Navigating healthcare staffing challenges: 3 execs share their strategies

The following healthcare executives shared with Becker's in October and November their strategies for retaining and recruiting staff amid the industry's workforce crisis.

Note: These responses were lightly edited for length and clarity.

Mark Mahnfeldt, MSN, RN. Vice President of Patient Care and Chief Nursing Officer at Emerson Hospital (Concord, Mass.): My big push for the next year in this role is to invest in our people. How do we drive professional practice here at the hospital and give our nurses the ability to grow? That's number one. Number two is really continuing with the culture that's been here for a while and making sure that we are emotionally supporting staff. That's huge for me.

Leadership visibility could never be more important, because if you have a good leader, your staff is going to be happy.

We were quite strategic early on by increasing our nursing compensation models so that we did retain people. It's not the strongest recruiting model, but it is a strong retainment model. We are struggling to recruit. We're not struggling to retain. We need to approach the way we recruit people much differently. The conventional ways of posting things on websites is not what we should be doing any longer. So we're coming up with different ways to recruit people, like selling our culture. One of the things that we're going live with in the near future is a whole webpage dedicated to nursing recruitment, and on that page will be video vignettes from frontline staff talking about the culture at Emerson and how they can advance. So when we bring someone on as a patient care technician, we want to be able to give them a path to the next level. So if you're a PCT and you want to become a nurse, how do we get you there? I think it's important for people to see a path for growth.

So we're investing in nursing education and growth hand over fist, any way we can. A big deal for me is making sure we have the administrative structure to meet the demand for nurses coming out of school with much less experience, so we've invested in additional full-time nurse educators.

Greg Till. Executive Vice President and Chief People Officer at  Providence (Renton, Wash.): First and foremost, I'd say that we're focused on retention. We know that the best recruiting strategy is a good retention strategy, and we want to do everything that we can to keep the caregivers that we have. And so from a financial perspective, a few months ago, we announced a $220 million additional investment. The biggest part of that was just a gratitude bonus for everyone in the organization to ensure they know that we really appreciate the sacrifices that they've been making over the past year and a half. 

Secondarily, we've done a lot in terms of retention to ensure that our caregivers understand that we really care about their mental health and well-being. Healthcare is going through pretty significant burnout, in addition to all the other crises that we're facing and just everything that we've been through over the past year and a half. So we've invested a significant amount more in our own caregivers' wellbeing. They have almost unlimited access to mental health resources, including 25 free behavioral health visits.

The third thing that we're doing is we're preparing our leaders really well to have stay conversations with our caregivers and doing everything that we can to reduce the conditions that create burnout. We've enabled them with new technology, we've enabled them with better access to free development for their careers, and even creative things like additional time off and leaves of absence if they really do need a break.

Just like everybody else in healthcare, we're faced with increasing attrition. Our caregivers really stuck with us through the pandemic. Last year, we saw the lowest levels of attrition since we've been measuring it at Providence, and that includes everything from new caregiver attrition to retirements. Well, this year, like everybody else, we've seen a spike in attrition, including an 18 percent increase in retirements. Our healthcare folks that stuck with us when they wanted to retire last year are [retiring] this year. And so we're really focused on doing everything that we can to hire. And for us, like others, we're hiring into a smaller pond. We're getting 50 percent fewer applications.  The unemployment rate in hospitals last month was under 2 percent.

And so it's even harder. A couple of the things that we're doing is we've attached referral bonuses to every single position that we have open in the organizations. This is a way that we can reward our internal caregivers for referring their friends, their family, their previous coworkers in order to fill some of the staffing gaps. We've also, like other folks, attached sign-on bonuses to our most competitive positions. Over 50 percent of our positions now have sign-on bonuses, including, in some of our markets, up to $35,000 for nursing positions. 

One of the things that we're doing that's not monetary is trying to highlight what makes Providence special. For us, as a faith-based, mission-focused, values-forward organization, we think that we have a great opportunity for caregivers to come in alignment with their calling in a way that can provide them with special experiences.

We've also made a pretty significant, especially for healthcare, commitment to development. We're aiming to make education debt free. We're not all the way there yet, but across our family of organizations, we've offered $5,250 in education reimbursement. We're aiming to make almost all of our certifications free or low cost to our caregivers, and we're showing them paths from lower-paid positions to higher-paid positions. So we put a lot of our time, effort and focus into the development and growth of caregivers — both current and community members who want to be in healthcare — to try to relieve the workforce crisis that's been building for the last 10 years in the industry. For the last 10 years, we've been opening more roles every year than we've been filling in healthcare, and it's just been exacerbated by the current crisis. 

Trish O'Keefe, PhD, RN. Senior Vice president and Chief Nurse Executive at Atlantic Health System (Morristown, N.J.): We definitely have focused and received feedback from our staff members in regards to having flexibility in their work. We've also ensured that we have a mentorship program, especially for our new young nurses that we've just hired. As you certainly know, they had limited experience when they were coming out of school. So we have organized a one-year residency program for our new staff coming out. We also are looking at our pipeline. We know our staff will be retiring. We've definitely seen an acceleration in that across the country, and New Jersey has definitely seen the same as well. So we need to make sure that we have a pipeline of new young staff coming in.

We have nurse aids and other team members that are interested in going into nursing, so we've created a shadow program — a boot-camp-type program — to help and support them through tuition reimbursement, mentorship and going back to respective schools. So that's just a couple of the efforts that we have been working on together. 

Creating an environment of support is so important. It's recruitment and retention, but it's also the environment that you work in. You spend a great deal of time in the organization that you work in, and you need to feel supported. You need to have areas of downtime, and that's one of the areas we've looked at from a resiliency standpoint for our staff to offer some downtime spaces. As we know, it's been stressful, particularly during COVID, but as our patients continue to return to receive healthcare, we need to support our very amazing nursing staff, and our team members in general, that we have at Atlantic.

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