Ep. 19 | Why It's So Difficult to Create Meaningful Change in Hospitals: Lessons from a Bedside RN Turned Entrepreneur
Written By Myles Parilla
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Here's my conversation with Zach Smith, a bedside nurse turned entrepreneur in a tech start up aimed to provide more autonomy back to nurses in managing their schedules.
Tune in to this episode as I speak with Zach on:
How the NurseGrid App started and his role as a founding member.
Lessons from his challenges in integrating their App in hospital scheduling systems.
His perspective on the current climate of the nursing workforce.
Zach's passion for advocating for fellow nurses is quite tangible in this raw and unfiltered conversation.
Guest Spotlight: Zach Smith
Zach Smith is a former bedside nurse turned entrepreneur. Zach helped found NurseGrid, the #1 Nurse App in the nation, which has received millions of downloads by nurses. He remains involved in other nurse-focused businesses, advising on both product and marketing, with an emphasis on advocating for the rights of other bedside nurses.
Connect with Zach:
LinkedIn: https://www.linkedin.com/in/zach-smith-bsn-rn-a781bb30/
Instagram: @wazzuzach
Like & Subscribe on:
Apple Podcast , Google Podcast , Spotify , Amazon Music
This episode was recorded via Squadcast and edited via Descript.
Transcript
Episode 19: Zach Smith
NOTE: This podcast was transcribed by an AI tool. Please forgive any typos or errors.
Myles Parilla: [00:00:00] There's a lot of articles just even in the North Pacific Northwest, right? There's an almost impending closure or what have you, because of the lack of funds. What would you say to these organizations who are, um, having this problem?
Zach Smith: Yeah. Um, figure it out. It's like, not my problem. I'm speaking from the perspective of a nurse, like, Oh, I'm so sorry that.
You don't have enough money to pay what people are willing to work for. Like I get that hospitals have a challenging situation. I don't think nurses all oftentimes wanna acknowledge that we came in here to take care of patients safely. And it's not our responsibility to be put in unsafe situations to keep these patients alive.
It's your job. This is your business. It's not our business. This is your business to figure out how to make it work. So figure it out. Our system has to find a way, but nurses are about to break.
Myles Parilla: [00:01:00] Welcome to the insightful nurse leader. This podcast is focused on assisting nurse leaders become effective managers and change facilitators.
All right. Welcome to our 19th episode of the Insightful Nurse Leader. Our guest today is the founding member of NurseGrid. And also a nurse entrepreneur. I'm personally fascinated with this person's background coming from being a bedside nurse to becoming a VP of nursing and being a founding member of a great company and now really transitioning to working on the next venture.
Our guest today, Zach Smith welcome.
Zach Smith: Thanks for having.
Myles Parilla: Well, really glad to have you here. So Can you tell us about your motivation on starting the company?
Zach Smith: Yeah, so, I was working bedside when, Joe, the founder of NurseGrid approached me, who's a long time friend of mine and I'd worked with him on one of his previous ventures and we were always kicking ideas back and forth and he said, Hey, I'm about to start a a new company and I think you'll find it [00:02:00] interesting.
Do you wanna join my team? And it was just him and another guy at that, at that point, we just had begun fundraising and, you know, he had a business plan and sort of an idea and a concept. And what we talked about and, and really how we centered the mission was sort of, Trying to create technology, that was built for the end user, the nurse themselves.
And the insight that we drew that from was, how many things do you use in a hospital that you're like, who designed this? Right? Like, clearly not a nurse. Or someone who assigned this to be a task for me doesn't really understand what it's like to work bedside. And certainly that was the case in scheduling technology.
We've all been on the other side of, of , trying to operate, the various scheduling technology that's out there. And it just feels archaic and old. Much like a lot of things in hospitals, unfortunately, and, uh, not really built for the end user. And the more you dig, the more you find that, the reason is is because the, the key decision makers are the C-suite executives in hospitals, right?
