The pandemic has heavily impacted no other industry as much as the healthcare industry. It brought numerous challenges and uncovered many flaws in the existing system. How can leaders navigate and deal with these problems? Joining Dr. Santor Nishizaki to shed light on the situation is April Hansen, Group President of Workforce Solutions at Aya Healthcare. April touches on the adversities faced by healthcare workers highlighting the disproportionate impact of the pandemic, the unfair stigma towards travel nurses, and the issues on personal safety that threaten them daily. With this, there’s currently a lot of weight on the shoulders of leaders in the healthcare and nursing space to tackle these issues. What can be done moving forward? Will having a multi-generational workforce be the new norm? Are hybrid solutions the answer? Will travel nursing and telehealth solutions mitigate these problems? Get to know more by tuning in.

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Leading Others: A Story Of Entrepreneurship And Healthcare With April Hansen

Our guest is April Hansen. She is going to talk about her leadership experience in entrepreneurship and healthcare, and how she has been able to balance work and family. As Aya Healthcare‘s Group President of Workforce Solutions, April Hansen, MSN RN, is responsible for strategic business development, workforce solutions, program operations, recruitment augmentation, and clinical services support. Hansen has led her team through exponential growth and several acquisitions, expanding the distribution channels for Aya’s 40,000-plus clinicians.

A strong proponent of lifelong learning, April created the Aya Scholars Program, the industry’s first clinical ladder and professional recognition model for travel nurses to ensure their continued career growth. April is a nurse and entrepreneur. She successfully cofounded a clinical management technology to ease the administrative burden of healthcare student clinical placements in 2012 and achieved a successful exit when the technology was acquired in 2016.

In addition, she cofounded a mobile application for nursing engagement and achieved support through a nationally ranked startup accelerator in partnership with Microsoft in 2017. Lastly, April was published in the February 2022 issue of Nurse Leader on the shift in the US staff nursing landscape and the June 2019 edition of Nursing Administration Quarterly on disruption and healthcare and the role of nurses in leadership. She has also served as an expert for national media outlets, including CBS This Morning, CNBC, Associated Press, Marketplace, and Forbes. Let’s hear what April has to say.

April, welcome to the show. We’re so happy to have you here.

Thanks so much, Santor. I’m excited to be here.

You’re such an accomplished person. You’re an entrepreneur and president of the division. You work in healthcare and a nurse. You’ve done so many cool things in your life. Can you tell us a little bit about your story of where you got to where you are now?

My story is maybe commonplace, at least at the beginning, for a lot of entrepreneurs and people that have a solid work ethic and strong passion. It’s funny, someone once told me that a word that was used to describe me was relatable. I was like, “I’m totally relatable.” They’re like, “No, you’re not. Your career path is superhuman.” I was like, “No, it isn’t. It’s completely accessible.”

I grew up in a small town of about 3,000 people in Northeast Wisconsin with one stoplight and a very blue-collar middle-class family. Prior to maybe one uncle in my family, nobody had achieved a Bachelor’s level of education. They were trades focused and hardworking. From my earliest years, I can recall always having a desire for health care, but I loved business.

My mom likes to remind me that I started my first business when I was three. She used to have my aunts and some other friends over. I would serve them coffee and I would demand payment when I was a small child. It was fun to think about that. Growing up in a small town had its advantages. It was safe and affordable. Although we were not wealthy by any means, we were still able to live a decent and nice life with that. I do think though, that growing up in a small town in today’s world had some disadvantages too. We are not a diverse community. Diversity, equity, inclusion and things of this nature, we didn’t even talk about them or know.

My cultural exposure growing up was relatively limited. I knew that there was a lot more than this world could offer. I wanted to take advantage of seeing that and charting my own way and path. As I got into my work years, I started working at a young age. I started working at fourteen as a waitress and starting to support myself and fill in where my family didn’t have the income to support me, which was okay.

I started packing some money away and I knew I was going to go to college. I knew that I wanted to see the world. Eventually, my college pathway led me to do a practical nursing degree and then I finished an Associate’s degree in Nursing. I worked as a certified nursing assistant while I did my licensed practical nurse. I worked as a licensed practical nurse while I did my registered nurse.

Once I finished my Associate’s degree in Registered Nursing, I took on a full job time. I was fully working and paying for my own way to live. I then immediately went back to school to finish my Bachelor’s degree while I was working full time as an Associate’s degree. The cool part about breaking out of the small town, I decided to become a travel nurse. I had my sight set on America’s finest city. I left the frozen tundra of Wisconsin and made my way out to California. I started to appreciate and understand not only how life was different in different places in the US but also how healthcare was different.

