Becker’s Healthcare Podcast – Episode Summary

Episode: Restoring the Nursing Workforce at Penn State Health, Milton S. Hershey Medical Center
Guest: Michele Szkolnicki, Senior Vice President & Chief Nursing Officer
Host: Scott King
Date: February 21, 2026

Overview

In this episode, Michele Szkolnicki, Chief Nursing Officer at Penn State Health's Milton S. Hershey Medical Center, discusses the organization’s journey to restore and sustain its nursing workforce following the immense challenges brought on by the COVID-19 pandemic. The conversation touches on her background, strategic workforce initiatives, the impact of their efforts, headwinds for 2026, and perspectives on the fundamental role of nursing in organizational growth and financial resilience.

Guest Background & System Overview

[01:02 – 01:55]

• Michele Szkolnicki introduces herself as the CNO with four and a half years at Hershey Medical Center, highlighting their recent application for a fifth Magnet reaccreditation.

• The medical center comprises 471 adult beds and 160 children's beds, is part of a 7-hospital system, employs about 22,000 people, and is home to the Penn State University College of Medicine.

  “We are the academic medical center of the Penn State Health System...happy to say that we just put in our application for our fifth magnet reaccreditation.” – Michele Szkolnicki [01:02]

Key Initiatives: Restoring the Nursing Workforce

[02:11 – 05:25]

• The central initiative over the past year (culminating a multi-year effort) was restoring and stabilizing the nursing workforce after the pandemic, which left the hospital with high turnover and vacancies, and stressed staff.

• Michele emphasizes a multifaceted approach:

  • Unit Redesign: Retooling units to appeal to newly graduated nurses by specializing floors and reflecting nurses’ interests in various specialties.
  • International Nurse Recruitment: Launching a program to bring in international nurses as a sustained replenishment strategy.
  • RN Ambassadors: Empowering current nurses to act as ambassadors at schools and job fairs, sharing genuine workplace experiences.
  • Professional Development: Strong focus on specialty certifications and BSN program partnerships.

• Outcomes:

  • Sustained turnover rate under 9% for over 13 months.
  • Nursing vacancy rate down to 2.65% (as of December).
  • Medical-surgical units with 0% nursing vacancy.
  • Improved staff engagement scores and perceived happiness.

  “I am not a person who believes in this silver bullet theory. There’s a lot of things you need to do in tandem in order to restore nursing workforce.” – Michele Szkolnicki [02:29]

  “We have under a 9% turnover rate...combined, our vacancy rate...is 2.65.” – Michele Szkolnicki [04:24]

Detailed Efforts: Giving Med-Surg Units an Identity

[05:44 – 08:03]

• Commonly, medical/surgical (med-surg) units are hard to staff as many nursing graduates seek out ED or critical care roles.

• The team addressed this by defining unique specialty identities for each med-surg floor:

  • Created medical specialty floors and certification pathways (e.g., geriatric “niche” units).
  • Dedicated floors for orthopedics, neurosurgery, MIS, surgical specialties, and cancer care.

• Result: 0% vacancy rate on all seven med-surg units as nurses are drawn to specialization and opportunities to gain expertise.

  “I am very, very proud and somewhat amazed to be able to say that our med surg units, we have a zero percent vacancy right now in all of our seven medical surgical units.” – Michele Szkolnicki [07:14]

Priorities & Headwinds for 2026

[08:13 – 11:43]

• Key Concerns:

  • The potential impact of HR1 (insurance coverage reforms) may increase the patient population unable to pay or uninsured, affecting hospital margins.
  • Sustaining workforce gains amid financial tightening and increasing regulatory complexity.
  • Pressure from insurance denials and rising operational costs.

• Role of Nurses:

  • Nurses are pivotal in addressing financial and care delivery headwinds—particularly in discharge planning, reducing hospital-acquired conditions, and facilitating patient mobility to avoid complications.
  • Focus on maintaining gains (“watering the grass”) rather than cyclically rebuilding staff levels.

  “I kind of liken it to watering the grass...you have to sustain. And I think sometimes that’s where we lose it in health care, that we achieve something and then we let it go and then it deteriorates.” – Michele Szkolnicki [09:53]

  “Nursing can contribute...especially around length of stay and getting patients ready to be discharged...so that their hospital stay does not make them more infirm.” – Michele Szkolnicki [10:47]

Most Challenging Task Ahead

[11:51 – 14:19]

• Shifting the Nursing Cost Narrative: Moving from viewing nursing labor as an expense to seeing it as a value generator.

  • Nursing’s direct impact on length of stay, readmissions, and Case Mix Index (CMI)—all major drivers of hospital revenue and expenses.
  • Nurse-led documentation and patient education help optimize reimbursement and reduce costs.

  “How can we take that nursing expense and shift the focus from cost to value generator?...Nursing is one of the most valuable resources in a hospital and I believe it’s one of the most underutilized.” – Michele Szkolnicki [11:52, 13:44]

Organizational Growth Opportunities

[14:26 – 15:54]

• Nursing as Value Generator: Recognizing and empowering nurses’ role in improving organizational value, rather than being seen solely as cost centers.

• Leadership Development: Preparing nurse leaders and middle managers to step up as administrative suites shrink and shared services expand.

  • Emphasis on local (“on the ground”) attention and management, not just centralized support.

  “One of the most important things that I think I’ll be doing this year...is developing our nurse leaders and those middle managers, because they're going to need to do more and they're going to need to work differently...” – Michele Szkolnicki [15:00]

Memorable Quotes

• On Multifaceted Workforce Restoration:

  “I am not a person who believes in this silver bullet theory. There’s a lot of things you need to do in tandem in order to restore nursing workforce.” – Michele Szkolnicki [02:29]

• On Unit Specialization:

  “Giving these med surg floors an identity and a specialization...nursing students were attracted to them.” – Michele Szkolnicki [07:05]

• On Sustaining Initiatives:

  “You have to sustain. And I think sometimes that’s where we lose it in health care, that we achieve something and then we let it go and then it deteriorates.” – Michele Szkolnicki [09:53]

• On Nurses’ Value:

  “Nursing is one of the most valuable resources in a hospital and I believe it’s one of the most underutilized.” – Michele Szkolnicki [13:44]

• On Leadership Development:

  “Middle managers...are going to need to do more and they’re going to need to work differently in order to be able to support those resources that are being restructured.” – Michele Szkolnicki [15:10]

Key Takeaways

• Restoring workforce stability requires multi-pronged initiatives, not just one solution.
• Unit specialization and empowerment of frontline nurses are highly effective in recruitment and retention.
• Nurses are critical to both hospital financial health and patient outcomes—properly leveraging their expertise maximizes value.
• Future challenges center on financial and staffing sustainability; leadership development is key.

This episode provides detailed, actionable insight into how Penn State Health’s leadership is actively redefining approaches to building, sustaining, and leveraging the nursing workforce to weather ongoing healthcare industry challenges.