[00:03:00] The people at the very top. And the further up you go, the further away you get from the bedside experience. And so when people are creating technology and solutions and selling it to hospitals, they're trying to create it and sell it in a way. those purchasers will sign off on it. And, and I think that is a recipe for how you end up with tools that don't really meet the needs of the end user themselves.
And just having been having worked bedside and being on the other end of that, So many times we wanted to flip the script. we wanted to give power back to nurses, give, nurses a voice and a say in what scheduling technology they want to use. So the whole model was predicated on let's create a free mobile app, that nurses will love and they'll use.
And, you know, you can connect with, basically you enter and manage your schedule. You connect with other colleagues. You can see their schedule, you can see who they work with. You can swap shifts, all those sorts of things. And it's totally free and it's independent of the facility. But you do assign yourself to a department when you create an account.
And so the [00:04:00] strategy was that we would get it's, you know, sort of the Trojan horse strategy. We would get a lot of nurses using our technology inside of hospitals without hospitals ever even knowing. And then we would approach hospitals and we'd say, Did you know that you have hundreds or on some cases over a thousand people, nurses who are using our technology in your hospital to manage their schedule?
Clearly this is a sign that your current scheduling solution is not meeting their needs because they're going outside of it to, to use our solution. And then, uh, we offered them sort of our paid platform, which. An opportunity for, for the departments to, you know, upload and manage their schedule and distribute it, to the nurses themselves.
And so that's, that was the sort of model. But what we were focused on was sort of giving that power and voice back to nurses, giving them a say in the decision making process by letting them pick and choose the technology they want to use. And then using that as influence in the sales process that we took to the CNOs and the executives at hospitals.
Myles Parilla: Mm. Wow. Fascinating. You know, you mentioned two words that, struck chord with me. [00:05:00] Archaic and old. As a previous nurse manager in nurse leadership role in, in the ER before, you know, I managed the. Schedule and I, you know, made sure that, shifts are covered and such, and working in different organizations in, that role.
you know, you hit the nail in the head. It's archaic and, and it's disjointed there. There's no interoperability and, you know, it's difficult and this dissatisfying for from nurses and, what you did with nurse grade is really speaking to
what nurses need at the front line to have more of an efficient way to have consistent coverage. What was the value proposition to organizations you already emphasized, it's focus on the end user. What was the value proposition on the organization side?
Zach Smith: Yeah, so there's a few things. One, we believe the roi, the return on investment the hospitals we're gonna see was increased nurse satisfaction , and that's a hard sell. Unfortunately, I, I learned this, running the marketing department, for nurse grid, [00:06:00] and that you have to invest in resources and tools in your staff to then see a return on that investment.
But it, it takes an upfront investment. You know, purchasing technology, switching in our case, switching to our technology to invest in your staff to use the tools that they like to use. And what we found when we would survey staff a month after, they would implement the nurse grid manager, which was what we called at the time, our, our paid scheduling solution for hospitals is that nurses immediately saw a boost in satisfaction.
And, you know, I know you're familiar and, and maybe some of your listeners are familiar, the cost of, turnover per nurse, I mean, there's kind of always different numbers floating around, but it's always somewhere between 45 and $80,000, depending on the specialty for every nurse that you lose.
And certainly this has become an issue since. That time at nurse grid, pre pandemic when we were growing our company. And now, you know, hospitals are losing nurses, like crazy. And I think it just shows [00:07:00] you have to invest in your employees, invest in the staff to retain them, but also to satisfy them, keep them happy.
And what we wanted to do is, is we wanted to give that opportunity to hospitals, but there was a whole bunch of other efficiencies we wanted to create too. One nurses immediately have the schedule. The second it's live. No More emails that you have to log into the intranet. sometimes only accessible when you're at work and you're like trying to check your schedule, while you're like, you know, jotting down notes, preport and, and figuring out, okay, what days do I work?
