COVID-19 Fears and Frustration Add to Recruiting Challenges for Hospitals

Most healthcare organizations were already experiencing a supply-and-demand gap for top talent before the pandemic. Now things are getting desperate.

(Editor's note: This is the third article in a series on the healthcare labor market from the CFO perspective.)

For the past several months, the federal government has tried a variety of measures aimed at helping workers and families cope during the pandemic. But government measures apparently aren't going far enough in the healthcare sector, where thousands of nurses have reportedly left the profession due to fears and concerns around the pandemic.

If accurate, this trend could be crippling to not only the industry, but the nation's well-being. One obvious solution is to fill the pipeline with more nurses—lots of them—as quickly as possible. A second solution would be to convince thousands of frightened and frustrated healthcare workers to stay the course. But there are several factors working against that goal, says one hospital executive.

"The pandemic has had a profound impact on our industry," stresses Clifford (Cliff) Loader, chief financial officer at Northern Arizona Health. "The pace and intensity of the sickness has overwhelmed, exhausted, and burnt out many clinical staff. We are hearing from other organizations that 30% of RNs nationwide have left the profession due to the pandemic. This leaves healthcare organizations fighting for what nurses are available."

Making matters worse, "we now find ourselves competing with local businesses who also need staff.  Just the other day, McDonalds was advertising $20 per hour to start, which makes it difficult to retain some of our non-licensed staff," Loader says.

As a major healthcare center, one might think that Northern Arizona Healthcare could keep pace with hiring needs, or at least have first crack at skilled talent. Nothing could be further from the truth, Loader says.

"We're finding it difficult to find people to fill open positions. We currently have over 600 positions posted for hire. This difficulty isn't limited to clinical staff, but runs the gamut of positions in our organization," Loader explains.

Job openings abound across the board, not just in nursing

Northern Arizona Healthcare, a healthcare organization that encompasses more than 50,000 square miles. The organization employees more than 3,500 doctors, nurses and other healthcare experts. It serves more than 700,000 people in communities across the region and provides comprehensive healthcare services through two hospitals —Flagstaff Medical Center, a Level 1 trauma center, and Verde Valley Medical Center.

Northern Arizona Healthcare also has primary care and specialty physician clinics, outpatient surgical centers, the Heart & Vascular Center of Northern Arizona, Cancer Centers of Northern Arizona Healthcare, EntireCare Rehab & Sports Medicine, Fit Kids of Arizona, and Guardian Air and Guardian Medical Transport. As a nonprofit healthcare system, the organization is governed by a volunteer board of directors.

All of those services require a large number of professionals with a variety of both advanced and basic skills. And with the impact of the pandemic on the industry, Northern Arizona Healthcare is finding it challenging to fill openings across the board.

Registered nurses are in especially high demand, Loader says. But the organization is also challenged in the sourcing of allied health professionals in the areas of imaging, laboratory, and respiratory therapy.

"We are also frequently looking for medical assistants and CNAs to join our team," Loader says.

But there's hope. Perhaps more than ever, healthcare organizations across the country are dependent on local sources for producing new healthcare professionals, whether they be private or state universities and colleges, or specialty training facilities. Northern Arizona Healthcare is fortune to draw on the state university system, and that relationship will be even more critical going forward.

"Northern Arizona University is located in Flagstaff and has always been a great source of talent for us," Loader says. He says he does not believe the pandemic has significantly impacted the healthcare-related programs at the university.

"Though in-person education has been limited, the programs have continued virtually," Loader points out. "We also benefit from being in a beautiful place that attracts outdoor enthusiasts of all types. That contributes to us often being able to recruit to the area."

But what remains to be seen is how many new future hires will enter the pipeline, and enroll in medical degree or certification programs over the next few years, or whether the number of students attracted to the healthcare field will offset the numbers of workers now leaving.

The immediate role of government and industry

A beautiful location and outdoor recreational benefits are nice-to-have recruiting draws, but they only go so far when it comes to securing the numbers of workers that a healthcare organization needs to maintain services, let alone grow. That challenge is likely to get worse over the next couple of years.

A recent survey by the American Association of Critical-Care Nurses found that out of 6,000 critical care nurses polled, a full two-thirds (66%) have considered leaving their jobs due to the pandemic. A number of reasons were cited by respondents:

• 67% said they are afraid of putting their family's health at risk
   
• 76% said patients who are unvaccinated undermine nurses' physical and mental well-being
   
• 92% said they believe the pandemic will shorten nurses' careers

With such a large supply-and-demand gap for skilled workers in the healthcare sector, Loader says both the government and the healthcare industry have important roles to play in addressing the problem.

At the industry level, "we need to find ways to improve processes, introduce new technology, or find other ways to make the nurse's job less burdened, so they can take on a broader scope of responsibility," Loader says.

"Nurses, today, do many tasks that can be done by lesser skilled employees, can be automated, or can be eliminated," Loader explains.

At the government level, Loader says government could help immediately by being more flexible around overtime work rules. This would involve working with human resource and finance departments in redefining a standard work week.

"Some staff would like to work longer hours for several days, then have several days off, "Loader says. This is a situation not unique to healthcare. Among the lessons of the new remote and hybrid workforce is the desire by employees in several sectors to work longer days, but with longer weekends off.

Work-from-home employees have gained a considerable amount of time back from not having to commute to a job, and they want to take advantage of that gain. This trend is causing some organizations to rethink what should constitute a normal 40-hour work week, and whether it can or should be done in less than five days.

"Currently, overtime rules make that prohibitively expensive to do," Loader says.