Articles of Interest
Job Order Index (November 2017-April 2018)
Right now we’re all getting in the swing of spring, but before you know it, it will be summer, then fall … and you know what fall means, right?
If you said Staffing Industry Analysts’ Healthcare Staffing Summit, give yourself a nice, congratulatory pat on the back!
Healthcare Staffing Summit 2018 will run November 5-7, at the Hyatt Regency at Colorado Convention Center in Denver, Colorado.
This year’s festivities mark the 16th annual HSS — another great opportunity for healthcare staffing leaders to gain insights and inspiration.
So, keep enjoying spring for now, but be sure to look ahead to the fall by saving the date for this year’s Healthcare Staffing Summit! Click here to learn more or to register now.
POSTED BY AMN HEALTHCARE
Nursing has always been fundamental to the principal objective of healthcare delivery — quality patient care. Today, nursing is also a vital factor in the transformation of the healthcare industry, including the trend toward corporate consolidation, an increasingly competitive environment, and the focus on patient experience. The results of the AMN Healthcare 2017 Survey of Registered Nurses reflect nursing’s place in the changing healthcare landscape.
As healthcare organizations today must provide excellence in patient care while controlling costs and transitioning to value-based reimbursement, quality leadership has become significantly more important, including to nurses. A large majority of nurses believe that there should be more nurses in high-level leadership roles. Central to this aspiration is the feeling among many nurses that they are not adequately supported by their current leaders. This suggests a disconnect between leadership and the nursing workforce, a critical challenge considering that nurses are one of the most important factors influencing patient experience.
The 2017 RN Survey strongly suggests that a generational change in the nursing workforce is well underway, with a wave of Baby Boomer retirements among nurses already in progress. Since the survey was last taken in 2015, the percentage of nurses who say they will retire in less than a year — among those who are now planning their retirement — has risen significantly. This also may be a factor in the growing shortage of nurses.
Regarding shortages in nurse staffing, half of nurses say the nursing shortage has worsened over the last five years – considerably more than in 2015 – while a much smaller percentage today say that the shortage situation has improved. This mirrors the situation that healthcare providers and staffing companies are currently witnessing, as nurse openings have become harder to fill and utilization of temporary nurses has increased. Managing clinical staff in times of acute shortage is a major challenge for the industry today and for the foreseeable future.
The realities of an extremely competitive job market are reflected in the survey data on licensure and education. Nurses strongly support national licensure rather than the state-by-state process, an initiative now underway through the Nurse Licensure Compact, which could help streamline the hiring process, improve providers’ access to quality nurses, and also facilitate telemedicine. The survey also showed that the percentage of nurses who say they are seeking a higher degree has dropped since 2015. Taken together, these two issues suggest that nurses may be more focused on getting a better job through the highly competitive marketplace than through obtaining additional education and training. With new and better career opportunities so plentiful for quality nurses, additional education may become less appealing. The downside for patient care is that educational attainment has been linked to improved quality and outcomes.
AMN Healthcare conducts the biennial survey of registered nurses to provide the healthcare industry with immediate and up-to-date information directly from one of the largest and most influential sectors of the healthcare workforce. The 2017 Survey of Registered Nurses: Viewpoints on Leadership, Shortages, and their Profession provides nurses’ views on the issues important to them in the changing environment of healthcare. This survey report is provided to healthcare leaders and managers, policymakers, regulators, the media, and to nurses to enhance understanding of this vital profession.
The 2017 Survey of Registered Nurses, conducted by AMN Healthcare, was completed by 3,347 registered nurses. The survey questionnaires were sent out in March and April 2017. In the survey, percentages are rounded to the nearest full percent, causing some graphs and charts to total over 100%.
SUMMARY & SOME KEY FINDINGS
In the current transformative era of healthcare, nurses find themselves playing a vital role in organizational success, now more than ever.
One area that has become increasingly important to success in healthcare is leadership, and nurses have their own very clear preferences on how organizations should transform leadership. An overwhelming number — 82% — say that more nurse leaders are needed in healthcare, and only 5% disagree. Nurses are somewhat disenchanted with their leaders, with approximately half saying that they don’t trust their leaders, don’t think their leaders care about them as an individual, and don’t believe their leaders support their career goals. However, while most nurses say that healthcare organizations need more nurse leaders, most also say that they do not want to become leaders themselves. The disconnect between nurses and leadership is a challenge that can affect the supply of nurse leaders, turnover, retention, morale, and patient experience.