I was able to live and work inside these various different healthcare systems as a travel nurse, which opened up a whole new set of opportunities and learning. Had I stayed sheltered in my small town in Northeast Wisconsin, I don’t think that I would have had exposure. I don’t think I even ate sushi until I was 23. I needed to break out of that town and go try some different things. From the earliest time, I knew that I loved business and healthcare. I was functioning in the travel nurse space.

When I was around 24 or 25, I decided to start my own travel nurse company, my own healthcare staffing company. I would work a twelve-and-a-half-hour shift. I would go to Barnes & Noble and I would sit there like a loiterer, reading as many business books as I could find on how to start a company. I didn’t know how to start a company but I taught myself that with the power of the early days of Google and a lot of books at Barnes & Noble. I started my own small staffing company.

That was an incredible opportunity for learning and failures. Some of those days were ugly and some of those decisions were terrible, learning what I did. From there, I was able to chart a course through maybe some good luck and misfortune and get further connected to the Corporate America side of travel nursing. I found my way to America’s largest company at that time. I joined that company in 2010. I worked my way up through the ranks and joined them as a nurse on their clinical team, doing compliance and clinical credentialing stuff. I ultimately spent seven years at that company and had found a strong promotable pathway and growth inside that organization.

I left there ultimately in 2017. I was a vice president of their workforce on the sales side of the organization. I made the decision in 2017 to go work for a disruptor that was in the wings of the healthcare staffing space. It was a tech company that was functioning in the healthcare staffing space with a super cool vision, early-ish growth and virality. I loved the way that the CEO thought about the company and how it was positioned. I made that move in 2017 and I’m still there.

 

When a nurse is able to make the sacrifice and accommodate the unique work-life balance of what it means to be a travel nurse, they can achieve some pretty great benefits. Share on X

 

It has been several years with Aya Healthcare. We’ve now demonstrated 9X revenue growth in the last few years. It’s a crazy digital transformation and platform growth. This hyper-growth experience is something I can say, I never contemplated living in this little town of 3,000 people with one stoplight in Wisconsin and desiring diversity and inculturation. I can’t say that that was in the plans or even understood, but it has been an incredibly wild ride.

You also have other businesses on top of all of that. We’ll get into more of your personal life in a little bit. I have some questions there. What are your thoughts about imposter syndrome as you’ve continually moved up? All of us have dealt with that when we try something new or we’re in a leadership role. How have you been able to overcome it?

It’s a brilliant question because enough people don’t talk about it. I believe imposter syndrome is hands down real. It’s real at every level of the organization. This may not be true for everyone but for some people, there’s almost this belief that when you come into an organization or when you come into a job, somebody knows what they’re doing and that they’ve figured it all out, and everybody else is acting along the lines that they’ve determined. What I’ve learned in at least my career to date, which I’m certainly not claiming to be an expert, is that collectively, it’s the decisions that people are making together that ultimately generate this thing that some people come into the organization think somebody else already knew and had already laid out.

I don’t think anyone is immune to imposter syndrome. I do think though, that not everybody understands when they’re reacting to the feelings of imposter syndrome. They can’t name it. They can’t call it out. Instead, sometimes you see things like autocracy and that autocratic style of leadership or dictator style of leadership. Insecurity-based moves from leaders or managers, or envy and those sorts of things come into play.

A lot of it roots back to this feeling of imposter syndrome and whether or not you’re the right person to do the job. Even if you are, who tells you that you are? You don’t know. Nobody is going to tell you. It’s a super real thing. I don’t think we talk about it enough. I’m way open about the fact that every single day of my life, I’ve battled some elements of imposter syndrome.

As a president of your department, as a parent and as a friend, there are many things. I remember being a dad for the first time. You could read as many books as you can, but every kid is different. I wanted to bring it up because I’m interviewing a lot of successful people on this show. I want other people out there to feel like they’re not alone. Not everyone has this stuff figured out.

When I started my first company, and I told you I was at Barnes & Noble reading books and all of this stuff, I didn’t know how else to do it. I didn’t know who would have taught me how to do that. I quickly realized that nobody. You teach yourself and you go through the lessons learned. Through your network, you find great mentors and good resources. Now, it’s easier than ever because information sharing is so much better but it’s not well-scripted.

Every entrepreneur, in particular, goes out to the world with this little voice in the back of their mind. Sometimes it’s a big voice and it makes you fearful. Sometimes it goes away and you feel accomplished, but it’s there for everyone. Every company I’ve started since then, even when I started a company and I sold it, I got an exit, which was like a dream come true. Still to that day, I was like, “Did that really happen? That’s amazing.”

Thank you so much, April, for saying that. The audience will appreciate that because it happens. I’ve dealt with it too, when you’re leading someone. Also, when you get promoted above your peers. It can also be challenging. I want to ask you this next question. Feel free to come at it from a healthcare perspective if you like, but how were you able to deal with adversity in your career? How did that change with the pandemic? I know being in healthcare, we all are grateful for you and your team’s hard work, even in your industry, to keep us all safe.

