BETHLEHEM, Pa. — The coronavirus pandemic took a toll on the nursing industry, leaving a field already struggling to maintain employees in need of more workers across the country, officials say.
Projections show demand for nurses is expected to grow as the baby boomer generation begins to retire. Added to that is a shortage of health care educators, making it difficult for nursing schools to offer programs, because of the lack of teachers, health care professionals say.
“What's happening right now is nurses don't have the resources or the numbers of nurses in a hospital to give that care or deliver that care. So what we're seeing is a large number of bedside nurses leaving the profession because they're not satisfied. They don't feel like they're giving the best care possible,” said Wayne Reich, a registered nurse and chief executive officer of the Pennsylvania State Nurses Association.
In the Lehigh Valley, health systems say they are working to not only attract new talent, but retain their current workforces.
Statistics from the Hospital and Healthsystem Association of Pennsylvania show a more than 30% vacancy rate across hospitals statewide for registered nurses (RN) and other nursing staff.
"In the last year at Lehigh Valley [Health Network] and nationally, we are starting to stabilize," LVHN Chief of Nursing Annmarie Chavarria said.
"Things are getting better over time and there have been lots of initiatives and attention paid to that.”
"Our vacancy rate is still higher than we would like it but it's also improved dramatically over the last year.”Annmarie Chavarria, chief of nursing at Lehigh Valley Health Network
Chavarria said LVHN’s turnover rate is half the national average.
“Our vacancy rate is still higher than we would like it, but it's also improved dramatically over the last year,” she said.
The health network has implemented multiple initiatives to stabilize its nursing workforce, according to Chavarria.
“What we're really focusing on at this point is making this the best place for nurses to work by investing in things that help them not only become really good nurses when they get here, but grow professionally over time,” she said.
“Their entire career could be spent here and we could continue to invest in how they are growing as professionals.”
'Pandemic changed the landscape'
Chavarria said incentives come into play especially when a position is hard to fill, such as telemetry and medical-surgical (med-surg) nursing.
“LVHN offers a variety of sign-on bonuses for qualified candidates,” she said. “The bonuses are designed to help attract nurses and other health care providers to LVHN, with up to $50,000 for medical/surgical RNs at our Schuylkill facility.”
Chavarria and LVHN Administrator of Talent Acquisition Megan Morris both said their focus is more on a positive workplace culture.
“We have had a lot of focus on some flexible staffing model models, where we can continue to be competitive as an industry," Morris said.
“So flexible schedules, where we can insure allegiant style programs, as well as gig work-type programs for nurses where they can pick up specific shifts with Lehigh Valley, even before they sign on as a full-time colleague.”
“The pandemic certainly changed the landscape of the workforce and available labor market. However, we have continued to remain nimble and agile to ensure we are attracting and retaining top talent across the workforce that we support.St. Luke's spokesman Sam Kennedy
Many of the health systems across the country are doing the same to attract new talent, officials say.
St. Luke’s University Health Network is not only focusing on competitive salaries and benefits, but culture, as well.
“The pandemic certainly changed the landscape of the workforce and available labor market," St. Luke's spokesman Sam Kennedy said.
"However, we have continued to remain nimble and agile to ensure we are attracting and retaining top talent across the workforce that we support."
He wouldn’t elaborate on signing bonuses for St. Luke’s nurses, saying that information is not public.
Five-figure signing bonuses became popular if not common in the health care industry during the pandemic.
“Hospitals are very guarded with this information because they don't want to put it out there because they don't want their competition to try to outdo them,” said the state nurses association’s Reich.
“My motto that I've told nurses is the higher the sign-up bonus, the worse the working conditions are because they wouldn't be paying you a $50,000 sign-up bonus if it was a great place to work.”
But Reich went on to say there are other factors that can impact the level of incentives to join a team.
“Sign-on bonuses can vary wildly depending on what the need is in different areas,” he explained. “So, maybe in some rural areas it might be a little higher or in larger metropolitan areas it can vary, too.”
Nursing schools join the hunt
As health care companies work to recruit and retain talent, nursing schools are working to help close gaps by attracting new students and educators.
Dawn Goodolf, the associate dean of the Helen S. Breidegam School of Nursing and Public Health at Moravian University in Bethlehem, said there’s more interest in nursing now than during the pandemic.
The demand, coupled with a greater focus on workplace culture and compensation, are likely contributing to that.
“We initially saw a dip in enrollment [since the pandemic], however, we are now seeing an increase in interest. Currently students are highly recruited and don't have an issue finding positions,” she said.
Goodolf said in order to recruit new students into nursing, her team uses nursing-specific open houses, and admission teams travel to meet with students to discuss the nursing program.
"As we all are aware, there continues to be a high demand for high-quality registered nurses,” Kennedy said, adding the number of applicants at St. Luke’s School of Nursing has remained stable.
He said demand in the Lehigh Valley still is high, and the pandemic may have encouraged some who were unsure of their career choice to explore health care.
Recruitment, retention
St. Luke’s School of Nursing has a program to promote growth from within. Kennedy explained the process by saying St. Luke’s employees, provided they are benefit-eligible and in good standing, may apply to the “Be A Nurse Academy.”
Acceptance into the program lets employees take nursing prerequisite courses with little-to-no out-of-pocket costs.
Once prerequisites are completed, candidates are eligible to apply to the school of nursing. If they are accepted and remain benefit-eligible and in good standing, they will have their tuition covered up front by the health network.
That means students pay only for uniforms, books and dorm fees (if living on campus).
St. Luke’s School of Nursing graduates about 200 nurses a year, with St. Luke’s retaining about 80% of those, according to Kennedy.
“This has been a key recruitment tactic for St. Luke’s which has enabled us to fare much better than other health institutions,” he said.
'The best career in the world'
At Lehigh Valley Health Network, Chavarria said building up the pipeline is key to ensuring full staffing in the future.
“When I go to talk to nursing students, I say, 'Welcome to the rest of your life. You pick the best career in the world, because there is absolutely, positively no end to the options you can do with this degree,” she said.
“If you decide to become a nurse, then your options are endless, right? You can work in a hospital, you can work in an office, you can work in a clinic, you can work in an insurance company, you can do research. I could go on here for half an hour, but you will never have to be unhappy because you have a world of options."
Morris, the talent acquisition administrator at LVHN, said the entire medical field is looking to attract new employees. She said many of the programs offered to attract nurses are similarly offered in other fields, from technicians to physicians.
“We work very hard doing a lot of the same programs, making sure that we have educational affiliations, making sure that we support our own colleagues and really growing our own and doing those training programs,” she said.
Said St. Luke’s Kennedy: “Attraction of top talent also means that we are connected with our community educational partners ensuring that students understand the options available to them in health care that are both clinical and non-clinical.
“This involvement not only targets colleges and secondary schools, but also high schools and technical institutions. It also means that we are attracting candidates that are more tenured in their careers due to the many leadership opportunities that we have available,” he said.
Nursing tops the list of most-trusted professions in the U.S. year after year, according to a Gallup ethics survey.
Reich said the demand for more nurses is inarguable.
“However,” he said, “what we really need is to find out why nurses are leaving the bedside and create incentives that keep them at the bedside."
He said the Pennsylvania State Nurses Association advocates for House Bill 106, the Patient Safety Act, which limits nurse-to-patient ratios in certain settings.
“We believe that enacting these minimum safety standards for nursing and their staffing in acute care hospitals would encourage nurses to stay because I think it would give them a little more resource and a little more safety that are there and they can ensure that safety standards are enforced,” he said.
