Kristy Duffey, Chief Nursing Officer with Optum, explains why she is optimistic about the future of nursing -- even amid the pandemic.
You don’t have to search too long to read or hear a story about the crisis in nursing today. And it’s easy to understand why: Nurses are on the front line of the coronavirus pandemic, and they are bearing the brunt of the impact. Burnout is a real issue. Attrition rates are rising and retention rates are falling. But nurses are also part of the solution, especially in addressing long term primary care shortages that are predicted to come. Kristy Duffey, Chief Nursing Officer with Optum, explains why she is optimistic about the future of nursing.
SPEAKERS
Kristy Duffey, Ira Apfel
Ira Apfel 00:05
Hello, and welcome UnitedHealth Group’s Weekly Dose Podcast where we’ll get you up to speed on the latest trends, shaping the future of healthcare. And now, the podcast is available on Apple podcast and Spotify. I’m your host Ira Apfel and this week we’re talking about the future of nursing in the United States. You don’t have to search too long to read or hear a story about the crisis in nursing today. And it’s easy to understand why nurses are on the front line of the coronavirus pandemic, and they are bearing the brunt of the impact. burnout is a real issue. attrition rates are rising and retention rates are falling. But nurses are also part of the solution, especially in addressing long term primary care shortages that are predicted to come. Joining us today to discuss the state of nursing is Kristy Duffey. She’s the chief nursing officer with Optum. Well, Kristy Duffey, welcome to the podcast.
Kristy Duffey 01:02
Hey, thanks for having me. Good morning.
Ira Apfel 01:04
Good morning. So my first question to you is, as the chief nursing officer, what are your perceptions of nursing right now? What are you hearing from your colleagues? What? What are you seeing in the marketplace?
Kristy Duffey 01:18
Well, first, let me start with just the state of nursing today so that we can ground everyone. Nursing is the largest health care profession, we have more than 4 million registered nurses in the US and over 270,000 advanced practice nurses, which are nurse practitioners in the US. So when you think about that nurses are touching more consumers, patients members than any other health care profession. And I’m really close to this, as you said, being the chief nursing officer for Optum, this is a topic that’s very near and dear to my heart. And I’m hearing a lot of things that I’m seeing a lot of things and I’ll start first with, nurses are starting to feel pretty tired and burnt out, primarily due to COVID, which I know you’ve talked a lot about in your podcast is that nurses are expected to do more. And they’re not seeing much respite, especially since now we’re seeing a heightened increase in the Delta variance. And then I think there’s also this, I want to say dichotomy. But you have, you also have nurses trained to take care of patients and members out in the field on the frontline. And then they have to come home and they have the stress of home, whether that’s homeschooling their children, or, you know, having to help them. They’re having a sense of isolation, too, I think when they get home with their kids. The other areas that I’m seeing is that we’re also seeing an increase in retirement, 40% of nurses are actually over the age of 50. And by 2030, we’ll have over a million nurses retiring. And then the last point that I want to underscore is just not enough nursing instructors to fill this gap. More than 80,000 people were turned away just in 2020, in both undergrad and grad programs, because there just wasn’t enough faculty to teach nursing students.
Ira Apfel 03:10
So there’s a lot to unpack there. And I’ll take it step by step. Because you broke down many colleges for sure for sure, which is great. My first thought, though, is to kind of focus in on the pandemic. Obviously, it’s been going on now for quite some time. And obviously nurses are really bearing the brunt of this. As you know, frontline responders, Has anything changed in terms of the challenges that you’re seeing, or they’re seeing today versus 20 months ago? Has anything gotten better? Or are there new challenges that they’re facing that no one was really dealing with? From the nursing community say, you know, 20 months ago?
Kristy Duffey 03:55
Well, I would say it’s definitely gotten better. 20 months ago, we were dealing with something that we have never dealt with before or ever experienced before. And I would say in the beginning, I mean, even to the point of just getting enough personal protective equipment or PP was difficult. And I think nurses in general felt a bit helpless or powerless because at the time when COVID started, there really wasn’t a treatment. And so it was it was more making people comfortable versus being able to treat them and so I also think it was it was difficult for nurses in the beginning to because families weren’t able to come in and see their six loved ones. And we were really the only avenue for families to see their loved ones through FaceTime, zoom Skype, any mechanism to be able to let them see them. But But taking it to where we are today I would say that we’ve made so much progress, especially with vaccines, we’re seeing really good results in our membership and even in our clinical workforce. And now there is a treatment as far as for patients who have chronic conditions that get COVID, we’re actually able to give them monoclonal antibodies to help them get better quicker. So I think I feel like there’s light at the end of the tunnel. And that we can move forward and that our nurses are much more well equipped now to be able to treat and they don’t feel as powerless.
Ira Apfel 05:35
Do you feel like the fact that there is a treatment and there are vaccines? That’s really the thing that’s that nurses are kind of grasping on to kind of pull them through all this fatigue and all this burnout?
