Nursing in Healthcare Administration

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Dr. Swanson-Biearman speaks with our team of the how a background in nursing can translate into the field of healthcare administration.


Speaker 1:Hello everyone and thank you for joining today’s webinar where we will be discussing nursing and healthcare administration and how it correlates to Duquesne University’s Online Master of Health Administration degree. I’m glad to be joined here today by Dr. Brenda Swanson-Biearman, who is the Director of Public Health Programs at Duquesne University Rangos School of Health Sciences. Hello, Brenda, how are you today?

Dr. Brenda:Very well. Thank you.

Speaker 1:Wonderful. And before we get started, can you give us a brief overview of yourself and your nursing background and how you moved into healthcare and the role you’re in today?

Dr. Brenda:Sure. My line through nursing has never been a straight one, my path has been kind of crooked. And, I find things that are very interesting and that I tend to go off on a path and concentrate on those for a while and then I changed my mind and go back to different things. That’s the great thing about nursing is that you can actually do that. So, I started my career here in Pittsburgh, Pennsylvania. I got my bachelor’s degree from Carlow University and I worked in intensive care and emergency medicine for several years. And, then decided that I wanted to concentrate more in toxicology and poisoning so I started to work at Pittsburgh Poison Center and worked there for about 15 years and had a very lucrative career. I was able to learn how to do research and how to work well with pharmacists and physicians alike, then I decided I wanted to go and study that further and learn more about research.

Dr. Brenda:So, I went to the University of Pittsburgh where I got my MPH in epidemiology and I thought that what I really wanted to study was injury research which I still have an interest in. I was an NIH fellow there in the aging group and then from that point on, I started to go into PA education. Someone asked me if I would come and teach other research for their students, I said, “Sure”. So, I went and started that which quickly moved into a full-time position where I was at Chatham University for about seven or eight years. And then Waynesburg University came and asked me if I wanted to run online education for all their graduate programs at the university. I was happy to do that and I thought it was something new, something fun, online was just becoming really hot so I thought this is a great thing to do.

Dr. Brenda:So, I went over to Waynesburg for awhile was there for about five years, got the whole online graduate programs settled with a lot of different majors. And then I decided that I really miss teaching. Although I did teach in some of the nursing classes over at Waynesburg, I wanted to go and just kind of move over back to clinical education, the PA department. So, I finished my doctor of nursing practice at Waynesburg University while I was working there and decided to go back to Duquesne University. So, I went to Duquesne and started with research again and then fell in love with simulation again and teaching students all about simulation.

Dr. Brenda:So, after doing that I’ve also done some teaching in nursing administration. I teach in the doctoral program at Waynesburg University and I’ve also have sat on many of their capstone which is like a dissertation committee and still do that to this day. So, I have worked in many different places mostly in education. I worked very closely in public health. I like to work on projects that involve systems change and administrative things that involve nursing and medicine and pharmacy. As a nurse I’ve been able to move back and forth through almost any area of medicine or healthcare that I like. So that’s why I really liked nursing and actually marrying that with health administration, because that really lets you float just about anywhere in the healthcare system.

Speaker 1:Wonderful. Yeah, it seems like you’ve done so much lucrative work in so many different healthcare fields. And, I’ve seen that a lot with many different nurses and it’s usually not a straight line or straight path that you can take your career into so many different aspects of healthcare. Whether it’s, like you were saying, directly through into nursing or into some of the other fields of like the poison center things you were working with and then going more into the healthcare side. And, I think nursing and healthcare administration can really go hand in hand. So, I hope we can kind of discuss that a little bit more in depth in today’s discussion point. So for everyone today, I’m going to quickly go over the discussion points. Like I said, we’re going to go into each of these a little bit more in depth, first being the benefits of nursing knowledge and education within the MHA role, followed by why nurses would want to earn their MHA rather than a master’s degree in another field, how the roles may differ in hospital settings between nurses and health administrators and the future job growth and salary.

Speaker 1:So, I’m excited to jump in here today. I think we’re going to have some really good discussion from you, Brenda. So, if you just want to kind of take it away of the benefits of a background in nursing and the knowledge that they have and how that can be correlated over into an administrative role.