Or trying to do that when you have a moment during your shift. We wanted schedule accessibility to be really key and, and that sort of creates more fluidity and, and flexibility, within the staff. So now it's easy to see. People who I might be able to swap with. So our technology made it really easy, and when you would facilitate that swap, I would send it directly to the manager and give them all the appropriate information.
So a lot of it was about creating efficiencies, trying to give time back to the schedulers and the managers and the administrators. Who were managing the schedule. [00:08:00] I mean, schedules are chaos in hospitals, right? It's so complicated. And I feel for these schedulers oftentimes because just being on the other side trying to develop technology, the deeper you dig, the more complicated you realize it is and, and how challenging it is.
But we were trying to bring a real modern interface, use a mobile app, you know, how novel of us right, to use a mobile app. It sounds like obvious, but back when we were starting nurse grid, There wasn't a whole lot of mobile app solutions for some of the larger scheduling technology companies out there.
Now, they've all tried to create mobile solutions, but our's still, you know, is the most popular and successful one. So a lot of it was about, you know, trying to create inter satisfaction and improve retention within your staff, but also, create a lot of efficiencies, within the workflows that are present in these complicated, scheduling process.
Myles Parilla: That's good. So what's the outcome? Were you successfully able to integrate that with organizations in actually, using the the app or platform?
Zach Smith: [00:09:00] So that's a great question and, when I speak about nurse grid, most people know about the mobile app. You know, oh, it's the, the Molo that everyone's using and we have seen tremendous success with the Trojan horse, strategy of getting nurses to use our free mobile app. I think we're coming up on probably 500,000 active users.
You know, over the course of the years we've had, somewhere around 2 million downloads. I mean, the market's only, you know, somewhere if you're including CNAs, five to 7 million in the US anyway, we're US based app. And so we've seen. Incredible traction with the mobile app. We still were running into barriers in the hospital selling our scheduling technology, to the hospitals.
It's just really difficult to sell into hospitals. Our initial strategy was to sell to managers in departments and, that proved to be more challenging than we were hoping in that managers didn't always know or realize or believe they had the power to purchase scheduling technology. , you know, [00:10:00] so they would immediately kick it up to their executives, the CNOs and the CTOs, the c chief technology officers, cuz they wanted to make sure that it was, you know, fireproof and they weren't gonna have any bugs that were gonna fly in.
People are scared of the cloud sometimes, right? Like you can't have the cloud in a hospital. There's patient information here, even though we're only dealing with nurse schedules. And so that would immediately kick us into this long sales cycle with hospitals, which is the sales cycle. We were trying to avoid these, you know, as a startup, you can't have a one to two year, conversation with the hospital before you close the deal.
And it's also a slower rollout. So, to answer your question, more succinctly. We had success with the mobile app. We struggled with the manager app selling it into hospitals as a small organization, and it's something, it's an insight that I've learned. And kept with me as I've pursued other endeavors and considered opportunities into the future.
Selling into hospitals is very challenging, even when you have the nurses win, that you're back, and their support in what they want to use. And it's [00:11:00] something that I think we still see today, that even when nurses are clamoring for something, it doesn't always get done. And I think that's frustrating for a lot of nurses and in what we, you know, what we hear and what we see is that the voice of nurses inside of hospitals needs to be, listened to, needs to be heard for those nurses to feel valued and seen.
And in our case, it wasn't quite enough to get it done over the edge, but we still created a really successful app that provided a lot of value to a lot of nurses and ultimately another organization. Saw that same value, which is why we were acquired in early 2020.
Myles Parilla: Thank you for that. You know that's in a way sad. To hear about the lack of regard or engagement on providing, more empowerment to nurses to be able to better manage your schedules. If you were to do it again, would you do it from a different angle, perhaps approach the board, or perhaps approach directly the C-suite [00:12:00] or, you know, the financial benefit to it.
Zach Smith: there's a lot of different ways to approach it. I still think the free mobile app, Trojan Horse Way was, smart and sound and there was a lot of value just creating tools for the nurses.
you know, I've gone back and forth as I've considered a lot of different opportunities, and, and startups that I might pursue.
