I am still amazed at how in the matter of a few weeks, we went from record low unemployment to all-time record high unemployment insurance claims. I am also amazed at how in two- or three-months employers went from struggling to fill many types of positions to unprecedented layoffs. The lasting effects of the coronavirus pandemic have caused recruitment innovation to become a necessity for healthcare recruiters and their employers.
During the pandemic, employers who previously shunned video interviews, embraced them and found them to be effective in making quality hires. ‘Sacred cow’ onboarding and orientation processes were set aside in order to get new hires started in record time – and in most cases they worked very well. Also, more recruiters working from home became a new norm at a time of record hiring for some. The saying ‘necessity is the mother of invention’ has never been truer. Perhaps the greatest healthcare recruitment innovation was how rigid and redundant state level licensing processes were suspended in favor of professional licenses being more widely recognized nationally.
Another stark reality exposed by the coronavirus crises was the urgent shortage of qualified doctors, nurses and other types of health professionals. The crisis surge quickly exposed the great vulnerability and fragility of the American healthcare workforce. Within a matter of days, and despite many doctors and nurses being displaced from their ambulatory and primary care positions and available for redeployment, healthcare administrators were sounding the alarm that they did not have the staff needed to care for a growing number of patients. It did not take long for the immutable forces of supply and demand to manifest themselves with hourly rates for nurses in some locations exceeding $150 per hour and even higher contract and travel staffing rates.
Alarms should be ringing among healthcare leaders everywhere as what was experienced for a short period of time during the pandemic, is where creditable workforce projections say we are headed over the next ten years under normal conditions. The staffing panic of recent times should not be forgotten when the pandemic subsides and a sense of normalcy returns to everyday life. The projected shortages of the future will be chronic and not something that will pass in a few months as a pandemic does.
The U.S. Bureau of Labor Statistics projections indicate that more than 203,000 new RNs are needed each year for the foreseeable future to fill newly created positions and replace retiring positions. In the four years between 2015–2018, the number of new RN grads passing the NCLEX exam averaged 157,000. Assuming that each of these new nurses who are eligible to practice enters the nursing workforce, this suggests that every year the nursing deficit is growing by 45,000.
Simply not having enough nurses to fill open positions in absolute numbers is not where this crisis ends. With unprecedented levels of retirements being backfilled mostly with new grads, healthcare employers (particularly in acute care settings) will face a significant loss of nursing knowledge and experience at the same time that the complexity of care continues to escalate. As recently as 2017, The Journal of Nursing Regulation published research conducted by Dr. Peter Buerhaus that projected the U.S. nursing workforce will loose 2 million person years of nursing experience each year from 2020–2030. His projections indicate that the U.S. nursing workforce will have a breathtaking 20 million less person years of experience in 2030 as compared to today.
Clearly employers will need to engage with educational institutions to not only train more nursing students but to ensure that graduates are able to quickly make meaningful contributions to the workforce. This needs to be done without the need for extensive on-the-job residency and training programs. If current healthcare professionals are to be enticed to remain in or return to the workforce, then a recruitment innovation in retention practices is sorely needed.
Additionally, employers will need to increasingly look to recruiting qualified and experienced nursing professionals from other English-speaking countries around the world. While this may not be an entirely new concept, the ability for employers to directly hire high-caliber international candidates into permanent positions without incurring recurring staffing agency and travel nurse fees is already rapidly gaining acceptance. With a motivated cohort of English-speaking nurses around the world who have been educated to U.S. standards and who are often working in modern healthcare facilities in developed countries, international candidates can and will need to be a larger part of the overall workforce than ever before. Having done this very work for the past 22 years, WorldWide HealthStaff Solutions Ltd. has the experienced based confidence to be able to work with healthcare employers of all sizes across the country.
The international nurse recruitment option will become even more attractive than it currently is should the U.S. government place a higher priority on granting permanent residency visas for highly skilled, well paid healthcare professionals. Given that the U.S. Department of Labor has designated Registered Nurses as an occupational group in perpetual shortage for at least 10 years, now is exactly the right time to implement common sense immigration reforms. No reasonable person, regardless of their political views, will be opposed to more doctors and nurses being welcomed to our country.
It will be interesting to see how lessons learned during the pandemic will be carried forward as new best practices. Some questions for healthcare employers to consider:
Will employers embrace recruitment innovation or stick to the same old recruiting ways?
Will employers meaningfully reduce their ‘days to hire’ and ‘days to start?’
Will more recruiters be working from home?
Will professional licenses be more easily transferable from state to state or nationally recognized?
Will medium- and longer-term workforce planning receive a greater priority?
Whatever permanent changes the recent pandemic will bring to healthcare recruitment practices and strategies, it is imperative that healthcare leaders embrace their workforce planning from a perspective of national supply and demand and get away from the pervasive ‘robbing Peter to pay Paul’ recruitment practices of today.
If you are a hospital or healthcare employer seeking to improve your nurse recruitment pipeline, click here to download the USA Client Presentation Guide to learn more about direct hire international healthcare recruiting.