The Human Side of Healthcare: Employee Engagement with Ni-Cole Bernier

In a world where technology constantly evolves and redefines industries, it’s easy to forget the heart and soul behind the machinery: the people. In today's episode, we're taking a pause from cutting-edge tech to unearth the true essence of healthcare: its human side. We navigate the integral aspects of employee engagement, resilience, and wellbeing that shape the healthcare industry.

Our esteemed guest, Ni-Cole Bernier, stands out as an embodiment of these values. With her deep roots in HR, recruitment, and most crucially, employee engagement, Ni-Cole has revolutionized the work environment at MUSC. Holding the title of Manager of Wellness & Resiliency, she has taken up the mantle to enhance the life quality—mentally, physically, and emotionally—of an impressive roster of over 15,000 team members.

In this episode, listeners will learn about:

✔️ Ni-Cole’s inspiring journey from Nursing to an influencer in Healthcare.
✔️ The core strategies to cultivate and boost Employee Engagement.
✔️ Insightful methods to identify and navigate burnout in healthcare settings.
✔️ Proven tactics for optimizing both individual and organizational potential in the healthcare industry.

Thank you for listening to this episode of The Pivotal Podcast. We hope you found it informative and engaging. If you enjoyed this episode, we would appreciate your support. Please consider leaving us a review, providing feedback, or sharing the podcast with others who might find it valuable.

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For more resources, show notes, and additional content, visit our website at www.PivotalHires.com. Follow us on social media for behind-the-scenes insights, announcements, and discussions.

Thank you for your continued support, and we look forward to bringing you more exciting episodes in the future.

Chapters

• 0:00 Introduction
• 2:07 Ni-Cole's Journey: From Nursing Recruitment to Wellness Advocacy
• 6:05 Finding Purpose in Healthcare: Ni-Cole's Insights on Recruitment and Career Choices
• 12:08 Embracing Career Transitions: From Past Decisions to Future Possibilities
• 13:44 Holistic Employee Wellbeing: Engagement, Communication, and Comprehensive Benefits
• 19:16 Measuring and Addressing Employee Resilience in Post-Pandemic Healthcare
• 24:08 The Interplay of Self-Care, Trust, and Leadership in Healthcare
• 30:45 Recognizing Burnout and Navigating Career Transitions in Healthcare
• 44:35 Redefining Employee Engagement in Healthcare: Beyond Just Salary
• 47:09 Closing Remarks: Empowerment and Accountability in Modern Healthcare

Transcript

 All right. Welcome to the Pivotal Podcast, where we unlock the future of healthcare and delve into the compelling journeys of industry influencers. If you're passionate about healthcare, curious about innovative strategies for employee well being, or exploring a career move into this field, you've tuned into the right show.

I'm Ben Marley, and I'm here to guide you through the maze of change in healthcare. In today's episode, we step away from technology to dive into the human side of healthcare. We'll be exploring the pivotal role of employee engagement, resilience, and wellbeing in the industry. Joining us is Nicole Bernier, a trailblazer in the healthcare field with a rich history in HR, recruitment, and employee engagement.

Nicole's made notable strides in improving employee satisfaction and fostering a culture of wellness at MUSC. As the manager of wellness and resiliency, she's now uplifting the mental, physical, and emotional health of over 15, 000 team members. Nicole is a certified worksite wellness specialist, a certified health coach and a certified patient experience professional.

She currently works full time as I said, as the wellness and resiliency manager for MUSC health and addresses workforce advocacy, stress management and burnout and helps teams and individuals develop positive coping skills, courageous conversations and resilience in both their work and personal lives.

Nicole's worked for MUSC for over 19 years in a variety of leadership roles and provide strong interpersonal skills and employee engagement patient experience. Leader development, strategic goal alignment, operational excellence and wellness initiatives. Nicole routinely promotes holistic well being and her personal and professional work by encouraging others to make small, positive changes in their everyday lives.

Previously, she created, managed a wellness blog for several years, served as a board member of a local YMCA. Taught aerobics and annually serves as a team coach for the American Heart Association Heart Walk. Nicole was born in Charleston, South Carolina and earned her undergraduate and graduate degrees from the College of Charleston.

Welcome Nicole. Thank you so much for being here today. Thank you 

Ben. It's a pleasure. 

Yeah. I'm super, super excited for our conversation today. So let's jump right in. What initially drew you to the field of nursing and health care? 

So I've always wanted to be in health care. I've always wanted to help people in some way.

And of course grandparents ended up visiting the hospital and doctor visits and things like that. multiple times as a child, and I just liked it. Originally I wanted to be a physical therapist, but you know, life just kind of happens. And I'm now working in healthcare and have been for a long time, but just in different capacity.

I still get to help people, but it's not direct patient contact. 

Yeah, that's super interesting. It's really funny that you say that you liked the doctor visits because I've got really young kids and generally like they're, they're okay. Like they love their pediatrician unless it's like a wellness visit with shots.

