This article is sponsored by ShiftMed. This article is based on a Skilled Nursing News virtual discussion with Jacob Laufer, Chief Operating Officer for ShiftMed. The discussion took place virtually on November 29, 2022 during the SNN Staffing Summit. The article below has been edited for length and clarity.
Skilled Nursing News: For those of you that don’t know, ShiftMed serves as a workforce management platform for skilled nursing operators, as well as other providers along the care continuum. Without further ado, Jacob, I think we’re ready to dive in, so take it away.
Jacob Laufer: I’m excited to spend some time with you guys this afternoon, walking through our latest Annual State of Nursing Survey. To give you guys a little bit of context, ShiftMed is the number one nursing job app across America with over 100,000 W2 employees. We provide services across the home, all the way into post-acute and acute settings across over 115 markets, and have done over 4 million hours of care in the home and over 10 million hours of care in post-acute and acute facilities.
I’m hoping to bring different perspectives that we see across the whole continuum of care and how people are doing with all of the workforce challenges, and what nurses across different care settings are saying that they are desiring and looking for to have a better work-life balance and working relationship with their employers. Without further ado, we will dive in here.
We thought it would be really important to first start with a very macro view of what the outlook is for health care employment and where we are as a society as far as staffing and labor challenges. It’s interesting to see from being on multiple of these panels, as well as different industries, even being at conventions around Amazon Web Services and what they’re doing, where you would think you would hear things about people making innovations on different big data analysis and sets, and almost every single panel turns into a workforce subject and what they’re hearing.
It is interesting though to look back and see that there’s actually never been a better time to be hiring across, looking back over 20 years. Obviously, we had the Great Recession starting in 2007 to 2009 where hiring took a significant plunge. Ever since that bottom, we have been increasingly ramping up the amount of hiring activities happening across this country.
The issue is that you hear a lot about is quiet quitting, obviously, across LinkedIn or other professional platforms. Employees across this country are also turning over at record rates. We’re seeing this play out into health care in specific where, from a net hiring basis, every single month, we are in a continuous cycle of adding over 700,000 nurses and aides across this country but also losing 700,000 aides and nurses across this country. We’re not making any net hiring progress in health care when we can’t control the amount of turnover and retention activities that we need to focus on. A lot of our annual nurse surveys are going to focus on the insights of what those nurses need and look forward to being a part of.
With this net hiring base that we’re not making a lot of progress on, over the past 20 years, starting around 2012-2013, we started to see a real increase in the amount of demand for health care jobs. Even in the first parts of COVID-19, this actually dipped, and then as you can see, has really surged from 2021 to 2022. A lot of that has a lot of factors that deal with it, one being the burnout from COVID-19, we’ve lost about 500,000 nurses and aides alone from the experience of working through a global pandemic.
The second is, and I always equate this to – which is very important for all of our skilled nursing operators – if this is a baseball game, we’re still in the dugout of the care needs of the future here. We are seeing that the forecast of this is to accelerate from about 2.1 million unfilled jobs all the way up to 3.2 million by 2026.
The first baby boomer, our largest generation in this country, does not turn 80 until the year 2025. The amount of demand that is going to be needed when that largest generation across our country hits their prime care needs, and particularly, prime skilled care needs, our demand is really going to put us off-pace here and we have to figure out how to recruit and retain more of these nurses and aides.
SNN: What can facilities do to hire more effectively and consistently, given that demand for HCPs is outpacing the supply?
Laufer: Yes, so a lot of that we’re going to cover in what our annual nursing surveys say, but the number one thing that continues to come back is just flexibility and flexibility of schedule that nurses and aides are looking for. We even see this at a very high level. We’re obviously a large recruiter of nurses and aides, and we see this play out across even Google search results, where if you look at the trend of Google search results, part-time jobs have returned back to their pre-pandemic levels and actually well ahead of their pre-pandemic levels, but full-time jobs are still about 30% to 40% off from what they were before the pandemic.
There have been some larger societal changes in what nurses and aides are looking for, and that’s something that we hear from our over 100,000 W2 employees, as well as what our survey is going to indicate as well. You also see this larger flexibility playing out as well because you’re seeing the health care workforce is increasingly heading to ambulatory care groups as well as home health, in all of which you typically see inside of home health, specifically a much more flexible schedule or different variations of schedule that allow you to work around whatever you may be dealing in your particular life.
Our average nurse or aide on our platform is a 46-year-old female that typically has two or three children that they’re caring for. The burden of that is, for everybody on this call that has little ones at home knows, is very challenging and comes with different types of demands. The best way for employers to recognize that is by finding the flexibility that they can have on their schedule there.
It’s something where, as you look at this chart, you can see that even hospitals and nursing care facilities are some of the slowest growers in the health care workforce where overall, health care employment is up, but we’re seeing the largest gains of that being made in offices of your local outpatient ambulatory care group that’s probably affiliated. I live in the D.C. area. Lots of Inova communities, as well as going into different childcare services or social assistance, home health aides is where we’re seeing the largest trends of this information coming from.
SNN: Jacob, could HCPs be moving to ambulatory groups and home health because the pay is better, you think?
Laufer: Yes, there certainly are some- there’s always some responses from a lot of our nurses and aides in the survey of what they’re looking for, although pay is a secondary benefit compared to flexibility. We also have a large list of recommendations here around a lot of the non-monetary benefits that we believe are extremely important across skilled nursing. Just given that skilled nursing can’t operate or work like a restaurant can.
Because of the reimbursements in our country and the way that that is set up, skilled nursing operators, in particular, don’t have that much flexibility to make those different things, so we really love to focus on meeting these non-monetary benefits. Whether it’s focusing on having a flexible schedule or other really innovative things that we want to share with you that are available to everyone in the public, whether that’s meeting people for transportation, instant payments, or finding different ways for them to work a flexible schedule.
Now you all have a sense for where our workforce challenges are, where we’re not going to be able to necessarily hire our way out of this. This is actually only going to, unfortunately, probably get significantly worse before it gets any better. That’s why listening to our nurses, listening to every one of our employees, and figuring out what matters to them, how we can retain them, is so important.
The first thing that was really overwhelming in this year’s survey is that nurses are really feeling the staffing shortage. Overwhelming, 99% of them reported that they had some type of staffing shortage at work. 40% of them believe that this is even negatively impacting their mental health. Every single week there’s new research on burnout and how that is also impacting a lot of our patient care.
We also saw that come through with almost half of them responding that patients they don’t believe are getting adequate care, or that the nurses and aides aren’t able to come given the staffing shortages and the burnouts, they’re not able to bring their whole self to that particular patient or that particular resident just given where we’re at in the current workforce. Again, this is where we think that there’s a lot of compassion needed from employers to find the flexibility that nurses and aides are looking for.
The other thing that was really troubling inside of this past year’s survey is that we had about an 18% increase of nurses and aides indicating that they’re likely to leave the profession within the next two years. We think that this is very important information for us all to take in to figure out how we find ways to promote flexibility. Listen to every single one of your employees, focus on the culture, things that you can control to really not further exacerbate this issue.
This excerpt has been edited for length and clarity. To watch the full discussion on video, please visit:
ShiftMed delivers an on-demand workforce marketplace that connects over 350,000 credentialed nursing professionals looking for flexible work with healthcare providers needing additional nursing staff. To learn more, visit: https://www.shiftmed.com/.
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