RETIREMENT AND NURSE SHORTAGE
The 2017 RN Survey also reveals new information about the wave of Baby Boomer retirements among nurses, which has been predicted for many years. Data from the survey suggests that the retirement wave is already underway. The percentage of nurses who say they will retire in less than a year has risen significantly since the 2015 survey, and the percentage who say they will retire in four years or more has decreased significantly. This suggests that the retirement timetable for Baby Boomer nurses has advanced, since approximately 10,000 Boomers turn 65 every day, according to the Pew Charitable Trust. The retirement wave of Baby Boomer nurses will create a particular drain on experience and institutional knowledge, which are critical to organizational success. In addition, older nurses often are in specialties, most of which are in high demand.
Baby Boomer retirements also will exacerbate nursing shortages, a growing problem that the survey addresses. The percentage of nurses who say that shortages have worsened in the last five years grew from 37% in 2015 to 48% in 2017, while the percentage who said shortages have not worsened dropped from 34% in 2015 to 22% in 2017. Nurses witness the problem of shortages first-hand on the unit, plus they likely see the plethora of new job opportunities opening for them. Their unique outlook adds more evidence to a problem that’s almost universally recognized within the healthcare industry, though not necessarily known by the general public.
The super-heated job market for nurses may have influenced their responses to questions about licensure and education. Nearly seven in ten nurses said that a national licensing system for nurses would be more helpful to their careers than the state-by-state system. The National Licensure Compact is already underway, and 26 states now have reciprocal licensing, though the most populous states are not part of the compact yet. The major nursing organizations support the national compact.
In every RN survey, nurses have been asked about their viewpoints on their chosen profession and their current jobs. Every year, a very large percentage of nurses say they are satisfied with their career choice, while a very small percentage – usually in the single digits – disagree. However, a significantly smaller percentage, though still a majority, say they are satisfied with their current jobs. More than half say they worry that their jobs are affecting their health, though this is probably not surprising for the emotionally and physically demanding job of nursing. Many say they often feel like quitting, and they hope they will not be working at their current job in a year.
But then, two-thirds say they would encourage others to become nurses. Clearly, the pride of nursing runs very deep. Though fraught with challenges, nursing is the backbone of quality patient care, and most nurses would never want to do anything else.
To learn more and view the study in its entirety, click here.
Healthcare organizations face growing challenges in finding the nurses they need, according to nurse leaders, most of whom say that these problems will get worse in the next five years. Healthcare organizations may not be prepared for this worsening supply and demand imbalance, considering that their human resources expenditures usually tally approximately 1% of operating budgets (Bloomberg BNA, 2016) and that talent acquisition is only a fraction of that amount.
A common viewpoint within the healthcare industry, derived from daily experiences on nursing units and in HR departments and backed up by research (American Association of Colleges of Nursing, 2017), is that nurse shortages exist right now and are getting worse. Worsening Shortages and Growing Consequences: CNO Survey on Nurse Supply and Demand measures the views of Chief Nursing Officers (CNOs) and other nurse leaders on the magnitude and impact of the shortages.
The survey results show that most CNOs say nurse shortages exist at their healthcare organizations now, and that they expect the shortages will get worse over the next five years. Those findings are bolstered by a recent survey of registered nurses by AMN Healthcare. It found that a growing percentage of nurses believe the nurse shortage has gotten worse in the past five years, while a shrinking percentage say the shortage has not gotten worse (AMN Healthcare, 2017). CNOs represent the forward edge of clinical leadership, providing an authoritative and reliable point of view about patient volume and acuity level and the supply-and-demand pressures on the nurse workforce.
CNOs are directly involved in long- and short-range planning and administration of nurse staffing. They also recognize the true complexity of demand, including the need for the right mix of specialty and experienced nurses, as well as the need for effectively blending staff, agency, and early career nurses on the unit. In addition to CNOs, nurse leaders surveyed for this report also include the titles of Chief Nurse Executive, Director of Nursing, Vice President of Nursing, Senior Vice President, Chief Operating Officer, Clinical Nurse Leader, and Clinical Administrator.
— Marcia Faller, PhD, RN Chief Clinical Officer, AMN Healthcare
A large majority of CNOs say the nurse shortage at their organizations is moderate to severe, and most say this problem will become increasingly worse over the next five years. CNOs see shortages negatively affecting some of the most important aspects of healthcare: patient satisfaction, quality, care, and staff morale. Recruitment of adequate numbers of quality nurses is facing significant roadblocks that may not be overcome by internal solutions alone at many healthcare organizations.