And then they're like, no, thank you. You know, they're like, yeah, I don't think I don't think the healthcare industry and atmosphere is for me. That's funny. So Nicole, what would you say has been one of the most fulfilling aspects of the various roles you've held in this industry? It 

really is about seeing people grow in their profession.

I've seen individuals starting out as students and over time they have worked in whatever role it was that they went to school for, and now many of them have become leaders. And so seeing them work and fulfill their purpose is very inspiring to me. 

Yeah, no, that's amazing. And speaking of working with students, do me a favor and do our listeners a favor, kind of walk us through like the various roles that you've had, just like a quick overview of like where you started in the industry to like where you are now.

So we get a better snapshot of all the different ways you've interacted. 

Yes, absolutely. So I started out as a recruiter for the college of nursing, recruiting students for the bachelor's masters and a PhD program. Did that for a few years, transitioned over to the hospital side, working in HR. So I was a nurse and healthcare recruiter did that for several years.

Then I had a department that was very large, worked very closely with them, ambulatory care transitioned over to that department as the service excellence manager, which is kind of a fancy name for patient experience. And so I all oversaw patient experience and employee engagement for all of those outpatient clinics.

So That was a tremendous opportunity. The department worked really well together, got to know the patients, the leaders and the staff very, very well. So I moved back over to the university side under finance and administration as the director of organizational excellence, employee engagement and leadership development.

And I was able to work with a lot of teams behind the scenes. So public safety, HR, engineering facilities, the grounds team. So a lot of people who do a lot of great work, but don't really get recognized in healthcare. So it was very interesting to work with those individuals and now I've transitioned as the wellness and resiliency manager back on the hospital side.

So I've kind of flip flopped back and forth over the years, but my entire tenure has been within 

USC. Yeah, that's amazing. And it's interesting because it's like, A lot of that stuff in the background that goes into health care that patients don't ever see because it's behind the scenes. Right? So I feel like I have just a ton of questions for you right now, which is good for having this conversation, but just about the recruiting side and what that looks like.

But then also the employee engagement side. Right? And I think it. Is all so relevant. It all ties in so well, because it's like, what, what do we do that initially draws people into this? And then once we have them here, how do we keep them here? How do we keep them engaged? Keep them happy, set them up to thrive long term, right?

So I'm really excited about this. So can you, let's go back kind of to the beginning here. Can you share maybe a story that stands out from your time recruiting either nurses or nursing students or. Even at the same time, maybe when you're thinking about that story what are the, what have you found that motivates people to pursue these types of careers?

Well, so a lot of times people go into health care because obviously they want to help people. They don't necessarily have to be clinical to be able to do that to service other folks. But a large percent of those people who have gone into health care, they've been impacted in some way by either a family member or a friend who may have had a health issue.

They were a part of that process. And because of that, it caused them to want to help other people and to be a part of the process of healing 

others. That makes a lot of sense. I mean, I've definitely heard that too before getting into recruiting and starting the recruitment firm that I launched at the beginning of this year.

My work was actually primarily with high school students helping them with their college admissions process, right? Figuring out their target careers, figuring out what schools were best to get them there. And you're right. When I think back over that time, Yeah. Most of my students that had a real desire to get into health care, it was it was because of either like a personal health situation they experienced and the help that they got and what an impact that made on them or oftentimes that of a family member, you know, like an uncle or a grandparent or a parent or something.

And that really inspired them because they saw personally what an impact people in health care can make on others lives. Right. So that makes a lot of sense. Do you have any stories that really, that you remember from either recruiting students or, and I know that was, or or nurses and that was, you know, kind of in the beginning of their career, right.

But does anything really stand out from that time? Yeah, I 

actually have one that I think I'll probably never forget. So when I worked for the College of Nursing, I recruited a student, Amy for the bachelor's program. She, she was very happy go lucky, a very good student. She went on to graduate school.

Ironically, a couple of years ago, I had to have a very minor procedure and she ended up walking in as my CRNA. And so we both recognized each other and so it was kind of funny. We laughed about it. But it was, I felt comforted knowing that I knew this person and she was going to take good care of me. But just to see her transition so many years ago as a student and now all of a sudden she's doing something that she loves to do.

That's phenomenal. Yeah. And you got to, I don't know. I feel like that would probably be rewarding for you to seeing sort of like the fruit of your labor, right? Like paying off in, in a way that helps multiple people, right? Like it helps the patient she's impacting, but if she's still there it's obviously been a great fit for her too.

So you really helped her as well. So that's really amazing. That's super cool. How, all right. So when, when you were recruiting, like, how do you communicate the The value and significance of health care roles to potential either nurses or students. I mean, what's, what's the real value proposition, I guess, when you're trying, like, I don't even know, like, when you're trying to recruit students, what does that look like?