There are a couple of different ways that I could approach this question, but I want to speak from a place of recency effect and be vulnerable about this. I would say that the place where I have put all of my effort, energy, passion and work in health care, especially in the last few years, is in the crossfire of adversity. Travel nursing, which is where I have dedicated a huge bulk of my professional career, is under fire right now. Our nation’s healthcare system was incredibly broken and vulnerable prior to a pandemic ever hitting the healthcare system. We had operated with a lean mentality and just in time, thinking to the point of scarcity prior to the pandemic.

It took this black swan event and this two by four to hit the system upside the head, and shake out the fact that there were big vulnerabilities there. We didn’t have enough nurses as a nation. We did not have any excess bench strength or capacity. It’s like running a never-ending basketball game when you only have five players. There’s no one to call it off the bench.

That’s the place where our healthcare system was. In the beginning stages of this pandemic, as healthcare systems in certain hotspots, we’re calling upon travel nursing as an industry to answer the call. The work was noble and it felt respected. We were able to control a lot of variables that were much easier to see at that point in time.

At the same time, nurses were feeling the call. They were making an impact and it was measurable. It was visible. It was rewarding, especially for people that function in this space and for nursing as a profession. Now you fast forward a couple of years. There’s a whole set of circumstances that have changed the narrative. Nurses are now almost being criticized if they want to be members of the gig economy or if they want to take advantage of that flexibility and that mobility between employers that other professions like IT and finance professionals have done for years.

 

If an opportunity is there, the difference between whether or not it is visible or invisible is what you do with it. Share on X

 

If nurses want to be a traveler, there’s almost like a bit of a black eye being applied. Part of it comes down to wage scale issues and all of these different components. Healthcare, never being an employer in the gig economy at any scale, has built a lot of complexity. Personally, I sit at a little bit of a professional crossroads because I believe in the power of what travel nursing does for nurses as individuals.

I believe in the response mechanism that our nation has within the travel industry to move talent from one community that doesn’t need it to another community that desperately needs it. I believe in that power but then daily, we’re hearing on the news and all these other things, some pretty egregious allegations around this industry. I know that’s not my company and it’s not what we have done, but that’s hard. I’m speaking freely about this right now because I have not felt to be in a place of a ton of adversity in my career as opposed to where I am right now.

You talked about how travel nurses are better for the nurses and also for the communities. When you say better, what do you mean by better?

It’s not better for everyone. I should qualify that. There’s a certain type of person that’s well set up to be successful as a travel nurse. There are certain situations that don’t dictate that, and they’re not right for the profession. There’s only about 2% of all nurses, based on the available data that work as travel nurses. It’s a small population that can effectively be in this gig style economy. When a nurse is able to make the sacrifice and accommodate the unique work-life balance of what it means to be a travel nurse, they can achieve some pretty great benefits.

They can cycle through health systems at a pace faster than what most people experience in their careers. Each place that they go, they’re setting up learning in a different way. Let me give you an example. When we were moving clinicians into hotspots in the first waves of the pandemic, the care protocols were not yet defined. The hospitals themselves were learning how to care for COVID patients. Great health systems in Seattle and New York are going first, helping to define how you keep people alive when they come in with this novel virus. Our travel nurses were on the front lines of that protocol development.

As other communities became impacted, and it wasn’t just centralized to these geographic locations that were hotspots, it was the travel nurses that brought a lot of the learning from these places to these other health systems. I remember getting a call from a colleague in Green Bay, Wisconsin saying, “April, we’re going to have to bring in travelers for the first time. We haven’t used travelers in probably a decade, but I have a unique request. You need to help us find travelers that have been in the thick of things with COVID at other hospitals because we don’t know what we’re doing.”

In that way, it was moving knowledge and providing interoperability of intellectual property around this country to help save lives. That’s a unique opportunity as a nurse to do something that you didn’t go to school for. That’s your experience speaking for you and moving around. That’s a benefit that you can’t put a price tag on.

Not only that, having the knowledge transfer but reshaping the gig economy. I don’t see why it couldn’t work. The market will decide, as with any type of business.

You’re right. The market will decide. There are always all sides of the marketplace. There’s your demand side and supply side and the economic model that dictates a lot of things in the middle. The economic model for healthcare is strained in many ways. It’s basically a giant complex system of payers, providers and politics. It’s heavily regulated for a good reason, but we already know that our healthcare system performs poorly in many ways compared to other developed nations in terms of the outcomes that we deliver for the amount of money that we spend. At our core, we have fundamental flaws and challenges and, maybe more positively, opportunities.

