An end in sight for nurse staffing nightmares

Robin Stimac

There are many ways to combat the nursing shortage, but most of them are not long-term solutions. To truly resolve the issues that stem from the nursing shortage, it is critically important for healthcare organizations to provide staff with the right technology to maximize resources and skilled labor. It is possible to make the most of internal resources before relying on overtime or agency usage. With the right approach, nurse satisfaction should grow and patient care should improve.

In real estate, the hot phrase is “location, location, location.” Similarly, in healthcare, the focus is often “labor, labor, labor.” In recent years, healthcare organizations have experienced a widespread nursing shortage, while trying to control costs and mitigate the impact on quality patient care. The U.S. Department of Labor reports that job openings in the nursing field will grow by 22 percent nationally in less than 10 years.

There are a few factors affecting this nursing shortage.

An aging nursing population: The average age of registered nurses (RNs) is 46, according to the 2008 National Sample Survey of Registered Nurses released in September 2010 by the U.S. Department of Health and Human Services. This report also found that “older RNs comprised 44.7 percent of the total RN population in 2008, compared with 41.1 percent in 2004 and 33.4 percent in 2000. The percentage of RNs who were 60 years and older increased from 13.6 percent in 2004 to 15.5 percent in 2008.”

With the recent economic downturn, many nurses who were on the verge of retiring continued working, as people across the country found their retirement funds were negatively impacted. Instead of retiring into an uncertain economic future, many decided to wait out the recession by working. These nurses will undoubtedly look to retirement as the economy bounces back, intensifying the nursing shortage.

Nursing schools are recruiting and educating a younger population of nurses to help alleviate this issue, but the American Association of Colleges of Nursing (AACN) reports that current enrollment levels are “not sufficient to meet the projected demand for nurses.” The AACN points to shortages in nursing faculty and resources that only compound the problem, with over 54,000 qualified nursing school applicants turned away from nursing schools in 2009.
Economic concerns: The current uncertain economic landscape has forced hospitals and health systems to focus on improving their operational margins and cutting costs. Pressure from healthcare reform is forcing healthcare providers to find extra monies to fund projects aimed at achieving meaningful use and other patient care initiatives. Healthcare costs are also escalating at unsustainable levels as the price for prescription drugs and new medical technologies rises. This all adds up to a heightened focus on operational improvement efforts.

Increased demand for health services: As more people become insured and the baby-boomer generation matures, it will become even more critical to have the right staff with the right skills in place to meet the increased demand for health services.

All these challenges are driving an even greater need for the right mix of labor scheduling and staffing. The ability to hire people with the right skills and schedule them where they are most needed is crucial to the success of healthcare organizations. But without the right technology in place, this is nearly impossible.

I recently spent the day with a Lawson Healthcare customer who was considering purchasing Lawson Scheduling and Staffing, a module within Lawson Workforce Management solution. At one point, I asked a staffing coordinator, “What do you do when you have an open shift? How do you fill it?” Her answer was immediate: “I call the first person I think will say yes.” This was not surprising. Many staffing administrators don't have visibility to make better staffing decisions, but they have immediate needs to ensure safe staffing levels. The right technology can provide staffing offices a real-time, enterprise view of their nursing workforce, which can help staffing offices better understand who has the right skills, time and bandwidth to pick up an extra shift without incurring overtime or having to turn to expensive agency staff.

Another healthcare organization, and Lawson customer, Samaritan Health Services, was given a no-agency directive in 2009, which was especially difficult to achieve since they had spent $13 million on agency staffing the previous year. Still, they took a strategic approach with a project called the Inter-Facility Staffing Program. This program needed to meet several objectives, including decreasing agency costs and ensuring that nurses in the community could keep working.

The program allowed internal nursing staff to float across the five hospitals within their health system. To help the program succeed, Samaritan Health Services used the shift-bidding technology within their Lawson solution and encouraged their nursing staff to bid on open shifts and earn additional income. This was also a great benefit to the health system because their own nursing staff had prior knowledge of the charting system, how the hospitals operated. They didn't have to spend additional time training outside staff on their policies and procedures.

The Inter-Facility Staffing Program has been a huge success for Samaritan Health Services, helping them reduce external agency spend by $10 million in one year. The program also helped to keep nurses in the community employed, even through the recent economic downturn. This has resulted in more satisfied nurses, staffing coordinators and patients.

There are many ways to combat the nursing shortage, but most of them are not long-term solutions. To truly resolve the issues that stem from the nursing shortage, it is critically important for healthcare organizations to provide staff with the right technology to maximize resources and skilled labor. It is possible to make the most of internal resources before relying on overtime or agency usage. With the right approach, nurse satisfaction will grow and patient care will improve.

Robin Stimac is
industry strategy director,
human capital management,
Lawson Healthcare.
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