As the demand for nurses grows, some Mid-South hospitals have responded to the shortage with various recruitment and retention strategies. But despite the efforts, several experts say hospitals will continue to face staffing challenges because of the retirement of baby boomers, an aging population, and a shortage of nursing faculty in higher education.
Memphis-area hospitals compete for both new and experienced nurses by offering incentives such as referral bonuses, tuition reimbursement, loan payment programs, internship and residency programs, employee-friendly work environments and recognition and professional development programs.
“Compensation is an issue, but it’s hard to retain nurses when there is a shortage, so it’s important for hospitals to maintain career development at bedside for nurses and provide areas for advancement,” said Wendy Likes, Ph.D., professor and dean of the College of Nursing at the University of Tennessee Health Science Center. “Nurses want to work in an environment where they are recognized and appreciated.”
Many Mid-South hospitals offer compensation bonuses for nurses depending on areas where there is dire need. Earlier this year, Saint Francis Hospital offered $10,000 signing bonuses for hard-to-fill positions such as medical surgical nurses and emergency department nurses.
Carol Ross-Spang, chief human resources officer with Methodist Le Bonheur Healthcare, said Methodist offers a special referral program for medical surgical nurses. Any employee who refers a new hire for the medical surgical unit will receive a referral bonus as well as the new employee.
Additionally, officials at Saint Francis, Methodist and Baptist Memorial Heath Care say they recognize that nurses want a pathway for advancement. Baptist and Methodist officials mention that they offer tuition reimbursement programs and loan payment programs for nurses.
According to Ross-Spang, Methodist spends $3 million annually on tuition reimbursement for its employees to further their education.
Susan Ferguson, vice president and chief nurse executive at Baptist Memorial Health Care, said Baptist offers a tuition loan payment program in which $12,000 is paid over three years to a nurse who has recently graduated from a nursing program.
“Additionally, we offer a program funded through our foundation for Baptist nurses who want to continue their education and receive a bachelor's degree,” Ferguson said.
Additionally, Baptist, Methodist and Saint Francis honor their nurses in various ways during National Nurses Week, which this year is the second week in May.
“Turnover and retention are directly correlated with leadership,” said Lisa Cox-Shafer, senior vice president and chief nursing officer for Regional One Health. “People leave managers, not institutions. Hospitals must have engaged leaders who engage a team, are problem solvers and work with employees toward specific goals.”
Nancy Averwater, vice president and chief human resources officer at Baptist Memorial Health Care, said it’s critical to invest in leadership development to make sure hospital leaders are well equipped the handle each employee’s needs.
Baptist has implemented a program called the Baptist Leadership Development Initiative in which more than 1,000 leaders from across the hospital system meet quarterly in one room for an entire day to listen to various speakers on relevant management topics.
Currently, Baptist’s retention rate is 88 percent, which is above the national average. According to the 2017 National Healthcare Retention and RN Staffing Report, which is compiled by Nursing Solutions, Inc., a recruiting and retention firm, the national turnover rate for nurses last year was 16.2 percent.
Nikki Polis, chief nurse executive for Methodist Le Bonheur Healthcare, said Methodist invests in nursing students and new nursing graduates by offering internships and externships for nursing students and an RN residency program, which she says is part of Methodist's overall retention plan.
“Our retention plan starts early, and we consider these programs as part of our retention strategy,” Polis said. “Last year we hired 300 nurses into our RN residency program, which is a program that helps transition newly graduated nurses into the workplace.”
The results are seen in the hospital system’s demographics.
According to Fortune magazine, 32.4 percent of Methodist employees are millennials.
Methodist Le Bonheur’s efforts have been noticed nationally. The hospital system was recognized this year by Fortune as one of its 100 Best Companies to Work For.
According to Ross-Spang, Methodist’s turnover rate for first-year nurses is well below the national average. Streamline Verify, a human resources management organization that focuses on exclusion screening for medical professionals, says 17.5 percent of nurses leave their jobs within the first year after graduation.
“We have fluctuated between 8 and 12 percent since our internship programs started three years ago,” Ross-Spang said.
Despite the various compensation packages, bonuses, leadership programs and recognition efforts of hospitals, demand for nurses is outpacing supply, which creates more opportunities for nurses.
“There are now more opportunities for nurses,” Ross-Spang said. “There is an increase in acuity in a hospital setting, and as a result there is a need for more nurses to care for patients.”
Regional One's Cox-Shafer agrees.
“Nursing is different now than 20 years ago,” she said. “Much has been pushed to an outpatient setting, and the patients inside the hospital are more acute.”
Additionally, baby boomers are driving up the need for healthcare and are approaching or beyond retirement age. According to the Bureau of Labor Statistics, 1.2 million vacancies will emerge for registered nurses between 2014 and 2022.
“Baby boomers are retiring and hospitals want to have a mix of experienced nurses and new graduates in every unit,” UTHSC's Likes said.
The American Nurses Association reports that 53 percent of nurses are older than 50, and predicts that one-third of the current nursing workforce will reach retirement age in the next 10 to 15 years.
In addition to a national nursing shortage, there is a shortage of nursing faculty at universities as well.
Several Mid-South nursing professors and chief nursing officers attended the Tennessee Deans and Chief Nursing Officers meeting in Brentwood, Tenn., last month and learned that nursing student enrollment has increased in the state.
“There is an increase in nursing student enrollment in Tennessee, but the nursing education system hasn’t kept pace, which has created a bottleneck in which nursing programs are having to turn away potential students because they have to meet a certain teacher/student ratio,” Likes said.
According to an American Association of Colleges of Nursing report, nursing schools turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints.
“Compensation is an area for concern, but nurses are clinicians by nature,” Likes said. “Academia is foreign to them, and there isn’t a good pipeline to choose from currently.”