Nurses — the backbone of the American health care system — have never had more opportunities to call the shots on where they want to work. A shortage, made far worse by COVID, has competing health care systems offering hefty signing bonuses and other sign-up perks. That includes Novant Health.
Compensation is clearly king with some nurses, especially those paying off student loans or looking to bank money for life dreams like a down payment on a house. But it’s not the only factor that drives decision-making on where to work. And just as importantly: on deciding where to stay.
Interviews with nurses who’ve worked in multiple health care systems make it clear: They want to work in hospitals where nurses are valued, heard and embraced.
And as the lucrative travel nurse contracts slowly wind down, some travel nurses are making Novant Health — home to more than 7,500 nurses at 15 hospitals in sunny North Carolina — their career choice.
Here are some factors nurses will be examining as they decide where to land.
Support from leaders
Time and time again, Novant Health nurses say unit nurse managers and the leadership above are more inclined to visit patients at the bedside than they are in some other hospital systems where managers remain in their offices.
“Leaders will pitch in on the floor by starting an IV, for example, whenever things get hectic,” said Angela Bullock, assistant nurse manager of the emergency observation unit at Novant Health Forsyth Medical Center. "When they’re there working side-by-side with you, you’re feeling supported.”
And leader rounding — visiting patients in rooms to ask detailed questions about care and talking with team members in their units to hear about challenges — is a core priority at Novant Health.“Every Wednesday, all leaders – and not just clinical leaders – round on units with intentional check-in questions and then compare notes at the end of the day to determine if there’s something the clinical teams need that’s missing,” said Daria Kring, vice president of center for professional practice and development at Novant Health.
“Most nurse managers hit the units first thing each morning after the safety call to assess the pulse of the day,” she continued.
“And all VPs and above participate in the Walk-a-Mile program, which pairs senior leaders with frontline team members for several hours to see firsthand what the work looks like.”
Bottom line: The leader gains stronger appreciation for work challenges that can be addressed, and team members feel heard and valued for their bedside work.
The importance of diversity
“Everyone talks about diversity and inclusion. Everyone says they believe in it, but to actually see it and live it every day is very, very important,” said Brittany Moore, a nurse manager at Novant Health Presbyterian Medical Center in the hemodialysis unit. “Being an African-American leader, I see a whole lot of us. I pride myself on our unit being a diverse unit.”
Questions? Chat with a Novant Health recruiter.
She said team members on her unit represent an array of cultures and nations and that diversity plays a part in why patients want to come to Novant Health for dialysis.
Previously, she worked at another system where she saw less diversity at the leadership ranks. People of different backgrounds “need to see other people who look like them. I think that's very important.”
Support for education
If culture is a top consideration for many nurses, education is a close second. “Novant Health’s center for professional practice and development provides robust continuing education for nurses,” Kring said. “With 48 full-time clinical nurse educators, we have a larger faculty than many schools of nursing. These educators deliver hundreds of classes each year to support nurses with their knowledge and skill development.”
Novant Health also offers a nurse residency program that allows
new graduate RNs the time to gradually assume their duties and responsibilities.
During the first year, nurses have the option to rotate every 12 weeks up to four
rotations within their specialty to different units in the hospital or market
they’re hired into. Nurse residents will complete over 100 hours of training
and 200 to 400 hours of precepted training to fully transition to independent
New nurses also get a “preceptor,” or veteran nurse mentor, who shows them the ropes for up to three months. Within the profession, new nurses historically have not always received complete support from veteran nurses.
Novant Health, though, appreciates new nurses and understands they are vital to caring for the community. It is committed to supporting all new nurses.
“If a new graduate nurse is struggling, we work closely with the nurse to provide extra support for success,” Kring said. After residency, learning does not end. To maintain licensure, a registered nurse must complete 15 hours of continuing education each year. But Novant Health nurses usually do much more.
“We have hundreds of classes in lots of formats – virtual, online, classroom and simulation. Novant Health nurses also have access to over 450 Lippincott courses, addressing just about every topic a nurse could want,” Kring said. Last year, nurses completed over 34,000 courses offered by Lippincott, a top publisher of nursing textbooks.
When Bullock worked at another system, she had to figure out how to work in her own continuing education. There’s nothing wrong with that, she said. But she prefers the warmer vibe at Novant Health, where nurses get reminders not to fall behind or find themselves having to cram it all in at once. “They take care of you,” Bullock said.
Why become a Registered Nurse at Novant Health in North Carolina?
- Named one of the nation’s 150 best places to work in health care by Becker’s Hospital Review.
- Leapfrog grade A ratings.
- Leadership development programs.
- Eight Magnet-Designated medical centers.
- Designated as Best Places for Diverse & Women Managers to Work by Diversity MBA Magazine.
- Team Approaches in Quality Improvement Award Recipient from the Society of Hospital Medicine.
- Recognized by CMS for quality and safety with six 4-star and two 5-star Acute Care facilities.
Sometimes, it’s the little things. For instance, Presbyterian Medical Center in Charlotte had a talent show on the front lawn this spring where team members belted out their favorite songs while colleagues munched on a free barbecue or vegan lunch. “I have a lot of friends who are nurses,” Moore said. “They don’t see things like this.”
Or in some cases, the efforts in their systems don’t pack a lot of imagination. “I have one friend who keeps telling leaders: No more pizza!”
After four years at Novant Health, Bullock left for another health care system in 2017 to gain more trauma experience. She returned in 2021 because she felt a “lack of warmth” at the other employer. She’s been a patient in the Novant Health system, too, and said she appreciates the care she’s gotten as a patient and as a nurse. “The techs, the nurses, the anesthesiologist, the doctors – everyone explained everything clearly to me before my procedure. They took good care of me as a patient.”
Opportunities to self-schedule
Novant Health also tries to take care of nurses when it comes to work preferences. Nurses have a voice in which hours they work. Nursing leaders try hard not to tinker with the schedule. “You can put ‘unavailable’ on the schedule if you’re not able to work that day,” Bullock said. “If I have to tweak or balance the schedule, I will never put someone on who’s listed themselves as unavailable.”
‘Culture is everything’
Kring sums up the bottom line: “Culture is everything to nurses. Money only gets nurses in the door. Sign-on bonuses are sometimes part of doing business in a competitive market. But once settled into a position, if the team culture is not there, there is no amount of money that will convince a nurse to stay. Our work can be stressful and demanding, but when you work with an incredible team, you feel safe and supported.”