The Value of Veterans in the Health Care Workforce

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Tom Haederle
Health care providers nationwide need more trained, skilled, experienced people to help meet their needs for patient care. Military health care veterans such as medics and corpsmen offer these in-demand talents, but translating them into a comparable civilian setting where their training is valued and respected can be complicated. That's why the state of Wisconsin took action to ease the process, and so far it's working well.

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Tom Haederle

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Tom Haederle
Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. Today we hear from two chief nursing officers associated with the University of Wisconsin system about the steps they've taken to tap into the great resources that military health care professionals have to offer in nonmilitary settings. As we learn, cultural differences are something that civilian health care employers need to keep in mind as military service members are, quote, “Focused on completing their mission.”

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Tom Haederle
Let's listen in.

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Elisa Arespacochaga
Thanks, Tom. I’m Elisa Arespacochaga, vice president of clinical affairs and workforce. I'm joined today by Anne Mork, CNO, ambulatory and nursing care services, UW Health, and Luke Sticht, former vice president and CNO, American Family Children's Hospital, UW Health Kids. And today we're going to talk about how UW Health really shifted from being military-friendly in their culture, to a culture that really is truly ready, willing and able to welcome and support military- trained team members in pursuing their health care careers.

00:01:40:01 - 00:01:48:21
Elisa Arespacochaga
So to get started, I'm going to start with you, Anne, and then I'll turn it over to you Luke. Tell me a little bit about your organization and your role.

00:01:48:24 - 00:02:18:26
Anne Mork, R.N.
Thank you Elisa. I'm thrilled to be here today to talk about this really exciting program. First off, UW Health is a large academic integrated health system affiliated with the University of Wisconsin-Madison. The system is comprised of six main hospitals, 90 primary and specialty outpatient locations serving over 800,000 patients annually. UW Health holds Magnet status and has been re-certified in Magnet four consecutive times.

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Elisa Arespacochaga
Wow. Congratulations. I know that's no easy feat. Luke, just tell us a little bit about who you are.

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Luke Sticht
Sure. Thank you very much, Elisa. Luke Sticht, the former vice president and chief nursing officer for the American Family Children's Hospital. And I'm also a commission nurse corps officer in the U.S. Navy. I hold the rank of commander, been in the Navy for 15 years, both active duty and reserves, and continue on in that role presently.

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Elisa Arespacochaga
All right, well, let's get into the work that you both led together. And I know, as I have talked to you about this work, you were really focused on how you were going to grow your nursing workforce in the midst of the pandemic and all of the challenges that, you know, everyone faced at that time. You really wanted to find ways to connect with those who were separating from the military, who were looking for health care training, who had some health care training, but weren't necessarily in licensed roles.

00:03:17:01 - 00:03:25:12
Elisa Arespacochaga
How did you start to find opportunities both at the state level within Wisconsin and then specifically at UW?

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Anne Mork, R.N.
It really, began in part to address the nursing workforce challenges that we have in the U.S. We are well familiar with the fact that the aging of our population is propelling with a significant increase of those aged 65 and older in Wisconsin. Positive relationship exists between these demographics and the need for health care services, chiefly due to the increase of chronic and complex conditions requiring care.

00:03:52:13 - 00:04:29:09
Anne Mork, R.N.
The program really started with my CNE, Rudy Jackson was contacted by Ann Zenk, R.N., MHA, senior VP of workforce and clinical practice at the Wisconsin Hospital Association. She served as the head of the coalition that partnered with Heroes for Healthcare to pass legislation, Assembly Bill 720. Heroes for Healthcare is a nonprofit organization, administering to Wisconsin military medics and corpsmen WIS-MAC program for transitioning medically-trained veterans to work in civilian health care.

00:04:29:11 - 00:05:08:05
Anne Mork, R.N.
They have an excellent vision, and that is simply to guide military members through a seamless transition from service member to civilian life to ensure that their skills, training and experience are translated, respected and accepted at educational institutions and health care facilities. When medically-trained service members and veterans transition to civilian life, their training and experiences, as many of us know, does not always translate into comparable jobs in health care, which in turn can lead to unemployment, underemployment, or complete abandonment of the health care field.

00:05:08:07 - 00:05:46:06
Anne Mork, R.N.
So to talk a little bit about the Assembly Bill 720, was signed into law in Wisconsin in 2022 and gave us this huge opportunity. It was signed by Governor Evers. It allows certain persons who have recently served as an Army medic, a Navy or Coast Guard corpsman, or an Air Force aerospace medical technician in the U.S. Armed Forces, to provide certain skilled health services as part of a program facilitated by the Department of Safety and Professional Services, without having to obtain a license, so the licensure is temporarily waivered.

00:05:46:08 - 00:06:31:21
Anne Mork, R.N.
We are the only state other than Maryland who has this law in place. The difference between Wisconsin and Maryland is that Maryland waivers the licensure forever, and we waiver it temporarily. So the bill directs the DSPS in collaboration with the Department of Veterans Affairs, the Medical Examining Board, and the Board of Nursing to establish a program in which military medical personnel, I'm going to call them MMP, may temporarily practice certain skilled health services in an inpatient and outpatient health care facility under the direction of a physician or physician assistant. Can be a podiatrist for certain roles,

00:06:31:21 - 00:06:40:15
Anne Mork, R.N.
registered professional nurse or advanced practice nurse prescriber without having to obtain a license from the respective boards.

