One-On-One With Nantucket Cottage Hospital's Jeanette Ives Erickson

Jeanette Ives Erickson was in Florida when she got the call.

The former chief nurse of Massachusetts General Hospital was retired and reflecting on her long career, which had just been capped off with one of the most challenging and rewarding assignments she had ever received: running the Boston Hope field hospital during the COVID-19 pandemic.

But the phone rang, and the person on the other end was calling her back into action once again. Nantucket Cottage Hospital’s President and CEO Gary Shaw had abruptly announced his resignation, and the Board of Trustees was asking her to step in as the hospital’s interim leader.

“I was asked and I said yes,” Ives Erickson said. “This is a wonderful community and a wonderful hospital.”

And she should know. For Ives Erickson, it will mark her second stint as Nantucket Cottage Hospital’s interim president and CEO. She previously served in that role for six months following the departure of Margot Hartmann in August 2019. The qualities Ives Erickson saw during that time in the NCH workforce and the community at large made the decision to come out of retirement a little easier.

“The spirit, the integrity of the people, the belief in this organization, the important role this hospital plays in this community, all of it,” Ives Erickson said. “What I see is the willingness and desire to do good. Not just on behalf of the people in this hospital, but that the citizens are getting good healthcare and preventative healthcare.”

Ives Erickson’s return comes at a time when the hospital is emerging from the COVID-19 pandemic, but now searching once again for a permanent leader, grappling with more than 50 vacant positions across its workforce and a housing crisis on the island that has only escalated since she was last on Nantucket. The 14-bed hospital is also up against the same challenges that healthcare organizations across the country are facing: a shortage of nurses and burnout among existing staff members.

“What I’m seeing here isn’t any different from what I’m observing elsewhere: there’s a true crisis in healthcare,” Ives Erickson said. “I don’t think Nantucket is in a crisis, but I think healthcare is in a crisis. Healthcare workers are exhausted from COVID.”

So over the past two months, as Ives Erickson and the hospital’s Board of Trustees and senior management team finalized a new strategic plan, she said those concerns over the NCH workforce rose to the top.

“I’ve made the investment in the workforce my No. 1 area of focus,” Ives Erickson said. “We’re the second largest employer (on the island) and that’s a responsibility of the CEO to make sure as an employer you’re making a safe environment, with reward and recognition programs and ways in which you address the individual and collective needs for this community. We have to create a new culture.”

Forging that new culture will not be an easy task, she acknowledged, especially for a small, community hospital – a size that is increasingly rare in healthcare amid ongoing rural hospital closures – even with the support of its corporate parent, Mass General Brigham.

But some might say that the relationship between the massive healthcare system and the tiny island hospital – which longtime Nantucket physician Dr. Tim Lepore once described as “the mating of a Great Dane and a Chihuahua” – is actually one of the challenges to establishing that new culture. How does NCH keep its unique identity but also fit into the larger MGB system? How does the CEO keep their local board and staff on the island happy while also answering to the system’s leaders in Boston?

Ives Erickson said she doesn’t see it that way. The tactics may be different on Nantucket versus Boston, but the goals are the same.

“Today we lined up our areas of focus against the overall strategic goals, and it was a moment of great pride that our areas of focus matched MGB’s” Ives Erickson said. “The language might have been different, but the focus is the same. Focus on the workforce, the community, and clinical expertise.”

As far as clinical services, Ives Erickson said she and her team are aware of the challenges the hospital faces from the increased volume in patients – not just in the summer months but also year-round – as well as some of the criticism regarding a lack of access to providers in the primary care clinic for timely but non-emergency medical needs.

By mid-May, she said, the hospital will launch an urgent access clinic in the Anderson Building – similar to the hospital’s walk-in clinics of years past - specifically to address those types of medical needs. Along with the clinic will come system improvements and workflow changes to the intake process when patients arrive, so they can better determine whether they need the emergency department or the urgent access clinic. It will allow for quicker triage decisions, she said, with the goal of reducing wait times for patients and providing the appropriate level of care. The hospital will also be adding two new full-time, year-round nurse practitioners this summer who it hopes will improve access to primary care, while continuing to promote virtual provider visits through Mass General Brigham.

“I’m calling it the summer to remember,” Ives Erickson said.

Two months into her tenure, Ives Erickson said the search for the hospital’s permanent president and CEO has begun in earnest. A search committee has formed, and the specifications for the role have been completed, which focus on conveying the importance of the hospital’s success to the community, and its mission.

“You have to want to work at Nantucket Cottage Hospital, you have to want to live on Nantucket,” Ives Erickson said. “And you have to understand the unique value of how wonderful this place is.”

Almost every conversation Ives Erickson has now about Nantucket Cottage Hospital seems to always come back to one singular issue: housing. It’s on the front burner for every island business and organization this spring, as the Nantucket housing market has reached new levels of absurdity with the lack of options for renters and first-time homebuyers.

Nantucket Cottage Hospital does have a stockpile of housing assets – both on its campus and off. Just last month it invested $3.7 million in two new duplexes in the Richmond Great Point development off Old South Road. But almost all of its housing units are currently dedicated for so-called “travelers,” the temporary staff members hired through agencies to fill vacancies for a set amount of time. None of the NCH housing units are permanently dedicated to year-round staff members.

It's a quandary that Ives Erickson said she recognizes and understands must be addressed.

“When I look at housing, I’m looking at two areas: one of which is the need to provide housing for travelers, but also housing for our own employees, our permanent employees,” Ives Erickson said. “A lot of focus has been spent on creating housing for travelers. But how do we address what is a huge financial burden from the cost of housing for our year-round staff? I’m concerned about the rental properties being over the top. So what is the plan that the no. 2 employer (on the island) needs to develop for both populations?

“We’re not going to get out of having travelers,” she added. “But we need a plan for housing, and not just for doctors and nurses. Health care systems don’t exist without our support staff, and those are the most vulnerable when it comes to housing. It’s very much on my mind.”