What hospitals should consider when hiring teens

Aaron Gillingham has a firsthand perspective on the advantages and potential problems hospitals and health systems may face with hiring teenagers. 

That's because Mr. Gillingham, who serves as senior vice president and chief human resources officer at West Des Moines, Iowa-based UnityPoint Health, has a 17-year-old daughter working in the organization's food and nutrition area and can discuss her experiences with her at home.  

"As my daughter started working with patients, often who are very sick, I was surprised by the emotional toll that took on her initially," he told Becker's. "And so [my team has] been talking about help that we can provide through early job shadowing or job-realistic job previews to help new team members."

It is among the lessons health system leaders are passing along to other organizations considering hiring employees as young as 16. Workforce shortages are not new to hospitals and health systems. However, the COVID-19 pandemic intensified these challenges, making it more crucial than ever to hire the right people for the right roles.

Organizations have used several tools to fill staffing gaps, including sign-on bonuses and bringing in new graduates from colleges with healthcare programs. Hiring teens is another option.

This consideration begs the questions: What jobs make sense for teenagers to hold? What are some advantages and potential problems with hiring teens? 

Opportunities in hiring teens

To begin answering these questions, it is worth acknowledging that healthcare organizations have been hiring teen workers for years, according to Jeremy Sadlier, executive director of the American Society for Health Care Human Resources Administration.

"While teens don't make up particularly desirable candidate pool for current openings, the efforts to expose teens and young adults to healthcare careers as a long-term strategy to help offset candidate shortages has been going on in the industry for decades," Mr. Sadlier told Becker's. "Creating more opportunities for work study programs, healthcare career exploration, and highlighting fulfilling clinical careers from an early age must continue if we ever hope to get the industry out of its workforce shortage."  

Before September 2021, Columbus, Ohio-based Mount Carmel Health System only hired applicants who were 18 or older. However, the health system lowered its minimum hiring age to 16 last fall, with the first 25 hires who were 16 or 17 years old coming on board earlier this year, according to Mount Carmel Regional Director of Talent Acquisition Rachel Barb.

Primarily, the teens have been working in areas such as environmental services, nutrition services and patient transportation. Then in June, Mount Carmel launched its inaugural patient-facing role for those 16 and older: a student support associate position.

"We did elect to have specific criteria that students coming to us are actively enrolled in a nursing program or a prenursing program throughout their high school [career], so that we are really looking to support and foster their interest in long-term career growth and positioning them well to continue to work for us after they graduate from high school and ultimately matriculate into a nursing program or another allied health program," Ms. Barb said.

She said student support associates work closely as a part of the care team, with a multiskilled technician. The younger workers can help with tasks such as bathing patients, taking patients' vital signs and restocking equipment. 

Because there are limitations regarding the hours high school students can work, there is an opportunity to look at scheduling more creatively, Ms. Barb said. 

"That's an area of opportunity that our entire workforce is looking at — increasing flexibility and providing opportunities outside of traditional 12-hour shifts," she said. 

She said modifying the hiring age has also helped bring people into the organization who are representative of the communities the health system serves, as well as opened the door for those interested in launching their careers in healthcare. Additionally, Ms. Barb views it as an opportunity to capitalize on the effects of the pandemic.

"It's been so difficult and really painful for so many of our clinicians," she said. "But on the other side, it has really inspired a lot of those younger folks that are interested in wanting to make a difference and help in their communities. And this is a pathway to provide that opportunity, [while] highlight[ing] that our rates of pay are much more competitive and aggressive, versus working in other environments that traditional high school age students would work, like retail or fast food."

Mount Carmel aims to hire another 25 teenagers, or potentially more, by next summer. 

Meanwhile, UnityPoint Health also has teens working in environmental services and food and nutrition, a majority of whom are 18 or 19 years old. Mr. Gillingham said teens typically are not working in clinical roles, but once they have more experience, they might go through a type of certified nursing assistant certification program.

"Where we have 18- and 19-year-olds in the roles, they may start to get the training under their belt to really get into more patient-facing roles," he said. "… Then our hope is that they get some experience in there and they're able to take advantage of our education reimbursement programs. We've got some new programs that we are currently under consideration and developing … in terms of how we get people into very specific career sets and provide them training and investment to be able to keep them within the healthcare environment."

Overall, fewer than 400 of UnityPoint Health's 32,000 employees are teens. Mr. Gillingham said the teens working at the organization can gain an understanding about what it is like to work with patients and their families, clinicians and other healthcare professionals.   

Potential downside 

While health systems pointed to benefits of hiring teens, they also acknowledged the challenges involved. 

For example, managers must ensure they are prepared to work with high school students or students early in their college careers because they may have different scheduling needs and not as much understanding about what it is like to work in a healthcare environment where there are privacy rules and direct encounters with patients and their families, Mr. Gillingham said. 

Mr. Sadlier noted other factors, too. He said teens are not often viewed as the strongest candidates. 

"Healthcare institutions, like other industries, are required to follow employment and labor laws on who they hire. There's an unfortunate reality in that the roles teens can play within the healthcare workforce are incredibly limited," Mr. Sadlier said. "Many of the healthcare industry's most entry-level openings — food services, environmental services, supply chain and equipment transport — are either expressly forbidden or have one or more essential function declared hazardous in the employment of minors. This is not to say that teens have no place in healthcare, but those under 18 will likely continue to have limited opportunities."

He also cited the fact that nearly every healthcare role requires a high school diploma or GED as minimal qualification, and about half of the work eligible teens will not meet that requirement.

Additionally, Mr. Sadlier pointed to consolidation of administrative assistant, file clerk, and clerical positions within healthcare as a contributing factor to limited opportunities for teens. 

"For many years these types of roles were plentiful, but reductions in reimbursement have seen significant [full-time equivalent] reductions and eliminations of administrative assistant and clerical roles; couple that with the industry's move to electronic imaging and medical records and file clerk roles have suffered the same fate," he said. 

Advice for executives  

For hospitals and health systems considering hiring teens, Mr. Gillingham recommended first understanding the culture the organization wants. He also recommended organizations focus on their values and ensure they have an engaged workforce. 

Lastly, he encourages hospitals and health systems to ask themselves one simple question. 

"For us, it's all about hiring the right people for the right jobs at the right time, and giving them the right training to ensure that they really understand what it's going to be like to work in that environment," Mr. Gillingham said. "Given where we are as a nation right now with job shortages, I think you have to ask yourself, 'Why not?'"

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