Kristy Duffey 05:49
Yeah, I think I would say so. I think that by having the vaccine, we’re seeing that the people even we’re seeing a breakthrough of some people getting COVID, even with the vaccine, a small percentage, but when they’re getting sick, they’re not getting as sick. And then by having the monoclonal antibodies, and working with our OptumRx teams, we’re actually able to overnight, there’s monoclonal antibodies anywhere in the US, so that we can distribute them within 24 to 48 hours, which is something that’s really nice being part of United Health Group, we’re able to get to all parts of the US rural, urban areas that otherwise may not be able to have these specialty treatments.
Ira Apfel 06:33
You mentioned earlier that there are other challenges in the nursing profession, such as retirees, and in large numbers and also a lack of instructors. Let’s take them one by one. I was surprised to hear that so many nurses are retiring and above the I guess you said the age of 50. What are they’re just not as many nurses coming in younger nurses. What are you seeing there?
Kristy Duffey 07:01
Well, I think I think it’s twofold. I think one is, as I said, there’s just not enough instructors to fill this gap. I mean, if you think about there’s 4 million nurses and a million are going to retire in the next eight years, that’s a pretty large gap to fill. One of the things that we’ve been doing at UnitedHealth Group is really supporting universities where I have teams of nurses that are adjunct faculty to universities, where we have University affiliations with more than 220 universities to help precept students. So I think I don’t think it’s, there’s one answer for it. I think people want to get into the nursing profession, but honestly, I think there’s just a lack of the faculty, instructors and things of that nature.
Ira Apfel 07:50
And so with the instructor issue, it’s not so much that they’re retiring as, as it is, you’re just going to need a whole bunch more. What are the challenges, the hurdles to getting more instructors? You mentioned some of the things that you he is doing, but I’m wondering, are there other kind of larger, industry wide or maybe even policy solutions?
Kristy Duffey 08:15
Yeah, I mean, I think from a well, that’s, that’s a loaded question there. I would say that, from a policy perspective, I think one of the things that we need to do, and we’ve taken a position at UnitedHealth Group that we’ve been advocating for modernizing more practice laws so that we can have full, full practice authority for all nurse practitioners across all states. So today, there are restrictive practice agreements where I think only in about 23 states in the District of Columbia that nurse practitioners have full scope of practice. I think that’s an area that we need to continue to, to push on working with the American Nurses Association, the American Academy of nurse practitioners. So that so that we can practice across state lines. And one of the things that I saw during the pandemic that was really helpful, was there were waivers. We had emergency authorization waivers, where our clinicians or nurses and nurse practitioners could practice this across state lines. So in fact, in New York City when their 911 lines were getting so many calls, they couldn’t answer. I was actually able to redeploy over 1100 nurses to support their 911 lines, because we could practice across state lines.
Ira Apfel 09:34
I’m curious, from your perspective, and what you hear from colleagues, would that ability to kind of take over a lot of the primary care practices and roles would that be fulfilling or would that be kind of a such a change to what the traditional nursing you know, tradition? Practice would be that it would be also kind of lead to other challenges, and other, you know hurdles to overcome. I’m curious about that.
Kristy Duffey 10:09
Why don’t think, I actually think it’s gonna it’s much more rewarding for the nurse practitioner who’s been trained to be able to function and their full scope of practice and be able to take care of their patients and member’s needs. So I think it’s going to be much more fulfilling. But I do think that as, as we’re seeing the issue that I talked about with not having enough faculty for the need, I think that’s something that we have to continue to work on to ensure that that, that we’re able to fill that gap with instructors. I would also say one of the challenges that we do face is that we’re seeing more and more nurses go through their undergraduate program, become a registered nurse and not have much experience in the field and go right to grad school to become a nurse practitioner. One of the things that we’ve been working on at Optum and UnitedHealth Group is a fellowship program for when nurse practitioners that may not have as much experience in the field would have, we’re actually partnering with George Washington University, and it’s a two-year program where when we would hire the practitioners on, we would go through all of our Home and Community Care businesses, and help the practitioners feel autonomous and comfortable in what they do.
Ira Apfel 11:31
You know, we’re still not completely out of the woods yet with the pandemic. But I am wondering if, you know, with the treatments, the monoclonal monoclonal antibodies, treatments, vaccines, some, perhaps making these waivers permanent? Do you feel optimistic about the state of nursing despite all the challenges, or do you think it’s just it’s a little too early to tell?
Kristy Duffey 12:00
I definitely feel optimistic. I mean, this is something I’ve been a nurse for more than 25 years, and something that I’ve never experienced in my lifetime. And just to see the teamwork and all of us coming together and seeing the glass half full versus half empty and supporting each other. I’m really optimistic about this bringing the nursing profession closer together, and that the world really needs us and depends on us and, and so I think it’s been a catalyst to bring us together more.
Ira Apfel 12:32
Kristy Duffey, thanks so much for being on the podcast today.
Kristy Duffey 12:35
Thank you so much for having me.
Ira Apfel 12:37
That’s it for this episode of UnitedHealth Group’s Weekly Dose Podcast. And don’t forget, you can now subscribe to the weekly dose on Apple podcast and Spotify. Just search for UnitedHealth Group would be those podcasts and it’ll come up. Please give us a follow. Thanks for listening and have a great rest of your week.