Advancing Health Podcast Summary

Episode: "Rebuilding the Pipeline: The Nurse Retention Turnaround at NYC Health + Hospitals"

Date: October 29, 2025
Host: Elisa Adaspakwachaya, Group VP for Clinical Affairs and Workforce, AHA
Guest: Natalia Sinias, Senior VP & Chief Nursing Executive, NYC Health + Hospitals

Episode Overview

This episode spotlights NYC Health + Hospitals’ remarkable turnaround in nurse retention. Host Elisa Adaspakwachaya talks with Natalia Sinias about how collaborative leadership, innovative programs, and empowering front-line nurses reversed alarming turnover rates, transforming nurse engagement and the workplace environment.

Key Discussion Points & Insights

The Catalyst for Change (01:07)

• Problem Recognition:

  • 2019 turnover rate for nurses: 46%
  • Shocking data prompted urgent focus on retention.

• Action Steps:

  • Initiated Nurse Residency Program as a foundational strategy.
  • Appointed a Senior Director of Professional Practice to develop over 200 professional governance councils across the health system.

Quote
"The data really led us to focusing on retention. We had a turnover rate of 46%. And as you can imagine, that was really shocking." – Natalia Sinias [01:07]

Front-Line Engagement and Shared Governance (02:20)

• Empowerment:

  • Structured opportunities for nurses to express concerns and drive change.
  • Collaboration with labor unions to enhance program meaning.

• Culture Shift:

  • Created learning moments for leaders on listening to front-line staff.
  • Achieved five Pathway to Excellence designations, two with distinction, recognizing positive practice environments.

Quote
"Establishing structural empowerment and that infrastructure was actually really exciting. And I think hearing from our nurses, understanding what they wanted to see, partnering with our labor unions, was the answer, really, to ensuring that our nurses were engaged." – Natalia Sinias [02:20]

Results: Dramatic Drop in Turnover (03:37)

• Current Turnover Rate:

  • Reduced to 7%, far below the national average.

• Attribution:

  • Success attributed to:
    • Nurse residency
    • Professional governance councils
    • Fellowship and clinical ladder programs
    • Senior leadership and city support

Quote
"Our turnover rate is now 7%, which is phenomenal...that is because of the commitment of the entire C suite here at New York City Health and Hospitals." – Natalia Sinias [03:37]

Recognition
"That is, just to put it into perspective, significantly below, in fact, less than half of the national number of turnover rates." – Elisa Adaspakwachaya [04:49]

Success of the Nurse Residency Program and Career Pathways (05:37)

• Program Scope:

  • Over 2,000 participants, 1,000+ graduates.
  • Emphasis on NYC H+H’s mission to care for the underserved.

• Career Support:

  • Educate nurses on intra-system opportunities for career mobility.
  • Encouragement to participate in governance and professional development.

• Unique Mentorship Innovation:

  • Graduates can become mentors; uses AI for mentor-mentee pairing.
  • Over 100 mentors actively supporting peers.

Quote
"We created something here...which is really unique...the mentorship opportunity...using an AI platform to pair a mentor with mentee...that has been just phenomenal." – Natalia Sinias [06:56]

Fostering Connection and Culture (07:52)

• Philosophy:
  • Leverage nurses’ intrinsic desire to care—not just for patients but for colleagues.
  • Encourage peer support and camaraderie as retention tools.

Quote
"If you're tapping into what is in a nurse's genetics, it is about caring for other people." – Elisa Adaspakwachaya [07:52]

Lessons Learned and COVID-19 Impact (08:34)

• Key Takeaways:

  • Communication and Visibility: Ongoing, transparent dialogue with staff remained vital.
  • Consistency: Maintained residency programs and safe spaces even during the pandemic.
  • Listening: Fundamental to all programs and events—from fireside chats to town halls.

• Result:

  • Success in retention linked to nurses believing in the mission and being integral to solutions.

Quote
"I think the one lesson I've learned is the importance of communication and staying connected with those doing the work." – Natalia Sinias [08:34]

Memorable Moments & Quotes

• On Leadership Support:
  "[Our CEO] has been our number one supporter with the City of New York to ensure that our nurses have great contracts...to see this remarkable result." – Natalia Sinias [04:38]

• On Mission:
  "They know that they are part of the fabric that makes us great and that they are part of the solution to continuing to provide excellent care to our patients." – Natalia Sinias [09:30]

• Host’s Praiseful Send-Off:
  "You're there to serve them in the way they are there to serve their patients. And I think there's no higher compliment for a leader than to know that." – Elisa Adaspakwachaya [09:40]

Important Timestamps

• 01:07 — Recognition of retention problem, initial steps
• 02:20 — Front-line engagement, governance, labor partnerships
• 03:37 — Turnover rate improvements and attribution
• 05:37 — Nurse residency and mentorship program details
• 08:34 — Lessons learned, importance of communication
• 09:30 — Nurses as crucial to organizational fabric

Conclusion

NYC Health + Hospitals’ nurse retention turnaround is attributed to bold leadership, data-driven interventions, and authentic engagement of front-line nurses. Their model—marked by innovative residency and mentorship programs, robust professional development, and a culture of listening—serves as a blueprint for improving nurse retention amid industry-wide challenges.