How LifePoint Health Is Combating Nursing Workforce Challenges with Scalability in 2026

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By G Hatfield

As the state of healthcare continues to evolve, the reality is that the nursing workforce is going to face even more challenges in 2026.

While CNOs try to build a more sustainable workforce, tightening budgets are putting more strain on health systems and higher costs of education are making it harder for people to become nurses or to advance their nursing careers.

According to Michelle Watson, chief nurse executive and senior vice president of clinical operations at Lifepoint Health, sustainability will be the first key workforce challenge for CNOs in 2026.

“We see gaps not only in bedside nursing, but [we’re] starting to see gaps in the nursing support roles,” Watson said.

The second challenge will be maintaining connection and engagement with nurses while creating professional growth at every stage, and the third will be leading a multigenerational workforce.

“When I think about nurses entering the workforce today, they’re entering their profession where they grew up in a fully digital age, and I’m working alongside nurses with decades of experience who [were] trained in a very different healthcare environment,” Watson said. “It’s not [about] choosing one over the other, but the challenge is intentionally designing an organization where every generation can thrive.”

To combat these workforce challenges, Lifepoint Health has implemented two scalable workforce programs.

RN residency program

Lifepoint Health launched its RN residency program in the first half of 2023 with the goal of improving retention and building the confidence of new graduate nurses.

“We saw in our own internal data, and we see this across the industry, that new graduate nurses are often at the highest risk of leaving their employment within their first year of becoming a nurse,” Watson said.

The program involves structured support for nurses working at the bedside, Watson explained. The nurse residents can work in a cohort model with their peers and a dedicated preceptor, which provides the extra support needed within the first year of working as a nurse.

“That also gave us the opportunity to identify where we need to continue to support the nurse residents with continuing education or additional skills,” Watson said, “and most importantly, how [we are] helping the new nurses entering our organization get connected with other nurses and [starting] to build that relationship.”

When the program was launched, 23 of the 60 acute care hospitals were selected to run the first iteration of the program to make sure it would deliver the intended results, Watson explained. Since then, the health system has scaled the program across all 60 hospitals. In 2025, the residency program drew in nearly 800 RNs.

“We have seen the direct correlation from when we implemented the nurse residency program until today,” Watson said. “We have decreased the less-than-one-year residency turnover by 65%, and we have retained 86% of all residents that have come to work for us.”

To continue the success of building a workforce pipeline at Lifepoint Health, Watson explained that a fellows program was the logical second phase to keep building on the success of the residency program. The RN fellows program was launched in early 2025 and is the newest program.

“As we think about the residency program, which is designed to support entry into practice, the RN fellows program is intentionally designed to support experienced nurses, and this program is very focused on five high impact specialties,” Watson said.

The specialties include acute care, critical care, emergency care, perinatal care, and perioperative care.

“This program supports nurses in those specialty areas to continue to advance their education and then also positions them to be able to sit for their national certification once they complete the fellows program,” Watson said.

The fellows program is currently live at 23 of the acute care hospitals, and 123 experienced nurses have enrolled. Three nurses have already completed the program and earned their specialty certification.

Developing a scalable strategy

Watson described Lifepoint’s strategy for scaling these programs as deliberate and intentional. They considered what the field needs, and the feedback from the CNOs and nurses about what could be brought to each facility. The goal was to start on a smaller scale and then see how well the programs were adopted.

Watson emphasized that scaling a program to all 60 hospitals at once would have made adoption very difficult, and so it’s important to scale at a pace that hospitals can absorb.

“I think that is the secret that we use,” Watson said, “it’s deliberate, it’s intentional, it’s thoughtful, and that thoughtful adoption does drive better outcomes than if we just did rapid expansion.”

For CNOs who are working on building a more sustainable workforce pipeline, Watson recommends focusing on three key steps. The first is to meet nurses where they are.

“We need to meet our nurses where they are at and have leaders be quicker to adapt to the multiple generations that we’re leading,” Watson said.

The second step is to make career pathways more visible to nurses and help them see what is possible in a nursing career.

“How do we create this visual pathway so that nurses do see the career potential that is ahead of them for the next decades of their profession?” Watson said.

Lastly, leaders need to stay present, visible, and engaged with the workforce.

“We have to be visible, we have to round, and we also have to make those genuine connections,” Watson said. “I think that is more important than probably any program that I could design to support the workforce.”

G Hatfield is the CNO editor for HealthLeaders.