From 600 Travel Nurses to Nearly Zero: The Hybrid Leadership Model That Changed Everything

Hi, my name is Sarah Cantwell and I am a director of RPO Services with Human People Solutions and also serve as the talent Acquisition Director for Adventist Healthcare. Hello, I'm Jennifer Bergman. I serve as the AVP of System Clinical Programs and Recruitment Services with Adventist Healthcare. So we're going to start at the beginning back in 2017. Can you take us back to what recruiting looked like before the partnership with Human and Adventist? Sure, absolutely. At that time I was serving as a senior nurse recruiter. I had all of nursing nurse practitioners and PAs and one of my colleagues had the emergency room and we were really struggling with that recruitment. So we had brought on one human recruiter to focus on the ed. So what was the staffing in ED looking like? So we had a ton of turnover. I think at that point we had close to 40 ED nursing vacancies that we just couldn't keep up with because of turnover. So I joined the organization in 2018. So about a year into the partnership and Jennifer's role was changing again and she was going to start building the residency program and focus on building a nurse residency program. So I joined as the second human recruiter at that time and actually took her portfolio. So it's kind of it all. All began and took her nursing portfolio, a lot of cardiac roles there at Washington Adventist Hospital. And so she's. She and I started transitioning that to me and team started to grow. End of 18, going into 19, we slowly added, you know, a recruiter seat here and there and really kind of started almost 50, 50, you know, of human recruiters and internal Adventist Healthcare recruiters. I guess, you know, the world kind of shut down. March. What was like Action Plan 1, like what do you need to do most important on the checklist? Yeah, sure. I mean it was staffing because we were using a local agency and we weren't just getting, we weren't getting any hires to cover, you know, all these vacancies. So I ended up reaching out to someone that I had previously worked and then there was just the floodgates open. I was onboarding nurses that were coming off of assignment from New York to fill all of our vacancies. And in the meantime Human came in and they managed the team, like Sarah was saying, and then just started assisting with filling vacancies for the entities because we were still trying to do that is to fill the vacancies along with bringing on the agency staff to fill those immediate needs. Our operations and focus immediately had to go to what roles, what vacancies do we still need to fill, you know, working with leaders on if we're not doing this, you know, for example, we have a lot of, you know, outpatient sites. If we're not seeing patients and bringing them in, that's obviously we can shift that focus. So what, what acute and inpatient care still goes on and what roles, not just clinicians but non clinical does that involve? And so we quickly shifted to that and any processes that we were in, that we had, that existed then and even that we were looking at improving and had discussions on, we had to shift to what does that look like. So our team heavily supported and worked with occupational health. What does an onboarding model, you know, look like for these hires that we are still bringing in? What. What is centralized recruitment and candidate experience look like right now? Because we had to shift from really just we need mass volumes and we're probably going to be bringing in people from. And then also too with our current workforce who could still work or who, who needed to step down, you know, who now had children at home that they were. They couldn't work. And so it was a lot of that for the really the first several months. Nice. There's a. You guys had really, really high turnover. I mean your emergency department turnover was the original problem you guys had. But then you also had around 600 travelers within the system within like the human traveler reduction program. How efficient was that with everything that was kind of happening, especially within Covid travelers and all that. So we initiated, actually I shouldn't say we human initiated that program after Covid because we had so many agency nurses. The, you know, the leaders wanted us to do whatever we could to get the agency nurses out just due to budgetary reasons. But that was when you guys came in and came up with a lot of creative ways to either convert those nurses or utilize them and other capacities. Well, I think with your background in travel staffing nurses, you know that. Not that it was easy by any means, but when you shifted to that focus, we so quickly had so many resources and pipelines to bring that travel in. And then when it kind of stabilized and it was okay, now we had it. We even at the time had an off site. Washington Adventist Hospital actually served as a Covid only site through a. So you know, we had extra sites. We have travel staff. And then once it started stabilizing, it was kind of like okay, now where do we start making cuts? And I think that was really probably the onset and the kicker of human marketing and recruitment marketing plan. And we started with the welcome home plan. For agency nurses and partnered with, you know, the CNOs and the leaders on who are. Who's been working for you agency that you just would love to keep and who. How can we rebuild this workforce but not, you know, keeps those that have been with us for months. And so that began the welcome Home Agency. We built an incentive package and perks and one that we now know after doing it for several years and speaking with colleagues and organizations throughout the country, how blessed we were with the