The opportunities to fix some of the deep-rooted problems in health care have been put on center stage with this pandemic. One of those opportunities that are highlighted right now is the fact that healthcare talent has a highly interoperable skillset. This skillset can be effective in Virginia Beach or Seattle. That’s great because it allows us a continuity plan and a sustainability plan. It’s not for everybody, but the workers that are choosing a gig style of employment can be part of that continuity plan, eliminating geographic disparities in where talents lie.

That’s great to hear that and see this innovation happen during the pandemic, and give them a chance to do something new. For some people, we could get bored. That leads us to my next question, which is, what is it like to be a Millennial leader and to be a disruptor?

For me, it’s fun. There was a period of time that I didn’t think I realized I was a Millennial.

Is it because people said bad things so it’s like, “Millennials, that’s not me.”

 

Having a multi-generational workforce is a strategic differentiator in any business, and having a Millennial leader at the center of running a multi-generational workforce is a recipe for success. Share on X

 

It’s, “Those Millennials.” I was one of the first generation of Millennial leaders born. I don’t think I identified right away with what that meant, but I can look back now and I can go, “Of course, I’m a Millennial leader.” I have the influence of a generation of parents and grandparents and others that had impeccable work ethics. I drive a lot of my work ethic from there, but I also have always grown up believing that anything is possible.

Do you know how sometimes we’re criticized for everybody getting a cookie and everybody getting a trophy? I don’t necessarily believe in that. What I believe is that everybody could have an opportunity. What you decide to do with that opportunity is widely controlled by you. There are always going to be external factors that will play into whether or not things are possible.

I also believe, and especially this drives me as a Millennial leader in the fact that if an opportunity is there, the difference between whether or not it is visible or invisible is what you do with it. That is something that I’ve brought into my own career path. Maybe part of it, to your earlier question, was overcoming the imposter syndrome, believing that I deserved a voice at that table or that I had something important to say, and I was going to make sure somebody heard it. Maybe it was crazy sometimes or maybe not, but that’s a highlight of being a Millennial leader.

I love my Millennial colleagues, my Gen X colleagues, and the Gen Z experiences that I’m starting to have in raising teenagers and all of this stuff. Having a multi-generational workforce is a strategic differentiator in any business, and having a Millennial leader at the center of running a multi-generational workforce is a recipe for success. It’s the exact right combination of dedication, inspiration, and mature thought but never settling for the status quo that enables a multi-generational workforce to be successful.

There are studies out that say, if you have a multi-generational workforce, you’re going to be more innovative and meet customer expectations.

You’re able to think about things in different ways. You can be more agile on the innovative front end, but then you still have the respect for the lessons learned and the understanding of human nature over time. With that comes the experience. Having the different generations together in the workforce, being assembled and fueled by a Millennial leader, is unstoppable when done well.

You talked about Gen Z. As they’re starting to trickle into the workforce, Gen Z was born approximately 1995 to 2012. What would you say from your own experience would be Gen Z’s greatest strength? What advice would you give to people who are leading them as they’re entering the workforce?

I’m going to put a little bit of a mother angle on this because I have a freshman in college, my stepdaughter, Gracie, and my stepson, Owen is a junior in high school. The thing that they have in their back pocket is that they think first about how technology does something. They don’t have to think about, “I have to get this done and then maybe there will be a technology that will get it done.”

It’s a natural search on how technology can get something done. I even watch my daughter, who is about to be ten. She was born in 2012. She’s right on the edge. I even watched her in her fourth grade do things on Google in her Google Classroom and all these things that I would probably have to look up how to do it, and I’m pretty tech-savvy.

Being born with this digital DNA, it’s natural for them. They have expectations that technology takes care of low-value things that humans shouldn’t spend time doing or things that don’t need emotion that humans should spend time doing. There’s an expectation. Their biggest strength is they’re not going to tolerate legacy thinking and outmoded practices for any length of time in the workforce. They will be the drivers. There’s an expectation that that experience is delivered in some form of digital fashion.

The other part is they also seek connections and they seek connections with humans. Maybe there’s a digital interaction component, but the feedback cycle is strong. You mentioned that I own a couple of businesses. I own two restaurants and we employ a ton of people just coming into the workforce right now. The ability for them to interact with adults that are not their parents in person is probably the greatest opportunity for growth for them, and understand how to manage conflict and those things, but they don’t shy away from it. That’s what I love.

I’ll see our sixteen-year-old workers in one of the restaurants that we own, and they’re having conversations and bantering back and forth with the Gen X-ers that they’re working next to and they’re not afraid. That’s what is so fun. They have their sites open to the world. They don’t struggle with technology. Although they need some coaching may be on relationships and things of a person, they’re not afraid of them, which is so great.

