Dark storm clouds are brewing as COVID-19 threatens to overwhelm an already stretched nursing workforce. Read on to learn what some hospital executives are doing to meet staffing challenges head on.
Things have changed since the early days of the pandemic when elective surgeries were at a standstill. Nurses accepted travel assignments to COVID “hotspots” to compensate for cancelled shifts, furloughs and layoffs. Other nurses eagerly stepped up to work outside of their own state to fight on the frontlines in a harder hit area of the country.
Now, hospitals across the country are feeling the strain caused by the fall’s virus resurgence. The number of available hospital beds are shrinking and higher numbers of healthcare workers are getting sick. This time around, the virus is more widespread and there simply isn’t enough travel nurses to fill the gaps of a nationwide staffing crisis. Now, more than ever, healthcare leaders are being creative with new strategies for supporting healthcare workers on the front lines.
A Public Plea
A staffing “perfect storm” is brewing as COVID-19 patients flood hospitals across the U.S. The UW Health System in Wisconsin responded to the urgent situation by publishing a 2-page open letter in the Wisconsin State Journal. The ad asked residents to join healthcare workers in preventing further virus spread within their community.
Quote
“Wisconsin is in a bad place right now with no sign of things getting better without action. We are, quite simply, out of time. Without immediate change, our hospitals will be too full to treat all of those with the virus and those with other illnesses or injuries. Soon you or someone you love may need us, but we won’t be able to provide the life-saving care you need, whether for COVID-19, cancer, heart disease or other urgent conditions. As health care providers, we are terrified of that becoming reality.”
All of UW Health’s faculty, staff and colleagues from around the state signed the letter, making a powerful statement.
I recently read an interesting article in Becker’s Hospital Review, Strategies for COVID-19 Staffing Shortages from 8 Hospital Execs, that shared strategies used by 8 hospital executives to staff adequately during the pandemic. Here is a look at a few strategies used by executives in the article and other healthcare leaders.
Increase the use of part-time and per diem staff for additional shifts.
I know... you’re thinking “what part-time and per diem staff”? This strategy may require hiring additional part-time staff and being creative with their work hours. Perhaps a nurse is willing to work 6 hours during the shift’s busiest time.
Deploy nurses who work away from the bedside to join frontline nurses in supportive roles such as vital signs, treatments, medication passes, admissions and discharges.
Sharing resources within healthcare systems to prevent a single facility from becoming overwhelmed.
Offering incentives to nurses at another affiliated facility interested in signing up for extra shifts at another struggling facility. In some cases, short-term contracts are offered to per diem nurses to fill a vacant full-time position.
Identifying any duties of frontline nurses that could be performed by another person. For example:
Assigning a phlebotomist to the ER or ICU to help with blood collection.
Cross-training surgical and cath lab nurses to transfer and discharge patients to conserve beds in ICUs and intermediate care units.
Adding a unit secretary position to nightshift
Adding a “site manager” to COVID units to act as a runner for the care team. The site manager can get supplies or perform other tasks that decrease the number of times the nurse (or other healthcare worker) has to leave the COVID patient’s room. This will down the amount of time spent donning and doffing PPE.
Using telehealth when physicians and other providers are quarantined and unable to provide in-person care safely.
Reduce the risk of staff contracting or transmitting the virus. Implementing infection control teams to change the work culture by encouraging staff and faculty to speak up when they see safety issues. Send the message “everyone has a right to contribute to a safe work environment”.
Moving PPE to facilities that need it the most.
Enlisting the primary care and family physicians to help by working in an affiliated or local hospital.
Many nurses hold supportive positions in departments throughout the hospital, such as information technology, quality management, and education and case management. Assigning these nurses times to work at the bedside can ease the workload for other staff. I’m almost certain you’ll hear a few “I haven’t taken care of patients in years” and “I’m not comfortable with my bedside skills”. But, it only takes basic nursing skills to change a simple dressing, follow-up on pain levels, call in consults and other time-consuming tasks.
We Want to Know
Are you part of an innovative plan or strategy to address staffing shortages? If so, we would love to hear your story. Tell us about the creative solutions and initiatives in your community.