I mean, are you talking with people who have a general idea? Like, Hey, I think I want to get into health care and you should come to our program specifically because they're already thinking about nursing or are you talking to students that really don't know what they want to do? And you're like, Hey, have you considered nursing?

Think about all these things. Yeah. Yeah. Yeah. Well, 

when I was a recruiter for the College of Nursing, many times, they already knew that they wanted to go into health care and obviously become a nurse. Sometimes you would get some students who wanted to be in health care, but they were a little unsure.

And so I always advocate for young individuals and students that if you are a little bit unsure, go out and do some volunteering, go do some shadowing, the more experience that you can get before you embark on that journey of going to school. The better because you'll get an idea of what you really want to do.

Healthcare is great because you don't have to be at the bedside. You can work in IS, you can work in administration. You, if you're a numbers printer, but you still want to be in healthcare and help people, you can do that. So the more they can expose themselves before they start school, the better. Because sometimes, you know, people might go to school, they do a semester, they encounter something they don't really like, and then they back away.

There's nothing wrong with doing that, but if they can do that on the front end, the better. 

Yeah, absolutely. It's super great. And I have a personal experience there too. I thought I wanted to get into medicine. I thought I wanted to be a doctor. And then I had an opportunity to shadow doctors during one summer in high school for a couple of weeks at a local hospital in Arkansas where I grew up.

And I Everything was great until I had the opportunity to watch a couple of surgeries. And I just like. Turned white and got dizzy and got really sick to my stomach. And I thought, huh, okay, maybe this is weird. You know, the coincidence the first time, second time it happened, I was like, Oh, I don't think this is for me.

So not going into school and, you know, studying for the MCAT and getting in and doing all those things before I found that out, that shadowing really paid off, but in not even just for students, I mean, there's so many people. Looking to transition careers, right? And kind of regardless of what stage of life you're in or what stage of career you're in, if you're looking to make a transition to something that's fairly new, the more information you can get about that from somebody else that's in the field, the better, right?

So you can only glean so much from reading things online, but from having conversations with people that are in the profession that you're considering, or even if you're able to get some sort of job shadowing opportunity. That's where you're really going to be able to get a clearer picture of, Hey, okay, is this going to be the next best move for me?

So I love that advice. Yeah, 

absolutely. And your point about it doesn't matter your age or making a career change. I was just doing a nurse residency training and three of the individuals that were in there, this was their second career. Wow. 

Yeah. That's amazing. That's what they're transitioning into nursing.

Yes. Okay. What kind of backgrounds were they coming from? 

One was finance. I think one man was engineering and I don't remember the third one, but yeah, I'm in complete 

transition. Yeah. No, that's awesome. And you know, sometimes I'll talk to people that are in their thirties or in their forties or whatever.

And they're like, Oh, I feel like I've, I've made it so far in my career. I've committed so much time to this that I just don't know how I can make a transition and whatever they're doing. I think the conversation that comes to mind, I was talking with a friend who's an accountant who was just really miserable doing it right.

And. She's like, I mean, I've been, I went to school for this and now I've been doing it for like 15 or 17 years or something and I was thinking, yeah, but okay, if you're mid thirties, you've got another 25 or 30 years or so that you're potentially going to be doing this. If you're miserable, do you really want to be miserable for another 25 or 30 years?

And with that much time left, like, don't you feel like you could go get into what you're really wired to do and then make an impact there and thrive? We can't get into worrying about the sunk cost of the time that we've already spent. I'm like, yeah, there's a grieving process there, right? Over, over maybe that time that we feel like could have been better utilized, but we can't change that.

All we can change is what we do going forward. So let's do the thing that we're supposed to be doing going forward. Right advice. So tell me a little bit about employee engagement and what that looks like. Like what does it actually mean? What are you trying to do and what you do now? And then how do you go about doing that with strategy?

Like what kind of strategies do you use to, to improve employee engagement? And that's kind of a barrage of questions there. 

Yes. Employee engagement is really about, employees want to feel valued. They want to feel heard. They want to feel a part of the organization. And so one of the ways that organizations can do that is communicate.

And I would almost say over communicate. Sometimes leaders or companies feel like, oh, well, we don't have any new news. We don't need to share anything at this time, but when people fail to do that, or companies fail to do that, employees are left to speculate. And sometimes speculating has more of a negative component than just sharing.

Hey guys, there's no new updates to project X or whatever they may be working on. So making sure that we are over communicating with employees employees in our days, they really want to ensure that the company they work for have a robust benefits program, which also includes well being especially the younger generation.

They are looking for that work life balance and almost demanding it to a point. And so making sure that as an organization that we are communicating, providing resources and support, providing developmental opportunities for those individuals, because as long as you can keep them engaged, the more productive they're going to be.

Yeah, absolutely. Absolutely. I love that because I really believe the core of what I do firmly believe we've all been created with a purpose and been equipped with gifts and abilities to accomplish that purpose. Right. And not everybody is going to find like the ultimate purpose and meaning for their life in the work that they do, but we spend such a bulk of our waking hours doing work.