Nurse Shortage Worsens
• More than 70% of CNOs say the nurse shortage at their organization is moderate, significant or severe. Of those, 35% say it’s significant or severe.
• CNOs say their nurse shortage will get worse in next five years: 28% say the shortage will get worse in one year; 43% say it will get worse in two years; and 61% say it will get worse in five years.
• The percentage of CNOs who say there will be no change in the nurse shortage drops from 61% in one year to 17% in five years. Consequences for Healthcare Organizations • More than 80% of CNOs say that the difficulty in recruiting nurses at their organization is moderate, significant, or severe. Of those, 41% say it’s significant or severe.
• CNOs said the two greatest challenges to nurse recruitment are the lack of access to high-quality talent (32%) and the location of their organization (37%). Neither of these factors can be changed from within the organization itself.
• 34% of CNOs say the nurse shortage at their organization has a considerable or great negative impact on patient care.
• 41% of CNOs say the nurse shortage has a considerable or great negative impact on patient satisfaction.
• 61% of CNOs say the nurse shortage has a considerable or great negative impact on nurse morale.
The survey was administered in July 2017 to 11,639 nurse executives with a 2% response rate. The survey was sent from AMN Healthcare and The Center for the Advancement of Healthcare Professionals in collaboration with B.E. Smith.
To learn more and review the whole study, click here.
New year, new NATHO Board! NATHO welcomes new members and thanks all individuals who have previously served or will serve in 2018 on the NATHO Board of Directors.
For 2018, we welcome Cross Country’s Wendi Dusseault as Board President and thank outgoing Board President, Craig Meier, of Medical Solutions for his service and leadership.
Congrats to TNAA’s Gene Scott and RN Network’s Lynne Gross, on their election to serve another term. And, a big welcome to new 2018 Director, Bobbi Henson of Jackson Healthcare.
NATHO also wishes Jonathan Ward a warm goodbye as he has rolled off the Board for 2018. Thanks for your service, Jonathan!
Here is the full 2018 NATHO Board of Directors:
Wendi Dusseault, Cross Country Staffing
Vice President/President Elect:
Abigail Tremble, Randstad USA
Carolina Araya, AMN Healthcare
Lynne Gross, RN Network
Bobbi Henson, Jackson Healthcare
Craig Meier, Medical Solutions
Pamela Oliver, Trustaff
Gene Scott, Travel Nurse Across America
Mark Stagen, Emerald Health Services
Bill Tracewell, Delta Healthcare Providers
Kim Windsor, Fastaff
Andrea Zveibil, Cirrus Medical Staffing
Thanks and welcome to everyone on the 2018 Board. We look forward to a productive, successful year!
It was an honor serving as NATHO President throughout 2017. I am passionate about the NATHO mission and feel it is our responsibility to ensure we provide the highest quality travelers to the clients we serve. The end result is providing excellent patient care and making a positive impact to our travelers’ patients and their families. Our members’ dedication to this high standard is inspiring and it’s been a pleasure meeting with so many committed leaders within our industry. Our Board of Directors is completely focused on providing tools to help our members build great companies focused on quality while maintaining a high ethical standard. I am proud of our Board’s accomplishments, honored to be a part of it, and look forward to what NATHO can accomplish in 2018 under Wendi Dusseault’s leadership!
Job Order Index (January 2017-December 2017)
As of January 19, 2018, the Enhanced Nurse Licensure Compact (eNLC) has been implemented, replacing the original Nurse Licensure Compact (NLC). It’s essential for healthcare staffing agencies to get a good grasp on what this means for them, their healthcare travelers, and all future assignments.
According to the National Council of State Boards of Nursing (NCSBN), “Under the eNLC, nurses are able to provide care to patients in other eNLC states, without having to obtain additional licenses. Nurses with an original NLC multistate license will be grandfathered into t eh eNLC. New applicants residing in compact states will need to meet 11 uniform licensure requirements. Those who do not meet the new licensure requirements may still be eligible for a single state license.”
While 24 of the 25 states in the original NLC have successfully transitioned to the eNLC, that’s not all there is to know. Certainly, there are plenty of states that easily transitioned, but some will not be included, some have been added, and others may be waiting to join pending state legislation that makes their path to eNLC possible.
Healthcare staffing agencies should educate themselves on the status of all states in order to help guide their travelers and facilitate hassle-free starts by ensuring that your travelers have all the necessary credentials for the job they’re meant to fill.
Luckily, the NCSBN has some excellent resources, FAQs, and updates available on their website. To learn more and to educate yourself, your team, and your travelers, click here.
