Cross Country Healthcare’s annual national survey of nursing professionals and students finds nurses remain passionate about patient care despite historical issues in need of reform. Barabasa
National survey participants include 1,780 nursing professionals and students at healthcare and hospital facilities between May 11 and June 24, 2022, in partnership with Florida Atlantic University’s Christine E. Lynn College of Nursing.
Overall, the study revealed that nurses remain passionate about patient care, citing helping people through meaningful work (66%) but highlighted areas of dissatisfaction and ongoing industry challenges, including pay rates/compensation (86%), staff shortages (53%), stress (39%) and burnout (35%) as the top career dissatisfiers facing the profession. The survey, conducted in collaboration with Florida Atlantic University’s Christine E. Lynn College of Nursing, provides meaningful and actionable insights to equip healthcare facility leaders, academia, nursing students and professionals with the most pertinent issues challenging this occupation.
“Nursing is one of the most trusted professions in the world. A nurse is with you at all life stages—from birth to death and everything in between. They make life-changing decisions daily,” says Hank Drummond, Ph.D., MDiv, BA, RN, Senior Vice President, and Chief Clinical Officer. “This study allows us to check the pulse on today’s challenges facing the profession and address them head-on by hearing their concerns and taking action.”
National Survey Key Findings
Student nurses reported they are most concerned about stress (45%), not enough staff to meet demand (35%), and feeling overworked (27%).
Nearly one-third (28%) of nurses indicated their desire to leave the profession had increased dramatically since the pandemic, while those who said their desire to stay had increased since the pandemic dropped from 24% last year to 4% this year.
Doing meaningful work, income and lifestyle are the main drivers for staying in the field. However, almost half (48%) of currently employed nurses said they would not become nurses again if they could talk to their former selves or did not know if they would.
30% of nurses said they plan to work in the profession for the foreseeable future, although 23% plan to look for a new career in 1-2 years and 13% plan to retire in 1-5 years.
“The results of our survey of nearly 2,000 employed and student nurses point to ongoing challenges that the profession faces, providing us with a roadmap to address their concerns with innovative strategies that meet the needs of the nurse and the healthcare system,” says Safiya George, Ph.D., APRN-BC, FAANP, dean & professor at Florida Atlantic University’s Christine E. Lynn College of Nursing.
The Christine E. Lynn College of Nursing offers accredited programs at all levels to prepare and train students including various tracks for a BSN, Master of Science in Nursing (MSN), Ph.D. and DNP focused on Caring Science. A BSN-DNP program with a Psychiatric Mental Health Nurse Practitioner concentration and post-graduate dermatology and telehealth certificate courses and other concentrations that intersect innovation and technology are also offered to address healthcare provider shortages.
Room for Meaningful Change
Cross Country Healthcare is deploying strategies to transform the nursing profession, including an ongoing examination of pay rates and retention practices, identifying new pathways for education, licensing, and talent development, focusing on flexibility and growth opportunities and investments toward innovation to strengthen the nursing workforce.
“Nurses are passionate but exhausted, and there is room for meaningful changes. The demand for patient care is increasing exponentially,” says Michael Skovira, MBA, MPAS, PA-C, chief medical officer at Cross Country Healthcare. “We must change how we educate, train, hire, manage and treat our nurses. We have all the tools to start now, but we cannot implement these practices if we continue to blame the pandemic for a situation that has been growing for years. We need to come together as an industry and start now.”
Cross Country has launched several initiatives and continues to invest heavily in technology and digital transformation to support these strategies, including the new CrossCountry.com as a fresh way to engage nurses in a seamless frictionless manner.
Hiring temporary staff has become a necessity due to the growing shortage of qualified professionals in the healthcare industry. A recent report highlights that in the U.S., the turnover rate for Registered Nurses (RNs) has increased from 34.81 percent (2020) to 40.45 percent in 2021. In parallel, the healthcare sector faces an increased demand for quality care. Constantly juggling open shifts and new hires appears to be a new reality.
Turning to temporary nurses and healthcare workers (HCWs) can alleviate this burden if implemented correctly. In this article, we take a look at the top five challenges when managing temporary healthcare workers.
Challenge 1: Ongoing Staff Shortage
According to a study by Mercer, by 2025, the demand for healthcare professionals will outpace supply. With the aging population and an increase in chronic disease, more healthcare workers will be needed. For instance, the American Association of Medical Colleges (AAMC) pointed out that by 2032, the number of people aged 65+ will have increased by 45.1 percent.
Attracting and retaining top healthcare professionals today is critical if you want your organization to transition smoothly into the next decade. This is also applicable for temporary healthcare workers; their skills and expertise vary. The best way to attract talented staff is to make sure the working environment is conducive and rewarding for them. Employees who feel their work has an impact on the world are more productive, creative, and satisfied with their job. Offering a competitive salary and benefits package is the icing on the cake that might just encourage your healthcare staff to stick to your organization longer.
