Nursing doesn’t look like it did five years ago. Today’s workforce wants more control over when, where, and how they work, and many are willing to leave roles that don’t accommodate those preferences. Rigid scheduling models make it harder to recruit and easier to lose good nurses. Too often, staffing decisions still rely on assumptions that no longer reflect how the workforce actually wants to work.
For the first time, flexibility has overtaken pay as one of the top drivers of nurse satisfaction. In response, many hospitals are experimenting with new workforce models that blend core roles with more flexible or external options, but making flexibility work at scale takes more than just offering new shift types. It requires thoughtful implementation, strong operational buy-in, and a willingness to continuously evaluate what’s motivating the workforce.
Technology plays a key role in that process. Digital platforms give leaders visibility into workforce dynamics. They enable more responsive scheduling, reveal patterns across units and markets, and help identify where adjustments are needed. Flexibility alone doesn’t guarantee better outcomes, but paired with the right data and feedback, it gives health systems the ability to adapt with purpose.
Redesigning Roles to Reflect Real Life
Before stepping into a system-level role, I spent years as a practicing clinician in the medical telemetry environment and later as a nurse leader throughout acute care. I saw firsthand how rigid workforce models were wearing people down, especially when the demands of life outside of work didn’t fit into these “set schedules” in nursing.
I carried that perspective with me when I joined SSM Health in 2021, a fully integrated health system spanning across four states in the Midwest, serving both urban and rural communities. We were already using on-demand staffing, but at the time, it was more of a reaction to the pandemic than a long-term plan. As we moved out of crisis mode, we had to ask: What do we want our workforce strategy to look like going forward?
We created multiple employment tiers, including new PRN structures, to offer different levels of commitment. Some nurses want a consistent schedule. Others can only work a few hours between childcare or school pickups. Some want to try out a hospital or unit before deciding to apply for a core role. All of those paths should exist and be equally supported.
If nurses don’t have control over their schedules, they look for other employment options or decide to leave the profession entirely. By 2027, nearly one-fifth of the 4.5 million registered nurses in the U.S. intend to leave the workforce, and according to the 2025 NSI National Health Care Retention & RN Staffing Report, scheduling conflicts ranked among the top five reasons nurses voluntarily resigned.
Using Technology to Meet Evolving Needs
In a 2023 ShiftMed survey, more than 80% of nurses said that app-based platforms give them the flexibility they need to manage their schedules. That same technology gives hospitals greater visibility and control.
Digital workforce platforms allow us to manage both our internal team and an external pool of credentialed nurses in one place. The technology gives us more control over who picks up shifts, how coverage is distributed, and how we respond to changing needs across different hospitals.
In the past, many nurse leaders would have said that 80% of staff should be core. In today’s environment, that number may no longer apply. Instead of relying on benchmarks alone, we also rely on data to understand what’s working, what’s shifting, and where we need to adapt.
We’re able to track which shifts regularly go unfilled, which hospitals are seeing consistent staffing gaps, and how the ratio between core and flexible staff is changing over time. That kind of visibility helps us make adjustments before staffing challenges start affecting care or overwhelming the team.
We’ve also seen that flexible staffing can lead to long-term fit. Many nurses who start out picking up shifts eventually move into core roles. It’s a way for them to test out the environment, and for us to assess how they collaborate, communicate, and show up for the team.
Safeguarding Quality and Culture
Flexibility can’t come at the cost of consistency. As we’ve expanded our staffing model at SSM Health, one of our top priorities has been making sure that patient care and team dynamics stay strong, whether a shift is staffed by core team members or on-demand professionals.
Every nurse, regardless of employment status, receives comprehensive clinical and operational onboarding tailored to their role before caring for patients. Training sets the foundation, but the real impact comes from the team dynamic. We’ve worked closely with clinical leaders to make sure on-demand staff are welcomed, supported, and treated like part of the team the moment they walk in the door.
Culture directly influences whether these models succeed. If flexible staff feel like outsiders, it can lead to communication breakdowns and higher turnover. When they feel included and valued, they’re more likely to show up confident, engaged, and committed to delivering safe and consistent care. When that support is in place, units run more smoothly, and we’re able to fill shifts with fewer disruptions.
Listening is the First Step Toward Flexibility
Building a more flexible workforce starts with listening. Workforce surveys can point to broad trends, but they rarely capture the nuances of being a nurse in today’s workforce. To understand what nurses need, we have to ask better questions and create space for real conversations.
Small group discussions give nurses the chance to talk openly about what’s working and what would make their jobs more sustainable. These conversations help us get to the root of what nurses need to stay supported in their roles.
Across those conversations, nurses consistently want more autonomy. They want the ability to manage their own time, to pick up shifts when it works for them, and to step back when life demands it. If a policy or system makes flexibility harder, it’s a sign to step back and reevaluate. The only way to build a workforce that lasts is to shape it with the staff it’s meant to support.
