• Paul DeChant MD, MBA

Elisa Arespacochaga: A Culture of Caring for Nurses

Elisa Arespacochaga, MBA, is Vice President, Clinical Affairs and Workforce for the American Hospital Association, has devoted much of her career supporting physician leaders and administrative leaders in co-creating organizational cultures of caring.


She is excited to be moderating a session on “Lessons Learned from Nursing Leadership” at the upcoming Healthcare Burnout Symposium, featuring Chief Nursing Officers from Providence St. Joseph Health and Cedars-Sinai in partnership with the American Organization for Nursing Leadership.


Arespacochaga recommends listening to nurses as the first step. “Nurses see the organizational processes that drive administrative burden, and they do so differently from physicians. We haven’t always asked them, but when we do, we can learn about a number of relatively small fixes that make a big difference.”


While the pandemic has taken a heavy toll on the entire health care workforce, examples of communities of caring and peer support have shown how clinicians can help support each other. As an example, in one hospital, “No one cares alone” has become a motto on how to organize work and think about colleagues.


Arespacochaga notes that this team support is particularly important early in a nurse’s career. Many hospitals have high first-year nursing turnover. With a focus on peer support and fostering relationships early in orientation, things change. Nurses feel that someone cares about them.


“I’ve come to realize the importance of this question in engagement surveys”, she notes. “Does someone at my work care about me as a human being?” When the answer is yes, engagement is stronger. “When someone shows they care, and we assume that the person across from us comes with positive intent, we can work through most challenges, even during times of stress. it may well have provided some support to keep clinical teams supported throughout the pandemic.


That said, she emphasizes that burnout is not a new or simple problem, and it will take many different solutions working together to change the culture. Some examples include:

  • Redesigning work processes and team functions to manage the overload. There simply aren’t enough practitioners for many currently designed care processes, and new approaches to training those with some clinical experience can bring additional support more quickly.

  • Empowering clinicians to solve their local problems locally. Part of what drives overwhelm is the sense that they are not empowered to make changes they know will help.

  • Hospital leadership engaging directly with front-line caregivers. When leaders see the significance of the challenges their staff face, it motivates them to engage more deeply, and vice versa, when the front line sees leaders truly engaged and “walking the walk” of well-being.

  • Everyone collectively owning the well-being of the organization and caring for co-workers to create a positive environment.

The pandemic has changed these conversations. If you’d like to learn about how it’s changing nursing, you find value in attending the session, “Unparalleled Times: Lessons Learned from Nursing Leadership” on Tuesday afternoon, January 25th, at the Healthcare Burnout Symposium in San Francisco.

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