My next question is, what advice would you give to leaders in healthcare specifically? You’ve touched on it when you’re talking about travel nurses, but on helping create a healthy culture and strong employee engagement. I read some statistics that were saying that folks in healthcare, especially during the pandemic, are having higher turnover rates than other industries. It’s rightfully so. It’s been difficult. What advice would you give to any healthcare leaders to increase employee engagement?

 

Workers in healthcare have been disproportionately impacted by this pandemic. Share on X

 

This is such a key area of opportunity right now, and it’s not even a nice to have but is a must-have. I’m not sure if you caught the masterclass that I released on the qualitative research study that I did with some of my colleagues. What we know about the state of our healthcare workforce right now is that they’re more stressed no matter what their job is or what environment they work in. Your stress level is higher. What we know is that your satisfaction and your happiness, which is distinct from satisfaction, are lower. Workers in healthcare have been disproportionately impacted by this pandemic.

Directionally, I would say education and healthcare are right in there together. The disproportionate impact on this sector exacerbates every problem that other industries feel that they are on center stage in healthcare. I like to talk about the healthcare workforce being in the eye of the storm in this pandemic effect. If we break it down, part of the complexity of this is that the concerns are much deeper than burnout.

This is actual trauma. Clinical burnout is a factor of it, but what we’re dealing with is trauma and our feelings of betrayal, “How could I have been set up inside a system that was so vulnerable that had no resources to back me up. I had no training to be ready for war, even though I was asked to be in a war for the last few years. I felt like I had no choice.”

There are some fundamental issues that have to be dealt with here. First and foremost, we are never going to be able to heal our nation’s healthcare system and our workers until we get out of the crisis. We have to get out of the crisis. People cannot heal and begin to respond until the crisis is done. That means that the tools, resources, investments, and things that need to be done on a broad scale stage to stabilize the work environment and the structure of our healthcare systems need to be priority number one. Number two that I feel passionate about is if you’re a nurse leader, you can focus on just one thing because that’s all you have the capacity to do, or if you’re a physician leader or hospital CEO, anyone that’s in a position of influence inside the organization, think about physical safety as number one.

The reports of violence against nurses and healthcare professionals are skyrocketing, not just by patients but also by their family members. When someone’s physical safety is threatened, this is Maslow’s number one level of hierarchy, how can you even think about getting back to a place of self-actualization and purpose and these things when you feel physically threatened? Broad-scale moves, sweeping regulations and legislation are things that need to be priorities.

I’m going to share a short story. I was about to board a flight to go to Portland. I was sitting at the Minneapolis Airport. The captain came and grabbed the gate agents’ microphone. I don’t know what happened on his last flight, but he wanted to make sure that this flight knew there would be no funny business on his airplane.

What he said was, “When all of you decided to come through security today to come aboard this plane, you gave up some of your rights and freedoms. Because of that, you now sit inside one of the safest places in the world to be, and that’s in this airport. When you decide to board my plane in a couple of minutes here, you’re also going to give up some freedoms. That means you’re going to comply with mass mandates and all these different things. Any unruly behavior against the flight crew or us is punishable by Federal law.”

Why are those same protections not afforded to America’s healthcare workers? When patients and their families are entering the healthcare system, why is it okay to physically abuse a healthcare worker? Why are we having leaders in healthcare testifying now and across several states trying to get state-level regulation to protect healthcare workers and these sorts of things when our nation needs to take a broader stance on this? I share this because if nurse leaders and healthcare leaders can impact one thing to make immediate traction on gaining the trust and gaining retention of their healthcare providers, they have to provide a safe physical work environment in order to be able to begin the rest of the healing that needs to be done.

Thank you so much for sharing that. As someone who hasn’t been in the hospital in a while, I’m a little shocked to hear that that has become an issue. Everyone, if you see something, say something. Would you suggest maybe having more security guards or metal detectors? What would that look like?

It’s all of the above. It’s also internal processes on how to activate shows of support. One of the nurse leaders that I’ve worked closely with is a brilliant nurse leader in the healthcare industry. She said that hospitals would love to add to their security staff, but those are also in short supply. The roles they are able to hire are big. It’s a tolerance component too. What do we tolerate? If there are some broader implications about what happens if you do have an incidence of violence against healthcare professionals, right now, there are no consequences because it’s not well-defined. It’s defined on certain state levels but there’s no common understanding.

Most people understand if you assault a flight attendant, there are big problems. That plane will land. You will be extricated from the plane and you’re going to have a bad day and years that will follow that. There is no common mentality and mind-share amongst this in healthcare. It’s a problem if we can’t guarantee physical safety to a reasonable extent.

