CastleBranch and Becker's Hospital Review logo lockup


Reversing the Nursing Shortage:
Q&A with Nicole Bradford


In January 2022 Becker’s Hospital Review hosted a live webinar featuring CastleBranch Vice President of Research and Development Nicole Bradford examining the issues impacting the sophisticated pipelines for nursing education and employment. Specifically, Bradford spoke to strengthening the ecosystem between higher education and hospitals to increase the supply of qualified nurses to fill staffing shortages across the nation.


As part of CastleBranch‘s effort to move the conversation from issue awareness to actively developing and implementing solutions, we are pleased to present some more insights derived from a post–webinar Q&A session with Nicole. After reading the summary of this Q&A below, please feel free to reach out to us with any questions about your particular issues in staffing open nursing positions at

Q: Will you be recording and sharing the deck after the webinar?

A: Yes! You can view the presentation and learn more here.


Q: Your title is VP of Research & Development at CastleBranch. What does that entail?

A: Honestly, it’s a pretty broad role. The most important aspect is representing the voice of our customers and the markets we serve. That starts with understanding the problems and challenges they face deeply through research. The most valuable insight comes when we hear directly from the industries, through people who are doing their best with what they have today, giving us insight into the many opportunities for improving their work. Once we have this foundational understanding, we leverage best practice product development processes to map out potential solutions. Ultimately building them, testing them, and releasing them to the market. We strive to produce a scalable quality solution addressing the full magnitude of the problem we look to solve. And we measure the level of customer satisfaction as a gauge of our success.


Q: What is your personal and professional connection to nursing?

A: My time at CastleBranch has helped to open my eyes to the gravity of the issues nurses face. This goes for students, those applying for nursing programs, new grads, and newly licensed and employed nurses. I’ve had the opportunity to speak directly with many along the various milestones in their own educational and professional journey. You can’t help but feel compelled to want to help them since they spend all their energy helping others. I also am blessed to have several family members in the profession.


Q: What feedback has CastleBranch received from healthcare organizations regarding staffing shortages and turnover with nurses? How does that feedback correlate to national trends?

A: In broad brushstrokes the feedback is that there are staffing shortages and the turnover is a major challenge for all involved. This aligns with national trends. Those national trends indicate there is a supply challenge, there is a demand for more nurses. Now, not all geographic locations are encountering the same challenges prescriptively; in some areas nurses aren’t getting hired as quickly because regionally they have sufficient supply. So we acknowledge there are some pockets where the issue is less painful, which gives us the unique opportunity to investigate further, and apply those learnings to addressing the problem overall.


Q: How long does it take to see a change in staffing rates when incorporating CB FutureFocus™? What is the quickest ROI?

A: The answer will depend on a number of factors specific to your facility, including what your baseline for turnover for newly licensed new graduate nurses is, your total number of annual hires, and total number of clinical rotations available. However, if you are able to adjust your supply chain early and often, ROI can be achieved before a hire actually takes place – especially if you’re able to prevent a hire that results in a quick turnover.


Q: The use of financial incentives to hire and keep nurses has not helped alleviate staffing shortages at hospitals; why not?

A: There are a couple of different lenses we can look at this through, from a purely economic and business standpoint there will generally be a higher paying job for nurses out there when there’s limited supply, and prices (compensation) continue to rise — we’re experiencing that now in our everyday lives with inflation and our grocery bills. So the math tells us that will continue to happen until the demand levels off, or the supply increases and can satisfy the demands. The other factor when we talk with thousands of healthcare organizations across the country, when individuals are taxed, when they are challenged they are looking for support and career opportunities where they are. They are really craving some motivation to stay in their roles and weather the storm rather than have to go through the process of looking for a better fit elsewhere. Though compensation is a critical component of retaining nurses, we are hearing that the intrinsic value, their fit, within their role and the organization is of high value as well.


Q: What are some of the reasons new nurses are quitting the profession outright or moving on to other healthcare facilities so soon in their professional careers?

A: Part of what we’re hearing is the nursing profession is very difficult, very challenging. It takes a special individual to be a nurse, and something we recognize is transition shock. New nurses experience a side of the nursing profession they sometimes aren’t necessarily prepared for. Unfortunately, there are things like nurse bullying in the workplace, from peers and mentors. This is not prevalent everywhere, but it’s just one example of so many things that make it difficult for a new nurse to get up to speed and motivated to stay.


Q: In the webinar you discuss the concepts of a nursing pipeline and nursing supply chain; how do the two differ and why is that important?

A: The nursing supply chain is the measurable process that gives you the data, the information and insights to identify all of the complexities across the processes that are happening. It also gives you the opportunities to address fail points, aspects that need to be remediated. The nursing pipeline is what’s flowing through the process, it’s the people going through the process. You want to understand them and have them understand you, so they can become part of a healthcare facility over the long term.


Q: Does CastleBranch have similar tools, or are you developing similar tools, for other areas of healthcare staffing?

A: Yes. While nursing is often the leading point of the national conversation, CB FutureFocus™ and CB Bridges™ can be used to help improve outcomes for all clinical positions within healthcare, including but not limited to nursing, phlebotomy, EMS/EMT, physical therapy, occupational therapy, respiratory therapy, nurse anesthetists and more.


Q: How do you see the use of personal as well as professional data provided by nursing students as part of the solution, especially in regard to hiring new grads who are the right fit for open positions and vice/versa?

A: I’ve had the opportunity to hear some impactful stories about why that information is so important. One of the most recent is a nurse manager who was evaluating a nurse in their unit. The nurse’s performance was lagging, so the nurse manager dug a little deeper and uncovered some characteristics about that person and some of their desires, that would make it challenging for them to find success in that particular unit. There’s a happy ending, though; they were able to make a recommendation to that nurse and HR, to get them into a better unit to find more fulfillment while continuing to serve as an important part of the facility. That’s honestly the bones of the stories we’re hearing; experienced nurses know there’s aspects of their work that makes them tick, makes them feel like they’re going to like working in a particular environment. New nurses have an idea and a dream, but not always the experience to validate that. Though all of this may change as that nursing student becomes a newly licensed nurse and eventually an experienced nurse, it’s important to have that baseline understanding.


Q: What is the ideal profile of a potential new hire according to the data your tool collects?

A: That’s up for you as a healthcare organization, and that individual nurse to decide. As an example, there are core characteristics that people have (like drive and motivation), and core pillars that your organization thrives on (like an unwavering commitment to timely patient care), and exemplars of team members that drive your core pillars forward and possess very similar characteristics. It starts with data and information to create those baselines so that over time “the right fit” becomes even more evident.


Q: CB made some bold statements in the webinar. Do you believe your company can solve the nursing shortage?

A: Simply stated, no. Not just us on our own. However, we do believe we have developed ways to help to solve it and address a critical aspect — the supply component of supply and demand — by focusing on newly registered nurses as an aspect of that supply. More specifically, through the facilitation of the entire collaborative supply chain through our SaaS and managed services solutions.


Q: What is the major takeaway you’d like people to garner from a discussion on this topic?

A: I’ve had an opportunity to work with some amazing nurses on a committee centered around nursing, and one of the members said inaction is not an option. I love that quote and I feel it applies here. I hope that everybody sees that they have an opportunity to be part of change and take a different action to address the nursing shortage by focusing on data and information with students entering their facilities.

Nursing in Crisis: Rebuilding the Talent Supply Chain from Within and Reversing the Nursing Shortage