Key takeaway: The market for temporary HCWs will become more competitive. Do your homework, and analyze your competitors’ offerings before devising an attractive package.
Challenge 2: Dealing with Staff Retention
Staff turnover is a major issue in the healthcare industry. A 2021 report by NSI Nursing Solutions reveals that hospital turnover increased by 1.7 percent (year on year) and currently stands at 19.5 percent. This increase is due to shortages of staff and resources, which are being stretched beyond their limits as hospital demands continue to grow. The same report states that the average hospital loses between $3.6m – $6.5m per year from RN turnover cost alone.
One way for healthcare organizations to reduce employee turnover is by investing in long-term training programs. Training programs should be designed for professionals at all levels, including your temporary staff. Everyone should be given opportunities for professional development and training. Investing in lifelong learning is essential, as it creates an environment that supports employee growth.
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Key takeaway: Temporary work is very often a stepping stone to a full-time position. Capitalize on this and invest in the development of your temporary staff, as they can potentially turn into full-time employees.
Challenge 3: Closing Skill Gaps
Temporary staff has become an essential piece of the puzzle for many healthcare organizations. Yet, there are possible skill gaps between full-time workers and temporary staff. These gaps can have a negative impact on your workplace dynamic and care quality. For instance, temporary HCWs may not always have the same amount of hands-on experience when compared to full-time employees. Moreover, temporary HCWs are less likely to embrace your company culture.
To mitigate risks associated with skill gaps, you need to find the right people and match them with the skills that are needed. Focus on hiring your temporary HCWs based on their specialties, such as a Certified Nursing Anesthetist if you need help for administering general and local anesthesia. Hiring temporary HCWs based on their specialties makes it easier to correctly match each individual to the department where they’ll perform best.
Key takeaway: Hire temporary HCWs based on the specialties you need, and not just to fill a vacant position. Consider offering them mentorship opportunities.
Challenge 4: Fighting Burnouts
The healthcare industry exposes employees to a high risk of burnout. Studies suggest that at any given time, one in three physicians is experiencing burnout. The same goes for temporary healthcare workers – they usually work under high-stress conditions, with little time to recover. The growing shortage of qualified healthcare staff makes things worse. Both full-time and temporary healthcare workers have more patients to manage due to understaffing.
Reducing staff burnout is critical for all healthcare organizations as it can be detrimental to the quality of care given to patients. The work environment is a major factor in healthcare staff burnout. The minimum you can do to reduce stress on your staff is provide a safe working environment, free from unnecessary hazards. Additionally, both your full-time and temporary staff should be encouraged to rest appropriately. This is especially important if they have been chaining long hours.
Key takeaway: Temporary HCWs are also exposed to burnout, which can lead to poor quality of patient care. Keep your workplace healthy, and provide staff with a decent work-life balance.
Challenge 5: Offering Flexibility
Offering flexible working hours is becoming more and more popular in the healthcare industry. It offers numerous benefits, such as enabling staff to manage their work-life balance better, reducing the risk of burnout, and even adding to the appeal of your job advert. Yet, this can easily get out of hand – managing 24/7 working hours and multiple shifts is already no easy feat; doing so for hundreds of workers, some employed full-time and some part-time, can quickly become a stress-inducing task.
Optimizing the staff scheduling process is vital for your healthcare organization if you offer flexible working hours. The process should be streamlined for both managers and end-users. Consider opting for an employee scheduling software instead of excel sheets or printed attendance books. Bonus points if your chosen scheduling app is intuitive, mobile-friendly, and has built-in time tracking capabilities. These features alone can save you hours and potentially make life easier for all your staff members.
Key takeaway: Flexible working conditions are gaining more momentum, especially following the COVID-19 pandemic. Streamline your staff scheduling process and opt for a resource-saving solution.
To Sum It Up
The healthcare sector has steadily been growing more competitive over the past decade. As the population ages, the demand for healthcare professionals is ever-increasing. In the United States, the baby boomer generation is aging and as a result, they will need many more healthcare services. The US Bureau of Labor Statistics estimates that by 2030, the number of jobs in this sector is expected to grow by 1.2 million. Filling those positions is not going to be easy. Drastic policy changes and developments are needed to turn the healthcare sector into a sustainable industry.
At my nursing school pinning ceremony, the professor informed my graduating class that we would all become leaders. She gave her famous “oh the places you will go” speech as we all listened, and excitedly dreamed of our futures. In that moment, I don’t truly think I thought I would become a leader, innovator, or change maker in such a diverse and large field. Little did I know she was correct I would become a leader. Nurses are all leaders in a variety of ways.