If we can get that in alignment with the way we've been wired, that engagement is going to go through the roof. You know, in our, we're going to really move from just like. The surviving and kind of getting through the grind of work to thriving in what we're doing. And I really feel like that spills over into everything in life, right?

Like how we feel outside of work and our relationships and just in our personal lives and everything, right? So when we can get that engagement, it's, it's just so important and productivity goes up. Retention goes up, right? And satisfaction, like everything goes up. Tell me more though, about these, like the wellbeing programs that the, the younger generations are so mindful of now, I guess, and desiring so much, like, what does that actually entail?

Yeah, so historically, you know, well being or wellness for a lot of companies meant like physical or nutritional well being, you know, are you providing opportunities for them to go to a gym or maybe having a lunch and learn about eating healthy or something like that? But now it's about holistic well being.

So what does spiritual health look like? What does social support look like? Financial health look like, and then of course, since the pandemic, what's really important right now is the mental wellbeing. And so a lot of individuals, especially the younger generation, they are looking for, what is the company offering for me for my mental wellbeing and all the other ones that I just mentioned.

In other words, EAP program?

Or can I get discounts or use for free, either mobile apps or to speak to a counselor? What's available for me to again, have that work life balance. And if I am struggling with something, who can I contact that can help me? 

That's amazing. What clarify for me, what does EAP stand 

for? Great question. So it is employee assistance program.

So it's kind of like an internal counseling program. Some companies offer it in house and then other companies, they make contract with a vendor outside. But usually what happens if an employee is struggling with something whether work wise or personal, then they can connect with a licensed counselor and have free sessions with them for X amount of time.

Wow. 

That's amazing. So that makes sense, right? I mean, if we're looking at an individual holistically and we say, Hey, a lot of factors contribute to your health, right? There's your physical health, your nutrition, your fitness which contributes to your emotional, your mental health spiritual financial, because there's a ton of stress that comes when our, our finances are out of whack when they're mismanaged, right?

So if you provide all those things, I feel like there's, there are multiple layers of benefits there because the person's going to have reduced stress when those things are in proper alignment which is going to enable them to be more focused at work and to feel just better overall. Right. But it also says.

If the employee, if the employer is the one providing access to these benefits, it communicates the employee. Hey, they really value me. They care about me, which makes them care more about the company. They work for too. Yes, 

yes. And retention usually increases because of all of those opportunities for them.

Yeah, that's amazing. That's great. Are there, so retention seems like that would be a natural thing to look for, but are there specific metrics or signs that you guys look for to measure employee satisfaction and engagement? Yes, 

so not only retention rates, but also call out rates. We are also looking at patient experience, survey data quality indicators can sometimes provide information.

Recently in the last year and a half, I've actually been looking at resiliency scores, which is a part of the employee engagement survey. So what that means is employees may provide a high result from the survey, but the resiliency piece on that survey may be really low. In other words, are they decompressing after work?

Is their work meaningful? Are they finding joy and purpose in their work? So to me, that's really important because yes, they may like the work they do. They may like and think that they're providing good quality patient care, but if they can't decompress when they go home or they always feel like they're on, they're going to burn out very quickly.

Wow. 

So the communication you were talking about earlier sounds like it's actually two way communication. It's not just, Hey, this is what we're doing as an organization, but it's also saying, Hey, how are you doing as an individual and getting that feedback from them? Yes. Okay. 

Honestly, we use a lot of those different types of metrics, but we also get anecdotal evidence from wellness forums that we do and small groups and focus 

sessions.

That's super interesting. Okay. Wow. Cool. So how have you seen these strategies impact the organization and the employees? Well, 

in particular providing training as it relates to either leadership development or well being training or what we call resiliency training is one, the employees feel like they're being heard because the one thing that happens with employee engagement surveys, especially if their annual surveys, sometimes you'll have employees feel like, okay, you know, we did the survey, we provided feedback, but nothing happened.

And so sometimes it just, May depend on what's going on. You know, if they're wanting a piece of equipment, that could be a long process. But when we come in and we do these focus groups, or we meet with teams, we really want to hear. What is going on and what can we help you with? What can we support you with?

What can we train you on so that you can work within the parameters that you have? In other words, reminding them, what are some things that you can control? What are the things that you can't control? And then what part of this is stressful to you? And is it really a threat to you or is it a perceived threat?

And that's a huge difference. 

That's super interesting. Cause as you were saying that I was really just wondering, like, are things. Fairly specific based on individuals or based on the types of work that they're doing or are there some common threads that kind of just go across like the whole organization?

I mean, if you look at a 15, 000 member organization, obviously there, there are a lot, there's a lot of variety and types of roles and types of work people are doing, right? But what you just said about perceived threats versus like real threats, like that's something that. Is going to be regardless of role, right?