Yep. Mine did it too, right down to the “unfortunate timing” statement. It was gross. I’m in an entirely different state than both of you.
It's ****ing disturbing that this is the norm, and these greedy pieces of garbage will continue to take these bonuses because they've worked "so hard" ?
It's ****ing disturbing that this is the norm, and these greedy pieces of garbage will continue to take these bonuses because they've worked "so hard" ?
Yeah, we were told that it shouldn’t bother us because they “earned the bonuses in 2019” and deserved them. In the meantime my colleagues are puking before coming to work due to the stress from the insane workload.
Okay, got my assignment. I’m normally in a physician’s office, have never worked in a hospital setting aside from doing some clinical rotations in nursing school. Anyway, I’m doing COVID testing for scheduled preop pts. The nurse who’s over the coordination of this is sending me to train on one of the acute care floors for one day (and I’m still working 5 8-hour shifts) then I’ll be helping with med administration. I still don’t have access to the Pyxis system! I’m also an LPN so I need to be extra careful that I’m not giving anything outside my scope. I’d almost rather continue torturing people’s noses with a Q-Tip than do med administration!
The problem we're having is that most of our nurses are jumping ship and running off to become travel nurses where the pay is 3-5 times their going rate. We have lost so many nurses since the start of the pandemic. We've had to hire travel nurses to supplement the ones leaving, and we're still short staffed. Everyday we get word that someone else is quitting. We now have more travel nurses than regular staff.
The problem we're having is that most of our nurses are jumping ship and running off to become travel nurses where the pay is 3-5 times their going rate. We have lost so many nurses since the start of the pandemic. We've had to hire travel nurses to supplement the ones leaving, and we're still short staffed. Everyday we get word that someone else is quitting. We now have more travel nurses than regular staff.
The problem we're having is that most of our nurses are jumping ship and running off to become travel nurses where the pay is 3-5 times their going rate. We have lost so many nurses since the start of the pandemic. We've had to hire travel nurses to supplement the ones leaving, and we're still short staffed. Everyday we get word that someone else is quitting. We now have more travel nurses than regular staff.
Jumping ship? Running off?
It sounds like the problem is that your place is only able to scoot up to the table if they think they have to. They probably should've done that with the employees they already had. It's quite possible that it isn't as much about pay as it might seem.
Specializes in Clinical Leadership, Staff Development, Education.
On 2/14/2021 at 9:46 AM, ICUGirl said:
We now have more travel nurses than regular staff.
Do you think pay increases would help retain nurses? I work in a hospital that will not hire contract nurses, just keep working with critical staffing shortage.
Do you think pay increases would help retain nurses? I work in a hospital that will not hire contract nurses, just keep working with critical staffing shortage.
I think pay increases help, but only to a point. I work in a hospital with high pay, but people still leave over working conditions. Mostly it's staffing shortages, but also we don't have very good routes to transfer to other departments. We seem to spend a lot of time and money on new med-surg nurses who leave after about a year to go do ED or L&D nursing, and I wish we invested in internal specialty training to keep them.
I'm going to have to see how things are post-COVID in regards to staffing because I have no desire to be this overworked for my whole career. I've definitely seen staffing levels ebb and flow, and when we've been really short staffed in the past, we eventually hired on more people to alleviate it. Hopefully that happens in our "new normal."
In the meantime, people who want to pick up extra shifts can earn like a traveler due to incentives and overtime. Remember that traveler contracts pay well because they are often difficult, and the contracts are short in part because people can only handle grueling conditions for so long before they burn out, no matter what money is offered.
Yes, I believe pay increases would've helped to keep many of our nurses. But also, we did have bad working conditions which helped to catapult nurses right out of our unit into the travel world. So, it was a combination of bad working conditions and the lack of pay. Many of our nurses would learn how much the travel nurses were making doing the same job under the same bad working conditions and would become bitter. So, to solve that problem, they became travel nurses too. But we were like family, so I believe had they used that money to pay their permanent staff, those nurses would've stayed even under the current working conditions. Many of them are coming back to my hospital, but as travel nurses.
Hoosier_RN, MSN
3,968 Posts
It's ****ing disturbing that this is the norm, and these greedy pieces of garbage will continue to take these bonuses because they've worked "so hard" ?