Nicole Weathers
 
I want to be over there and it's OK.
 
00:49:29 Dr. Katie Boston-Leary
 
And I've seen that work in a beautiful way where there's this open call for people to put in in this centralized space where they feel they want to transfer to. And again, it's good to do that because instead of leaving them entirely, losing them entirely to another organization, you're keeping them the organization and they're just moving around and they'll put in their request.
 
00:49:50 Dr. Katie Boston-Leary
 
In the centralized place, all the leaders will review it. But then there's an understanding that from the leaders that you are not going to go back and shame these folks to you.
 
00:49:59 Dr. Katie Boston-Leary
 
Know.
 
00:50:00 Dr. Katie Boston-Leary
 
When they when they're making these requests.
 
00:50:02 Dr. Katie Boston-Leary
 
And because that's the first reaction, how could you leave after all that I've done for you and all the things we had and all the hugs that we shared? Like, how could you like?
 
00:50:11 Dr. Katie Boston-Leary
 
That should not be.
 
00:50:11 Dr. Katie Boston-Leary
 
Happening. So there's a there's also that part of it, and it's a very beautiful thing where they have overall retention because people just tend the move around within the organization.
 
00:50:22
 
Which is what you.
 
00:50:23 Nicole Weathers
 
Want absolutely, and I think that's becoming more and more of the norm too, that people aren't staying, they're not going to stay for 30 years in the same role. They want some of that mobility. And so how do we embrace that instead of having it work against us?
 
00:50:38 Nicole Weathers
 
Well, Katie, I feel like we could talk and talk.
 
00:50:40 Nicole Weathers
 
And talk about.
 
00:50:41 Nicole Weathers
 
This topic forever, but I just want to again thank you for coming and sharing your wisdom and expertise on this topic and I really appreciate all that you've shared with us today.
 
00:50:53 Dr. Katie Boston-Leary
 
Happy to be here and thank you so much for having me. Always a pleasure to talk to you, Nicole.
 
00:51:00 Nicole Weathers
 
Wait before you go, I want to make sure you know all about our suite of resources you can use to support your new graduate nurses. This includes our Academy, a coaching program designed for organizations as they prepare for the implementation, and ongoing sustainability of a nurse residency program. Work one-on-one with residency program.
 
00:51:21 Nicole Weathers
 
Experts to make sure your organization is residency ready.
 
00:51:25 Nicole Weathers
 
Our clinician well-being course is an asynchronous online course that aims to enhance the well-being and resiliency of healthcare professionals, equipping them with the necessary psychological capital to navigate challenges inside and outside of work. Supporting nurses is another asynchronous online course for preceptors, mentors and coaches.
 
00:51:45 Nicole Weathers
 
To learn the skills they need to support any new hire.
 
00:51:49 Nicole Weathers
 
Both of these offerings can be used as a stand-alone professional development opportunity or to augment any nurse residency program. And we can't forget about the program that started it all. The online Nurse residency program. This includes A comprehensive curriculum designed to support new graduate nurses, applying all the knowledge they learned in school.
 
00:52:09 Nicole Weathers
 
To their practice, we focus on professional skills, personal well-being competencies, and new graduate nurses even get the opportunity to create real change in their own organization.
 
00:52:20 Nicole Weathers
 
Offered completely online and in a blended format, this program is highly adaptable to all clinical practice settings. You can learn more about all of these programs and more of what we offer using the links in the show notes.