Dr. Brenda:Sure. I don’t have to tell you or all nurses, but nurses are very flexible. We tend to create our work settings so that it works well for us and we create it so that it works well for other people as well. So, nurses understand how to provide optimal care and how to work inter professionally understanding the importance of a solid visionary leadership. So, filling into more of administrative role takes you away from bedside nursing or types of nursing that involve direct patient care into a role where you’re overseeing patient care and making decisions about patient care along with budget and supplies and things like that. Help to organizations are very high-performing anymore, we work on collaborative teams. We are now teaching all of our students to work in teams and medicine, pharmacy, they’re all learning how to work with teams as well, but we want to seamlessly deliver better, safer healthcare with increased patient satisfaction and better patient outcomes and that’s always the goal.

Dr. Brenda:So, when you go to school and you decide what you want to do, the MHA really does teach the skills necessary to lead healthcare. It’s very different than just going and getting an advanced degree in business or one of the types of business because business is business and it does not have that humanistic portion of healthcare that we talked about. But the MHA we’ll talk about how we develop business initiatives and how we develop policy. What goes into developing policy, you’ll learn budgeting, finance, supply chain, management, all the things that have been… Something that we’ve had to worry about recently with the pandemic. Now because of that, we’ve had to change a lot of things that we’ve had to do and people in administration have had to become flexible. Those who are not flexible have left. So, we have seen people who were unable to control this disaster situation that we’re in now and so we need people who are malleable and can mold themselves into new positions and make different kinds of decisions. Nurses are perfect for this.

Dr. Brenda:So, the other thing that nurses are good with is working with regulatory aspects of healthcare, we know what the rules are it’s different than business, business has their own set of rules. Absolutely we have different regular regulatory issues we have to think about pharmacy regulation, supply regulation and then of course all the aspects of patient care regulations and the public health implications of that as well. So, nurses are able to adapt to the understandings issues involving day-to-day operational care of healthcare facility. So, there’s a lot of different facilities that you can work in and you may just work in day to day operations, you may be in charge of a specific department or you may be someone who’s a systems leader and nurses are excellent people to be visionary leaders in these healthcare facilities.

Speaker 1:Yeah, absolutely. I completely agree with you. I think nursing has such a kind of advanced way of looking at this and seeing the more value-based care taken within the administrative field. And aside from just the business that the MHA role will teach you, but a lot of those nursing skills come from a lot of that time being with patients and their families and adjusting it that way. So, it’s not just about kind of the numbers and just the money that comes through for the whole healthcare industry. And you’re absolutely right as being flexible as well, I think for this year especially, I mean, where would we be without some of our nurses and their kind of points of view and how the whole healthcare industry has probably changed a lot this year due to this pandemic and COVID and everything around that. So, I think you had some great points.

Dr. Brenda:Yeah. And one of the things about nursing that some people forget, of course nurses don’t forget, but not only are we taking care of the patients, we’re taking care of the family too. [inaudible 00:10:04] used to have on a holistic view of our patients. We look at how they fit into their family, how are they going to go home? How are they going to be okay? How can they get their medications? We look at all of those things and it’s like a mini system is looking at the family and the dynamic of that family and society. So, our brains are already set to do this.

Speaker 1:Absolutely. I 100% agree with you. That is so important to the holistic approach of like I said, for the value-based care within health administration. So, kind of moving on, I know you’ve hit on a few of these topics in here already, but could you go into a little bit more depth of why nurses should pursue their MHA rather than getting a master’s degree in another field?

Dr. Brenda:Sure. Nurses can move upwards and outwards in many ways and so, there’s a lot of different degrees that are available to them that they may be interested in. Some are interested in education and will pursue as some kind of advanced educational degree. But if you want to go into administration, I think it’s important that you look at something that has healthcare background entrenched in the program like an MHA program. So, what that does is that it takes the knowledge that you have of healthcare already and marries it with the knowledge of business that you need to run a healthcare facility. So this field changes a lot as we’ve noted before and we need people who can do a lot of different things. So, sometimes people like to work with numbers and do budgeting and that can be done at the unit level or that can be done at the across the hospital or just across regions of the hospital, or in charge of the entire healthcare system which nurses do do.

