The 'disconnect' between what nurses want and what hospitals are offering

Hospital executives report that the generation gap of differences between newer, younger nurses and their more experienced counterparts is not only creating team conflicts but also adding to hospitals' difficulty attracting nursing talent, according to the "2023 Healthcare Executive Report" released by Incredible Health on June 13.

"There is a large disconnect between what nurses look for in an employer and what employers officer to hire and retain nurses," according to the report, which compiled survey responses from executives at 100 hospitals and health systems in May 2023. 

Hospital systems are focusing on sign-on bonuses, increased salaries and patient-to-staff ratios, but 80 percent of younger nurses said they want flexibility when it comes to scheduling, according to the report. Only 11 percent of healthcare employers are offering this sought-after perk. 

Additionally, 25 percent of newer nurses surveyed said they would leave the profession because of "limited career advancement training and opportunities," but health systems are not focused on attracting and retaining nurses with these types of programs.  

Instead, hospitals prioritize previous experience and qualifications when recruiting nurses. That being said, 40 percent of health system executives said more than a quarter of the nurses currently employed in their hospitals have less than a year of experience. Further, more than half of the nurses (53 percent) working in these systems had been employed there for less than five years.  

The report said 94 percent of health system leaders said the nursing shortage has reached a "critical" level, and 68 percent said they don't have adequate levels of nursing staff to handle another "large-scale health crisis." 

"No surprises from the data — seems to be spot on," Janice Walker, BSN, RN, system executive vice president and chief nursing executive at Dallas-based Baylor Scott & White Health, told Becker's. "Organizations must become more candidate-centric in their efforts to recruit strong talent; we can no longer just rely on our reputations but must put active, aggressive workstreams in place to go after the talent (no matter what age or experience)."

More key data points from the report:

  • The vast majority of health systems (93 percent) are using travel nurses to keep up with demand.
  • Three-quarters of leaders who responded to the survey said temporary nurses make up 25 percent of their nursing staff.
  • Almost all executives (96 percent) said they are planning to secure permanent nursing staff over temporary staff as a top priority.

"The paradigm is shifting and permanent effects on nursing care are taking place now. At Bassett, we are turning our attention to redesigning the nursing workflow model with an eye toward getting nurses to practice to the top of their license," Tommy Ibrahim, MD, president and CEO of Bassett Healthcare Network in Cooperstown, N.Y., told Becker's.

"We are focused on implementing new team-based care delivery models, emerging innovations and technologies, and partnerships that improve efficiency and augment quality, while addressing nursing burnout and moral injury, responding to the generational desires of new nurses entering the workforce, and creating a sustainable and economically responsible model long term," Dr. Ibrahim said. 

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