packages we were able to offer. Yeah, but there were other, you know, we had the tier three folk pool, we had the CNAs we were bringing on. There were, you know, many programs that were developed or pipelines to be able to, you know, support the staff. And I also, I do want to add that like Sarah said, we had the old Washington and Venice Hospital. We used that as, like Sarah said, a Covid only hospital. But Human was fully responsible for that location. They were staffing that location. They were working with the leaders, they were scheduling. I mean, it was all hands from Human for that facility. We had nothing to do with that because it just, you know, our. We just didn't have the bandwidth. We're talking about workday implementation with Workday with your. Your TA system and all of that. She would remember what being before Workday. I heard about it for the first several years, but there was a lot done on paper. Gosh, so much on paper. And handed it. Yeah, I mean, it was just so outdated. We would have candidates come in and fill out all this paperwork. There would be like paper applications. And we did have an ats, but I'm not sure it wasn't useful at all. It had, you know, inaccurate information. And so it was just. We had candidates coming in and taking exams to see if they qualified or had done. Exactly. Surely hiring leaders would send me. Here's their test results. Yeah, I mean, it was just. Yeah, I. I mean, I just. I still think about all like the files I had in my drawer, you know, just with candidates and bottom. And I mean with the implementation of Workday, it started, you know, it was kind of the bare necessities too, I would say. Yeah, certainly from where we sit today with it. Yeah, absolutely. I mean it became. Is. Is so more than just ats. I mean, it's a full functioning H. And even where it was and what it stored in its capabilities when we implemented it in 2018 to where it is today. But even within the first few years of having it, centralizing things that really played a part in recruitment operations that we could have visibility to. Without going through all the chance, you know, like compensation grades and eligibility and just record keeping. It just became more and more instrumental to making it more efficient. Yeah, because if you think, I mean, we've come so far with workday, I mean, it's so automated now because when we first started out, I mean, the recruiters were still doing the manual offer letters and we're still, you know, we didn't have any templated emails or communications or. I mean, it's come such a long way as far as that. How does aligning questions with job family change the quality of hires and relationships with the hiring managers? That was all you. That was a big project. Sarah did I. I think I saw it when it was all said and done and put my blessing on it, but that was something she worked on. So I think prior to really obviously the pandemic, they. And you know, I was recruiting at that time, there was talk and discussion and I believe even an outside consultant brought in to look at what is, what is the interview, you know, portion, hiring interview, portion that recruiting look like. And so that was kind of in development and then of course got tabled. But when we went back to it, the thought behind it then was let's have a set of questions for every, every job. And that's what recruiters will give managers and managers. And we have 4,000 plus job profiles throughout the organization. So, you know, in 2024, just kind of quickly realized that this is just not most efficient. And also, you know, we, we really through a lot of the, I guess, compliance work and things that we did as an, as an HR team within the system realized that we've, we've got to fine tune this a little bit and really be aware and support our hiring leaders in the types of, that we set them up to ask these candidates. If I'm a hiring manager for a nurse in critical care or for environmental services and interview housekeeping, I know what I need to ask them as far as their skills and the team and the role of the job. But what are we setting them up to be equipped for? To ask those appropriate, you know, compliant questions that they need to know to, you know, get a feel for their work background and ethic and all those things. And that quote, unquote fit, right. And so that behavioral interview format is really what I wanted to get us to. And so the consolidating it into the, the job family, we went down from trying to have a set of questions for everything to bucketing it and what is an entry level position look like, what is support services? What is clinical? What is leadership? And that's where we really had room to improve. We built questionnaires. And I, I said, Jennifer, can, can I do this or take a stab at it? And she says, by all means. And then we, you know, I remember coming to you and saying, do you like everything? And you're like, let's go, let's, let's run with it. Because it was like this thick. I mean, you know, I, I like to put together a good paper copy. But it was folders and folders of. And recruiters. And it just wasn't efficient. It wasn't efficient for the recruiters and the hiring leaders. And do I have to ask all these questions? So now we've given them a guideline. You know, there's things you, you to protect yourself and the organization. Just ways to say it. We can still ask this question, right? Here's the way to say it. And so we have the, the behavioral interview format. And it took a little bit of. Once we re blessed it and signed off of it and introducing it to the system executives and the departments, it was, you know, change. But now I think it's just running like a. And we're even getting further talk about workday with implementing it to where