Efforts Underway to Address Increasingly Dire Staffing Shortages

One major issue that the healthcare industry is facing right now is staffing shortages. Specifically, nursing staff and IT professionals are scarce and in high demand. The COVID-19 pandemic along with the “Great Resignation” only exacerbated these already dangerous shortages.

Regarding nursing, in the online “Forefront” section (formerly the Health Affairs Blog) of Health Affairs, David I. Auerbach, Peter I. Buerhaus, Ph.D., Karen Donelan, Sc.D., and Douglas Staiger, Ph.D. published an article on April 13, 2022 entitled, “A Worrisome Drop In the Number of Young Nurses.” The article shared startling statistics, including data covering the entirety of 2021 showing that the total supply of RNs decreased by more than 100,000 in one year. This was the largest drop observed in the past four decades.

As for IT professionals, San Francisco, Calif.-based Splunk Inc., a data platform company, in collaboration with Milford, Mass-based Enterprise Strategy Group, a computer consultant company, released a survey entitled “State of Security 2022” on April 13, 2022. The survey polled 1,200 security leaders and gave very troubling results when it comes to staffing challenges.

The survey states that “Fully 87 percent percent of respondents report skills or staffing challenges; 53 percent say they can’t hire enough staff and 58 percent cite an inability to find talent with the right skills. Again, a perennial issue, but these trends are heading in the wrong direction: 85 percent say it has gotten harder to recruit and retain talent over the past 12 months—during which the so-called ‘Great Resignation’ played out across industries.”

Pam Damsky, a director and co-leader in the performance practice at The Chartis Group, Chicago-based consulting firm, says there are two major impacts to hospitals and health systems with these staffing shortages. “The first is cost,” she says. “When you don't have enough staff, in order to have that staff, you have to pay a premium to get staff either through overtime or agency staff. And the second is that you may not have the capacity to serve patients. Or in the case of IT, to get projects done that need to get done. You may have to close ORs or close beds and not take on as much IT transformation work, because you just don't have the staff to do so.”

Zack Tisch, VP of innovation at the Brentwood, Tenn.-based Pivot Point Consulting, explains how the COVID-19 pandemic exacerbated IT staffing shortages and touches on the Great Resignation. He says that “With the Great Resignation, it's harder to get staff than ever and a lot of organizations just feel like they kind of have this insurmountable mountain to climb and when you're operating from a position of being understaffed, that just makes it even more difficult. Often, you can do only a good job with kind of the bare minimum—making sure that the systems are up and running and safe and stable and protected. But if you're really trying to do things to help push innovation forward or push your organization forward to be more data driven, being able to put dashboards in front of your decision makers to help them influence where they direct resources in the organization helps to provide better support for clinicians and helps pull data for research purposes. All these kinds of things that are hugely impactful and beneficial, get harder and harder to do, the worse of a staffing position that you're in.”

As to what can be done, Damsky comments on the workforce overall in the industry, because at the highest level she doesn’t differentiate between types of staff. She says that “I think there's a number of things that can be done. We start by thinking about recruitment and retention, making sure that you're sourcing candidates from the right place and that you are interviewing them quickly and getting them in the door so that they don't have time to go somewhere else.”

“There’s some longer-term and shorter-term strategies here,” she adds. “Recruitment is short term if your processes are efficient and making sure you've got market competitive pay is another short-term thing. Creating an environment is a little bit of a longer-term piece. For example, having the right staff that you need to do a project, so people don't always feel like they're understaffed or overworked. Optimize the unique contributions an individual can make to a project or to a patient care team. It's also about making sure that you have frontline management, at any level that's relevant, be present and know how to support their teams and really create an invigorating daily environment.”

Tisch says that there’s an approach that he’s seen that applies to both nurses and IT professionals— providing individuals with career paths that are personalized to them and also align with the mission of the organization. “Regardless of what they specifically do in healthcare, there's usually a very personal mission driven component of that, where they feel like they can improve lives, they can make things better and feel like they can be a small part in helping researchers cure diseases, help doctors at the bedside, or save lives—certainly for nursing and anybody in a direct hands-on role,” he comments. “But even in IT, that's still very important. Senior leaders need to help people understand why their job is important to the organization and how they can make the organization more successful for patient care.”

In a January 2022 online “Forefront” section of Health Affairs, Y. Tony Yang and Diana J. Mason published an article entitled, “COVID-19’s Impact On Nursing Shortages, The Rise Of Travel Nurses, And Price Gouging.” The article explains that one of the benefits that RNs see in travel nursing is salary—potentially tripling or quadrupling what they would make as a staff nurse at a hospital. Before the COVID-19 pandemic, nurses made an average of $73,000 per year. Today, travel nurses make anywhere between $5,000 and $10,000 per week. The difference is, frankly, staggering.

The allure of travel nursing is not a surprise considering the extreme differences in salaries. And hospitals may be fighting what seems like a losing battle but there are strategies organizations can use. Damsky says one approach is to retain the staff they already have. “Sometimes organizations are able to recruit those traveling staff members, not all of them, but the ones that they want to and some of them are willing to stay. We are seeing a decline in those numbers, though, so hopefully they are starting to come down nationally. You can have travelers for 12 weeks, but you can continue your recruiting for people who want to be nurses in your community. Part of that is hiring less experienced nurses but then having the sufficient support internally to help those nurses feel comfortable in their practice and feel supported in the work they do. That's a big issue for nurses is to make sure nurses in their first year to stay and feel supported.”

Tisch wraps things up with some feel-good advice that rings true for the types of individuals in the healthcare industry “There's a lot of really smart people in healthcare that are kind of looking for somebody to inspire them and to also give them a place where they can be great and do innovative things. I'd say more than anything try to set up and enable that kind of culture. Certainly, there's a lot of competition for resources and the more you can pay somebody that always increases your opportunity of making them want to join your organization, but I think ultimately for most people that I talk to, it isn't it isn't really about the money. It's about that alignment with mission.”