It's like, okay, what am I perceiving is what potentially is negatively impacting me personally or my ability to do this work? Yeah, that, that seems like it would be super, super impactful. Yes. 

I would say that, you know, some of the most common things that we hear about, not only for our organization, but across healthcare in general is short staffing.

The pandemic really took a toll on health care in general, and some people feel like, okay, the pandemic is over, but it doesn't mean that the results of it are over. We're still struggling with short staffing. We're still struggling with a lack of supplies. It's getting better every single day, but you had a lot of people who decided to go ahead and retire because of the pandemic.

And so healthcare in general is still trying to bounce back from that. And then you take into account, you had a lot of people who worked through the pandemic. And so they have pushed through. And they're exhausted and they're tired then they have their own personal stress on top of that. So really trying to teach them how to self regulate to do self care every single day so that they can provide the care that's necessary.

Yeah. What are some of the, like the decompress?

Yeah, 

absolutely. You know, you can look on the internet or you can search it self care and you're going to start seeing things like, oh, go get a bubble bath or go get your hair done or you know, go take a swim or something like that. All of that is great. But when we talk about self care, it's really about what can you do every single day to refuel you.

So in health care, particular those who are working on the front lines. They're not going to the bathroom. They're not eating lunch. They're not taking a break. You've got to be able to do all of those things to take care of yourself. And then, like I was talking about earlier about the decompression, when you go home at night, are you completely disconnecting from your phone so that you can actually sleep?

So that you can spend time with your family or friends. And so it's those things that are very important for you so that you can refuel and be ready day to day. Another thing that we teach is just simply breathing. And sometimes we ask that question. We'll go into a team and we'll ask them, okay, how many of you are breathing well?

And of course we get the look like, come on, Nicole, are you serious? But it's true. A lot of people in healthcare, if you're stressed, you're shallow breathing. You're not taking in deep breaths. Your sympathetic nervous system is activated, and so it's really about calming down self regulating so that you can be there to take care of the patients and the families.

Yeah, and I bet that that does that, that employee engagement, the, the wellness, the well being the healthy decompression activities that all probably really directly influences quality of patient care and patient satisfaction to. 

Yes, it is directly correlated. There's a lot of research out there and there's actually a saying out there that says if you've got healthy, happy, engaged employees, then you're gonna have happy, engaged patients and families.

So if you think about it, it takes everybody during a patient's visit to ensure that it's a positive patient experience. And so if you're a patient, you encounter someone who seems to be a little stressed. If you're already nervous and a little scared about your visit, you encounter someone like that.

Then that's probably going to elevate your anxiety even more. 

That yeah, absolutely. Totally. It's like, it's like anything. I mean, even as a parent, like walking home, if I've had a walking into home if I've had a stressful day at work. And I don't take a few minutes, you know, before I walk in the door to kind of reset everything.

My kids can pick up on that, right? And then, like, they know, like, oh, there's this weird feeling in the air, like, daddy's not the same, he's not, like, playing with us the way, and, like, it, it really sets the tone for everything. So I can totally see how, in, like, a patient environment. We read each other like people read each other and you can tell, okay, is this a person that increases my level of stress when I'm around them?

Or do they decrease it? Do I feel comforted being around them? And I think that especially when somebody is in a vulnerable situation, like needing their health to be taken care of, right? That's really one of the most vulnerable times of our lives. One of the most vulnerable places we can find ourselves.

Yeah. It's super important to be able to feel comforted and well cared for by, by whoever or caretakers are. 

Yes. And it is about trust. You're trusting people to take care of you. And so if you don't have that connection or you don't trust the care plan, then you may not follow it. 

Yep. And I, I bet what goes into that to part of that trust, it takes time to, to build a little bit of rapport with people.

Right? So if you feel rushed and like you're mentally elsewhere, like you're just checking things off a list or you have to go on to the next thing because of short staffing or whatever that is, that seems like that would negatively impact that, right? That perceived patient care, even if they're getting all the boxes checked, right?

Like I got all my physical needs met that I, that I had to have done, right? But if I didn't feel cared for, right. That definitely changes. And I actually, I, I had a doctor's appointment or with my nurse practitioner for my primary care physician just a few weeks ago and she sat and talked to me and answer my questions for like 20 minutes.

I mean, I was literally like looking at my watch, like, is this okay? Like, should you be spending this much time with me? Is it all right? But when I left and I actually got like a patient survey afterwards and I was just like. And I even said to my wife, I felt so well cared for. 

Yes. Yes. And that's very important.

Because they took the time with you. That's what patients and families are looking for. But I want to kind of switch that switch it just a little bit been in that employees are looking for that as well. So from their leaders. You know, from senior leaders, they want to make sure that they are feeling valued as well.

And building that trust. If leaders or colleagues are not getting to know each other productivity is not going to be as high. So it is about getting to know each other, being there, supporting each other, building that trust, over communicating, and providing an environment that supports their overall engagement 

and well being.

