Organizations cannot return wholesale to the nurse staffing approaches used prior to Covid-19. In addition to exposing staffing shortfalls, Covid-19 accelerated changes to the nursing workforce that will make it more challenging to staff as organizations once did.
1. The surplus of nurses is disappearing—and trending toward a shortage.
Nurses are already leaving the profession due to the tremendous stress and burnout caused by working in a pandemic. We expect that trend to continue across the coming year, particularly among late-career nurses who choose to retire early. We also expect mid-career nurses to continue to leave (or not return to the workforce) due to evolving family obligations. The unknown here is the RN pipeline. In the short term, disruptions to clinical rotations and the NCLEX could slow down the transition from academia to practice. But we’ll have to wait and see if overall enrollment numbers keep up with demand in the years to come. Bottom line: organizations should expect nurse shortages for the next few years.
2. The experience-complexity gap is quickly turning into a chasm.
Despite some work before the Covid-19 pandemic to close the experience-complexity gap, most nursing leaders found progress slower than they hoped. Now, organizations are losing experienced nurses at a faster rate than previously predicted. Additionally, Covid-19 itself has added a layer of complexity to the care environment that is challenging for any clinician, let alone a novice nurse.
3. The wants and needs of the nursing workforce are changing.
In the United States, 96% of professionals, including nurses, want more flexibility at work, and many industries are headed in that direction. But more importantly, many nurses need more flexibility. Amid the pandemic, parents struggled to cover childcare and other home obligations while working. While some organizations offered short-term solutions to meet this need, it was not enough. We are now seeing more nurses leave the profession or seek flexible roles outside of acute care that better accommodate personal lives. This trend will continue if organizations can’t meet the growing needs of the workforce.
Provider organizations face more barriers to flexibility than other types of organizations due to 24-hour operations for many and the highly specialized workforce. But staff demands along with the impact of Covid-19 on the workforce makes building a flexible nursing workforce an imperative for all provider organizations. Having a flexible nursing workforce is the best strategy to help organizations staff with fewer FTEs and experienced nurses, while also actively retaining and attracting more nurses to the bedside role.
What is a flexible nursing workforce?
A “flexible nursing workforce” is more than a float pool. While traditional inpatient float pools are a vital resource, many organizations have maximized their impact over the last decade. A truly flexible nursing workforce must move beyond this—and include different RN roles, locations, hours, and responsibilities. However, a flexible nursing workforce does not mean all nursing FTEs must have flexibility. Specialization is still critical to provide safe patient care and is an engagement lever for many RNs. Rather, it’s a balance.
To do this work well, the strategies you implement must meet the individual needs of your organization and staff. Historically, staffing focused primarily on the needs of the organization. As the workforce changes, their needs and preferences need to be weighted equally. This dual mandate should serve as your north star for this work, only selecting mutually beneficial solutions.