Dr. Brenda:So, if you have an interest in that some people will go in and get their MHA and maybe take a couple extra finance classes of course, a finance class is already a part of an MHA program. You want to make sure that for good patient outcomes that your staff is all trained appropriately, that you have all of the equipment that is necessary so you need to know budgeting. You’ll need to know about the supply chain management of being able to get all the equipment that you need in time and then how to get everybody trained and then how to evaluate that they’re trained properly. And, I’m sure that you’ve all been through then you get the retest six months, a year down the road and the possible retest after that, because we want to make sure that our staff remains competent. So, those are things that health administrators will do. Very difficult to do these things when you just have a degree in business.

Dr. Brenda:We will actually show you how to do this in the healthcare arena. So, the biggest change that we’ve seen and has slowly evolved over the last 15 years or so is moving into electronic health records and nurses have been key in making sure that this happens. They’ve worked with IT people to make sure that the language of nursing and medicine and pharmacy gets translated properly into the IT components of the electronic health record. So, these electronic health records are going to be living, breathing entities because we’re constantly changing them and nurses and often informaticist who are nurses are in charge of that. But we do need someone who has the overall administrative knowledge to make sure that we have the most updated electronic health record in our facility that it’s working properly, that we have a solid backup plan in case something happens to the EHR.

Dr. Brenda:There’s a lot of things that administrators take into consideration that not necessarily someone who’s working with in direct patient care would be concerned with. So, we know that in business that if the IP portion goes down so maybe you’re offline for an hour or so, this is a huge deal in healthcare we can’t have our electronic health records offline for a while. Patients need medications, they need to have them administered, we need to be able to charge them, we need to be able to do all of the things that require our computers to be working at all times. So, that does make it a little bit different than just being in business, but these needs and changes have been occurring a lot and certainly very rapidly in the last year due to COVID-19. And because of this we saw that regulations have changed, rules have changed, ability to get money has changed, budgets have changed.

Dr. Brenda:We had people who just used to keep PPE, personal protective equipment, they just kept some in their hospital because they knew they would need it for contaminated patients or very ill patients. We never anticipated the onslaught of COVID patients that we were going to get so people were not ready. So, we needed to make sure we got all that equipment, we needed to make sure that our nurses were safe, that our physicians were safe, our respiratory therapists are safe. We also had to look at different ways that we treated people. Hey, maybe it’s not the greatest thing to intubate somebody, but to use a BiPAP instead to decrease aerosolization of COVID. So, we’ve had to change a lot of ways that we look at things and our nurses are certainly key because they do partner very well with physicians and pharmacists than all the other key players in the healthcare arena.

Speaker 1:Yeah, absolutely some great points in there. And then talking about either just the overall business aspects that still are needed within here and especially, you’re saying like IT related and everything kind of opened my eyes a little bit of to the online medical records and how extremely important they are and how well managed they need to be moving forward. And especially in a time like this of ,extreme upwards of importance. So thank you for going through just kind of the different ways that MHA could really elevate your career in that aspect. And our next topic. Again, you’ve kind of touched on this a little bit, but can you just also explain maybe the difference in a hospital setting of nurses versus a health administrator more specifically.

Dr. Brenda:Sure. The great thing about having nursing background it’s just very advantageous when wanting to become a health administrator. Nurses understands how hospitals work and that’s their base for how they operate. Most nurses provide some form of direct patient care, but when they move they take that skillset and that knowledge of what’s needed into administration. Then we know that administration is not just nurses, we have the CEO, we have physicians, we have a full hospital board. We have a lot of people that nurses have to interact with especially nurse leaders and our MHA students and graduates. So, we expect that you will see the overall systems care that has to be provided. We have to pay attention to not only our pharmacies, are they getting medications that they need? Is there some kind of restriction? How is the lab doing? Are they able to move specimens in and out quickly? Have they been certified within the last two years like they’re supposed to be?

