You may not know it yet, but a revolution has begun in the healthcare industry. No, I’m not talking about blockchain, artificial intelligence, access to medicine, or patient data. The revolution I speak of is against something that has been lurking throughout the nation for a while – hiding behind tired eyes and busy schedules. The issue? Burnout and the clinician deficit.
How big of an issue it is? It’s a multi-billion dollar issue. That’s how much healthcare facilities have poured into staffing in an attempt to fight the fall; believing that was the only solution. This has unfortunately only covered and simultaneously fueled the problem. So what do we do? Here we touch on the problems facing the healthcare industry and the possibilities that are just on the horizon.
Many of you have most likely heard the term “burnout” by now. It was, in fact, recently deemed an official medical condition by the World Health Organization. Defined as “a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress,” burnout is highly prevalent in the nursing profession. A study performed by RN Network found that nearly half of the nurses working in the United States have considered leaving the field for reasons very similar to the symptoms of burnout.
- Feeling Overworked
- Not Enjoying Their Job
- Lack of Patient Time
- Too Much Paperwork
- Wanting Something New
Other symptoms of burnout include:
- Constant Fatigue / Exhaustion
- Feeling Under-Appreciated
- Feeling Disengaged or a Lack of Enthusiasm About Work
- Compassion Fatigue / Emotions are Blunted
- Feeling of Helplessness or Hopelessness
- Intolerant to Change
One contributing factor to burnout in the healthcare industry is that we’re in the midst of a nurse shortage. In order to fill newly created positions and replace retiring nurses, the Bureau of Labor Statistics projects the need for an additional 203,700 new RNs each year through 2026. According to the 2019 National Healthcare Retention & RN Staffing Report by Nursing Solutions Inc., only one in five hospitals reported a RN vacancy rate of “less than 5%”. They go on to say, “when the labor market tightens, hospitals have historically sought to bridge the gap by utilizing overtime, agency staff and travel nurses. All of which are costly strategies and can lead to issues with quality, safety, physician satisfaction, employee satisfaction and the patient experience.”
Don’t get me wrong – retirement is a great thing. It’s a goal most people strive for in life. But it becomes a problem when ⅓ of the workforce (approximately 1 million baby boomer nurses) all reach the age of retirement at the same time. The average RN in the United States is 50 years old and, according to the December 2017 AMN Healthcare study, 73% of RNs over the age of 50 hope to retire or scale back in the next 3 years.
All of which begs the question: if the nursing staff we currently have was reduced faster than expected, who would care for us? How would this impact things such as wait times, medical costs, insurance rates, and patient care? And what could we do to entice them to stay while building up future generations of nurses? We’ll address these questions in just a bit.
The strain of the clinician deficit can be felt all the way back to the beginning of a nurses career. Due to factors such as an insufficient number of faculty, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs in 2018 (as reported by the AACN’s 2018-2019 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing).
While finding clinicians is an issue, keeping them is just as difficult. A 2017 study by Compdata Surveys reports that the average turnover in healthcare jobs increased from 15.6% in 2010 to 20.5% in 2017. This puts the turnover rate in healthcare second only to hospitality by 8.9%, and the reason seems to be a straightforward case of supply and demand. In fact, the U.S. Bureau of Labor Statistics reports an unemployment rate of only 2.6% for health care and social assistance in June of 2019.
The 2019 National Healthcare Retention & RN Staffing Report reports that hospital turnover is on the rise with the average hospital having turned over 87.8% of its workforce over the past 5 years. “Executives need to be concerned since this is a leading indicator of future financial pressure, and patient & employee satisfaction”, they go on to say, with 2018 hospital turnover rates being the highest in over a decade.
When the need for nurses is great and the supply is limited, the result is a workforce that can go wherever they please. When high turnover mixes with simultaneous growth in the needs of the industry, it generates staffing gaps that have a dramatic impact on a facility’s bottom line.
As I’m sure you’ve gathered by now, this is an expensive problem. Various reports state that it could cost anywhere from $37,000 to $104,440 to replace a single nurse, and that “hospitals could lose $5.2 million to $8.1 million annually” due to turnover.
When considering how important nurse retention is, there are multiple aspects a facility must account for, including:
- New Employee Training Costs
- Overtime Payouts
- Increase in Staff Workload / Risk of Burnout for Additional Clinicians
- Staffing Agency / Travel Nurse Fees
- Staff Dissatisfaction / Lower Retention Rates
- Patient Dissatisfaction / Accident Rates
Some of these factors have a direct dollar amount associated, whereas others have more of an indirect impact. It is, however, those that have an indirect impact that sometimes have the most devastating impression on the facility’s business as a whole with considerations such as bad press and lawsuits.
