By Pete Mercer
March 2024 – The Journal of Healthcare Contracting
Nurses are increasingly citing burnout, emotional and physical stress, and pandemic-related challenges in the workplace. These stressors have led many nurses to leave the profession for different jobs or careers.
So, how have individual health organizations addressed nursing shortages?
AdventHealth
In January 2023, Orlando, Florida-based AdventHealth allocated a grant provided by the State of Florida’s Linking Industry to Nursing Education (LINE) Fund to support nursing students at AdventHealth University. The funding purchased new healthcare simulation equipment to ensure students feel confident and prepared to begin their careers.
“Increasing nursing student access to simulation education will help future nurses develop greater competence, confidence and critical thinking skills,” said Julie Vincent, chief nursing executive at the AdventHealth Central Florida Division. “Simulations allow students to practice in a safe environment, learn from their mistakes, and receive immediate feedback from professors and supervisors.”
The State of Florida predicts the shortfall of nurses to continue within the next decade. The grant funding aims to meet a critical need of the state through nuanced educational opportunities for students in the healthcare field and more nurses entering the career pipeline.
Kaiser Permanente
The solution to the nursing shortage won’t be solved by “hiring alone,” according to Anthony A. Barrueta, senior vice president, government relations, Kaiser Permanente. “To address the “40-70% burnout rate for healthcare workers and the 3.2 million healthcare workers needed to meet current and future demand, America must diversify its health workforce.”
Kaiser Permanente provides clinical education opportunities that reduce financial barriers for students in healthcare, Barrueta wrote in a blog post. Kaiser offers financial assistance to students and current employees in the form of tuition waivers, scholarships, and career transition programs. These programs support underrepresented students and employees while diversifying the healthcare workforce. “For patients, having doctors and other clinicians who, through lived experience or learned cultural competence, share or understand their background is critical. For workers, a staff that appropriately reflects the community with which they identify can help address feelings of isolation, misunderstanding, and burnout.”
Mercy
Missouri-based Mercy has relied in part on international nurses to address staff shortage issues in its healthcare system.
The IDN announced in March 2023 that 120 international nurses were working at Mercy South. Another 20 international nurses were working at Mercy Hospital Fort Smith in Arkansas, and the first international nurses had begun working at Mercy’s other acute care hospitals across multiple states. They are internationally educated and have the licensing and permits to work in the U.S., according to Mercy. The international nursing program began at Mercy South in St. Louis in 2019 to address multi-decade nurse shortages. The program “greatly assisted” the hospital system during the height of the COVID-19 pandemic because there were adequate staff-to-patient ratios during peak virus transmission, according to a release.
New international nurses receive 12 weeks of orientation, educational opportunities, and admission to a fellowship program that supports the needs of each individual nurse.
SSM Health
Many hospitals and universities have begun to partner to provide collaborative, hands-on education programs for students. Oklahoma City University and SSM Health St. Anthony’s have partnered to address healthcare staff shortages in Oklahoma. OCU students gain work experience at SSM Health St. Anthony’s while they are completing their nursing degree. In exchange for their work hours, students receive financial aid and scholarships to assist in funding their education.
Oklahoma ranks at the bottom of nurses per 100,000 patients; in the state there are about 700 nurses per 100,000 patients, which is about 450 less than the national average, according to the National Council of State Boards of Nursing and News 9 of Oklahoma City, Oklahoma.
The program connects students with a nursing mentor at the hospital to guide them through early career challenges. The goal of the program is to retain qualified nursing candidates within the state.
Franciscan Health
In Indianapolis, Franciscan Health and Ivy Tech School of Nursing are confronting the difficult transition from school to work life through an internship program. The transition from school to the hospital, without support, often leads nurses to burnout or to seek other careers shortly after graduation.
The partnership program educates students in a hospital setting, so they are prepared and confident once they begin their career in nursing. Franciscan Health hopes to ease the transition to the workforce through partnerships with area schools.
Of the nurses who go through this program, a large percentage, “90-95%,” stay in Indiana, said Angie Koller, Dean of the School of Nursing, Ivy Tech in an interview with Fox 59 News.
Students in the program work in paid internship positions for 8 to 12 hours per week in the hospital. Students shadow one-on-one with a Franciscan Health nurse to learn and experience the many aspects of the career before graduation.
Avera Health
The Health Resources and Services Administration allocated $2.5 million in funding to Avera Health in November 2022 in support of solutions for the healthcare industry staff shortages in South Dakota.
“We are looking to novel ways to better support the professionals we have through technology, to maximize innovative solutions for caregivers to spend more time doing what led them to this profession-helping others, and reduce time spent doing administrative and regulatory tasks like documentation,” said Rachael Sherard, senior vice president for rural health at Avera Health, in a press release.
Avera Health has introduced two programs through HRSA funding. The first program supports a three-year Rural Public Health Workforce Training Network Program to prepare rural nurses and ensure they are cross trained in skills including telehealth, documentation, health information technology, and virtual nursing. The second program is a Nurse Education, Practice, Quality and Retention Program (NEPQR) and a Registered Nurse Training Program (RNTP) that prepares BSNs and RNs for careers in rural hospitals.