Dr. Brenda:And there’s a lot of moving parts of the lab within the hospital… Hospital never sleeps unlike some businesses which kind of close up at five or six o’clock. But we do see that it’s critical that nurses are able to kind of have this well-rounded knowledge that they can use in all aspects of the hospital. If they moved out of the hospital settings into some of the other settings like urgent cares or large practices, they will do a lot of the same things sometimes just on a smaller scale. They may actually have some focus physicians and we’ll see this in the hospital as well, but there’s a lot of administrative roles and I’ll just touch on a few of them because some of them I had never even heard of before. And, they’re constantly coming out with a new roles for nurses which is very exciting.

Dr. Brenda:Nurse directors, these are people who absolutely use administrative things the course that they have to take. So this will be the finances, is communication, all the things that you would expect to find in a health business kind of background. Clinical coordinators, assistant chief officers, sometimes the CNL or chief nursing officers are often MHA trained nurses. Director of quality and we all know how important quality is, that we have met everything we do is measured by quality. So, a director of quality would also be in line with something that an MHA prepared nurse would do. And there’s different things like directors of innovation that that’s something that has been relatively new within the last 10 years or so.

Dr. Brenda:Where we start putting evidence that we see out in the literature to work what’s going on? What’s new? Let’s try this at our hospital. Let’s do some translational research where we translate somebody else’s research into our healthcare facility and see what happens this should work out the same way it did for the person who performed the research so then we want to also see how that works. We want to perhaps just follow up with some quality indicators or just get some basic statistics that we can use to report to the board and actually make changes to patient care and how we take care of patients and their families in the hospital based on this knowledge.

Speaker 1:Yeah, that one is new to me, the director of innovation. I’m glad there’s so much kind of growth and expansion within the healthcare setting and especially for nurses. And, thank you for also touching on it. This could be used for more than just a hospital setting that other healthcare facilities, laboratories that you kind of touched on those things, but there’s a lot of possibilities to use your MHA for and probably more expansion in the future and adding some more of these newer roles kind of something like the directors of innovation, other things in the future.

Dr. Brenda:I agree. I think [crosstalk 00:20:59]

Speaker 1:Go ahead.

Dr. Brenda:Oh, I was just going to say that the other thing that with so much change that’s going on in healthcare right now and medicine we know gets delivered more cost-effectively in the home. We’re putting a lot of nurses in charge of home care and medical things that are done to home that we typically use to keep people in the hospital for. We know Medicare and Medicaid are not reimbursing for certain types of patients who are returned to the hospital or have to be readmitted within 30 days. So, now nursing has really jumped on a lot of this home care of patients to keep them out of the hospital and to keep medical costs down, very important.

Speaker 1:Yeah, it’s extremely important. Completely agree. So, I think kind of our last topic and we were talking about this a little bit and the further job growth around the health care industry and then for nurses specifically in their roles kind of moving into a health administrator position. Can you talk a little bit more about the future job growth and maybe salary expectations? I know here on the slide we have listed from the Bureau of Labor Statistics that healthcare management is expected to grow 18% in the next eight years. I think that’s pretty astonishing and three times faster than the national average for other job growth. And I know for this year specifically job growth in certain industries is a little bit different, but I think an 18% growth is phenomenal for this industry. Can you touch on that a little bit more?

Dr. Brenda:Sure. And, you may notice that this number may vary a little bit depending upon where you look, but I think in several places so it looks like it’s anywhere. The lowest I saw was 18, the highest I saw was 21%.

Speaker 1:Wow.

Dr. Brenda:Yeah. And then of course it changes what year you’re looking at to up to 2025 up to 2028, but the Bureau of Labor Statistics is pretty solid when it comes to making these predictions and this forecasting. So, it is something that is growing very fast and the reason why this is is we have a very fast growth in hospital development, new clinics, new technologies that are always being created and the shifting of our patients. Again, shifting from the hospital to home care, shifting people who are dialyzed in the hospital to dialysis at a dialysis center.