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Elisa Arespacochaga
That's amazing. It sounds like quite the complex program. Luke, let me ask you, as a military health care leader, you've literally run hospital services around the world. How did you transition and what are some of the things that really both surprised you and also that you then brought to your work with UW to say these are the things that, you know, we honestly don't think of that are so very different in military medicine versus in civilian medicine.

00:07:12:06 - 00:07:24:01
Elisa Arespacochaga
I know the last time we talked, you had all of these things that just, I didn't even think of that were just commonplace for medicine and for military medicine. And then you got to civilian medicine and none of them existed.

00:07:24:03 - 00:07:43:22
Luke Sticht
Yeah. I think if you are a service member and you are a part of a military treatment facility here in the United States, in my experience they are very similar, to practicing in a civilian hospital. I think the differences I saw were if you were deployed downrange to a role two or role three facility, there are many differences.

00:07:43:22 - 00:07:54:08
Luke Sticht
And in my experience, the military does a great job focusing on their mission and especially, you know, deployed downrange, right.

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Elisa Arespacochaga
Let me interrupt you for those who don't know, including me, deployed downrange means in a foreign country or…

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Luke Sticht
Yes, thank you very much. So downrange for military language is, is you're deploying down to the fight, if you will. You know, really the mission of the military in those situations of military medicine is to preserve the warfighter, to save the warfighter. And so because of that, there's not a lot of room for office politics. There's not a lot of room for infighting between service lines, because we are all working for one common goal, which is to get that service member back out to the fight, to get them to a higher level of care, or to get them home.

00:08:36:23 - 00:09:02:23
Luke Sticht
Those are really the differences when you transition to a civilian facility, in my opinion, where oftentimes there is fighting between service lines. So there's a lot of politics, especially in leadership positions, that you need to learn how to navigate. But I think, really for civilian facilities to become more military ready, they need to know this, and they need to understand that military service members, they are focused on completing their mission, whatever that mission is.

00:09:02:23 - 00:09:36:01
Luke Sticht
They could be providing patient care in the ICU. They could be focused on fixing equipment and the biomedical engineering team. What have you. A lot of service members, they don't want to get involved in politics. They want to serve a higher purpose than themselves. And that's what their mission is. And so, if organizations can learn from those service members, it can oftentimes help teams in the civilian sector move beyond some of your bureaucratic challenges and just get the job done.

00:09:36:03 - 00:09:54:22
Elisa Arespacochaga
And I know, when we had talked, there are, a lot of the bureaucracy is different in the military versus in civilian life. So I know, just how you even talk about the skills you have as a leader and a clinician vary. Can you talk just a little bit more about that?

00:09:54:25 - 00:10:21:15
Luke Sticht
You put me on the spot here, Elisa. In the military, yes there is a strong chain of command. But we utilize concepts such as decentralized command where answers can be made in the moment by the right person at the right time. And so there is what we call the commander’s intent, which is also similar to a mission of an organization, if you will, as part of a command.

00:10:21:18 - 00:10:45:27
Luke Sticht
And, a good commander will make sure that every individual in the command understands what the commander's intent is. And then that trickles down to levels of service members who can make decisions because they understand the commander's intent. And so it is not strictly hierarchical. It is very much team. It's one of the best teams I've ever worked for.

00:10:45:29 - 00:10:57:15
Luke Sticht
And that includes not just the Navy, but joint service with all branches, including NATO branches that we served with overseas. All of us have the mindset of what do we need to do right now to complete our mission?

00:10:57:18 - 00:11:22:23
Elisa Arespacochaga
Anne, let me go back to you. You started to describe a little bit, but, can you tell me for the typical trajectory for one of your former military trainees, so someone who comes in and say, a Navy corpsman who comes in, can you talk a little bit about sort of what their opportunities are and how they can then advance their career without having to go back to, you know, Infection Prevention 101.

00:11:22:23 - 00:11:51:11
Anne Mork, R.N.
Thank you, that is such an excellent question. And I think Luke's comments and experiences really underscore the need for us to move that culture. It's not just about recruitment, it's about that retention and making sure that we understand the military life, as much as we expect military life to be seamlessly integrated into a civilian life. So it's really moving from a military-friendly to a military-ready organization.

00:11:51:11 - 00:12:18:16
Anne Mork, R.N.
And we've done a ton of work to move towards the latter, and we'll never be there. But it's a constant movement. So the typical trajectory from one of our hires, we have hired a medic recently. We hired a corpsman. Our medic has six years of invaluable health care experiences. Due to the active engagement and support from Heroes for Healthcare, who bring these candidates to our us with their résumés.