People are often in altered mental status and other things when they’re sick because they’re vulnerable and they’re sick, and that’s why they’re in a hospital. If we can’t at least ensure at the bare minimum that we’re going to do our best to provide a safe and healthy work environment for people to get into this field, we are going to be pushing a boulder uphill in repairing the healthcare workforce for a long time.

Thank you for sharing that. As someone who had a child in the NICU for a week, my first one, the nurses were incredible. It’s difficult to hear that. I’m sure with your company and you are advocating for it, we’ll see some change there.

 

People cannot heal and begin to respond until crisis is done. Share on X

 

We have to have a voice.

To shift gears a little bit to more personal life, you’ve accomplished so much. You’re still accomplishing so much. Even more, I know you’re going to accomplish. How have you been able to balance this? You have three kids, two stepchildren, and one daughter. It’s incredible. What advice would you give to parents who are expecting their first child and are worried about that balance? I remember worrying myself like, “How do I stay productive?” Tell me more.

It takes one to know one. You have accomplished incredible things. You worked through your doctorate. You have kids, you get it. I’m going to say something that might be unpopular and people can react to this. It would be fun to dialogue on it a little bit. I don’t know that I believe in balance, to be honest. What does that mean? Of course, there’s balance. Physics tells us that there’s balance, but I think about my life as a pie chart. Sometimes the slices of the pie grow and shrink and it iterates around the circle.

There are certain points in time when the professional demands of my life are intense. I think about the last few years, leading a company through hypergrowth, and leading the national deployment of healthcare professionals at a scale never seen before in our nation’s history and hopefully never see it again. That was intense. There were days when I don’t think my family knew that I existed and maybe I didn’t remember them either. There were days when I was strapped to that desk chair that I thought I was developing a pressure ulcer. The “balance” or that pie graph of my life was 99% work and 1% personal. It’s a sliver.

That’s not healthy. I’m not going to say it was right and/or healthy, but sometimes it’s reality. As much as we fight reality, then we get mad and we regret what’s going on and this sort of thing. As long as I address it and I call it out and say, “This is my reality right now,” and have that conversation. A quick example, I was at a conference for work. I got to give a keynote. I have this incredible energy and I’m excited about what’s going on.

I let my husband know that I was leaving for that week, “This is going to be an action-packed week. I’m going to do my best to stay connected with you and the kids this week but I’m going to ask you upfront for some grace. If I don’t text you back right away or if I can’t make the call right away or those sorts of things, give me some grace and we’ll talk about this upfront.” That has been functional in our working relationship.

The other part of that though is I fundamentally believe in work hard and play harder. When I have that opportunity to cut loose and do the things that I enjoy, I love outdoor sports. I have a snowmobile, boats, and fun toys to go play with. I love to cross country ski and hike. Doing those sorts of things and taking that own time too, where you put work on the shelf and you’re like, “That problem is going to be there when I get back.” Giving yourself that space is key.

What I know to be true, I can think about a few times when I’ve been burned out. That’s it and I had to recover from that. I certainly know that that’s a real thing, but if you’re investing time into stuff that makes you feel inspired, it refuels your gas tank. That’s what has been important for me. Although it seems like crazy and there’s a bunch of stuff going on, some of those things are fuel.

I love your metaphor with that pie chart because it’s constantly shifting. There may be a day when you’re the best president of your company, and there may be a day when you’re the best parent. That’s one of the best ways I’ve ever heard someone describe that. Also, having a partner that’s there for you and that has your back makes a big difference.

It’s huge, and also having that support system and that network. I have friends that are so helpful. One of my friends called me up and said, “If you’re going to have to spend this whole weekend working, why don’t you bring your daughter down here? Our kids would love to play with her.” I’m so grateful for that. That meant so much to me that my friends saw, “You’re going to have a busy weekend because of whatever was going on. Let’s provide a great time for your daughter so that she’s not sitting there and not getting any attention or whatever.” There are days too, when you can call out the fact that you suck. It’s totally okay.

I said this to one of my team members. We were having a dialogue in the hotel room and I was like, “Yeah, I suck at that.” I’m not going to beat myself up about it. I’m not going to let the imposter syndrome take over and be like, “You sucked at that. You suck at everything.” No, I don’t. I do pretty well at a lot of things. I don’t do great at everything. Be honest with yourself, give yourself grace, and build a support network.

My CEO had to tell me, “April, you need an assistant.” I was like, “I can have one of those? I can have somebody?” He’s like, “Of course, look at the job that you’re doing.” I’m like, “This is amazing.” What I learned is it wasn’t so much about hiring someone to help me. I had to be okay giving stuff away. That is a problem for a lot of leaders. I love my assistant. She is my right and my left brain. She has become one of my best personal friends. The more that I was able to let her into my life and give her things, the more lift and freedom that I got.