Okay. So I think I'm getting a better understanding of this now. So when you're saying over communicating, you don't mean blow up my email inbox, right? It's Hey, let's have some conversations and and actually invest this time with you. So you can see I as your leader value you and care about you and it gives you an opportunity to feel heard as well.

Yes, 

absolutely. I mean, we encourage rounding on employees with our leaders, but it needs to be a casual conversation. And just like you said earlier, it's not about checking about box. It's about, you know, checking in on you, then it kind of looks like maybe you haven't been the same today. Is everything okay?

Can I support you? Or what is adding to your stress today? What about that project that we were working on? Do you need some additional support? Do I need to bring someone in to assist you? So it is about getting to know the employees to make sure that they can be as productive as possible. And if they are struggling in some area, what, what resources, what support do we need to provide 

them?

Yeah, absolutely. And so your example, just then like you mentioned, Hey, it looks like you're struggling in this area or whatever. Are there early signs of burnout that employees and employers should be aware of or can be looking for? 

Yes. So for the employer if they start noticing, again, those call outs if they start noticing some team dynamics that are changing a little bit, there may be some more miscommunication, maybe a little bit of infighting.

You may even notice over time, patient experience scores are not as high, maybe even quality indicators start dropping, then that could be a sign that there's something going on. You may even notice low performance. From an employee standpoint, whether yourself or something that you may be noticing in colleagues is they may be a little bit more irritable.

Sometimes they could actually withdraw or self isolate. There may be some low performance. There's going to be an increase in depression or anxiety. Could be a lot, excuse me a lack of focus maybe even a sense of lack of joy or a lack of purpose in the work that they're doing maybe even an increase in cynicism.

So, again, if you get to know your employees, get to know your colleagues, you're going to know if they're not behaving the way they would normally do. 

Gotcha. Is there like, when it comes to burnout, is there a certain, like, I know with, when it comes to depression, I think the definition is, like, something, it's like a, technically, I think it's a feeling that lasts, like, Or a state that lasts like 30 days or longer to be technically classified as depression.

Maybe something like that. Maybe I'm off here. I don't know. I'm not, this is not medical advice. I'm not a doctor. Right. But is there something like that when it comes to burnout? Is there like an official, like, Oh, if you have these types of feelings for a prolonged period of time, if it's like three days, five days, two weeks, six months, like, is there some, is there some sort of metric right there where it's like, Hey, everybody has a bad day every once in a while.

But if I'm noticing something persisting over a period of time, do you have like a number like that that you look at? 

Not necessarily a number per se, but we do have a stress continuum. There is one particular class that we teach called stress first aid that talks about that. There is a stress continuum that we use that creates the common language for all of us to use. Now, obviously, if someone's going to go see a counselor or a doctor or something like that, it's going to look a little bit different, but this helps individuals to kind of look at this, see where they that being said.

We don't want people to think about stress in a negative way because there is good stress and there's bad stress. So we don't want people to think, oh, I'm stressed, and think it's ne necessarily a bad thing. So for burnout in itself, that's a little bit different than stress because it's unrelenting stress that just goes on and on and on for a long period of time.

And one of the best examples out there, and I know that we talk about this all the time, but the pandemic. If you think about it in the early days, it was kind of like, how long is this going to last? Oh, it's going to be a couple of weeks, maybe a couple of months, but it just kept going and going and going.

And so it was unrelenting. And so that's when it transitions into burnout is when it just continues on and someone is not getting the support and resources that they need to be able to cope well. With that type of stress, 

does there come a point that say, you've gotten the resources and you've tried, right?

Like the strategies to cope with the burnout and it's not getting better. Does there come a point when. You would advise someone to say, Hey, maybe you need to make a change, like in terms of the actual role that you're doing, like in terms of the actual work or career that you're doing right now. 

That is a conversation between that individual and perhaps their leader, because we certainly don't want to mandate something like that.

If someone's willing to continue to work now, if someone gets to a point where. It's causing more harm to them then obviously we are highly going to recommend that they get support for that. But yes, there are times when someone is in a particular unit or department, maybe they've experienced some traumatic events.

And they still want to work, and they are working through the resiliency and the self care and the stress management. And it, it's a good idea for them to transition to another role for a particular amount of time. So, for example, maybe you've got someone who's working in the ED. They've experienced multiple traumatic events.

They want to continue to work, but they don't want to do it in the ED. So what they can possibly do is transition to a lower acuity unit, med surg, maybe even outpatient. They're still using their skills, but they're just doing it in an area that may not Provide that intense, stressful situation. Now, with all of that being said, we'll want to make sure that they are working with somebody to work through that stress, because we don't want them to carry that in their reaction to stress to the next role that they're 

in.