it's just going to be files within and the recruiter can schedule an interview and say this questionnaire. And so it's working. That's working. You came up with that process and that's something that our, it took a little while, like you said, but the leaders are sticking to that process. You know, I mean, it came down to the questions along with, you know, we have to have three people in the room when they're interviewing. And I mean, that was a process that you put together that has been successful. I mean, we even have, you know, our C suites that will follow that process even down to panels because some of our executive level positions, they have one, two or three panels. So she broke it down into, you know, panel one, panel two, panel three and had a variety of questions because what we were hearing is the candidates would be like, I was asked the same questions like three times. So it's very detailed, very organized. It's, it's a, it's a great process. Well, I think we also found, you know, the recruiters get the feedback and especially in dispositioning a candidate, it was very subjective feedback. And when you went back and looked at the questions, it's, you know, there weren't questions included that could give them more of that objective, you know purview. And we had to get out of that gray area. The you know, do you recommend this candidate for hire is is kind of a yes or no. Not a you know not at this time or maybe later. And so we really just made those enhancements and the disposition reasons of why we you know disposition a candidate not a good fit is so general. What does that mean? And so really broke it down. Is it skills? Is it experience? Is it education? Is it a condition of employment? I think that's the key though because prior to Covid recruitment set at the entities like I mentioned when I first started I was at Washington Adventist Hospital and Covid really kind of it did. It forced us to centralize. I mean because we. That was the big thing is in order to be successful, in order to be able to staff the hospitals we had to work from a central location and then from there you guys also assisted with centralizing that process, building those processes, putting you know, putting those processes in place and just expanding from there. So I mean to this day we're still centralized and it's been probably one of the best things we've. We've ever done is to centralize that process. So that's awesome. So kind of with like the recruitment marketing, like how has that been an impact? I think I was. I think it was the first to reach out in regards to our careers page. Our careers page was, I don't know just wasn't up to par. And I actually reached out to AHC's marketing team and they had said we don't have the bandwidth. Can you reach out to human. So I think that's where we really. But you were looking for branding too and I think that's first where like our brand marketing team really kind of helped you the. The programs it just it would get. There was a careers page but the what it was just job postings and job links to apply and I think what you really wanted to do is show what programs have been built and what you know the. And that's how it started with and building that careers page and all of those those extra resources to where now where. Not that that was not helpful and wonderful and all those things I was like okay well you got your programs pages. Can I have one? And where we sit today with for the normal day to day operations where recruitment marketing came into really just I think I think the whole team would say we owe 2025 to recruitment marketing because of the things that we weren't doing yet or needed to do more of and so we really took what was successful. The nurturing campaigns, the social channel campaigns, the nuanced things like geofencing and all of these things that it's just second nature to them. But it's, you know, where, where can we go now? Said hiring manager wants to post on, you know, this board, this board, this board, we get little roi. Where can you know, what do we need to do? And it's that campaigning and that outreach and I have to you know, give credit to. I think it was the beginning of 2025 when we had our recruitment EVP created by marketing and that a lot of time, hours and months went into building that through the branding and the work that you did and realizing that like we have an opportunity to give our recruiters a tool to kind of put this all together. And so the recruitment EVP was created around, you know, what, what we were lacking is that the organization does a phenomenal job in branding the mission, the values, the vision of Adventist Healthcare. But I think we all know how recruitment, I always say recruitment marketing is its own even from that. So where we felt we were lacking maybe in that branding is speaking to it to an employer and as an employer of choice. And so that paired together building that recruiter EVP and supporting messages and copy lines and content to where when they are going out sourcing. And we're not using it just for sourcing and our hard to fill roles anymore but building that around those three pillars of a recruitment messaging aligning with what is most important to the organization that faith based pillar, holistic care and you know what it means to become an employee. We're in a healthcare mecca up there with a lot of phenomenal organizations and educational institutions. But what sets Adventist Healthcare aside is the mission and values. And so it really, they really helped us communicate that and it gave a team such confidence in how they source and speak that outreach to candidates instead of just saying hey I came across your resume. Yeah, yeah. And it provides a consistent message. So the recruiters