Nursing’s Wakeup Call: Innovative approaches to talent, technology, and care models

Nearly every state is experiencing a nurse staffing crisis, with reports that nearly 1 in 4 healthcare organizations have a “critical” staffing shortage.

The pandemic exacerbated the nursing shortage due to the patient surge, forcing healthcare organizations to pursue new strategies, including cross-training nurses in non-critical areas to fill staffing needs on critical care units, hiring more travel and agency nurses, and deploying team-based care models. But are these changes enough?

In a recent webinar, Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, chief nurse of Wolters Kluwer, Health, Learning, Research, and Practice, along with Nanne Finis, MS, RN, chief nurse executive at Ultimate Kronos Group (UKG), explore this question and key findings from a new joint report and nurse leadership survey on the current and future states of nursing labor models and how those models might shift over time.

Wolters Kluwer – UKG survey findings

Survey respondents shared top workforce issues and how they were addressing the nursing shortage. Among the most critical findings: 87% of respondents in acute care settings, 92% in post-acute, and 76% in ambulatory care were experiencing nurse staffing shortages. According to current projections, the U.S. will need 1.1 million nurses by 2030 to fill gaps, said Dabrow Woods, noting that the shortage is worsening. “Since the pandemic, about 5% of our workforce has left the profession,” she said, adding that 100,000 baby boomers are also retiring each year. What’s more, nurses are leaving the bedside in acute care for other positions in areas such as telehealth, outpatient clinics or advanced nursing practice.   

The research also revealed a disconnect between the workforce challenges healthcare organizations acknowledge vs. how they plan to address these challenges. Healthcare leaders and professionals are emerging from the crisis and searching for sustainable workforce solutions. They are also creatively shifting nursing labor models and using new tools and technologies to optimize nurse staffing. “However, we're early into understanding if these models are effective and sustainable,” said Finis.

Adapting to a changing workforce model

Dabrow Woods and Finis agreed that the overwhelming change across healthcare in the last few years requires a new path forward with regard to nurse staffing and care models. “The scarcity of nurses and supportive personnel across all professionals in healthcare is having a devastating impact on the entire healthcare system,” said Finis. “We’re seeing through our research that pre-pandemic care models are no longer working during a crisis.”

According to survey respondents, “we absolutely need to be considering alternative care models if there are not enough RN’s to care for patients,” she added. “Team-based care is truly becoming the new reality.” These models bring together RNs, unlicensed assistive personnel, and LPNs with other disciplines, including physical therapists and rehab therapists. “During the pandemic, you saw such collaboration between the disciplines that we never saw before,” added Dabrow Woods, noting that float pools and other types of centralized staffing models are also increasing.

Key investments in staffing and technology

Dabrow Woods and Finis also said healthcare organizations are adding resources to handle tasks more efficiently, including mobile-first technology, robotics, telehealth, and other professionals with specialized skills to minimize the supply issue. Scheduling technologies are also rapidly advancing, allowing shift and vacation bidding to help balance personal and work life. However, the survey findings suggest that many organizations still rely on hybrid or manual scheduling models when handling day-to-day staffing needs. “There is an opportunity to use this technology much more robustly,” said Finis.

“Float pools are another great way to handle some of these major staffing issues occurring right now and will be occurring going forward,” added Dabrow Woods. “We need to start staffing differently by utilizing and cross-training our float pools as well as our staff to adjacent specialty units,” so staff can be redeployed easily.” Both agreed that relying on the agency staff model to fill all vacancies is unsustainable due to economic reasons. Agency staffing should be used to fill in the staffing gaps, not be the basis for staffing the entire organization.

Optimizing recruitment, retention, and care models

Unsurprisingly, the surveys revealed that staff burnout is the top workforce challenge, followed by emotional health and well-being, and a lack of RN applicants to fill vacancies. “Our wake-up call is to implement strategies to balance nurses' emotional health and well-being, and get us back to a safe workforce,” said Dabrow Woods. “We need to foster resiliency within our organizations, address burnout, and moral distress and focus on retention and recruitment.” A safe work environment requires considering patient acuity and insure  an adequate number of competent nurses at the bedside, she added. This means staffing for surges and not just by the average census, which is how hospitals staff today.

Nurses must also learn to work within alternative care models, including a team model of care. And organizations must provide flexible staffing options, including offering more than the standard 12-hour shift in acute care, said Dabrow Woods. She and Finis also said fostering resiliency is key to retaining talent, including addressing basics such as access to healthy food, having breaks, and child and elder care support.

Where do we go from here?

 “We have an opportunity to position our profession for the future,” said Dabrow Woods. “New nurses are looking to leave the profession within the first year, and we need to stop that.” She added that it is critical not to wait for legislative mandates to make changes. “Nursing practice and education have to collaborate; we cannot do this on our own.” Finis agreed: “We have to move ahead with innovating and changing how we think about our future talent pool.”

See webinar and full report here: Nursing’s Wake-up Call: Change Is Now Non-negotiable

This webinar was in partnership with UKG and co-presenter Nanne M. Finis, RN, MS, Chief Nurse Executive, UKG. As the chief nurse executive for UKG, a global provider of HCM, payroll, HR service delivery, and workforce management solutions, Nanne Finis applies her strong foundational knowledge of the global healthcare system to advance the application of innovative technology to create more meaningful and connected work experiences for all healthcare employees.

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