And the learning I have is, I would just, personally, I I would stay away from trying to sell directly to hospitals because of this specific challenge. In particular trying to get them to do away with something they're already using and start using your technology. And one of the biggest reasons is training in time.
Hospitals are just chronically overwhelmed. They just feel short on time all the time. I mean, of course the nurses are right, but even administrators feel like there's just so many things going on and trying to say, Hey, you know, nurses who actually like this scheduling technology better than the one that they're using?
And they're like, Yeah, but the one that we're using works well enough. [00:13:00] And so the thought of like unplugging all of that, Pulling up all those cords, figuratively speaking, although there's probably cords for some of this old technology. And then retraining people on a new technology is costly, expensive, and time consuming.
And it wasn't always the top priority for nurse administrators. And so, For one, if I were to do this again, And where I try to focus a lot of my energy is developing solutions for the end user, the nurses themselves, because they need a lot of help right now, themselves.
But the actual pitch two hospitals is a challenging one. I think there's ways of doing it. But, you've gotta be real strategic and smart about how you approach them, and how you apply pressure on them in the specific solution that you choose, to get them to invest in it.
Because of all the challenges that I just spoke about.
Myles Parilla: Thank you for sharing that. So the past two years, obviously we know what's, happened in the past two years and a lot of upheaval in the nursing profession and actually any [00:14:00] profession in that regard. Looking at the nursing profession at large now, current state, what do you think nurses actually need?
Zach Smith: I think they need to realize the power they have. I think a lot of nurses believe they have power and leverage. They just don't know how to actualize it. And this is where I put a lot of thought into and in what kind of role can I play in helping consolidate the nurse voice.
And perspective. So much of what I spend my time on online, on LinkedIn and promoting is trying to bring light to the situation that nurses are in. And there's been so many articles written on it, and so it feels like it's been spoken about and written about ad nauseam, but you just don't know unless you've worked a short staff bedside shift.
You don't know what it's like until you've been there. And even myself, I've been away from the bedside, six, seven years now I feel like losing touch. Like I can, I can sense [00:15:00] myself forgetting what it's like. To work three 12 night shifts in a row and come home exhausted and then having to try to sleep during the day and switch my schedule, like even like elements to that aspect of life, you, you start to lose sense of, and fortunately my wife's a nurse, so I get to hear all of the , the, the challenges that she faces every shift.
All my friends are nurses and I'm totally immersed in this community, so I try to stay in touch, but. what it's like to be a nurse bedside right now, especially, it's only been exacerbated the last few years. I don't think people in positions of power fully realize that.
And what we need to do is, as nurses is, try to find a way to, utilize the leverage that we have right now. There's a shortage of nurses. There is a demand of jobs. and, you know, the healthcare in the United States is only gonna get more demanding. You know, the, boomers are.
getting older and, you know, gonna have higher admission rates, pretty soon, if not already we're seeing it. Covid [00:16:00] was sort of like a, spike in admissions. But we're gonna see other things like that and nurses are dropping out and, and we're losing a lot of nurses who are willing to work in these conditions and that only exacerbates the problem.
and it exacerbates the problem, but it also highlights the power that nurses have right now. You are the commodity that this market needs right now. Every agency that's out there, every tech company, Every hospital, they are all after you, whether you know it or not. You are the product, you are the the solution.
You are the tool that this market needs right now. And I think the sooner that nurses realize that and start finding ways to leverage that, the better. And I'm, I'm being vague, right? Cause I don't have necessarily like a solution in my hand right now. But I think it's, it starts with the mindset shift.
And, nurses are, are starting to go through that. But they just don't know how to, how to use it. And so, you know, we turn to unions and, collective [00:17:00] bargaining and, and that's obviously , had a lot of success in a lot of places. there are organizations in nonprofits who try to, to rally and create petitions and, and march and apply political pressure and stuff.
