When Beverly Fein surveys the nursing landscape at Holyoke Medical Center, she sees both positives and challenges, and the difference is generational. Take new nursing graduates, for example; the hospital hired more than 25 of them last year.
“Many of them do their clinicals here. They have a good foundation working for us. They like the environment. So we’ve been lucky — we’ve been able to attract them,” said Fein, senior vice president and chief Human Resources officer for Valley Health Systems, which includes HMC.
“And many others were student nurse techs with us, which means they come on earlier during their schooling, while they’re still juniors or seniors, and we hire them as techs, and that creates a pipeline for nurses,” she added. “Many have come through that pipeline, which is a good thing.”
But finding experienced nurses? That’s been much tougher — and it’s a common lament across the healthcare industry.
“The biggest gaps are in nursing, especially when it comes to RNs and LPNs. The shortage is huge. So how does that impact bedside care at hospitals and long-term care facilities? They’re feeling the shortage.”
“We’re always looking for experienced nurses,” Fein said. “We have had a number of different open house events over the year, and we’ve been able to hire experienced nurses. We have a weekly Walk-In Wednesday, and we’ve been able to hire some experienced nurses just walking in, getting interviews on the spot, offers on the spot. That’s been a tactic we’ve been using in addition to some strong advertising on our intranet, as well as all the social media platforms.”
Nicole Polite, CEO of the MH Group in East Longmeadow, a staffing and recruiting firm with a robust healthcare niche, understands the industry challenges as well.
Beverly Fein says Holyoke Medical Center has hired dozens of new graduate nurses recently, but experienced nurses are harder to come by.
“The biggest gaps are in nursing, especially when it comes to RNs and LPNs. The shortage is huge,” she said. “So how does that impact bedside care at hospitals and long-term care facilities? They’re feeling the shortage.”
As are other settings. “Home health and hospice are definitely feeling it. Even outpatient and ambulatory centers are feeling it. Then, there’s a dire need for nurse practitioners and physician assistants in primary and urgent care. Believe it or not, we’re even struggling with telemedicine, especially in rural areas and underserved areas.”
The list goes on. Polite cited workforce gaps locally in behavioral health — psychiatrists, licensed social workers, and licensed professional counselors are in high demand — as well as physician specialties including cardiology and oncology (again, especially in rural and underserved areas). As for home health aides, she said the industry is exploding with the continued aging of the Baby Boom generation.
Michele Anstett, president and director of Visiting Angels West Springfield, promoted two CNAs into recruiting positions to bolster the home care agency’s efforts to maintain a workforce that keeps up with demand.
“They use their own personal stories and experiences with Visiting Angels to sell how much they love working here,” she said, adding that aides and nurses with plenty of options are prioritizing workplace culture as much as pay. “Now what is important is telling our story, and whether they like the way the work environment sounds.”
Karen Rousseau, dean of the School of Health Sciences at American International College, sees the workforce crunch from a different perspective — and a positive one for graduates.
She noted that nursing enrollment has been impacted a bit by free community college in Massachusetts, but it’s still strong, and there’s plenty of interest in AIC’s graduate nursing programs, with nursing recognized by many young people as a secure career choice, given the current state of the workforce.
“It’s a pretty strong job market in the region. The labor statistics show growth in PT and OT, and there continues to be a nursing shortage,” she noted. “Our graduates having no trouble finding positions. I’m hearing that current students seeking employment are being selective in what they choose.”
Glass Half Full
Anstett said recruiting has become more challenging in home care for a number of reasons.
“I’m a person who always thinks positively. I don’t try to dwell on, ‘gee we can’t get people.’ I try to think, ‘how can we get people?’ We do tend to use some different tactics, and it’s much different than before, when it was just putting an ad in the paper, and people would answer it. Now you have to get on social media, get on all these job sites, and you have to word it in a way that the algorithms won’t put it down at the bottom and no one will ever see it.”
Karen Rousseau
“Our graduates having no trouble finding positions. I’m hearing that current students seeking employment are being selective in what they choose.” — Karen Rousseau
One annoying aspect of the current market is … well, the ability of some applicants to be dismissive of the process, or even rude.
“A lot of times, we do have people that respond to the ads and seem interested, but then, when we set up an interview, they’re no-shows. One reason is they never intended to have a job, or applying for a job might have been a requirement to receive some kind of aid.
