Q&A with Rob Brooks, President & Interim CEO of St. Christopher’s Hospital for Children

In just over a year, Pennsylvania may have a shortage of 20,000 nurses – the worst gap in the country. By 2030, America as a whole could be facing an estimated shortfall of 1.1 million nurses.

The statistics are sobering, but addressing the staffing shortage in every layer of healthcare is a top priority for industry leaders across the country. And with collaboration, creativity and strategic action today, the future may be much brighter.

On September 25th, we’ll be bringing together three leading voices to discuss solutions to the nursing shortage for our first HealthKey Focus event, which will pair executive-level networking with a thought-provoking panel.

Rob Brooks, FACHE, president and interim CEO of St. Christopher’s Hospital for Children, is deeply familiar with every aspect of the challenges facing nurses today. He’s one of the few healthcare CEOs who is also a nurse, so we sat down with him ahead of the panel discussion to hear more about his experience and his insights for today’s leaders (and nurses):

How did you first decide to pursue nursing, and how does that clinical work inform your leadership of St. Christopher’s Hospital today?

When I was about 14 years old, I was probably getting into more trouble than my mother would have liked, and so she signed me up for a cadet fireman program through the Boy Scouts. Back then you could actually ride in the fire trucks and go on the ambulance – you were basically one of the crew.

We went on an ambulance call for a bad car wreck, and a helicopter flew in. I watched as the flight crew got out, swooped this person up and flew away. I immediately knew I wanted to do that.

So, I became a paramedic and went to nursing school. I worked in the Medical/Surgical ICU at Case Western Reserve University Hospital in Cleveland Ohio, and then as an Emergency Room Nurse at a Level 1 Trauma Center. After gaining that valuable experience, I was hired into my dream job at the time as a Flight Nurse for STAT MedEvac – UPMC’s flight program out of Pittsburgh – for about five years.

As a healthcare administrator, I think it’s extremely valuable that I can understand our clinicians’ needs and build strong relationships with physician colleagues based on like bedside experiences. Traditionally, a lot of healthcare administrators come out of a finance, business or public health background, lacking the clinical experiences that I have had exposure to. It’s helpful that I can understand what’s going on and relate to what they need.

You worked with the sickest of the sick and trauma patients – that sounds like someone who’s not afraid of a challenge. Why do you think you wanted to work in the hardest situations? How did that path lead you to where you are today?

I’ve always wanted to challenge myself. As a nurse or paramedic on a helicopter, you get to work at the highest level of autonomy, utilizing advanced protocols and performing advanced medical and surgical procedures in the field. A lot of the clinical work you can do on a helicopter is outside of what you can do in a hospital, because many of those tasks are done by physicians. We were doing things like surgical cricothyrotomy, which is creating a surgical airway and putting a tube in for someone who can’t breathe.

I just love to be challenged.

At the end of the day, healthcare is probably one of the most challenging executive roles across all industries. You’re dealing with the human element – physicians, nurses, staff, patients and their families – and then you have payer relations and the issues of how you get paid, which is especially nuanced for us as a predominant Medicaid hospital.

And on top of that, I think healthcare is the most regulated industry in the United States outside of maybe nuclear energy plants.

As someone who has worn both hats, how different does the staffing shortage feel as an RN vs. CEO?

When you’re in the trenches as a front-line nurse, it is very palpable if you don’t have enough support around you. As a clinician, navigating the staffing shortage is more about relying on your teammates, ensuring you have the support you need and making sure you don’t burn yourself out.

At St. Chris’, we’ve hired around 90 additional nurses in the last year to ensure we’re ready and staffed up when the large surges of kids come in. Pediatric care is very cyclical.

From an administrative level, we want to figure out how to grow the overall workforce to help end the shortage. We’re trying to understand what we can do now to retain people and ensure that our nurses are happy and stable in the job they have. And we’re looking at what the overall healthcare system can be doing to attract young people into the healthcare profession, and the role that our hospital can play in that effort.

How do you address the health and wellness of your employees as part of your retention and recruitment efforts?

The most important thing is to listen to your staff and find out what’s important to them.

We’re hearing that access to childcare is really important, so that nurses with young children have someone to watch the kids while they work. A flexible schedule is also valuable, as is the ability to self-schedule shifts and time off. We’re also looking at seasonal nursing positions that would have summers off, like teachers, because our volumes go down dramatically in the summer and we don’t need as many staff.

And as with any industry, it’s important to help our managers and staff recognize the warning signs for burnout so they can intervene early with help and practical solutions.

St. Christopher’s just received their 4th magnet recognition – putting you in the top 1% of children’s hospitals nationwide. How do you maintain such a high level of nursing excellence, and what else is St. Christopher’s doing to bring in the future generation of medical leaders?

I think one of the great things for St. Christopher’s is that the longevity of our nurses seems to be among the best in the country. We have many nurses who have spent their entire career here, like Claire Alminde, our Chief Nursing Officer, who came here as a nursing student.

I think what we need to do for the next generation is to change the paradigm. There used to be a saying that “nursing eats their young” – and if you didn’t make it through the gauntlet of being a new nurse, then you didn’t deserve to be there. That’s unfortunately the way it was for a long time.

But I think that hospitals and health systems have evolved and are doing a better job training and prioritizing new nurses. And today, I can tell you that our onboarding program for new grads is second to none.

During COVID, a lot of the nurses who were in school couldn’t do clinicals. They weren’t allowed to go to the hospital and get their hands-on experience. So, as we got out of COVID, we had a lot of new grads who were shocked at what they would be expected to do. Many of them just quit, and we saw our turnover rates starting to go up.

Claire got down in the weeds, talked to the staff and students and found this gap in their education. So, we expanded our orientation from what is typically six to eight weeks to six months – basically becoming the clinical training site for these new nurses so that they could spend the time they needed at a bedside, with a mentor, to get comfortable caring for small kids and babies. And that’s been instrumental. Our turnover rates have dropped dramatically. It’s a significant cost, but it’s worth it.

Outside of that program, we have about 2,500 different student learning touch points a year. We do a lot of out-of-town and out-of-state training for people who don’t have access to a children’s hospital, so we’re really invested in training the next generation of providers.

We also are working to introduce the next generation to healthcare through our Health Tech programs. In this program we are partnered with local high schools. In conjunction with the high school, we identify high-performing students with an interest in healthcare. We then bring these students in as full-time employees during their summers in high school with a paid internship that rewards them both financially and intellectually. Many of these students have gone on to higher education in healthcare, including nursing. This is an amazing program that we are looking to expand with additional funding from donors.

It’s amazing to see up-close the work that today’s leaders are doing to raise up tomorrow’s care providers, executives and innovators. Thanks for sharing your time and insights, Rob.