And it's sort of like yes to all of it, right? Like we need all of that and more we definitely need advocates and I'm trying to be one of those advocates in the best way I know how. but it needs for every nurse to realize that, they are in the most powerful position, in this market, and they need to tell all their friends.
And we all need to be on the same page about that so we can make meaningful change.
Myles Parilla: Zach, what do you think is a barrier for meaningful change you've discussed about dealing directly with senior executives? even, you know why it's so obvious right now, nurses are leaving. I'm not sure if there's a budge or a little budge. What is a barrier from your observation or experience?
Zach Smith: Yeah, we've seen sort of nibbling at the edges, doesn't really move things too much. and I would say before the last few years I was kind of always[00:18:00] observing problems from within the system. And more recently I've come to realize that I think change is gonna have to happen from the outside.
I don't think hospitals and and systems are going to change outta the goodness of their heart. We've heard all the arguments about money and cashflow and, you know, resources and things like that. so they feel like they're in a tough position, so they're not gonna all of a sudden, you know, See the light and start staffing more comfortably, Right.
and really, you know, listening to what nurses have to say and, and implementing solutions that don't have an immediate payoff, for the hospital. So, so I look at this from the outside, there's. Political action. Of course. I think more recently, a lot of conversations been happening, around how nurses, in our healthcare system, are an expense.
And not a revenue generator, right? You know, the physicians are the revenue generators. They're the ones writing prescriptions and orders and procedures that make the hospitals money. And the nurse is just the one that carries it out and flush the pillow. , [00:19:00] right? Like, it's like, Oh, you're just, you only cost money.
You don't make us any money. and that's just the way the healthcare system is set up in the United States. And so what are changes that can happen, through policy, that can shift, how we. Compensate nurses in the way that, with regards to how we charge patients. That's I think one piece of it.
The other piece of it is, you know what I was saying, hospitals aren't going to change themselves unless they're forced to. And how do you force change? Enforce maybe is too negative of a word, you know, more like pressure for change. I think transparency does a lot of that.
and social pressure. how can we apply pressure on a hospital to say everyone here knows what's going on and, You know, and you know, that everyone knows and that creates social pressure. And so, you know, I think about those, those annual surveys that they send out every year, right?
We all take 'em, all my research and conversations with nurses that I've done says they're all like, kind of what's the point?[00:20:00] Why am I, you get like 20 emails from hospitals being like, We're at 70%, we need to be at 90%. Please take the survey. I can feel everyone shuttering,
I say that.
Myles Parilla: Actually Zach, I was one of those people who actually remind staff when I was a manager, so I
feel guilty. I totally get
Zach Smith: you like, cause you're like, I gotta get to 90%. Right. You know, these poor managers sometimes I feel like are just caught in such a hard place. But, you know, trying to get to all these responses and so you're like, All right, fine, I'll, I'll take the survey.
And you go through all these questions and some of them kind of make you roll your eyes in the way they're worded and things like that. And, and then you take them and then you don't really hear anything. And then eventually you'll hear sort of cherry picked results, of whatever they deemed worthy to share back to you.
And who knows what the results were. I mean, part of me thinks like everyone needs to see these results instantly. Like, no, no. Like, don't, don't try to. PR caress it and make them seem [00:21:00] better or, or worse than they are. Like, let's see, let's see what nurses have to say about their experience.
And that's kind of what I mean by social pressure is like now, if they know that we know. And everyone knows now they feel forced to do something about it. And so things like that, transparency in particular, can apply this sort of social pressure that that creates a situation that's untenable for hospitals to ignore the problems that are going on rather than the ones that's just sort of bubble up, over time.
So, Kind of outside, inside, but, those are two of the areas that I look to that I think, change can happen. But if we just think that if we sit and yell about it loud enough on social media that change is gonna happen, it's, it's not, it's not gonna happen. These are big, powerful players, big.
oftentimes very politically connected players. And so these things aren't easy, but big meaningful changes is never without a fight and a struggle. And unfortunately, the nurses are the ones dealing with the struggle the most right now. but I do see light [00:22:00] on the horizon and, and think that we're heading towards something, something meaningful.
