How staffing flexibility can create a resilient nursing workforce

For years, healthcare systems have grappled with nurse shortages. The pandemic has motivated organizations to take a closer look at the causes of the problem and potential solutions.

During a roundtable at Becker's Hospital Review's 12th Annual Meeting sponsored by CareRev, two experts on the nursing shortage facilitated a discussion about activating local talent networks and creating a resilient, flexible, sustainable workforce model:

  • Will Patterson, RN, CEO, CareRev 
  • Mark Smith, VP, workforce strategy and analytics, Providence in Spokane, Wash.

Four key takeaways were: 

1. Listening to caregiver needs is the first step to greater workplace flexibility. In the wake of the pandemic, nurses have been slow to come back to work. The situation is complicated by dynamics in adjacent industries, such as childcare, that prevent nurses from returning to work. "Right now, the lack of available childcare is exacerbating our staffing situation," Mr. Smith said. "We have to be more open to becoming flexible. That may mean different shift patterns and new work relationships." 

Even before COVID-19, Providence was thinking about workforce flexibility in new ways. "It starts with mindset," Mr. Smith said. "We're focusing on meeting people where they are. Our caregivers must be heard and conditions of employment must be based on their needs. That will inform what we do in terms of deconstructing jobs, considering alternatives like CareRev or rethinking agency staff."

2. Healthcare systems are leveraging the experience of retired nurses. "We created an Emeritus RN program and hired back retired nurses in training roles on the floor and for new grads," the senior vice president and chief nursing officer at a multi-hospital health system in Pennsylvania said. "Our mantra is, 'We need your brain, not your back.'" Other organizations have launched similar programs in which formerly retired nurses mentor and onboard nurses in high-stress areas such as the emergency department. In some cases, emeritus RNs assist front-line staff with admission and discharge paperwork. Often, this work can be done remotely. "Highly skilled nurses who are retired may only want to work four- or six-hour shifts," Mr. Patterson said. "I think there's a real opportunity to rethink how long people are required to work."

3. It might be time to redesign what nursing roles look like. Although new programs and incentives are beneficial for attracting and retaining nurses, flexibility may require rethinking how people work. "We need to invite people into the conversation and completely reinvent the healthcare team," one participant said. "New roles may be needed that don't even exist today." Another attendee said, "We know we can't have an all-nursing care team. We have to be creative and adaptive. For example, we are using pharmacy techs in our emergency department to do medication reconciliation. We need to take away the obstacles to care so nurses can be at the bedside." 

4. The right onboarding workflow can contribute to staffing flexibility. Many aspects of the healthcare work environment are hard to change, but onboarding flexible staff is not. "There are thousands of people on the CareRev platform who want to work six-hour shifts," Mr. Patterson said. "With the right workflow you can onboard hundreds of nurses a month, and that adds up."

Culture change in healthcare will take time, but there are opportunities to make meaningful adjustments to the way organizations employ nurses. "I believe we can give nurses those moments of empowerment and enable them to work when they want, where they want," Mr. Patterson said. 

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