A lot of young leaders are thinking about how and when do you get to that point. How do you know when it’s right to start bringing people into your life to help? I strongly encourage young leaders now to take advantage of virtual assistants too. Take advantage of the tools or virtual assistants and things that can help you be more accountable, but be able to focus your time on the things that provide the most value. Maybe that is making your child’s sporting game while somebody else is figuring out your calendar for the week. There are different ways to incorporate tools that give you a lift.

 

Give yourself grace. You haven't failed if you need to ask people for help. In fact, you've probably done yourself and them a favor. Share on X

 

I was laughing because I literally hired my virtual assistant now. I’ve had other people help assist in the past but it’s too much. I had someone else on my show and he said, “If you’re transitioning into a leadership role, you should not be spending 30 minutes talking to a cable company about your bill. Outsource.”

There are so many great companies, and with the pandemic, that have a lot of people want to work from home. The company that I hired specialize in hiring moms that don’t want to go back to the office. I’ll send you their information. It’s an awesome and great experience. I feel passionate about supporting people who want to spend more time with their families.

Give yourself that grace. You haven’t failed if you need to ask people for help. In fact, you’ve probably done yourself and them a favor. The other thing that I’ve found is by nature, a lot of humans derive a lot of joy from being able to help other people. If you would just be okay with the fact that you need to ask for help or structure help, you’re probably helping other people gain joy as well.

That was a hard lesson learned. I do think that Millennials, in particular, are high-capacity people and we can get a lot done. The saying goes, “If you want to get something done, ask the busiest person that you know.” We naturally drown ourselves sometimes and then we feel like we failed if we ask for help. I know I’m generalizing that.

The statistics say that Millennials are the most burnout generation, excluding Gen Z as far as the statistics go. We are because we take on a lot. A lot of us try to pursue our passion too. That can be exhausting sometimes. There are some days where you’re emotionally fulfilled but you’re like, “I’m tired.” At the end of the day, we like purposeful work.

It makes us feel an impact. It makes us understand how we’re spending our time and how we’re going to impact potentially our legacy and the legacy of our families, nation and our world.

We already talked about the Great Resignation within healthcare. The first thing we need to do is protect our people. The next thing I want to ask is, what do you see the future of work as? I know for nursing, that’s face to face. It’s hard. They have telemedicine now, but generally across the board, do you think we should move to a hybrid, virtual or in-person? What are your thoughts there?

I have a few thoughts on this, but I will tell you my leading thought. There is still a ton of opportunity to rethink work in many different sectors, but particularly in healthcare. I could sit back now with a piece of white paper and draw two columns on it and write all of the work that nurses do in both columns. I could make a column that must be done in person and could be done virtually. Some companies are already starting on this but there’s a big opportunity to create a model in which nurses, in particular, could potentially work in hybrid jobs.

There could be nurses in the cloud supporting the work that’s being done at the moment by the nurses on the ground. Those nurses on the ground could take their days to go be in the cloud. This thinking may be the next step and not the complete future, but why not? All of this is computerized and digital. There are still things that must be done with hands, and then there’s a lot of stuff that must be done with brains. A lot of that brain work can be done when you’re not physically present. There’s a big market opportunity for some scrappy entrepreneurs and some good companies to come in and re-engineer that work.

Maybe health systems will figure it out on their own, but I do think the future of work involves hybrid employment. I also believe to my core that we should never get out of the business of being able to lay hands on people when we are doing the work of healing. From the beginning of our world, the most important component of being able to heal someone is to create and foster that human connection. You can’t send a robot to someone’s bedside and have them deliver grave news or have them deliver inspiration. That doesn’t happen, but humans do. I don’t think that there will ever be a total obstruction of that human element, but we could get so much better.

I will share this thought. The future of work in healthcare, in particular, can be heavily influenced by what doesn’t need to be done inside a healthcare institution. One of the things that are the silver lining is we taught everybody that they could do a medical test at home and that could deliver an outcome that could then be acted upon.

Something that will grow will be this whole life sciences component division around what else we can be doing at home that should not require expensive equipment and extraneous means to monitor and all this stuff, and then how could we keep people living their lives, but getting them back the outcomes that they need to know?

There will be a lot of growth in providers that help to take in information from people to prescribe some diagnostics within the middle to get that tool to them, whatever that may be, and then summarize that information on the backend and deliver a new set of outcomes while the person is in the cloud and the other person is at home. That’s going to be a big opportunity for work in the future.

 

Through using healthcare talent differently, through using the tools and innovation and technology that we already have in this world, we could deliver a new reality. Share on X

 

That could be through Apple Watches and that type of technology.

