Category Archives: Nurse Overtime

Why ‘boomerang’ nurses are ditching contract work for hospital staff positions

Posted on by • Posted in Health System, Hospital, Hospital Industry, Labor Spend Management, Nurse Agency Staffing, Nurse Overtime, Nurse Retention, Nurse Staffing, Nurse Travelers, Nurses Compensation, Nurses Shortage, Recruiting, Talent Management • Leave a comment
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During the pandemic, many nurses left hospital staff jobs for more lucrative travel jobs. However, many of these nurses are returning to hospitals for full-time positions, especially as travel pay falls and organizations offer new staff benefits, Melanie Evans writes for the Wall Street Journal.

How Allegheny Health Network re-recruits experienced RNs

Hospitals see more nurses return to their positions

During the pandemic, many hospitals struggled with staffing shortages as many nurses left their positions as a result of burnout or for more high-paying travel opportunities. However, many nurses are now returning to staff positions, especially as travel pay declines.

According to  Aya Healthcare CEO Alan Braynin, travel nurse pay is now down 28% compared to a year ago. Hospital openings for travel nurses were also down by 51% at the end of April compared to the same time last year.

At HCA Healthcare, the country’s largest publicly traded hospital chain, nurse hiring increased by 19% in the first three months of the year compared to the average across the last four quarters. In addition, turnover levels have almost declined to pre-pandemic levels, and HCA’s travel nurse costs have dropped by 21% in the first quarter of this year compared to 2022.

According to the organization, many nurses who initially left their hospitals during the pandemic are now coming back. Since 2022, around 20% of the 37,000 nurses hired at HCA hospitals previously worked for the company at some point between 2016 and 2022.

Similarly, Houston Methodist has rehired around 60 nurses who initially left during the pandemic. Roberta Schwartz, the chief innovation officer at the health system’s flagship hospital, said these returning nurses have helped the hospital make more beds available and keep up with an 8% increase in demand.

“The boomerang nurses have returned,” said Gail Vozzella, Houston Methodist’s chief nurse.

How hospitals are attracting boomerang nurses

To attract more nurses to staff positions, hospital officials said they are offering higher pay, as well as several new benefits, such as childcare, less demanding work positions, and more flexible schedules.

For example, Suzane Nguyen, who took a teaching job during the pandemic, rejoined Houston Methodist in June 2022 after she was offered a virtual job. In her new position, she collects patient information by video. “The stress doesn’t compare,” she said.

Similarly, Linda Allen, an ED nurse who left to work for a temporary agency during the pandemic, returned to Sentara Healthcare in 2022 after the hospital system increased its wages and offered new, more flexible schedules.

According to Terrie Edwards, Sentara’s regional VP, the organization has increased its nurse wages by around 21% in the last two years and now offers student debt relief up to $10,000, as well as adoption and infertility benefits.

Overall, these changes have helped Sentara hire around 400 boomerang nurses, which has reduced staff overtime and cut its travel nurse expenses in half.

“They really did step up,” said Allen, who became a full-time employee in September 2022 after initially working temporary 13-week contracts.

Outside of these benefits, some nurses are also just ready for more permanent positions after spending the pandemic working in several different hospitals. “There is something to be said for working in the same place every day, consistently,” said Alexis Brockting, an advanced practice nurse at Mercy Hospital South.

Younger hospital nurses leaving the profession altogether

Posted on by • Posted in Health System, Hospital, Hospital Industry, Nurse Agency Staffing, Nurse Overtime, Nurse Retention, Nurse Staffing, Nurses, Nurses Shortage, Registered Nurse (RN), RN Workforce, Talent Acquisition Strategy, Talent Imperative, Talent Management • Leave a comment

https://mailchi.mp/3390763e65bb/the-weekly-gist-june-24-2022?e=d1e747d2d8

The prevailing opinion earlier this year was that the hospital registered nurse (RN) shortage was being driven by older nurses retiring early or leaving hospital employment for less-demanding care settings during the pandemic. However, recent data shown in the graphic below paint a different picture. 

Hospital RNs with over ten years of tenure actually turned over at lower rates in 2021, compared to 2019. Meanwhile, the turnover rate for nurses with less tenure (who are typically younger) increased in 2021. While less-tenured nurses have always turned over at higher rates, we are seeing a new uptick in younger RNs leaving the profession. 

The size of the total RN workforce decreased by 1.8 percent between 2019 and 2021—and the decline was twice as steep for hospital-employed RNs. Younger RNs disproportionately drove this decline: nurses under age 35 left the nursing workforce at four times the rate of those over age 50. 