A Typical Day as a NICU Manager
My day normally begins with a very lengthy to-do list. I enter the unit or my office and the organized chaos begins. My day is filled with meetings, completing tasks such as scheduling for 180 staff, managing time and attendance for 180 staff, rounding on patients, families, and staff—and much, much more. Often at the end of the day I look back at the to-do list, and I have accomplished none of the tasks that were high priority for the day.
Being flexible and adapting to the needs of the unit is a quality one must possess to become a nursing leader. Prioritizing tasks is helpful, but understanding that often priorities change depending on the needs of patients, families, and staff is how leading a large NICU is accomplished. Like the life of a preemie, the life of a NICU manager has many ups and downs.
Currently, as an organization we are working to obtain Magnet designation. Empowering nurses to be leaders, innovators, and change makers is very challenging. Recently when speaking with a physician, he compared NICU nurses to mother lions, and this comparison is fairly accurate. NICU nurses are advocates and the voice for the tiniest patients each and every day. NICU nurses are protective and territorial when caring for these tiny patients. They nurture them from 400-500 grams (and sometimes less) to discharge three to six months later. NICU nurses not only provide care for these tiny patients, but they also care for their parents/caregivers and are emotionally attached to these tiny humans and their families.
Convincing a NICU nurse to change a process or method that they have been using is often met with lots of resistance. Could this be generational, cultural, or learned? Possibly, but part of my job as a manager is working with the diverse, multidisciplinary team to provide quality, evidence-based care for all patients in the NICU. Finding a way to change the culture or resistance to improve practices is one of the hardest aspects of my job, and can be physically and emotionally just as draining as being a bedside nurse. I have found that listening to staff and families and asking for their input while providing the “why” behind change has become one of the greatest tools I have as a leader. Asking or empowering staff to take part in problem solving has also become a very useful skill that I am learning and getting better at each day. Becoming a NICU manager does not make a NICU nurse’s personality change. We simply protect different territories and advocate in different ways than before.
Being a NICU manager is a fine balancing act that I am still working to perfect. My inbox is always full, and just when I think I have it empty another problem, issue, or task is waiting. The NICU is a 24/7 operation that never stops, and rarely slows. Although I find it difficult to step away from the NICU at times or put down my electronic device that my email is constantly updating on, I have recently discovered that this pause makes me a better and more focused leader.
As a leader and in life I attempt to live each day, knowing not what tomorrow brings, but being optimistic that what I am doing today will impact positive change, and lead to innovations and improvements for future NICU patients and families. It is often said that it takes a village to rear children. It also takes a village to manage a NICU.
As a labor and delivery nurse at UC Davis Medical’s Women’s Pavilion, Aracely Eres was well aware that advanced nursing degrees are necessary for healthcare because of the industry’s value of education and credentials. More and more hospitals are expecting RNs to make business decisions that affect patient outcomes, leading more practicing registered nurses to seek out RN to BSN programs to advance their education and career opportunities.
Already equipped as an RN with Spanish/English translation certification and volunteer work as an interpreter at UC Davis before going to work at Mercy Medical Center, Eres had a career path focused on making a positive impact on her patients and organization. When a nursing position opened up in labor and delivery, she quickly applied for the job, but soon realized that advancing her education was critical to her future success.
“I believe that the more education you have, the more power you have to drive your career.”
UC Davis is a teaching hospital that requires nurses to hold at least a BSN, so two years after beginning her job there, Eres began looking into online BSN programs. A BSN degree prepares nurses for a broader role in acute care, primary care, and community health settings, and provides education in other important services like nursing management, health promotion, and disease prevention. There is also evidence showing that patient outcomes are better in hospitals with a higher percentage of Bachelors prepared nurses and it helps hospitals advance to magnet status, making it an attractive requirement for many facilities.
After researching potential programs, Eres chose American Sentinel’s RN to BSN program, an online program that she could complete while still working full time. She knew a colleague who was an American Sentinel student and had an excellent experience, and the BSN program had all of the elements she was looking for in addition to being affordable and having a wonderful student support system. Eres’ first classes began in 2013, and after a positive experience while working full-time, she decided to continue into American Sentinel’s MSN program after she completed her BSN in 2015.
For nurses who plan to move into nursing management like Eres had been intending to do, MSN degrees are becoming the minimum education required for management roles because it provides specialized knowledge that hospital employers are seeking. A master’s degree opens up more opportunities, distinguishing an MSN educated nurse as the most qualified candidate for management positions. Eres chose a nursing management and organization leadership specialization for her MSN, ensuring she would have the skills and knowledge to secure a management role in her future. She now has her sights set on becoming a Nurse Practitioner. She wants to make an impact, and knows her education is what will help get her there. As Eres says, “I believe that the more education you have, the more power you have to drive your career.”
