Who do you trust the most? If you or a loved one has received medical treatment in the last year, it may very well be a nurse. For the 19th year in a row, according to a recent Gallup Poll, nurses were ranked as the most trusted and ethical of 15 professions. In fact, even as they came through the pandemic—their toughest year in the survey’s history—nurses’ approval rating rose another 4 percent.
But that reputation is hard earned, and our latest research indicates that it may soon come at a cost. Twenty-two percent of nurses say they may leave their current position providing direct patient care within the next year, according to our newest survey of 400+ frontline nurses. We spoke with Gretchen Berlin, RN, to find out more; she is a McKinsey senior partner who led the research and has degrees in nursing and business from the University of Pennsylvania.
Let’s start with your background and what inspired you to become a nurse.
I grew up in Lancaster, Pennsylvania. My mom was a professional opera singer and my dad was a high school principal. My older brother was born very prematurely, and as we grew up, his care team of nurses came to each milestone of his life, checking in on him at various points. I was always intrigued by the close relationships that they had built, and that inspired me to pursue a clinically oriented profession. Also, both my grandmothers had been nurses. One was a young widow who supported her family as a nurse and the other was a psych nurse who ended up marrying the doctor who had helped her manage a patient in distress.
Some people may be surprised to know we have nurses and other frontline healthcare workers here at McKinsey. Why do they join the firm and what do they do here?
Yes, we have a growing community of nurses in a variety of roles: leading our Center for US Healthcare Reform, working in professional development to help colleagues map out careers, building capabilities with clients through our Implementation Practice, and serving in our Social Sector Practice. We also have a large number of physicians and other clinicians, like pharmacists.
I believe a lot of them find that there are multiple ways to have impact on people’s lives, either one-on one with patients and families or at a larger-scale at the systems level. Both are needed and valuable, and McKinsey is an amazing way to achieve the latter.
This survey looked at nurses after a very tough year fighting COVID-19, which contributed to some nurses saying they were more likely to leave their current positions. What other changes has the pandemic created in the profession?
On the brighter side, 17 percent of respondents say that they will be staying in nursing because of their experience during COVID-19. We don’t know all of the reasons—it may be partially due to economic reasons—but we think it is partly due to the very gratifying experience they had in helping patients and their families; support they received from management and communities; and the pride they have in being nurses.
The opportunity for organizations now is to engage their nurses in ways that will encourage them to stay and grow. This is where some of the innovations we saw during COVID-19 may come in. One example is technology. In some areas, hospitals accelerated the uses of tech devices at the bedside that could integrate with patient records: tablets for communication, and other forms of virtual monitoring. About two-thirds of nurses say they are very interested in opportunities to provide remote patient care in the future.
Which of these innovations has the greatest potential to endure going forward?’
I believe the technology is here to stay and the pace of adoption will only increase. I think the real nut we have to crack is how to seamlessly integrate these advances into the workflow and change our care model around them, rather than just having the technology be one more thing in terms of cost and burden a nurse needs to deal with every day.
What would you do as CEO of a healthcare organization to show your nursing staff that you support them?
I would give nurses as much of a voice as possible in the governance of their hospital or clinic. They should have input to any aspect of a health system that affects their work, from hiring of team members, to supplies, to workflow.
And I would do everything in my power to ensure they have the staffing support and time to provide this input.
We know there is a correlation between patient and employee experience; the more satisfied your care team, the better your patient experience as well.
What would you tell someone who is considering entering nursing as a profession today?
Nursing offers an amazing ability to positively affect people’s lives either one-on-one in frontline positions or on a larger scale when working at the system level. It teaches you skills in empathy and communications, which are invaluable in all aspects of your life. And at this point, it basically provides permanent job security.
In the earliest days of the pandemic, when urgency was high but our knowledge about the virus was low, nurses and frontline healthcare workers heroically cared for patients. What did you see in the profession at that time that most inspired you?
I was so inspired to see what nurses and nursing leaders did at all levels—classmates who went from the OR to full-time ICU nurses in New York City; clients who filmed training videos in their hallways for nurses to rapidly learn how to support respiratory interventions. Their bravery and can-do attitude really shone. I am extremely grateful to our nurses who have been running to the fire since day one and continuing to care for patients and our communities today.