Some, some real change.
Myles Parilla: Thank you for the insights. Zach, do you think We perhaps may have the wrong or incorrect measures of success relevant to nursing.
Zach Smith: Right. Well, if we're being honest, the measure of success is profit. You know, the hospitals are businesses. We don't get into nursing to try to hit quarterly goals, and receive a bonus. If, you know, you meet your company's objective, that's the business world that I now live in, and, and familiar with, right?
It's a business. You gotta make money, you gotta show growth and improvements and stuff. but that's not why we became nurses, and that's not what healthcare is. Healthcare success is healthiness and, I mean there's a lot of variety, right? To, to what success means in healthcare , right?
freedom to live the life you wanna live, free from pain, access to care, things like that. and [00:23:00] so for hospitals who are businesses success for them, measurements of successes making more money In reality, a measurement of success should be not seeing you at, at my business, right?
My business is successful if you are not here. And so when you think about that model, how are we supposed to win? I mean, and we're all patients here, right? How are we as a society supposed to win in this system when, the incentive is for us to get sick and not be healthy?
Myles Parilla: Mm-hmm. So recently, right? With, all the strikes, with, you know, a lot of nurses becoming more vocal. Some talk about more money, more compensation, wanna be more valued, you know, and, and there's a, large group of , people speaking up about we want autonomy over our work, safety of our patients.
What does that actually look like? Just looking at autonomy, know what I mean? The, the concept of shared governance has been coined for decades now, right? We have like, magnet hospitals, you know, with shared [00:24:00] governance structures, but what's not successful in that model that nurses are still asking for actual autonomy and being part of the decision making table.
Zach Smith: The shared governance thing is interesting, right? Where I think a lot of nurses feel like they join these committees and everyone applauds the fact that there is a committee and then you spend this time. You know, coming up with ideas and then sort of like the surveys, what happens to them. Like sometimes they get implemented, but those are small, small, little, you know, bites at the edge of, the problem.
Like, I, I don't wanna like necessarily put down trying to do whatever we can because , it's sort of a, combination of a number of things that we need right now. We need more nurses who are willing to work in a hospital. People debate whether there's a nursing shortage or basically a shortage of nurses willing to work, in these environments. And it's the same. Right. Like we have a shortage of nurses who are willing to work in this environment, which is a shortage.
Well, what makes nurses willing to work [00:25:00] in these environments?
Well, better staffing. So it's a bit of a chicken and egg, right? So we need more nurses to have better staffing. But we need better staffing to have more nurses, and so part of the way that we can lure people back in is increase pay. There are nurses who will come back, who have left bedside, who will come back, for better pay.
We're seeing everyone and their mother go to go to travel nursing right now because there's better pay that has brought people back into nursing. So money is an incentive. It's not a long term incentive though. It's a short term, one that can patch a problem, and it's a piece of the solution of saying that I see you for what you're going through, especially now, and I'm going to compensate you For the tremendous amount of work and struggle that you're going through to keep things afloat right now. I think most of that is coming in the travel nursing world. I think per nurses are getting raises through unions across the nation in Seattle. I know it's happened a couple of times. Retention bonuses I think are interesting, but they're always like prorated out over two [00:26:00] years. And so like if you're willing to pay a nurse that's much more for two years, then you should be willing to pay it forever.
just increase the pay. Don't, don't do a bonus. It's just confusing for everyone. And I got $2,000 bonus that I can collect in chunks, you know, over time. so pay is a piece of it in order to bring people back. But the other, I think, element of it is just nurses really need to feel seen and they need to feel heard and there are things that management can do, to help this, but managers are in a hard spot too.
I mean, were you a, uh, an actual department manager.
Myles Parilla: mm-hmm. of the ED.