Facilities are so desperately in need of help that they’re pouring billions of dollars into staffing agencies. Definitive Healthcare reports that, according to the 2018 Medicare Cost Report, over $1.9 billion was spent in contract labor by just 10 hospitals. Staffing Industry Analysts reported the 2018 healthcare staffing market hit $17.4B in 2018. The American Staffing Association reported that, during the course of a year, America’s staffing companies hire nearly 17 million temporary and contract employees with 9% (or approximately 1.5 million) being in healthcare.
In order to decrease turnover, build their bottom line, and protect their reputation, healthcare facilities should focus on increasing staff satisfaction.
Now that we’ve discussed the negative, let’s focus on the positive. There are multiple initiatives in motion that intend to expand enrollment and capacity for nursing students, ease the application process, attract and retain faculty, and advertise careers in nursing. There are also various publications, such as Nurse.org and USF Health, that provide tips for dealing with burnout.
Make a Change
If you feel as though you’re incurring too much pressure in your current role, ask about switching to a lower acuity area in the hospital (even if just 1 day a week) or performing part-time admin duties. You could also consider a different specialization. There will be a greater need for nurses with specializations as people live longer and innovation continues to happen in the healthcare industry. Nurse practitioners and other advanced nursing careers (or those with certifications) will become increasingly important as time goes on.
Become an Educator
If being by the bedside is the cause of your stress, becoming a nurse educator could be a valid option. As mentioned before, the lack of qualified instructors is having a significant impact on nursing programs. By lending your knowledge, you could help educate and train the next generation of nurses. You may not make as much in salary, but you also won’t have the physically demanding shift schedule.
The only change we suggest against is a complete career change that removes you (and your knowledge) from nursing all-together. Taking into account all of the issues listed above, leaving healthcare would only contribute to a larger deficit and greater burnout for other clinicians.
Take Care of You
It’s more than just a line from Pretty Woman. It’s a necessity. Practicing self-care techniques can help you incrementally cut down on stress. Try incorporating some meditation time into your routine. This is even easier to do if you have a device such as an Apple Watch that prompts you throughout the day.
As you know, exercising and eating right is always a good idea. You probably recommend it often to your patients. Just be sure to practice what you preach! If the gym isn’t really your thing, extra-curricular activities can be a great way to not only get your steps outside of the facility, but to also interact with friends and get your mind off of work.
It’s honestly not the most appealing option, but that doesn’t make it any less important or impactful. Developing a coping mechanism can help lessen the impact of trauma or emotional stress. It’s also important to build strong relationships with your co-workers so that you have someone you can turn to for support and advice in the midst of a potential meltdown.
Try Travel Nursing
For those who are intrigued by the thought of seeing the country while caring for others, travel nursing is definitely up your ally. But for those of you who this doesn’t appeal to or has other reasons to be home each night (such as kids to tuck in), we have a different perspective.
Travel nursing doesn’t just apply to assignments that require a plane flight, road trip, or overnight accommodations. It could be that you’re picking up shifts at various healthcare facilities near your neighborhood. One of the top reasons why workers and hiring managers alike choose temporary or contract opportunities is that it offers flexibility and variety.
Per diem assignments can be a great way to get a change of scenery, meet new people that are in your line of work, make some extra money, or test out a few facilities before committing long term. And at Matchwell, we also think it could be the solution to many of the problems that are perpetuating the clinician deficit. As Dr. Troy Ahlstrom – MD, FHM, and CFO of Hospitalists of Northern Michigan – said in this article by The Hospitalist, “You prevent burnout by allowing people to change their work schedule depending on what’s going on in their life.”
What if healthcare organizations were able to directly access the clinicians they needed without sacrificing their facility budget to do so? What if simultaneously every nurse, from fresh out of a cap and gown to reaching the age of retirement, had the ability to set their own schedule or scale back at their own pace while still doing what they love and helping others? This is exactly the solution the Matchwell platform provides.
Matchwell is an online marketplace that empowers clinicians and healthcare facilities to come together in the easiest, most transparent, and most cost efficient way possible. Facilities get direct access to an extensive pool of pre-qualified clinicians, and clinicians get to control their calendar. We’ve removed the middleman to provide greater transparency and significant cost savings.
To learn more about how Matchwell can help your facility, visit wematchwell.com/hire or schedule a quick demo. Clinicians can learn more at wematchwell.com/work and easily start their free account at clinician.wematchwell.com.
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