That makes sense. Just like the transition itself doesn't necessarily fix everything, like getting away from the problem doesn't necessarily fix the problem. It's learning those, those coping strategies that are the healthy coping, right. And how to manage that. Okay. Yeah. Cause regardless of what you do, it's going to be different types of stress or different stressors that you'll encounter, but there's going to be stress and everything.

Correct. Yes. And, and like you mentioned, not all of it's unhealthy, but how and figuring out how we deal with it in a healthy way. Okay, that makes sense. And, and in healthcare, kind of like you've hit on a couple times here, there are such a variety of roles. It seems like there would be opportunity if somebody decided, Hey, I can't do this exact thing or in this exact unit right now, there are probably opportunities where they could stay within the same organization and switch to either a different department or even maybe a different type of role that they're doing right.

Yes. And that happens all the time. And sometimes it's not even just stress related. It could be physical. So if you think about it, someone who's worked in an inpatient unit for a really, really long time over time, they may feel like physically they cannot do that type of a role anymore because of the lifting or the shifting or something like that.

So again, they can step down and go to an outpatient clinic or they can completely change and go to case management, or they can go into informatics or they can go into Epic training or something like that. So they're still using their good clinical skills, but just in a different way. 

Absolutely. And Epic training would be like EHR.

Yes. Yes, that's awesome. That's super good. I know we've, we don't have a ton of time left. So I'm kind of looking over. We had a lot of different things we could potentially talk about. How do you feel like continual or continuous learning and development impacts employee satisfaction and retention?

A lot of 

people in health care want to continue to learn. Many times they need certifications. If they want to grow in their career, obviously they need to learn additional skills. And so it's something that people want and they need, but they struggle with two things. Usually it's, I don't have a whole lot of time to be able to do this outside of work.

Or how can I fund this? And so if organizations can provide that in multiple ways for employees, then that's just another added benefit. So, for example, allowing people to train on work time or in service time, or even offering to pay for a certification or a membership so that someone can go get that training and develop their skill set.

Okay. Oh, that makes a lot of sense. That's cool. And, and does some of this come back into like, I don't know necessarily how it works in healthcare, but when you're meeting with your leader or your supervisor if you're having say a quarterly or annual review or something does it ever come into play where you have say, okay, I'm here today.

I'd like to be in this position or this role. 1 or 2 years from now or whatever, what do I need to do to get there? Okay. And it's still going to benefit the organization. It's going to benefit me, right? I'm growing. I'll need these certifications. Let's put a plan in place to get me from where I am to where I want to be.

Is that kind of how that would happen? 

Yes, absolutely. We always encourage individuals that if they're interested in doing that. To definitely have a conversation with their leader during their annual performance evaluation or anytime, actually. And we certainly encourage leaders to look within to try to retain their employees.

Because again, people, a lot of people, they want to continue to grow and depending on the department they're in, usually there is some type of a career ladder that they can, grow into sometimes it depends on the years of experience, or it might depend upon a certification or additional education. So, yes, it's creating that educational plan so that they can grow because if we can retain our high performing employees, that's even better.

So, what about. If somebody's kind of come to the point where they know, hey, I can't, I can't do like the physicality of bedside anymore. And they know that they have an interest in data and they wanted to get into something like health informatics. I imagine that having that sort of conversation with their leader might be a little intimidating because you're basically telling the person whose team you're on.

Hey, I don't feel like I can be on your team anymore. But. Healthcare organizations like the size of MUSC, you've got other departments that would benefit like an informatics, you know, different informatics departments or data analytics or whatever that would still benefit from that employee's talent.

Right? So is there, I don't know, do you have advice for either? The employee themselves and how they would approach those sorts of conversations. Cause I can imagine that would be kind of a hard topic to broach, right? Or even advice for leaders who experienced people coming to them with that. Because you might as a leader, I feel like sometimes you have to put the organizational mission, like as a whole above just the mission of your individual team.

Right. And there comes a point where, Hey, okay. This might have an initial negative impact on my team, especially if I'm dealing with short staffing right now, that's gonna be an immediate, immediate negative impact. But this is a great person. I care about this person as a good leader, and I want them to thrive.

And I know that. They're, they're a great worker. They're positively contributing to the organization as a whole. So if we're able to, to utilize them elsewhere, that's a win for everyone, even though in the short term, it might not be a win for me specifically. Right? So any, any thoughts on, on how to approach that from either side, from the leader or the employee side?

Yeah, I mean, it would definitely be intimidating from the employee side, because you don't always know, you know, what is my leader? How are they going to react? But if you go with them with the idea, this is what I think I would like to do, and maybe even ask the leader for some advice on should I go and maybe job shadow somebody for a day or half a day?

Do you have any recommendations on someone that I can talk to to see if this is something that I'd really like to transition to? A lot of times those leaders will even help support that individual in that transition if it is something that they truly want to do. And the good news is if they are staying, staying internally, then it could be that the person can stay and help to train the new person that's coming on board while they transition to the new role.

