Welcome back to our blog series, “From the Desk of Dr. Julian.” I’m Julian Castaneda, MD, Medical Director at The Judge Group. Judge’s healthcare expertise meets the needs of healthcare professionals by identifying and providing the necessary talent across the entire healthcare landscape and developing and delivering training to healthcare companies. As a veteran in the medical field with a wealth of experience, Judge brought me on board to serve as a resource and advisor to Judge, as well as to our contractors and clients.
In this blog, I want to discuss how healthcare facilities can retain employees because this is a very serious issue we are all facing. In my own facility, we are short several anesthesiologists which means the workload is drastically increased for each of us. Every day I see nurses and other care professionals struggling with their duties because of understaffing and overworking. This takes a toll on our mental and physical health – this can’t be denied. It is certainly hard.
With this in mind, it is no wonder that understaffing continues and care workers are leaving the field or choosing per diem or travel positions that allow them more autonomy over their schedule and how much they work. What can we do about this? I cannot provide the solution to the issues plaguing us right now, but from what I have seen, there are improvements that can potentially be made to help the situation we find ourselves in.
Incoming staff is decreasing while existing staff are fleeing
A recent study found that students in nursing school are dropping out because they fear ‘ending up in a downward spiral of physical, psychological and social problems’ and ‘experiencing an increasing mismatch between expectations and reality’. While these fears may seem unfounded, overworking and burnout are very real issues medical professionals are facing right now.
In the past, the guarantee of decent pay straight out of college and a secure career was enough to encourage many to enter the field of nursing or other healthcare careers. However, as the research shows us, today this is not the case. For the third consecutive year, the number of students in baccalaureate degree completion programs – commonly known as RN to BSN programs – decreased, with a 9.6% decline in 2021.
Nurses today in traditional roles are overworked and believe they are underpaid as a result – while they watch hospital executives and leadership receiving large bonuses and making far more money than the staff. But retaining healthcare staff does not come down to dollars and cents alone. The healthcare workers entering the field from college are finding themselves quickly disillusioned and quickly losing control of their careers and their time.
Younger workers feel they lack control of their careers
An interesting fact uncovered through research for this blog is that young workers feel like they have little control over their career trajectory, and little say in their work environments. In fact, 55% of workers under 25 are anxious about their next step and unsure where they will find a place in the professional world with 1-in-3 believing they don’t control the next step in their career. This pessimistic outlook is largely due to the pandemic since many younger workers started their careers amidst understaffing issues. This is a significant contributor to the burnout issues we are also seeing among medical staff – in addition to the student loan debt many of these new nurses and medical staff have to reckon with.
How medical facilities can combat this
To combat this, medical facilities can provide mentorship programs to nurses and medical staff. They can also provide clear job descriptions and career ladders to demonstrate how staff can work their way into senior and supervisory roles. In addition, providing opportunities for continued education, upskilling, and cross-skilling to help the staff expand their skills provides them with more control over their career trajectory as well.
Pay is critical to healthcare employees
While some healthcare workers do not feel that they are underpaid, many do. The pandemic exasperated this position as nurses and staff were required to work additional shifts to cover the overpopulation of medical centers that was seen during the pandemic. While hospitals may not be overcrowded now, they are still understaffed – a topic we recently discussed in our blog on how the healthcare industry remains recession-proof – and that is weighing heavily on nurses and staff.
From the perspective of several nurses we spoke to in regards to this topic, they do not believe they are underpaid for the work they do – but that they are underpaid when you consider the circumstances surrounding their work. They spoke specifically of working doubles often because there isn’t enough staff as well as having far too many responsibilities on the floor when they are working because of understaffing. From one nurse’s perspective, she found it hard to maintain the high level of care she wants to give, and patients expect, because she is constantly rushing through her patients to get to them all in a timely fashion.
Nurses are turning to nontraditional roles to make more money
For these nurses, their hazard pay has steadily been decreased since the height of the pandemic in 2020 and additional incentives for working doubles and extra shifts have also been rescinded. For these nurses, the pay for a traditional position is no longer worth the stress. As a result, many are leaving to become travel nurses or per diem because they can make far more money per day/week and can receive living and other stipends that traditional nurses do not receive.
For quick reference, the average salary (across all specialties) for staff RNs is around $77,460 per year with an average yearly increase of around 3%. This does vary based on location and whether the position is a union position or not. Breaking that salary down, after taxes (at a 22% tax rate) that’s an approximate take-home pay of $60,148 per year: $5,012 per month, or $1,253 per week. Travel nurses on average (across all specialties) earn $3,000 a week, $12,000 a month, $150,000 a year with 2-weeks’ time off. That’s 139% more per year than the average salary for a staff nurse. While travel nurses will still need to pay taxes, potentially at a higher rate, they are still bringing in far more than a traditional nurse and have far more control over the types of environments and work they will find themselves doing.
Overall, medical centers must communicate better with staff
The larger the environment is, the harder and less likely it is that all staff are aware of the direction the medical center is going and the goals for patient care. However, when it is an “us versus them” or “staff versus leadership” mentality, the divide between the staff and the leadership grows with staff starting to believe that changes made are made against the staff, and not with them in mind. From my experience, I know that leadership tries to make the best choices possible for the betterment of the facility, the staff, and the patients. But that doesn’t necessarily mean that all staff sees it from that perspective.
HR departments are the front line in ensuring employees are happy and thriving in their positions. As I mentioned earlier, providing opportunities for learning and growth is pivotal to employees feeling like they can advance their careers and have control over their career trajectory. HR can provide the path to achieving goals employees are interested in achieving. However, transparency is necessary to make this work. Employees need to know what the path to advancement is and how to attain it. But they also need to know that the facility has their best interests in mind, as well as that of the patients. HR and leadership may not be as visible to patients as doctors and nurses are, but it is a vital component of a hospital’s — and a patient’s — health, as well as the mental and physical health of the staff.
Retaining employees comes down to the basics
It comes down to the basics for myself and the staff I interact with daily. Healthcare workers are overworked and are succumbing to burnout at alarming rates. Care workers who don’t feel supported or cared for by their facilities are facing these challenges in even higher magnitudes. To keep employees, we need to make sure they are cared for and provided for as best as possible. Transparency and listening to staff feedback are key to achieving staff that thrives. However, ultimately, the issues of pay and understaffing do need to be addressed or a solution to the issue will continue to evade us.
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