00:12:18:16 - 00:12:44:14
Anne Mork, R.N.
And we take them through the interview process. And I have partnered with all of the ones we've hired, especially in the beginning, because it's all about building a strong basic foundational program so that our MMPs will talk to each other and say, you know, in Wisconsin, we have a great opportunity to be given credit for the work that we have done.

00:12:44:16 - 00:13:13:15
Anne Mork, R.N.
We're starting to partner with colleges to look at, you know, giving credits as well. But even for us, I do an open house to look at the resume and give them recognition for the background that they have. We navigate the Memorandum of Understanding with them. That can be a little bureaucratic, and we try to make it a very seamless process from identification of a candidate to the interview process, to the hire, connecting them with our talent acquisition team.

00:13:13:17 - 00:13:44:15
Anne Mork, R.N.
And Heroes for Healthcare is there throughout the path. We then have to submit officially our license, your timeline. Again, Heroes for Healthcare will help track that. So if the MMP doesn't meet that goal, like, I'm going to finish nursing school in three years, and they need three and a half years, they need to formally reapply. So there are some stringent criteria that we must adhere to and be very sure for high fidelity to those programmatic elements.

00:13:44:18 - 00:14:19:13
Anne Mork, R.N.
But the process has been seamless. The average civilian health care professional is unaware of level and scope of medical education and training in the military. Prior to founding of the Heroes for Healthcare, the veterans had nowhere to go and struggled to find civilian jobs. So the trajectory is really successful in large part due to the Heroes for Healthcare support, and also the significant work that we have done with our talent acquisition partners at UW Health to build that culture.

00:14:19:15 - 00:14:46:08
Elisa Arespacochaga
No, this is definitely a partnership. And one that starts with you, but then really spreads across the organization. So, Luke, hopefully an easier question. What can hospitals and health systems do to really more proactively, both reach out to these team members and, you know, the partnership with Heroes for Healthcare is an example, to encourage them to come to the organization.

00:14:46:12 - 00:14:53:01
Elisa Arespacochaga
How do you help them once they get there, stay and feel connected to the organization once they start?

00:14:53:03 - 00:15:17:29
Luke Sticht
I think it starts with the organizations just recognizing the value that the individual’s military training provides. I've had multiple conversations with service members over the years who share with me that organizations oftentimes will look right past their military experience, and when they do that, I believe that it's a real detriment to that organization. As I said earlier, I think many military service members are there to serve something greater than themselves.

00:15:17:29 - 00:15:40:19
Luke Sticht
And when they get out of the military or they transition from active duty to reserve status, they don't want to lose that. They don't want to lose service and they don't want to lose camaraderie. So I think once an organization can acknowledge the training and the value that that training brings to their organization, I think the next step is really supporting the service members who are still part of the military or still hold onto that piece of that.

00:15:40:20 - 00:16:02:09
Luke Sticht
And most all of us do. Our organization at UW Health created a military service group member organization. It's a group of service members, both, you know, currently serving as well as, those who have retired or separated. And this group is robust. I think the last count was 35 members who meet together monthly, share stories, share challenges.

00:16:02:16 - 00:16:22:03
Luke Sticht
And it brings that camaraderie that they had in the military right back to the civilian sector. And it offers the support that our many military members are looking for during that transition. The support from the organization, right, legally, all organizations have to support Guard and reserve and reserve members. That's a real basic way to look at it.

00:16:22:04 - 00:16:41:08
Luke Sticht
Legally, I have to allow you to go on a two-week reserve duty. I think successful organizations are those organizations that go out of their way to support the service member in scheduling those two weeks, in scheduling those weekends off when they have to drill with their Guard or reserve units, helping those service members fill out leave of absence paperwork.

00:16:41:08 - 00:17:02:16
Luke Sticht
I know a lot of this sounds very basic, but when all of that falls on this service member and the organization treats it as a legal obligation as opposed to something that is benefiting the organization, the service member, and our country, the mentality can really flip to be much more of a positive experience for the organization and the service member, particularly with deployments.

00:17:02:16 - 00:17:32:21
Luke Sticht
If a service member gets orders to deploy somewhere for eight months to a year, yes, it's concerning for the organization, but it's very concerning for the service member and his or her family as well. So having a civilian organization that can support that service member during a deployment, ensuring that the family is taken care of through health insurance benefits or, you know, continuing to be able to use resources from the organization like counseling resources, daycare resources that were in place before the member had to leave.

00:17:32:23 - 00:17:56:21
Luke Sticht
Those are real things that can really set that service member up for success. And when they deploy, a lot of those challenges and anxieties that they have can go away. That type of action from the civilian organization, that's going to keep that service member there. He or she's going to feel like my family is taking care of while I'm gone, and I'm going back to that organization when I'm done with these orders because they took care of me.

00:17:56:23 - 00:18:20:15
Elisa Arespacochaga
Those are great examples. Thank you so much. And I think you've both highlighted great ways for the organization to think of this as just a huge value, and the various ways you can reach out and be proactive to support them in their journeys. Sounds like, UW really is on that path and continuing to be an example for others.

00:18:20:18 - 00:18:22:21
Elisa Arespacochaga
So, thank you very much.

00:18:22:24 - 00:18:31:05
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.