Recruiting a young and engaged workforce is particularly challenging for rural care providers. Innovative solutions such as signing bonuses and tuition payment are familiar tools many health care employers are using in employee recruitment. In this conversation, Susan Wathen, vice president of human resources at Hannibal Regional Healthcare System, discusses their unique approaches to finding and retaining future health care employees.

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Tom Haederle

Where will tomorrow's health care workforce come from? How can we recruit and encourage young people today to pursue careers in this critically important field? These questions face every hospital and health system in the country and are particularly challenging for rural care providers. Big challenges demand innovative solutions and one health care provider in rural Missouri has really stepped up to the plate.

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Tom Haederle

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Elisa Arespacochaga

I’m Elisa Arespacochaga, AHA's vice president for clinical affairs and workforce. And today, really excited to be joined by Susan Wathen, vice president, Human Resources, Hannibal Regional Health Care System in Hannibal, Missouri, and getting a chance to talk to her about recruiting and encouraging the next generation of the health care workforce. So, Susan, first, thanks for all the work you've done, and tell me a little bit about yourself and your role.

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Susan Wathen

Hannibal Regional is an independent health care system located in northeast corner of Missouri. My role is vice president of Human Resources, which means all of the HR functions roll up to me. Training or development, physician recruitment, employee health. And we have a child care center that has to report somewhere. So that is mine as well. You know, I'm part of the senior leadership team.

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Susan Wathen

And for an independent health care system, being a part of that team means that we need to be very nimble and collaborative as well. And so that's a bit about my role.

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Elisa Arespacochaga

It sounds like you've got a number of hats in your closet to fill. So like all hospital and health systems, you're facing recruitment challenges and not only recruitment challenges for today, but really thinking about the next generation of the health care workforce, which is even harder to do in a rural area. Can you share some of the great programs that you've got underway, both with your local educational system, your high schools, and then some of the opportunities you're putting together going forward?

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Susan Wathen

Sure. So we're doing a lot of the same things most of the listeners are doing. We are offering sign-on bonuses for hard to recruit positions such as nursing and radiology positions. We are paying for students' tuition. We're paying tuition for nursing students in exchange for coming to work force after graduation. You know, a certain level of commitment post-graduation.

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Susan Wathen

We're paying tuition for some hard to fill radiology positions. We are an official patient care tech apprenticeship program. So for those that have absolutely no health care experience but are interested and maybe even potentially down the road becoming a nurse, they can come in without any health care experience and go through our on the job training to become a patient care tech.

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Susan Wathen

And in the state of Missouri, that's just essentially an unlicensed CNA. So they're paid on the job. They're able to work full time in that role afterwards. If at some point they decide they want to go into nursing and further their education, we can help pay their tuition to do that as well. And we have partnerships with the local nursing schools.

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Susan Wathen

We have no cap on our tuition payments for one of the local universities there in Hannibal for their nursing programs, and we get a number of nurses for them. And then we have a little bit of a unique program called Work and Learn, where someone in any sort of university or community college, any accredited post-graduate level education...and they don't have to be going into health care. But if they will work in some of our frontline positions, such as dietary, EVS, phlebotomist and even some pharmacy tech one positions depending on how many hours they work each quarter, then we pay them a stipend for their going to school and work in those frontline jobs.

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Susan Wathen

So again, those are pretty similar to what a lot of places are doing. One of my favorite unique programs to help fill some non-clinical positions is what we call the BEST program. It's basic employment skills training. It's a partnership with our local high school, and it is for seniors in high school who have disabilities. They're either physically disabled or they're challenged.

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Susan Wathen

And honestly, for these students, their families plan for them before this program came to existence was probably going to be going on disability after they graduated high school if they graduated high school. So this is our eighth year for that program, and it places these seniors in internship roles on our campus. They learn soft skills, but then they are in positions such as environmental services and dietary materials management.

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Susan Wathen

And then we have that child care center. And so we've actually this year had our first intern in that child care center. We have been able to recruit and retain seven of those throughout the past years. And I'm sure we'll probably have the opportunity to recruit and retain 1 or 2 of those this year as well. So that's been, for the frontline non-clinical

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Susan Wathen

that's probably one of my favorite programs. It's just been life-changing for those high school students and their families.

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Elisa Arespacochaga

It gives them such a great opportunity to understand health care and be able to, you know, find a role that makes sense for them. That's wonderful. Let me ask and we'll get to your rural residency program that your personal mission to get done. But work like this doesn't exist in a vacuum. Obviously, you talked about a number of partnerships that you have already in place.

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Elisa Arespacochaga

How did you build some of those and how do you sustain them now?

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Susan Wathen

That's a great question. Relationships are key, and I think if you talk to anyone in rural health care, you're talking about rural areas. Those people have to have relationships to trust you. And so it's relationships internal but external as well. It's with the school districts. It's with the chamber. It's with your local governments. It's really building those partnerships and maintaining those relationships.

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Susan Wathen

You know, we're taking care of those same people in our health care system. And so they often will get to see both sides of that. But it's a lot about the relationships, any place in rural health care.

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Elisa Arespacochaga

I know you have on your plate building a rural residency, but you're not building that from nothing. You've got a program already in place. Can you tell me a little bit about where you're going with that work?

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Susan Wathen

Sure. So this is the eighth year that we have had third and fourth year medical students doing their clinical rotations at Hannibal Regional. We're a formal training site for the University of Missouri out of Columbia, Missouri, and for A.T. Still University out of Kirksville, Missouri. And we'll have some one off clinical rotations for people that maybe are in other medical schools across the country but have ties to the area.

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Susan Wathen

But those third and fourth year medical students do all of their third year rotations with us and then a number of their fourth year. And that has really been good for the physicians. I think our physicians were a little gun shy at first. It was change. It was new. It looked like it was going to be a lot of work for them.

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Susan Wathen

But what they have found is that these students really compliment the work they do. And the students keep these physicians very sharp. You know, the students are being trained. They're asking questions that sometimes cause the physicians to have to go look something up. So then just organically, our next step is to bring residents into the setting.

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Elisa Arespacochaga

That's awesome. So as you're, you know, based on your experience in building all these programs and your deep HR background, what's some advice you'd give for those who are saying from, you know, are in clinical departments or other departments, they're trying to figure out how to approach you - HR - and say, I want to build a program. What's your advice to them?

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Susan Wathen

I'm going to go back to relationships. You know, we have a little over 1,600 team members. I can't say now like I could when I started working there, that I really know everyone, I know their names. But I work hard to know people and build relationships with them. I think keeping that open door, doing rounding in all of the locations and areas so they at least see who we are gives them the opportunity to feel comfortable coming, instead of just going from the HR perspective, instead of just going in some place

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Susan Wathen

when you're coming in with bad news, come in with good news and build those relationships. I think that's true for any leader in rural health care.

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Elisa Arespacochaga

And I guess the flip side of that is all the folks listening should know that they can go talk to their HR folks, and especially when they've got a good point, you know, a plan to try something new.

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Susan Wathen

Right. Well, and I think with all of these programs we've talked about, it is not just HR. This crosses, it breaks down the silos, and it really crosses a lot of different areas in rural health care settings. Nursing is involved in many of these and nursing education. If our chief medical officer weren't on board for having medical students or residents, these programs wouldn't be going. Operations is impacted

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Susan Wathen

when we bring these interns on site and we need a classroom. It is not just HR.

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Elisa Arespacochaga

I'm glad you're leading the charge for Hannibal. And thank you so much for joining me today.

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Susan Wathen

Yeah. Thank you Elisa.

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Tom Haederle

Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.