The long-predicted wave of retirements among Baby-Boomer nurses is already underway, new data suggests from the AMN Healthcare 2017 Survey of Registered Nurses. This news intensifies the growing crisis of healthcare workforce shortages, forewarned by recent projections from the US Bureau of Labor Statistics that there will be more than 600,000 job openings per year for healthcare practitioners and technical occupations over the next decade.
Nursing shortages are already being felt throughout the country, and they are expected to intensify as the retirement wave becomes a more significant factor. The retirement wave is combined with other macro trends, such as the rising demand for healthcare services from our aging general population, to create a perfect storm of steadily worsening clinical workforce shortages.
According to the AMN Healthcare 2017 Survey of Registered Nurses, the percentage of nurses planning to retire in less than a year has risen significantly – to 27% in 2017, which is up from 16% in 2015. At the same time, the percentage who say they will retire in four years or more declined.
This suggests that the retirement timetable for Baby-Boomer nurses has advanced. The 2017 survey also showed that 73% of Baby-Boomer nurses who are planning to retire say they will do so in three years or less.
Other Research Confirms Retirement Wave and High Demand
The number of Baby-Boomer RNs peaked at 1.26 million in 2008; since 2012, roughly 60,000 a year have exited the workforce and that number is climbing. By 2020, Baby-Boomer RNs will number about half their 2008 peak, according to recent research from the Center for Interdisciplinary Health Workforce Studies. The declining numbers of Baby-Boomer nurses confirm the retirement wave.
The AMN Healthcare research on nurse retirements closely follows the latest Bureau of Labor Statistics (BLS) Employment Projections for 2016-2026, which showed that the healthcare industry will soon become the nation’s largest employer. The BLS data revealed that job openings for healthcare practitioners and technical occupations will average 624,000 a year. For non-clinical healthcare support occupations, there will be another 635,000 job openings per year.
Nurse job openings will average 204,000 per year over the next decade, according to the BLS.
Nurses Say Shortages Getting Worse
Comparative data from AMN Healthcare 2017 Survey of Registered Nurses also reflect a growing recognition from the front lines of healthcare that the nurse shortage is getting worse. The percentage of nurses who say shortages have worsened in the last five years grew from 37% in 2015 to 48% in 2017, while the percentage who said shortages have not worsened dropped from 34% in 2015 to 22% in 2017. Comments from survey respondents reflected their concern that nurse shortages can affect quality of patient care.
The retirement wave of Baby-Boomer nurses will create a particular drain on clinical expertise and institutional knowledge, which are critical to quality patient care and organizational success for healthcare providers. Our research, coming closely behind the BLS projecting an astonishing number of job openings for nurses, should be a wake-up call, because the healthcare industry will need solutions to cope with this impending crisis.
POSTED BY SARAH WENGERT, SENIOR CREATIVE CONTENT WORDSMITH, MEDICAL SOLUTIONS
A recent study from KPMG illustrates the fact that using Travel Nurses can provide a cost savings to hospitals throughout the United States.
According to the 2017 study, since KPMG’s last study in 2011, the U.S. economy has continually improved, leading to an increased demand and increased wages for nurses. The study investigates some of the factors and trends that can help hospitals better understand the overall cost of their labor and how to best implement a composite of full-time and supplemental labor strategies.
Hospitals who use Travel Nurses will appreciate the finding that Travelers save them costs on several levels. As the study indicates:
“When all costs are considered, traveling nurses appear to cost less than permanent nurses on an hourly basis. Cost data provided by hospitals indicates that the hourly, all-in cost for a full-time, permanent nurse is approximately $89. This hourly cost is higher than traveling nurses that cost approximately $83 per hour.”
Costs considered in KPMG’s measure included overtime pay, paid time off, retirement, insurance, recruiting, and payroll taxes — all of which vary by nurse type — while also investigating the various hidden costs associated with perm nurses, such as non-productive labor hours, more extended training/orientation, attrition, and resources needed to hire and re-fill positions.
For NATHO members, this data can be incredibly helpful in educating your hospital clients about how your services can help them cut costs while providing optimum patient care! Feel free to use KPMG’s study as an educational resource.
NATIONAL ASSOCIATION OF TRAVEL HEALTHCARE ORGANIZATIONS
Address: 5329 Fayette Avenue, Madison, WI 53713
(646) 350-4083, firstname.lastname@example.org
© 2019 National Association of Travel Healthcare Organizations. All Rights Reserved.