Healthcare organizations across the U.S. are grappling with nursing shortages and have been for decades. Due in large part to the COVID-19 pandemic, nurses are needed now more than ever, yet, the increased strain on the healthcare system is forcing many nurses to consider career changes. In a recent McKinsey survey, 22% of nurses surveyed indicated they are considering leaving their current position as frontline caregivers.
The extraordinary stresses of the pandemic, impacting both their professional and personal lives (including their physical and emotional well-being), have led many nurses to early retirement or resignation. Others, attracted by average weekly salaries of $3,000 - $5,000 (or more), are leaving their full-time jobs to pursue temporary assignments with traveling nurse agencies.
While the pandemic is front-and-center in discussions about the causes of the nursing shortage, it's actually only one of several contributing factors. An aging population and the increased access to public health care are placing additional strains on the nursing workforce. In fact, with more than 500,000 RNs expected to retire by 2022, it's projected that the U.S. will need 1.1 million new nurses to replace retiring nurses and meet the expansion of care access needs. This workforce gap creates numerous opportunities for nurses, though many will be working in less than ideal conditions, with increased patient ratios and longer hours.
Nurses leaving the workforce impact more than just staffing ratios
The nursing shortage has other significant implications for the public.
"The exodus of experienced nurses leaving the front lines, as well as turnover among early-career nurses, have led to a widening skills gap, creating major implications for a healthcare system in need."
So it's not just a workforce gap, it’s also a skill set gap.
Historically, frontline nursing is multigenerational. An ideal patient care shift assignment has a mixture of new nurses and seasoned nurses. Personally, I remember it taking a full two years before I felt confident in my job as a nurse. Even after formal orientation and training, I relied heavily on the experienced nurses who offered advice in my first few years. Unfortunately, no amount of studying and training can replace decades of experience. As experienced nurses leave the workforce, they are taking with them their collective years of knowledge. Nurses early in their careers, who are entering the workforce with less experience, are jumping head-first into highly complex and overwhelmingly stressful situations due to the pandemic. A nurse manager at a large healthcare system in the Atlanta area reports that nearly 85% of her staff have less than two years of experience. The increased stress and expectation that young nurses perform at a higher skill level sooner is causing many younger nurses to leave within the first year. Before the pandemic, 17% of nurses left within the first year, and 35% left in their second year.
The challenges are significant, and there's still no end in sight.
It's no surprise, then, that using agency nurses at premium rates, mandating overtime, and hiring and relocating nurses from other states have burned through hospital budgets in record time. To make matters worse, throwing all of these additional resources at the nursing shortage problem hasn't lessened its severity. This alarming trend simply isn't sustainable.
Yet, there is hope.
Leveraging technology in the recruiting and hiring process
Just as with virtually every other area of our lives, technology innovations have the ability to impact healthcare delivery in positive ways. Patients receive better care and communities have greater access to care due to increases in efficiency from innovations such as electronic health records and telehealth services.
Technological innovation in healthcare staffing, however, has been slow to catch up. Most facilities continue to rely on archaic and expensive models for filling staffing gaps at a time when the need to recruit, screen, and hire nurses quickly is more critical than ever.
The healthcare infrastructure is fragile, and inflating prices to give facilities access to qualified clinicians quickly - when they need them most - is not sustainable and, frankly, just doesn't seem right. The 2021 NSI report found that every 20 travel nurses an organization can eliminate will result in over $3,000,000 in savings. Hospital budgets are hemorrhaging money. What if we could stop the bleeding long enough to pause and look at another way to fill those staffing gaps?
At Matchwell, we see an opportunity - not to profit from the crisis - but to solve the crisis. We are using technology to proactively identify and curate pools of healthcare staff looking for flexible work options. Facilities can access qualified, pre-vetted staff through a monthly subscription. No agency mark-ups. No bill rates. No burning out your current employees with overtime.
Our founder and CEO, Robert Crowe, states:
"I was a 20-year staffing veteran when I realized I was on the wrong team. Healthcare organizations everywhere were hurting for staff…but we wouldn't tell them about all the people interested in their organization; we would tell them about the people we wanted them to know about…usually where we would make the most money. So I left and founded Matchwell."
Technology is not a “cure-all”
It's essential to keep in mind, though, that while technology can make the recruiting and hiring process more efficient and less costly, organizations can’t lose their focus on engagement and retention. Turnover is expensive, costing the average hospital $3.6-$6.5 million annually and Gallup reports that disengaged employees cost the US economy over $350 billion annually. Today's complex healthcare environment makes recruiting, retaining, and engaging great talent more challenging. Here are a few workforce trends and ways that you can thread them into employee engagement and retention programs for you to consider.
Today's workforce includes Generation Z, Millennials, Generation X, and the last wave of Baby Boomers. This means that four different generations of potential candidates are participating in the employment search simultaneously, each having different communication styles, cultural values, priorities, work styles, and more. Instead of seeing this as a barrier, reframe the collective knowledge and experience of having so many generations working together as an opportunity and perk of working at your organization.
Prioritization of Diversity, Equity, and Inclusion (DEI)
Social and political unrest combined with the COVID pandemic have highlighted the importance of meaningful DEI initiatives throughout our society, including the workplace. For healthcare organizations, DEI efforts should address patient care and also address employee issues and concerns. Facilities will need to understand and utilize the most effective strategies to retain current and recruit new staff at all levels, particularly in C-Suite positions. Now more than ever, workers want to be part of an organization focused on social justice and equity.
Rethinking traditional employee benefit programs
Recruiting and retaining a multigenerational workforce requires an understanding that different generations have different values and preferences regarding the employee benefits they want and need. For example, Baby Boomers are the highest users of healthcare services, so they tend to place a higher value on medical, dental, vision, and life insurance benefits. At the same time, they also focus on financial benefits to support their pending retirements. Generation Z employees are particularly concerned about job security, and they're looking for benefits that support career growth and development. They're also more likely to include supplemental benefits in their total compensation calculation, like paid time off, tuition reimbursement, and pet insurance. It's important to account for these generational differences and have benefit packages that reflect such diversity in values.
Flexibility is the future
The gig economy traditionally did not include healthcare. Nurses and other healthcare workers have been expected to work when they are told. WIth the industry focus on work-life-balance and burnout, flexibility is a key ingredient to consider. Clinicians are increasingly requesting flexibility and more organizations are starting to listen. A recent Harvard Business Review states: “Every job deserves some flexibility. . . organizations should offer flexibility to both office and frontline workers.” Create a framework within your organization that is mutually beneficial to healthcare workers and patients. Create guardrails and allow frontline workers to create flexible schedules within that framework.
Organizations are attempting to solve a problem forecasted for decades which now has the added complexity of a pandemic. Fortunately, technology is available to streamline hiring processes and to access and utilize clinicians more strategically than in the past. There is also research highlighting trends in the workforce that organizations must consider as they are focusing on engagement and retention of nurses. While there is more to learn and more conversations to be had before the staffing crisis is solved, an important lesson has surfaced: as an industry, it’s time for revolutionary thinking. Patient care and hospital budgets can’t afford to rely on our old ways of staffing.
If you would like to learn more or be part of the ongoing conversation, contact Joy Skovira, RN at firstname.lastname@example.org or Bree Becker, MSN, FNP-C, RN at email@example.com.