are all, you know, saying the same thing which is has been recognized by a lot of our executive leaders. They will mention that there'll be an orientation presenting and they just are, you know, love the fact that the candidates in the room understand the mission and they understand the, you know, our values and that comes from the recruiters and the EVP that made all of the difference with you know, just the hiring and just finding the right fit. Yeah. And where we are now working with marketing, I mean we're so integrated with our team Working with marketing is they're taking us to the next level of analytics where, you know, what is marketing mean? Now we do a very well job of the. The kind of nuts and bolts, I guess, but now there's a lot of, you know, question. It's kind of what's next is how do we compare in tracking by how the candidates find us? Yeah, we've got it down to. To track the candidate lifecycle once they've applied, but now it's even for that. Exactly. So that's what we're working on now. And the team has just been amazing and. And they partner. Our marketing team partners so well with the internal, especially our digital marketing team. They meet monthly and he's just so appreciative of the work they do. And then it's kind of copy and ready and he puts us online or wherever we need to go. And it's just the collaboration through partnership. It is, yeah. And our, you know, our executives were asking for various, you know, measures of success within marketing. And that was something that we didn't even know where to begin. And that's something we're currently working on. And the marketing team came up with. I mean, they basically came up with a way to track all of our measures of success that, like I said, the executives have been asking for, for years and we just haven't been able to do it. So like the hybrid leadership model that's really widely talked about, what did the early collaboration look like between Human and definist? It was really. I was so my background with nursing and like Sarah had said, I started developing various programs within the organization. So the original. I think when we started the hybrid leadership model, it allowed me to be able to build those pipelines. So I was able to build up the nurse residency pipeline that are. We have a very robust international nursing pipeline. And then the team, the human team would focus on just the everyday operations for recruitment and talent acquisition. And then once those programs were built up, I feel like that's when we really kind of started working together just on a really. On a daily basis. And I was the only. I served as the avp. They brought Sarah. Sarah was in as a director. And then we had a manager from Human. So they were completely off site and I was the only one that was on site. But it just. It worked. And it worked. It still. It works. It's been extremely successful because Human brings in so much knowledge that, you know, us as an organization just we didn't have. So from there it just. That's when it really flourished. I think too through Covid, we learned and saw how quickly, quickly we could ramp up a process, standardize, you know, what was temporary then, but standardized, standardized that and still have a positive candidate experience for those we were ringing in in a, you know, not positive time, but also for the hiring leaders. And I think the rapport and the trust building really began through that. And then when we started normalizing after that, and as Jennifer was saying, you know, we got programs and pipelines up and running. That's when we really kind of sat back and was like, okay, now what does that just everyday standard candidate selection process look like now? And we realized we had some process improvements to make and took some things that we, you know, liked that we ramped up really quickly. When Jennifer I really started partnering is on that standardized recruitment to selection process. What does it look like from the time of applicant candidate submits an application to. They start in day one orientation. Um, and so we've really built and evolved on that over the years. And that was something that was just certain components didn't exist, but the components that did weren't very centralized or standardized. And so it just kind of began growing from there. Yeah, I think that's the key though, because prior to Covid, recruitment sat at the entities. Like I've mentioned, when I first started, I was at Washington and Venice Hospital and Covid really kind of it did. It forced us to centralize. I mean, because we. That was the big thing is in order to be successful, in order to be able to staff the hospitals, we had to work from a central location. And then from there you guys also assisted with centralizing that process, building those processes, putting, you know, putting those processes in place and just expanding from there. So I mean, to this day we're still centralized and it's been probably one of the best things we've ever done. You work for Human, but you also work for Aventus. So you have a one on one with your manager here at Human, but you also have a one on one with your manager at Aventus. How is that partnership valuable within integrating the two systems together and really tying that close in? Well, I would say from my standpoint, I mean the opportunities, the learning opportunities, the just that my leadership staff there, Jennifer and Carlos and the team provide is just eye opening and being able to make this hybrid leadership position even possible and continue to work. I mean the, you know, I have a seat on the team, a seat at the table. It's not, it's hands in and hands involved. It's not relayed. You know, oh, we have this meeting and this is what. And we