Zach Smith: And how many, how many people did, you oversee? Like how many people were in your depart.
Myles Parilla: My last role, I had 84 FTEs in the ED and I had just, a few nurses in a new department.
Zach Smith: Like 84 direct reports is crazy.
How are you supposed to make all 84 of those nurses feel seen and heard and valued when you're reporting to all those? And I don't necessarily think, oh, the solution is to add [00:27:00] five more managers per department, cuz that's not necessarily a solution in itself, but your job is to manage the department, it's less about actually managing all of the nurses, and seeing to their needs. So who's looking after the nurse? And, and I don't know specifically what it is, but we need to make sure that the voice of the nurse is heard. And if nurses feel. If they feel seen and valued, that changes a cultural environment of a department, of a market in nursing.
And that paired with better compensation might bring more people back into the market. And if we can bring more people back in, now we can have at least the opportunity to staff better. But that still will require hospitals to say, you know, maybe we should have a float nurse who's floating around giving everyone breaks.
Maybe we should staff with a little cushion. But that, again, nurses are a cost. So every additional nurse that you're adding to a floor, is more money out of the hospital's pocket [00:28:00] and less profits for them now. We know all about the studies that show every additional nurse decreases patient, risks for, like nosocomial infections or, falls and all the rest of the things, right?
But again, you have to invest in order to see that return on investment. And hospitals just don't see nurses as something. That they're wanting to invest in. And part of that's because of our healthcare model that's set up so long answer to your question, but I think it's a culmination of solutions pay is a piece of it.
We need more nurses available and then the hospitals have to staff those nurses, that are available to work.
Myles Parilla: Mm-hmm. , thank you for sharing that. You know, looking at this from the side of the hospital or the organization or administration, what have you, recently, or I don't know, the past few months, covid funds have stopped, right? and those funds were used, well, generally speaking, were used to, pay for premium expense in labor like [00:29:00] travel, et cetera.
And now, they're claiming that, it's not enough money, not enough revenue, or we're about to tank, and there's lot of articles just even in the nor Pacific Northwest. Right. There's an almost impending closure or what have you because of the lack of funds. What would you say to these organizations who are um, having this problem?
Zach Smith: Yeah. Um. Figure it out, , it's like, not my problem. I'm speaking from the perspective of a nurse, like, Oh, I'm so sorry that you don't have enough money to, pay what people are willing to work for. That's, that's capitalism. That's how this works. It's not my responsibility to say, Let me take a pay cut while you figure it. or let me, you know, go to cap my wages while you figure out how to pay for an increase in the future. I mean, I get it. Like I get that hospitals have a challenging situation. I don't think nurses all [00:30:00] oftentimes wanna acknowledge that, but, hospitals are like, well, in a normal business, right?
If all of a sudden you know, I sell jeans, in the mall and then I have to pay everyone, the minimum wages increase and I have to pay everyone more well, I'm gonna increase the cost of my jeans. That's just you know, that's inflation and how things are supposed to work, but a hospital can't charge more for their services, as far as I understand.
And part of that is, you know, Medicare compensation and insurance reimbursements and things like that. so hospitals are like, Well, I would love to pay more for labor. And then make that up by charging more for the services that we provide. But that's not the system that we're in. but that's also not the nurse's fault, right?
Again, we came in here to take care of patients safely, and it's not our responsibility to be put in unsafe situations. to keep these patients alive. It's your job. This is your business. It's not our business. This is your business to figure out how to make it work. So figure it out because nurses are [00:31:00] literally dying and not, that's not hyperbole, right?
We've seen increase in suicide rates of nurses. Patients are dying. So figure it out because we're barreling towards a crisis. We're in the midst of it. but because of nurses, because the nurses who remain are holding on and shouldering the moral and physical burden that this current situation has, brought about We are still floating, but not for long, and we're losing more nurses than we're gaining. And it's only speeding up. And who knows if another pandemic comes around the corner, who knows if hospitals have learned their lessons or if, um, patient volume increases keep happening. It's only gonna get worse and there's gonna be a point at which we definitely don't have enough nurses to do this. So, that would be my message is, hospitals gotta find a way our, our system has to find a way, but, nurses are about to break.