South Dakota is a state particularly in need of nurse retention. These programs work with area hospitals such as Avera St. Luke’s Hospital in Aberdeen, South Dakota and Avera St. Mary’s Hospital in Pierre, South Dakota to provide education in cultural awareness, health equity, and literacy. The primary purpose of the programs is education and retention of nurses in the rural healthcare workforce, according to Avera Health.
Cleveland Clinic
Cleveland Clinic’s Dr. Lisa Baszynski, associate chief nursing officer, said in a podcast recently that reframing the nursing shortage narrative is the first step to addressing its challenges. The pandemic brought to light many decades-long issues within nursing, but also emphasized the care, resilience, and selflessness of individuals in the nursing profession.
Cleveland Clinic hopes to change the narrative of the nursing shortage to a more positive, meaningful one, encouraging nurses to continue to pursue a very fulfilling, human-care focused career path.
Cleveland Clinic has numerous education programs, such as the ASPIRE Nurse Scholars Program, that exposes young students to nursing as early as high school. The Cleveland Clinic also has extensive connections with universities and collaborative partnerships with deans, faculty and students to ensure a nursing pipeline into its healthcare positions.
For current employees, there are many professional development programs and opportunities for advancement throughout a career at Cleveland Clinic. Nurses in these programs are empowered to remain in the healthcare workforce.
El Camino Health
El Camino Health Hospitals in Mountain View and Los Gatos, California support individual nurse’s goals and careers through professional development and career transition programs. These programs allow for progression within a nursing career and help to retain nurses who are looking to advance in the profession.
The transition programs offered since 2020 include positions in the mother-baby unit, the critical care unit, cardiac/stroke telemetry, emergency department, labor and delivery, and operation room programs.
Providence
Providence expanded its caregiver education program in February 2022 across its Western U.S. hospital system to foster individual clinician growth and development in relation to the nursing shortage.
The expanded education program at Providence Health, in partnership with Guild, a professional development platform, will “enable nearly 100,000 healthcare workers and caregivers to obtain professional skills and experience,” according to Providence in a press release. These skills will further develop healthcare workers’ careers and build and retain the medical workforce for the future.
“At Providence, we believe the growth and development of our valued caregivers are key to our success,” said Darci Hall, Providence’s vice president of talent effectiveness and development. “Many have used our existing education offerings to excel in their careers with Providence. We’re excited our partnership with Guild will help us expand access to affordable education and enhance the experience to increase our caregivers’ success.”
On their first day of employment, eligible full-time and part-time employees of Providence will have access to healthcare education courses, undergraduate and graduate degrees, professional certificates, and English language learning courses. These educational offerings from Providence are key to investing in the growth and development of its current workforce.
UPMC
In December 2021, UPMC Health introduced an in-house travel staffing agency to retain nurses in its workforce. The goal of the staffing agency is to rely less on outside staff such as travel nurses; instead empowering UPMC employees to go where they are most needed across New York, Maryland, and Pennsylvania.
The program will be a retention tool for current staff and create a pipeline to bring new and qualified talent into the hospital system.
According to UPMC in a press release, “The advantages of this innovative program include competitive wages and excellent benefits that are unmatched by outside travel agencies, such as tuition assistance. The program also offers vast career growth opportunities and diverse clinical experience working and living temporarily in communities across UPMC’s footprint. UPMC Travel Staffing will rotate nurses and surgical technologists to different facilities for six-week assignments.”
CommonSpirit Health collaborates on nurse residency program
Dignity Health Global Education (DHGE) introduced a Nurse Residency program in April of 2023 in partnership with CommonSpirit Health (CSH) across 21 U.S. states. Nurses are a critical part of health systems, and the goal of the educational program is to address the high national rate of nurse turnover. The program aims to retain nurses in the healthcare workforce through empowerment and education.
In 2022, there was a 17% RN vacancy rate, with turnover for first year nurses at more than 31%, costing the U.S. an average of $52,250 in the year alone, according to a release and the 2022 NSI National Healthcare Retention Report.
The DHGE retention initiative is an online, industry-relevant education program in partnership with CSH that enhances healthcare operational efficiency through higher education. The 12-month Nurse Residency program provides coursework and industry training tailored to each health organization’s specific needs.
The program will “increase RN retention by targeting 20% or higher, saving millions in hiring and retention costs for U.S. healthcare systems,” according to a release. The program’s goal is to increase nurse workplace satisfaction, empower healthcare professionals, and improve healthcare staff’s workplace preparedness. Healthcare organizations can prepare nurses for a variety of healthcare setting scenarios through the Nurse Residency educational program.
“The healthcare industry at-large is profoundly aware of the current critical state of the nursing workforce,” said Kurt Hayes, chief product officer, DHGE. “We all need to do whatever we can to help alleviate the severe shortages. DHGE is proud to offer this innovative Nurse Residency program which aims to make a significant impact in nurse retention while simultaneously lowering hiring and retention costs for system partners, saving hospitals millions of dollars, which will ultimately result in better patient outcomes.”