really partner because for a period there like Jennifer was talking about, our focuses were very different. I mean she, you know, recruitment programs, onboarding all rolls up under Jennifer's purview. But that building those programs in the pipeline like that would take a lot of her time. And so focusing on day to day operations, the team management, that's where I, I knew, you know, they really relied on us and me as a leader to stabilize and make us feel like one collaborative team. It started with the team. Honestly if we didn't have, you know, I mentioned at one point we were really kind of 50, 50 until about the beginning of 2024. And we still today have two amazing internal recruiters that sit at, at corporate and then every, you know, the rest of the a 13 person team is human recruiters but we are one big team and family and it, you have to build that, that rapport, that trust. You know, a lot of, a lot of things that the internal recruiters at the time of, you know, coming out of the pandemic even going is just embracing and wanting to evolve with the things that I think we provide and you know, our measures of success as a rpo, what that looks like as internal measures of its success for the organization. And you know, just the standard operations of recruiting were very different and evolving from the time that even we were recruiting but that they were used to and sitting on sites and, and so forth. And it's even changed today. Yeah, you know, from where we were three years ago. But so that just the exposure I think and the, you know, I go up on a regular monthly basis and we do, you know, rounding Jennifer and I round with the CNOs and certain leaders. And so it's just that exposure that continues to make it work in the visibility. I couldn't do it without them. I think our philosophy has always been, you know, they're one of us. The whole entire team from you know, Sarah to Lisa to the recruiters, they're one of us. And in all honesty, sometimes I feel like you guys know more about the organization than some of our employees. I mean I think that's so important. I don't know any different but I think that's so important in our point. Whether we're serving as in this unique hybrid leadership model or not. Our recruit, our whole mission is to represent our client and our partnership and what it means. And so I think until you really do understand and can kind of dig in and be integrated and, you know, identify with those things that are so important. It only sets up our team for better success in doing what they're doing day in and day out. So they're confident and comfortable in speaking to these candidates, especially the ones that they have to go find. And so that's just kind of always been one of my philosophies from day one. Yeah. So for you, Jennifer, with the help of Lexerra and her team, it did free up some of your administrative tasks and gave you time to, like, do other things that you never really had the time for. You said you had a lot of projects going on. Could you explain a little bit more about that? Yeah, absolutely. So it gave me time to really focus on building up our pipelines and our programs and really trying to find creative ways to bring nurses or actually any role into the organization. So, you know, I. I never had to worry about, you know, if things were getting done, if, you know, meetings were being covered, calls were being covered. Like, I just. It was stuff that I never had to worry about because I knew Sara, you know, would take care of all that or, you know, that she was so involved with the leaders and with the organization. So it just. It allowed me also to be more strategic just in my role with, you know, my leaders and also a lot of my colleagues at the organization. So I feel like once we built that up, because we've now, since then, have pulled you into a lot of that, a lot of the strategy and a lot of the operations. So it just. It really allowed me just to. To grow our team, not necessarily the recruitment team, more of just the programs team and, you know, get out there and just be able to talk about the great things that we were doing with programs and, you know, pipelines. So it's. Yeah, it was. It's. It's just so beneficial. And like I said, we. And we have some of the top programs in the state of Maryland, and I wouldn't have been able to do that if I didn't have, you know, Sarah and team by my. And I think, obviously there was a heavy focus on nursing and those programs, but even so, there was a untapped market to get. To build upon our opportunities and our academic partnerships and pipelines. And so that's one of the. I say, newest, probably over a year and a half now that. That Jennifer has added. We have a robust nurse residency program. We have a certified nursing academy that was the first in the area. It's an art organization to have. And so those things are up and running and We've had some of the highest cohorts. And so now it was kind of like every time, what's next? And now it's. It's these academic partnerships and, you know, what. What other areas and programs do we do we bring in and focus in now? And what's the next academy? So at what point from the Adventist side led you guys to fully outsource recruiting to human? I would say just, you know, the quality of work, the. Just the positive experience we had throughout this whole, you know, this whole. And just also having that flexibility. You know, if we have a recruiter that's out or if we lose a recruiter for whatever reason, we can just either staff up or staff down immediately. So there's no gap in, you know, any of that service or, you know, customer service with our. With our leaders. So I think it's. It's the flexibility. It's just the knowledge that they bring. And it's