And so. That benefits the organization because the person hasn't actually left. And so you still have someone with that skill set and that experience internally who can help be a mentor to the new person coming on board. From the leader standpoint, I would say that again, it's a benefit for the entire organization.

Yes, it might be a little painful in the beginning because you are losing a valuable employee. But the point is, is that you want to see them grow. You want to see them move into a direction that they are very passionate about and then utilize them for maybe, Hey, can we still tap into you whenever we have a challenge, would you still be willing to do that?

And then supporting them to, like I mentioned earlier, any kind of job shadowing that they might want to do beforehand. 

And if they were transitioning to something like like the epic training role, like that seems like that would directly benefit a team that they were leaving potentially. 

Yeah, absolutely.

I mean, and sometimes what happens if, if they do end up going to a different team, it could be that where they're going, going is partnering with the department that they're leaving. So they're just in another role, but they still could be working 

together. Yeah, no, that's great. That makes a lot of sense.

I like that. When you think about the future of employee engagement and well being in healthcare how do you envision that? Or do you have thoughts on that? Like what comes to mind? Yes, I 

think it's just going to continue to grow. I mean, more and more people are looking for the value that organizations can provide them.

Historically it's been about you go and you do your job and you leave. Obviously you want to do the best job that you can, but especially the younger generations, they are looking for. What are the benefits that are being offered? I want to feel valued. I want to contribute to this organization in health care.

I want to be able to care for patients, but I want to know that you care for me as well. So what does that holistic well being look like? And they are really demanding work life balance or what we like to call work life harmony. And so. If organizations want to retain their current employees and then attract the best employees, they're going to have to provide that for all of the employees because otherwise employees are going to become dissatisfied or they'll leave.

It's really, it's really a great reminder to think about all the different things that contribute to employee satisfaction because especially in recruiting, I feel like I have conversations with people so often and it comes down to, okay, well, what's the salary? And it's like, Even studies show ultimately that's not going to be the thing that's going to keep you satisfied and engage long term, right?

Like, yeah, we need money to live, right? And making more money is nice, but it's not ultimately the only thing or maybe even the most important thing after a certain point of what's going to drive that engagement and feeling satisfaction and purpose and what I'm doing. So I love your, just your perspective on all these other things, these, these other assets and benefits that organizations can offer that really will drive that engagement and just improve the experience for everybody.

I think that's super great. 

Yeah, I mean, money is certainly important, and especially if you get someone who's a little dissatisfied, or they may want to pay raise if you're not meeting their goals, or they're not getting what they want from all the other things, or feel like they're valued and heard, that little bit of bump and pay, that over a couple of months is going to dissipate.

They're going to kind of forget about that bump in pay. They're looking for everything else and they want to feel like what they're doing is meaningful and providing a great service to the organization. 

Yeah, absolutely. Well, Nicole, is there anything else that that we haven't talked about today that you wanted to talk about?

I don't think 

so. You know, I think it really takes everybody working together to provide a great experience for employees. It can't be just the leaders doing it or the organization doing it. Employees have to take accountability to what they want and what is meaningful for them as well. So it takes all of us working together.

And then also we have to be mindful of the world is a little bit different now in health care. And, you know, we have to learn.

And what part of stress is something that we can control and what part of it can't we control? And then working within those 

confines. That's so good. And it's so much of life comes down to, okay, what can I control? What can't I control right now? And then, okay, what am I going to do about this? And then how am I going to accept the other?

Yeah. That's super healthy. I like that a lot. Well, Nicole, if somebody wanted to get in touch with you if they had follow up questions or just wanted to engage with you some way we talked a little bit about this before. LinkedIn is probably the best way to come find you there. 

Yes, absolutely.

They can look me up on LinkedIn and happy to connect with them. Okay, 

perfect. Well, Nicole, thank you so, so much for being with me today. I've really, really enjoyed our conversation. I know our listeners are going to get just a ton of value out of it. I know I have. So yeah, thank you so much for that. 

I have really enjoyed it, Dan.

I appreciate it. 

Yeah, absolutely. So we hope you enjoyed today's episode. And thank you so much, Nicole, again, for that conversation. I can just tell you care, right? And that matters so much as a leader in anything, but your, your heart for nurturing, healthier, more engaged, more resilient and like employees, healthcare workers, like that's, it's really inspiring.

So I really appreciate that. And I really do love what you talked about. Like, what can you control? What can't you? How do you take care of that stress outside of that? It's, it's huge. So as we wrap up today's episode, we leave you with this thought. The heart of healthcare with anything really, it just, it lies in people.

So when we foster their well being and nurture and grow their potential, we not only improve health care delivery, we also empower individuals to lead healthier and more fulfilling lives. So thank you guys so much for joining us on this exploration of the human side of health care. Stay inspired, stay focused, stay curious, and we look forward to meeting you here next time on the Pivotal Podcast.