Strategies for Nurse Recruitment During Shortage
by Rynae Golke
Registered nurses are among the most in-demand professions in the country, and while it may seem difficult to fill open RN positions today, the challenge has just begun. According to CNBC, the projected hiring growth between 2017 and 2024 is 16 percent. Additionally, the American Nurses Association reports that fewer nurses are entering the workforce, the average age of the employed American RN has increased, the aged patient population has grown, and the Affordable Care Act has improved healthcare access for millions of new patients. This means that even if you’ve found recruitment strategies that are working today, the market will require you to rethink the way you recruit nurses in the near future.
Exploring the Root Cause
The primary challenges healthcare organizations face must be addressed in order to successfully staff nurses at a level that meets the established quality standards within your organization. In this case, that means having a complete understanding of the root causes of the shortage in your organization, your geographical area, and even nationwide.
Fewer Nurses Entering the Workforce
According to the American Nurses Association, fewer than 10 percent of all nurses are under 30 years old due to a decline in nursing program enrollment for the past five consecutive years. The first step in problem-solving is identifying why fewer students are choosing nursing today and what measures you can take to change the statistics. Here are some possibilities:
- Millennials are more focused on work-life balance than any other generation and nursing is the least likely to offer it. The hours are long and coverage is required on nights, weekends, and holidays. It’s difficult to disconnect at the end of the day and the chances of working past your scheduled hours are high.
- It’s difficult to earn an income when earning a nursing degree due to the demands of clinical rotations. Many students may find it challenging to “work” 40 hours per week for a quarter or a semester without pay.
- It’s one of the few careers that requires an entrance exam in order to use the degree earned. Poor test-takers may avoid nursing as a major because it’s possible to invest three to five years in a degree that can never be used.
Consider the impact your organization can have on changing these statistics. Some ideas include offering innovative solutions for work-life balance, such as job-share options, guaranteed ending times, “mom” hours that cover the hours that daycare is open or the hours children are in school, additional paid time off, or better solutions for sick days so days off aren’t accompanied by guilt. Contemplate ways that you can ease the burden for students completing clinical rotations. Perhaps if they sign with your organization and work one day a week or a couple of weekends per month as a nursing assistant, you can provide income during their clinical rotation in the form of a sign-on bonus or advance on their potential nursing pay. Finally, consider offering exam preparation assistance, whether it includes free access to software or materials or free access to an expert who can assist nursing students in preparation.
It’s important to note that all solutions require an investment, but the investment is generally no match to the cost of a nursing shortage.
Fewer Nurses With Specialized Skills Are Available
Healthcare providers are finding the specialized nurse more and more elusive. Let’s consider the root cause:
- Experienced nurses are baby boomers, who are likely to be loyal to their employer and least likely to be open to new opportunities.
- Younger nurses are unable to gain specialized experience because they don’t have the experience to land the job, which creates a vicious cycle resulting in unfilled positions and unfulfilled nurses seeking challenge and advancement.
What measures can your organization take to address the shortage of nurses with specialized skill sets? Scripps Health in San Diego has implemented an education and transition program that trains nurses on the job and allows them to grow their skill sets in a transitional position before moving into a specialized nursing role. For instance, because finding OR and ICU nurses has proven to be difficult, they hire new grads to work in med/surg while training them to transition to OR or ICU. Most nurses are able to begin their transition just a year into their career. Consider creative ways to reach baby boomers and speak to their values, such as matching trumping the benefits they’ve earned with longevity in their current company and offering hours that satisfy their needs.
Fewer Nurses Are Interested in Rural Health
Rural health facilities are arguably in the deepest state of crisis. Recruiting nurses to rural facilities is exceptionally hard. Let’s consider why:
- Rural communities generally don’t offer the amenities a new graduate may be seeking; dining, culture, fitness, community events, and night life are minimal or nonexistent. Additionally, young families may not be satisfied with local schools, day cares, or activity offerings for their children, and in some communities, daycare or teacher shortages make recruitment even more challenging.
- Nurses fear that they won’t have the opportunity to utilize their skills in a rural facility because they don’t perform the same services (such as OR, ICU, OB, etc.) provided at urban facilities.
- Rural health facilities often operate under very tight budgets with close cash flow management, making it exceptionally hard to match the pay and benefits offered by larger facilities nearby.
- Young couples find that there is no work for the nurse’s spouse in the local community, removing relocation as an option.
- Nursing programs are unaccessible for those who are already living in and invested in the local community, making it very challenging to “grow your own” nurses from your nursing assistant pool.
In order to overcome these challenges, a bird’s eye view of the issues is required. It’s not uncommon for rural facilities to get involved in community government and betterment committees in order to improve attraction from young nurses and families. Offering perks and benefits that speak to young people, cutting in areas with a lower return to increase nursing salaries and benefits, and working with the local betterment committee to create a more attractive community with better jobs and more opportunities for fitness and culture may help. Consider making a nursing degree more attractive and accessible for your CNAs; offer tuition assistance, travel vouchers, and local clinical rotations.
Perhaps most importantly, rural facilities need to understand the market better than anyone else. Which cities are oversaturated with nurses and what would it take to attract those nurses? Which universities are graduating the most nurses? Which states have the longest duration between graduation and a nurse’s first offer of employment?
Key Takeaway: The only way to battle the nursing shortage is to be diligent in identifying the root cause of the shortage and working feverishly to combat it in your facility in creative and innovative ways.