just, you know, overall, the bundle. The bundle, everything included. So over the years, what strategies have proven to be the most effective in overcoming talent challenges, specifically around RN roles? Gosh. So I would say, I mean, I think the pipelines. Absolutely. I mean, we are so far ahead as an organization with the pipelines and, you know, mainly our nurse residency program and our international nurse pipeline. But again, you know, we've gotten to the point where now it's just so cohesive. I mean, Sarah assists me with the pipelines. The recruiters assist me with, you know, getting the international nurses to apply and push through for hire. And so it's. Now it's all kind of come together, but that's really what has been. Been working. But also, you know, the recruit, what the recruiters bring in, you know, the talent that the recruiters bring in. So it's a. It's really a combination of all of it. So you guys went from like 600 travel nurses to on the verge of 0rn openings, which is incredible. What does that milestone really mean for your team and your patients and the culture? Like, just, you came from here and now you're here. What does that impact? It's. Yeah, it's still. It's just. It's unbelievable where we've come. I mean, even pre Covid, just the number of vacancies that we've had pre Covid, and then what we went through after, like you said, now being almost zero agency usage, that's been, gosh, it's just speechless. Yeah, I mean, I'm like, yeah, we update the data every month and we're like, let's look at. Okay. You know, well. Cause I think like, when I started and I started working with the programs, the CNOs and even the CEO was like, we want a wait list for all the units. We want people, you know, just to be knocking down our doors to come in. And it's crazy to think that we're there. Like, we have more bodies than we do vacancies. So we're actually. Never thought we would get there, but we're there. Like, we could potentially have a wait list. We are going to be overstaffed on some units, you know, may be temporary, but I don't care if it's even for an hour. So to think that that was a request years ago and now we're actually there is just. I mean, it's. It really is unbelievable. Yeah, I. I think too, like to have to be able to say that we have a pipeline of nurses for acute care, you know, needs is just awesome. But it's. I mean, we have, you know, I can count on one hand, if not a couple of fingers, like the number of vacancies we have for an OR nurse right now, you know, and, you know, CVIR and those things. And just also seeing the. The joy and the celebrations of the team when, you know, they're like, I have. I mean, we look, I meet with the cnos every month and we go over their numbers and we just kind of. They crack me up. Cause they're like, where were we last year? Okay, go two years back. And it's like, you know, we were at 100 and then we celebrated being, you know, in double digits. And now we're looking at like under two dozen at, you know, entities. And so there's going to be turnover. There's going to be. One of the great things that we have is, you know, there's good internal turnover. We have at one of our hospitals, you know, in the med surg units, they have that opportunity to go to icu, pcu, critical care, and. But now we have that pipeline ready to backfill those med surg units, which are just so, so instrumental to that. That hospital. But I think the rewarding thing for me to watch too is how excited the hiring leaders and especially the CNLs are at their. Their turnover rates. Their RN turnover rates are, you know, significantly down. RNs are staying. They're not as transient and, you know, they're just also too. You've stabilized that workforce too, when it is all agency nurses. I'm sure team Clever, you know, that culture. Yeah, absolutely. They're feeling those cult that culture on those units again. And so it's. It's something really. Yeah. I mean, overall, everything has improved. You know, just the turnover, you know, the positive. Like you said, positive culture, the patient care, the quality scores, safety experience. Now that has improved, you know, since we've been able to the length of stay, I mean, it's a bundle. It is. But I think too what's exciting for us now being there with nursing is where we know our focus needs to shift next. And I think the same for a lot of healthcare organizations across the country, but it allows us to be at a place, and I think you said it earlier, a little ahead of the curve with nursing, but really focusing on those critical areas now. But for us and many systems I think are, you know, imaging and radiology and cardiac and surgical, they're just. There's more organizations seeking and needing than the talent pool even exists. And what does that look like next? You know, there's. There's areas that the pandemic really put on the map. I think that it's just not nursing anymore. So we're excited that we're in such a good place nursing to now take these initiatives and methods and the marketing and focus even more on. Not that we've always. So many of those has always been a critical focus, but really grow the pipelines in those areas now too. That's amazing. So now that you've reached this point, what are you going to do to keep that momentum going? So you kind of touched on it a little bit and you're going to look into other areas rather than nursing, like, how are you going to get better if that makes sense, if you can. You know what I mean? You guys are already at a point, but yeah, I feel like there's always room for improvement. And I think for me, you know, we have to look at. We still have a Tier 3 float pool at one of our entities, which we developed during COVID and the nurses are getting paid almost agency