Nurses are quitting faster than it takes to hire them. In the United Kingdom, a report published in July 2020 by the Royal College of Nursing said 36% of nurses were leaving the profession, compared with 27% from the previous year. Similarly, a survey run by McKinsey in May 2021 revealed that 22% of nurses wanted to leave their direct-patient-care positions.
These figures are concerning, especially as there had already been a global shortage of 5.8 million nurses even before the pandemic, according to the World Health Organization.
Myriad factors at play
Long before the pandemic, hospitals have been struggling to keep registered nurses (RNs) from leaving. In the UK, a think tank discovered that nurses leave the National Health Service within three years of joining.
Numerous factors have been cited for the exodus. Nurses have, for years, grappled with low pay and long shifts to cover for staffing shortage. On top of patient care demands, nurses have also complained about the lack of management support.
The pandemic brought to the fore the years-old nursing shortage that the healthcare industry is facing. Nurses have had to “do more with less,” working longer shifts and covering for inadequate staffing, without getting proper compensation. Many of them have reported the lack of access to food and drinks while on duty. Others complained of the lack of proper medical equipment, being asked to make their masks last “as long as they could,” and the overall feeling of management’s lack of concern.
Nursing is a thankless job, and in the time of COVID-19, it’s become a dangerous job. Many nurses have had to deal with everyday worries that they might be carrying the virus home and infect their families. They are exhausted at work and risking their lives every day. It’s no wonder that the pandemic has driven many nurses to burnout.
During the pandemic, many of us realized how important our healthcare workers were in the fight against COVID. We called them heroes. We sent food as a token of appreciation. We nominated them for numerous awards. We provided mental health support. We held weekly clapping for them (in the UK, this ran for 10 weeks under the program Clap for Our Carers).
These are all well-intentioned gestures, but it takes more than food, awards, and clapping to keep our nurses.
Real solutions
- Massive hiring. The simplest solution is, of course, hire more nurses. Many hospitals around America have been one-upping themselves in offering attractive compensative packages, such as sign-on bonuses or even relocation packages to encourage nurses to move. Because a growing majority of nurses in the US are foreign born and educated, a proposed Senate bill called the “Healthcare Workforce Resilience Act” aims to increase the number of immigrant visas issued to foreign doctors and nurses and reduce the waiting period.
- Better compensation and working conditions. Aside from increasing headcount, hospitals and healthcare facilities should also focus on improving remuneration to keep the nurses they already have through wage increases, hazard pay, retention bonuses, shift differentials and overtime pay. More than compensation, hospital administrators and managers should take steps to ensure their staff are able to take the necessary days off to get sufficient rest in between, keeping in mind that exhausted nurses do not provide the best care.
- Better nurse-to-patient ratio. Another important factor is the nurse-to-patient ratio. In many states in the US, there is no existing legislation that regulates the number of patients an RN can care for at one time, although the state of California was able to pass a safe staffing law, A.B. 394, which establishes minimum, specific, numerical ratio to remedy unsafe staffing.
- A seat at the table for nurses. A recently passed legislation and what has been called a “landmark law” in nursing in New York now requires general hospitals to include nurses and other staff when drafting staffing plans. A prerequisite for staffing committees is that they include registered and licensed practical nurses, ancillary staff members and hospital administrators so they have a say in staffing decisions. This is a giant step and enables nurses to play an influential role in policy and decision-making.
- Offer career development opportunities. An Illinois hospital administrator developed a clinical ladder to foster career development and recognition to retain their nurses. The ladder had three levels, with level 3 as the highest. To achieve this, one needed to have a BSN degree and professional certification, and provide a letter of recommendation, an exemplar of a holistic nursing practices, and a portfolio highlighting ones professional development and activities. This demonstrated that nurses could move up the ladder based on achievement and not tenure. With this program in place, the hospital was able to increase its BSN rate from 12% to 84%, with 20% of them even holding a master’s degree in nursing.
- Invest in education. The WHO’s State of the World’s Nursing report recommends investing in the massive acceleration of nursing education to keep up with global and domestic needs. For many fresh graduates, the lack of experience is often what stands in the way of getting hired. To address this, a hospital in Palo Alto has developed a yearlong new-graduate residency and transition-to-practice program that enables the hiring of new graduates and training them to fill all specialties, even the more challenging ones such as neonatal ICU or cardiovascular care.
Not a bottomless well
While it’s easy to say, hiring more nurses isn’t always the solution because there is no bottomless well of nursing applicants.
Hiring and recruitment managers for hospitals and medical institutions should understand that hiring is just one step in the process of finding talent. This should be supported by a retention program that aims to nurture a new nurse for the long term. This is what we call sustainable hiring, which aims to protect the numerous parties involved in the process: the origin, the receiving party, and the talent that is being exchanged between these two. But also, sustainability considers the value of the talent, with the intention of offering opportunities and space for this talent to grow.
But hiring sustainably also means aligning yourself with partners who also have this value at their core.
Wingspan has partnered with many NHS facilities in the UK to hire and deploy hundreds of nurses from the Philippines, and many of these nurses continue to be part of the fight against COVID-19. More than just screening and hiring talent for you, Wingspan sees through every hire from start to finish to ensure compliance with regulatory and deployment policies.
To understand how we can help you find experienced nurses that will stay for the long term, contact us at solution@wingspan-consulting.com.