Dr. Brenda:So, we’re moving people around to areas where they get more cost-effective care. And then of course, we always have changing laws and regulations and depending upon what area you go into. If you go into a long-term care administration with your MHA you can see that there’s Medicare is always changing their regulations. And, I know a lot of people love that challenge of being on top of that and making it work. So, it just changes all the time I’ve been in nursing for a long time and some things stay the same, but nothing stays the same. So, we know how we want to take care of our patients and that part kind of stays the same, but all the technology and the new things we learn is what changes and makes it exciting. But healthcare administration is kind of in charge of taking all these aspects that we look at with hospitals facilities and people need to run these things, people need to lead people.

Dr. Brenda:We can’t just take a group of people and put them together and say, “Okay, we need you to take care of the patients.” We need somebody who can organize this, create a system that functions, that moves well, that moves smoothly and that somebody to me is always a nurse. Because they’ve always learned to do that, get those nursing skills and bring that MHA skills in, the management skills, communication skills, all those things just work so well together. And because of that, it does require additional education so we do expect those salaries to be higher. So, I actually kind of low ball this average salary for healthcare administrator I’ve put in over $100,000 a year, it’s more like $120,000 a year, but of course you have to watch that depending upon are you in an urban area? Are you in a poor blighted area?

Dr. Brenda:Are you working for a federal facility? Which may have great benefits, but a lower salary. So it just depends on where you work, but the top 10% of healthcare managers earn more than $189,000 a year while the lowest earn around $58,000. And, the $58,000 a year that may be some of the very small clinics that may be in more rural areas and so those are taken into account as well. So, the salary level though will be directly reflected by your education and your experience and they do look at your nursing experience. And especially if your nursing experiences had on aspects of leadership team leader, a unit coordinator, unit leader, a nurse manager. As someone sees that you’re actually growing through their healthcare system that looks fantastic when you go to get an MHA and you actually are completing. So, not only are you kind of just walking the walk that you’re actually doing the talk as well and doing the work that’s required with the MHA. So, this is what makes this degree very valuable.

Speaker 1:I completely agree. And, those numbers are very high maybe I should go back and get my MHA.

Dr. Brenda:Well, I don’t know. People are leaving, they’re quitting in administration because they can’t hack the COVID. So, there may be room for you.

Speaker 1:Yeah, maybe. I know it’s a very tough area and time right now, but that’s when we need those tough people and those tough nurses that can transition into that role and really change the outcomes of this year.

Dr. Brenda:And I think nurses more so than any other healthcare member are more… We’ve always had to advocate for patients. We advocate for everything, we advocate for ourselves. We always put ourselves first and that’s what is needed in healthcare. And, that’s why the MHA works so well with nursing.

Speaker 1:I absolutely agree, that’s why we love our nurses. And, was there anything else or any other things you want to talk on today before we kind of wrap up?

Dr. Brenda:I don’t think so. Certainly you’ll give them information that they can certainly call you to get additional information about joining our MHA program which would be great. We do have concentrations for people who have specific interests those are in health informatics, data analytics. We have healthcare compliance and risk management. So, we always talk about safety so always a very important in compliance with regulatory issues. And then population health, because part of being in the hospital and running healthcare in a community is also making sure that your population around your hospital is safe and has everything that it needs to be safe. You want to find out if your community is at risk for something you need to be prepared for that, what can you do about it? Can you help mitigate it? So, these are all things with these concentrations that are very helpful depending upon what your interest is.

Speaker 1:Absolutely and thanks so much for hitting on those concentration areas that are unique to Duquesne University, MHA program. Well, just to kind of wrap things up, thank you so much for your time today, Brenda. I hope this is extremely beneficial to any nurses that are currently looking into our MHA program here at Duquesne University. If you are ready to learn more about our online master of health administration degree or the concentration areas that we had just talked about, including health informatics, health care compliance, risk management and population health, please reach out to your enrollment team today. So, thank you again, Brenda, for your time and I hope everybody has a great rest of their day.

Dr. Brenda:Thank you.