rates. So the focus now is going to be getting rid of the tier three because we have an influx of nurses and just trying to think outside of the box because like I said, we have more nurses than we do vacancies. So we're trying to think of other areas we can put them. Like some of our outpatient areas, we are looking at the clinical documentation specialist role or, you know, wherever we can try to try to fit them. But then like Sarah had said, just, you know, imaging is such a struggle. So really focusing on those hard to fill Areas with. But those are areas that we can now finally focus on. Yeah, now that you got that. And I think that, that, you know, never forgotten because, I mean, it's where I started recruiting is. I mean, my main portfolio after transitioning became rehabilitation, nursing and therapy and kind of that post acute side and post acute has grown considerably for Adventist Healthcare. But they can only grow more. The more staff, the more clinicians that we can find, especially in the outpatient settings. That's a big focus. And when you get the engagement and the excitement from the leaders of. Yes, I want to, you know, we have these ideas, we have these recruitment strategies. They've really worked well on the nursing side. I would like to see what they do, you know, on this post acute side. And so developing those. And that's really going to be a next, next step for us this year because they can only grow and bring in more to the organization in that model, the referrals they get, the more staff they have, et cetera. So we're excited to tap into that market even more now. No pressure. I'm gonna prove it. No, no. So I mean, Aventus and Human have worked together for almost a decade. Is there anything that really, you know, makes them. You guys work so well together. I mean, for me, I think when you spend so many hours and days and weeks and you know, talking about things. I mean, as we've worked on things and projects and strategies and really had to put our heads, plan, Jennifer has always given me the opportunity and the floor to bring in my ideas and speak to them. And I think we balance each other. She's obviously got the clinical background, you know, even prior to recruitment was a second career for me. But that communications background and PR and love for working with people and I think it's just we, we balance each other well. But we've just created this relationship and collaboration where it's so easy to talk to each other, to work together, to, you know, know each other, to where it's just she needs me to jump in somewhere where I'm not, you know, where I haven't been. I'm there and, and vice versa. I think we finish each other's sentences. We do. But I think I, and I give a lot of credit too, to my boss because that's just his. He's more of a mentor. That's his type of leadership. And like, you know, he's mentored me. I know, you know, he's mentoring Sarah. He'll. I mean, you know, he's always hopping on recruiter Calls and, you know, giving them positive feedback. You know, he's just, he's. Like I said, the biggest thing is they're Adventist healthcare. I mean, they're, you know, one of us. They're one of us. Yeah. And that's how we've always thought of the partnership. And I think that's part of the reason why it's so strong too. That's awesome. What would you give Jennifer, like, advice if someone was in your shoes like you were in 2017, what would you tell them? Yeah, my big thing that I always talk about is just the hybrid leadership model. I think it's so unique, it's so special, it works. And, you know, you're, you know, Sarah brings so much to the table that we, we just don't have. We, you know, either. We don't have access to. We don't have the resources for it, whatever it may be. So I think it's really, you know, just having that partnership and having, you know, that outside knowledge and, you know, just having that relationship is. I mean, it's great. I mean, that's the biggest thing for me is just the hybrid leadership model. So then my next question was, if you could summarize this journey in one phrase or lesson, what would it be? And I'm guessing yours is higher leadership now. Yes, I was like, I'm guessing. What about yours? One. Oh, this whole journey, it's been a journey, I think for me. It's just I've been in a position where I do pinch myself because they put so much trust and belief in me and faith. And I have to give credit to. To human and my human leadership over the years that saw something to challenge me and push me to that, that next level. And, you know, even my, my human bosses have, you know, he's that coaching mentality. And it's never, there's never a this way or that way. It's. Let's look at how we're doing it and where can we be better and where can we, you know, coach the team, coach you? And so taking all of that in and just having the autonomy to really share ideas and implement them. And I wouldn't have ideas or thoughts without, you know, human as well to share and bring to the partnership. But even my colleagues here, we're all different partnerships and clients that feeding off of each other. That's, you know, I'll go to Jennifer all the time I was knocking to so and so, and here's what they're doing, you know, here or being able to pay, pay that forward collaboration. Yeah. To what? But the exposure and just the belief that they have in me, and it's really just. It's brought me out of my shell. Absolutely. We talk all the time. When we were. When we started and first met and we were recruiters and we never thought that we would walk into some of the rooms and the conversations and the presentations that we do today, and we just. We have fun with it. We're proud to stand behind the work we've done and the team has done. Absolutely.