Myles Parilla: Mm-hmm. . Thank you. [00:32:00] Well, there is no question to your passion in helping nurses, and thank you for sharing that. So, Zach, what's next for you? Now that you've, you know, finished your, tenure at Nurse Grid, you're looking for your next venture, what does that look like?
Zach Smith: Yeah, so I'm trying to explore different possibilities, whether it's working with another organization I've been meeting with a lot of companies here the last few weeks, and it's been really interesting to see what are the startups out there in the field, Um, what are the big businesses, the staffing agencies, things like that.
But what I always, um, am looking for in these conversations is who do I feel really cares about the nurse and who do I feel is mission is centered around the nurse? I've had a few conversations with businesses where nurses didn't even come up. These are. Like nurse focused businesses, right?
And so it's like, well, hey, like like, I haven't even heard you mention the perils of, of nursing right now. so I, I listen for a lot of that. I wanna work for an organization if I work for another organization,[00:33:00] that really is focused on the nurse, but ultimately I wanna, I wanna start another business.
I've been involved in, a footwear startup that created a lot of, excitement and fun branding and, and led the, the marketing efforts around that. And did a lot of fun there. That was about bringing some joy and fun to the nurse's life in the midst of the pandemic, which is when I was a part of it.
And it was fun for me. But, but I ultimately left there cuz I just have my site set on bigger, more meaningful change and, part of it is assessing the situation, speaking to a lot of other industry leaders and folks like you and, people who have their hearts in the right place. And trying to just be diligent about the solution I, I end up pursuing.
And so, I don't know exactly what comes next, but I'm in the process of figuring that out. But I know whatever it is that I do, it's gonna be in service of the nurse and it has to be meaningful. I'm not really interested in things that don't actually make a difference and I wanna be a part of the solution moving [00:34:00] forward.
Myles Parilla: Well, Zach, thank you so much for your, passionate advocacy for nurses and the profession itself, and, other, healthcare professionals as well. How can our listeners connect with you?
Zach Smith: The best place to connect with me is on Instagram. I have, you know, I've got, I don't know, 2000 people follow me for some reason, , but they're mostly nurses, and so I feel fortunate to have. a bit of a, of a microphone, snow, pun intended here, to speak to nurses.
And so I'm constantly pulling, that community of nurses who follow me, and we're always talking about different ideas. And so if you were to ask any of them, I'm always like testing out different things. What about this idea? What does this mean to you? So we're doing like all sorts of polls and stuff.
I'd say that's probably the best way to follow what I'm interested in and, what I'm thinking about. And then, you know, dms and messages and stuff. So my, my Instagram handle, I guess I should probably say that, is wazzuzach, W A z Z U z a C H. Wazo the name of my [00:35:00] Yeah, my nursing school.
My college, Washington State University. We call it wazo. Um, so Wazo Zach is on Instagram and, I, I try to post their, you might see pictures of my kids too. So it happens. Uh, it's also my personal account, but, my personal professional life has become pretty blended anyway, so Instagram's probably a good representation of that.
Myles Parilla: Awesome. Well, Zach, thank you so much for this time. Really appreciate you sharing your thoughts and insights and uh, I'm pretty sure others more will follow you.
Zach Smith: Sounds good. Thanks so much. I appreciate and having the time to talk.
Myles Parilla: Thank you for listening view the complete show notes and all the links mentioned in today's episode, Myles Parilla consulting.com forward slash podcast. And before you go, make sure you follow or subscribe to this podcast so you can receive the latest episodes soon as they're released. And if you're enjoying the show, leave a rating and review in Apple podcast.
Thank you again for [00:36:00] joining. This is your host Myles Parilla and you're listening to the insightful nurse leader. you next time.