“It’s a different kind of mindset, and I don’t think it’s generational,” Anstett went on. “I definitely think it’s a society thing. We’ve had people of all ages do this ghosting thing. They come for orientation, and then they’re nowhere to be found. And it’s hard for us because it’s quite a process. We have to do background checks and reference checks and check their skill level, everything. It’s a dollar investment, and it’s heartbreaking when they get all the way through and you schedule them, and then they don’t show up.”
She said Visiting Angels continues to bring in quality caregivers, but the process is tougher, as she may wind up hiring two for every 10 interviews — and even then, their work-hour preferences might change between the interview and the hire.
As for retention, Anstett said it’s a mindset.
Nicole Polite says employers need to understand that potential young hires demand different a culture than in the past.
“I really believe a good work environment is the key. It’s creating a family culture at work, which is also very respectful of their family. If they need to get to something for their son or daughter, we do our best because we’re all moms and dads. My belief that no one in Visiting Angels is any better or more important than the other person. We’re all very important to the whole team, and I think that resonates.”
Another thing employers need to be mindful of today is burnout, Polite said, as many nurses and other healthcare workers are feeling it, and often feeling it intensely.
That’s one reason many nurses and doctors who are placed through the MH Group work in a contract capacity.
“Being a contract employee helps them to have work-life balance; they get to select when they want to work. The new term is Uber nursing, the ability to sign up for work when they want, like an Uber driver, which allows them more balance and to alleviate burnout.”
While the model is great for workers who desire it, it can actually benefit organizations as well, as the agency pays for benefits and malpractice insurance. Meanwhile, both sides get to test the waters before perhaps committing to something longer-term, Polite explained. “They find out, do they want to stay? What’s the environment like? What’s the culture like?”
Michele Anstett
“We’ve had people of all ages do this ghosting thing. They come for orientation, and then they’re nowhere to be found.”
She added that a nationwide shortage of nursing professors — who also sometimes feel burnt out — is taking its toll on the workforce as well, with many aspiring nurses being turned away from programs for lack of capacity.
Meeting the Needs
Speaking of higher education, colleges and universities with health programs are also looking at shifting needs in healthcare when planning new programs. For example, this fall, AIC will introduce a master of population and community health degree to meet a growing need for professionals who can mobilize community resources to address factors that affect people’s health and well-being.
“We feel there’s a need for public health in the community,” Rousseau said. “We had a master’s of public health, but we’re phasing that out. There hasn’t been a large demand for that, and UMass has a very large program. But a master’s in population and community health practice was driven out of the way we see the needs of employers in the region, and what will help them.”
Rousseau noted that there are many different types of roles in healthcare besides nursing, OT, and PT, noting another AIC program, its exercise science track. “It’s strength and conditioning, but you also use exercise as medicine to help people heal. You can perform all kinds of roles with that degree as well. Healthcare is a big industry. It’s not just the things you think of right off the bat.”
To meet its own workforce needs, Holyoke Medical Center has been innovative beyond just the Walk-In Wednesdays for nurses. Open houses for phlebotomists, another in-demand career, have been successful, Fein said, and the hospital has used temp agencies for roles like medical assistants and medical lab techs to test out their fit.
“We’ve recently been happy with the response to our open house events. It’s nice to have leadership from these areas present and for them to make offers on the spot if we feel there’s a great fit after the tour. If we have good dialogue and they have some experience and we feel good about them, we can bring them on pretty quickly. We’re trying to remove some of the hurdles and roadblocks, basically, and streamline the process.”
At the same time, Fein emphasized the importance of benefits to retention efforts, from a health package to a robust tuition reimbursement program that can funnel $7,000 to $8,000 annually toward a degree and help employees move into the positions they aspire to.
“I think a lot of new employees are very focused on work-life balance as well,” she said, noting that HMC has made some changes to vacation policies with that in mind. “That work-life piece is definitely significant with them. They’re speaking about it a lot.”
Polite hears the conversations, too.
“There will be a shift in the newer generation in terms of the healthcare workplace,” she told BusinessWest. “They’re in demand, and their demands are different; they have a different need for flexibility. So everyone needs to come to the table and come up with a better way to staff those medical positions, and it will need to include flexibility for employees.”
Filling in the gaps will take years, Polite she. “And the big fix is going to have to come from the government. There has to be some incentives for the younger generation coming in from their college years, giving them funding if they enter that field.”
It’s just one of many possible solutions to boosting the workforce, decreasing rampant burnout, and, most importantly, making sure patient needs are met.