A recent survey suggests younger RNs are less likely to feel their well-being is supported by their organization, and more likely to define themselves as “emotionally unhealthy.” To keep younger nurses in the profession, hospitals must increase the support available to them. Investments might include expanding preceptorship and mentorship programs, many of which were cut during the pandemic, and increasing behavioral health support and job flexibility.  

More than 4K Stanford nurses vote to strike in California

Posted on by • Posted in Health System, Hospital, Hospital Industry, Labor Organizing, Labor Relations, Labor Shortages, Labor Spend Management, Labor Strike, Labor Union, Labor Union Grievance, Nurse Agency Staffing, Nurse Morale, Nurse Overtime, Nurse Staffing, Nurse Travelers, Nurses, Nurses Compensation, Nurses Shortage, Nurses Union, Recruiting, Retention, Strike, Talent Acquisition Strategy, Talent Competition, Talent Imperative, Talent Management • Leave a comment
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UPDATE: April 14, 2022: Nurses will begin striking April 25 if they are unable to reach a deal with the system by then, according to a Wednesday statement from the union. The two sides have met with a federal mediator three times, and the strike would be open-ended.

Dive Brief:

  • Unionized nurses at Stanford hospitals in California voted in favor of authorizing a strike Thursday, meaning more than 4,500 nurses could walk off the job in a bid for better staffing, wages and mental health measures in new contracts.
  • Some 93% of nurses represented by the Committee for Recognition of Nursing Achievement voted in favor of the work stoppage, though the union did not set a date, according to a union release. It must give the hospitals 10 days notice before going on strike.
  • Nurses’ contracts expired March 31 and the union and hospital have engaged in more than 30 bargaining sessions over the past three months, including with a federal mediator, according to the union.

Dive Insight:

As the COVID-19 pandemic has worsened working conditions for nurses, some unions have made negotiating contracts a priority. Better staffing is key, along with higher wages and other benefits to help attract and retain employees amid ongoing shortages.

The California nurses’ demands in new contracts focus heavily on recruitment and retention of nursing staff “amid an industry-wide shortage and nurses being exhausted after working through the pandemic, many in short-staffed units,” the union said in the release.

They’re also asking for improved access to time off and more mental health support.

Nurses say their working conditions are becoming untenable and relying on travel staff and overtime shifts is not sustainable, according to the release.

The hospitals are taking precautionary steps to prepare for a potential strike and will resume negotiations with the union and a federal mediator Tuesday, according to a statement from Stanford.

But according to CRONA, nurses have filed significantly more assignment despite objections documents from 2020 to 2021 — forms that notify hospital supervisors of assignments nurses take despite personal objections around lacking resources, training or staff.

And a survey of CRONA nurses conducted in November 2021 founds that as many as 45% were considering quitting their jobs, according to the union.

That’s in line with other national surveys, including one from staffing firm Incredible Health released in March that found more than a third of nurses said they plan to leave their current jobs by the end of this year.

The CRONA nurses “readiness to strike demonstrates the urgency of the great professional and personal crisis they are facing and the solutions they are demanding from hospital executives,” the union said in the release.

No major strikes among healthcare workers have occurred so far this year, though several happened in 2021 and in 2020, the first year of the pandemic.

Understanding the implications of using agency nurses

Posted on by • Posted in Health System, Hospital, Hospital Industry, Labor Spend Management, Nurse Agency Staffing, Nurse Morale, Nurse Overtime, Nurse Staffing, Nurse Travelers, Nurses Compensation, Nurses Leadership, Nurses Shortage, Observation • Leave a comment
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The Great Nursing Resignation, and hospitals’ growing reliance on expensive agency labor (a.k.a. “travelers”) has grabbed headlines, for good reason. But lately we’ve heard a couple of anecdotes from health system leaders about the second-order impacts of the phenomenon that are worth considering as well.

First, as the ranks of agency nurses at hospitals have swelled, full-time employed nurses’ morale has plummeted—tenured nurses are having to orient their new temporary co-workers, then watch them earn up to three times as much money for the same work.

At the same time, willingness to work overtime among employed nurses has dropped. That’s not just because of burnout—it turns out that the nurses who were most likely to take overtime shifts are also more likely to have chosen to leave full-time employment to become travelers, where they are even more richly rewarded for working extra shifts. So, the “productivity” of the remaining corps of staff nurses has dropped, even as caseloads have increased.

One other implication we’ve heard about recently: the economic impact of “observation” cases, where patients are held in a staffed bed but not admitted—already a bad bargain for hospitals—has gotten worse. That’s because the cost of deploying staff to care for those patients has gone up, due to wage inflation and use of travelers. It’s hard to overstate the level of staffing crisis at most hospitals today, and the rapid growth in reliance on temporary staff will have consequences lasting well beyond the current surge.