It's Not Just A Shortage Of Nurses But Of Training And Understanding

If you’re in the healthcare industry, you’re likely not surprised by reporting like this:

"A serious shortage of registered nurses is forcing thousands of U.S. hospitals to function with skeleton crews, possibly causing hundreds of unnecessary deaths and injuries. Many nurses are simply getting old and retiring, but many experts blame the shortage on low pay, poor working conditions and low enrollments in nursing schools. Meanwhile, short-staffed hospitals are taking controversial steps such as offering large signing bonuses and recruiting nurses from overseas."

But what is surprising is how long this issue has persisted. The above quote is from nearly 20 years ago from a 2002 CQ Press article in which they projected a potential shortfall of 800,000 registered nurses by 2020. And as it turns out, that projection fell short. The nursing shortage is closer to 1.1 million, according to data cited by the American Nurses Association.

There are many reasons behind the shortage, from the increasing demand for healthcare from an aging society to, more recently, the stress of providing care during an ongoing pandemic. But not all of it is out of our control. Here are three strategies healthcare leaders could employ to ensure they’re attracting, developing and retaining the nursing staff they need to provide quality care.

Tip 1: Know What You’re Looking For 

If you were to say “We need to hire a nurse,” what do you mean by that? Are you looking for a nurse for an ICU, one based at a school, one supporting an outpatient center, a nurse at a clinic, a doctor’s office, an OB unit? Each of these can not only require vastly different levels of expertise, but they could also require different hours and a different quality of life. Beyond setting, what skills are you looking for? Are you looking for a teacher, someone trained in the latest technology, or someone who is skilled at developing quick rapport with children?

The term “nurse” is such a broad catch-all that healthcare administrators need to be very specific about the people and skills they need. They also need to ensure this description fits the existing talent pool, bucking the recent trend of hospitals seeking out candidates that are impossible to source even with competitive compensation and benefits packages not existing. In a recent MedCity News survey, a majority of healthcare facilities have started offering enhanced benefits packages including tuition reimbursement, flexible work options and cash-out vacation policies.

Tip 2: Make The Best Use Of What You Have

Upskilling and reskilling are essential business practices to building and retaining your existing talent. By upskilling, or building up the skills of your staff, you’re not only increasing your own facility’s capabilities and flexibility, but you’re also helping retain members of your nursing staff who are motivated by career development. Reskilling means teaching an employee new skills so they can take on a new role within your organization. I believe this is an essential attribute to protect valued employees from burnout and keep them motivated.

Importantly, re-evaluate what your nurses are asked to do. Are they responsible for tasks that don’t require their specific skill set? Moving those responsibilities to someone with less training — and, not unimportantly, lesser cost — can free up their time for tasks better aligned with their skills and help retain their services. The same is true for tasks that are beyond their experience: Asking nurses who care about serving their community to complete tasks they’re not trained for is a quick way to push them out of the building.

Tip 3: Build Up Your Nursing Executive Staff

I feel this piece of advice is especially important today. The chaos that accompanies nursing in a hospital setting has traditionally resulted in a great deal of turnover, a trend that has only increased with the tremendous pressure and burnout of nursing during Covid-19. Previously, though, facilities had nursing leaders and mentors, or experienced people who worked in the same facility for decades and could share their understanding and institutional knowledge.

Today, nurses are staying only a few years in a facility before getting poached by one offering more money or other benefits. The current shortage has also created a pay imbalance, where nurses can outearn even some executives. As a result, the ranks of nursing leaders have become depleted. This is a major issue from a quality of care and stability standpoint but also from a retention standpoint.

When you have this degree of turnover, you find new nursing graduates are being trained by nurses with only a few years of experience. They aren’t benefiting from the experience and softer skills of veteran nurses and mentors. Especially during an ongoing public health crisis, a facility offering stable, consistent nursing leadership can be attractive for nurses committed to building their careers. It also creates a more formal career path for newer nurses to follow.

Nursing During A Pandemic

As frontline workers during Covid-19, nurses are asked to put themselves and their loved ones at risk every day. Yet, they continually show up, knowing they have a critical role to play. Frankly, they are heroes. Our community's health is on their shoulders.

My hope is that new nursing graduates starting their careers during Covid-19 will develop a mindset that they not only want to become the most effective nurses they can be but also that they view their role as a generational role where someday it will be incumbent on them to pass what they learned about nursing during a crisis to tomorrow’s nurses. From generation to generation, the best way to pass on information and values is to grow within an organization. An inheritance of knowledge through long-term mentorship and coaching is essential for the healthcare system’s long-term viability.

Previously published on Forbes.