Apple Watches, online platforms, videos, and telehealth components, but then being able to do in-home testing and not taking people so far away from their lives. Where I live, we have a lot of snow and ice in the winter. I love that because I like outdoor winter sports, but why do we want someone who is 75 years old and maybe has an unstable gait to have to leave their house and go into a risky situation to go get their weekly blood draw done? That shouldn’t happen. It introduces risk.

I use that as a real example. My grandmother was that person. She was 75. She fell and broke her hip on ice and was heading to a doctor’s appointment. You think about those things. It’s a real situation but through using healthcare talent differently and through using the tools, innovation, and technology that we already have in this world, we could deliver a new reality. It will ultimately have a big impact on the way we work.

My last question to wrap this up is, what advice would you give to someone who just got promoted like a nursing supervisor or something that you wish someone told you when you first got promoted?

I have a ton of thoughts on this but I don’t want to bore everybody. One of my former bosses once told me something that, for me in the business world, became incredible to provide perspective. She said, “April, prior to this role, you were out in front of the green curtain and now you’re behind it.” I was like, “Oh.” Often, when you are an individual contributor or maybe you’re even in your first level of leadership, you don’t have the exposure to the raw information of how that system, that business, that company, that unit is run. You don’t know the real struggles, the decisions, and the problems that are being dealt with. When you are first in those roles, it can be overwhelming. You can be like, “This place is messed up. This is not what I signed up for.”

It’s going in and understanding that you don’t know what you don’t know. At least be open to the fact. When you get those first few shockwaves as a leader, be prepared for them. You don’t have to be prepared to know and understand what they are. You don’t have to defend against them. If you can recognize and say, “I knew this is what’s going to happen as I started to become exposed to how the business runs. I am not going to be shaken off my core. I’m going to understand that first of many learning, maybe not exactly what I thought I signed up for, but I’m going to work through it.” Know that you’re going to come out the other side of that better, more experienced and more prepared.

There is no textbook that is truthfully all-encompassing on how to be a leader. It can’t replace the experiences. There is no certification or point when you reach the top like, “I am now a leader.” That doesn’t exist. You don’t get a badge to be the leader. It is through your experience and through your lifelong journey of what you learn and how you influence other people.

That’s the biggest thing. Be prepared for some of the lessons that you never thought you were going to learn. Don’t get freaked out by them. It will be good for you after all, but you’re going to learn things that you didn’t ever be prepared to learn. Nobody is going to interview you for a leadership job and say, “Once you’re in this job, you’re going to see that we’re messed up.” Nobody is going to tell you that.

April, thank you so much for devoting your time and giving us advice for the next generation of leaders. Thank you for all the great work you’re doing in healthcare. I appreciate you being on our show.

Thanks, Santor. Thanks to everybody. I hope you pull one nugget of something great to take with you into your career. I’m grateful for all of the Millennial leaders and everyone that’s in this workforce right now. We have big jobs to be done ahead of us.

Thank you so much. Have a great rest of your day. 

 

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About April Hansen

TZL 3 | HealthcareNational speaker on hypergrowth leadership, peak performance, workforce dynamics, and resiliency.

As Aya Healthcare’s Group President of Workforce Solutions, April Hansen, MSN, RN, is responsible for strategic business development, workforce solutions program operations, recruitment augmentation and clinical services support. Hansen has led her team through exponential growth through new client expansion and several organizational acquisitions, increasing the distribution channels for Aya’s 45000+ clinicians. A strong proponent of lifelong learning, April created the Aya Scholars Program, the industry’s first clinical ladder and professional recognition model for travel nurses, to ensure their continued career growth.

Passionate for improving the clinician experience and solving workforce challenges, Hansen spearheaded an industry-first qualitative market research project examining the lived experiences of core staff, veteran travel nurses and new travel nurses during the pandemic and understanding how that lived experience influences nurses’ career choices. The research, “Mind the Gap: Repairing the US Healthcare Workforce” and its findings have been featured by Healthcare Dive, Axios and SIA and have been presented at numerous hospital and healthcare associations, including Wisconsin Organization of Nurse Leaders where Hansen served as the keynote speaker.

April is a nurse and an entrepreneur. She successfully co-founded a clinical management technology to ease the administrative burden of healthcare student clinical placements in 2012 and achieved a successful exit when the technology was acquired in 2016. In addition, she co-founded a mobile application for nursing engagement and achieved support through a nationally ranked start-up accelerator in partnership with Microsoft in 2017.

April currently serves on the Board of Directors for the Wisconsin Organization of Nurse Leaders, serves as co-chair of the Membership Committee with WONL and in the past served as an elected member of the Wisconsin Nurses Association Public Policy Committee. April was published in the June edition of Nursing Administration Quarterly on disruption in healthcare and the role of nursing leadership. She’s also served as an expert for national media outlets including CBS This Morning, CNBC, Associated Press, Marketplace and Forbes.