Nursing Leaders from MD Anderson Cancer Center, Seattle Cancer Care Alliance Share Insights on Succession Planning

Now is the time to address the future need for nurses on multiple fronts

MD Anderson News Release May 22, 2018

While some regions of the nation will experience greater nursing shortages than others in the coming years, hospitals and healthcare systems should plan now, reported two nursing leaders at the recent 43^rd Annual Oncology Nursing Society (ONS) Congress. The speakers from The University of Texas MD Anderson Cancer Center and Seattle Cancer Care Alliance said more than a million nurses will be needed in the United States by 2020.

To accommodate current and future needs, succession planning is vital to addressing a nursing workforce impacted by generational differences, changing clinical competencies, a competitive hiring environment and shifting health care landscape, said Debbie Cline, associate director of Nursing Workforce Planning and Development at MD Anderson, and Suni Elgar, associate director for Clinical Operations, Blood and Marrow Transplant at Seattle Cancer Care Alliance.

Effective succession planning can include comprehensive programming that addresses professional development, continuing clinical education, academics, recognition, leadership training and mentoring, but individual programs can be modified and still be successful. Too few hospitals and systems today have plans to keep its nursing pipeline primed and it’s vital to start the process, they reported.

“Hospitals and health care organizations need to invest now in succession planning to ensure there is an ample number of high-quality nurses now and for the future,” said Cline. “Succession planning programs must evolve just as nursing and healthcare changes, plus they must be inclusive, diverse, people focused and research based. It’s important to start looking now at nursing workforce issues, engaging on need, goals and strategies and ultimately, taking that first step.”

Dating back to the creation of the alliance, Seattle Cancer Care Alliance’s leadership has advocated for succession planning on a number of fronts, said Elgar, including the ambulatory setting where she is a nurse leader. In the outpatient transplant clinic, leadership historically endorsed an initiative to “hire one nurse ahead of need so competence always comes first.” She detailed how that has translated to present day where new nurses work one-on-one alongside departing or retiring nurses in the transplant clinic to ease the transition. Newer nurses are hired into an internal float pool which covers the leaves of primary nurses in the transplant clinic. As a result, when nurses retire, there are already well-trained internal candidates ready to step into the primary nurse role, said Elgar. In this model, developing nurses benefit from experienced nurses’ training in this highly nuanced and specialized care.   

As the nursing shortage looms ahead, institutions will need to think outside the box as they make a plan to continue to provide the high-quality care that oncology patients require, continued Elgar. One such method to preserve the “brain trust” of highly experienced nurses on the verge of retirement may be to encourage those nurses to continue to work in a telemedicine role in close proximity to the clinic staff. By rethinking the model of decentralized call centers, institutions can choose to keep experienced nurses who have transitioned to a telemedicine role in the clinic where they are able to simultaneously mentor newer nurses.

“Unit leadership and care providers on the front lines need to work together to advocate for succession planning,” said Elgar. “Collaboration on every level is vital to finding solutions and developing programs that address the many challenges of nursing and healthcare today.”

From its beginning 76 years ago, MD Anderson has been an institution driven by its signature multidisciplinary collaboration and care, and that philosophy also is reflected in its succession planning, said Cline. From academic cohorts that provide support to MD Anderson employees pursuing initial or advanced nursing degrees to graduate nurse residency programs and a year-long leadership development program known as Rising Stars, the MD Anderson succession plan focuses on long-term strategic workforce needs while assisting nurses and mid-level providers with their career goals and leadership skills. MD Anderson also has programs to support nursing research, travel for conferences and professional memberships.

“As one of the premier cancer centers in the world, we are fortunate to have visionary leaders and faculty who support and value the more than 3,700 nurses who care for our patients from all over the world,” said Cline. “For hospitals and organizations that may not have the same resources, it is possible to modify programs and tailor them to what works best for your team and your objectives. Even if you start slowly, think ahead, understand your budget, engage your staff, study the literature and work together on solutions and measurement.”