Nursing Workforce Shortage and Promising Solutions

The discussion begins with an introduction to the nursing workforce crisis, highlighting the challenges faced by Advanced Practice Registered Nurses (APRNs) due to the mass exodus of RNs from the field. The crisis has been exacerbated by newer RNs leaving the profession, leading to a significant staffing shortage. The panel, consisting of five experts, is introduced, and the moderator, Dr. Jim Bellinghoff, emphasizes the importance of addressing this issue. The recording of the discussion is announced, and participants are asked to mute their microphones and video when not speaking.

The panel discusses the cyclical nature of nursing shortages and the rapid changes leading to the current crisis. The pandemic has played a significant role, with the initial uncertainty around the virus transmission and treatment leading to quick adaptation and innovation in care models. The fear of the virus and its impact on fertility and family health led to early retirements and new nurses leaving the profession. This created a staffing shortage, with high costs for organizations as they turned to staffing agencies and travel nurses. The discussion also touches on the challenges of replacing nurses who resign, with a significant time lag between posting a position and it becoming productive.

The panel explores potential solutions to the nursing shortage, emphasizing the need for change in work models and environments. The importance of recognizing the value and image of nurses in society is discussed, as well as the need to engage diverse backgrounds in the profession. Strategies include changing work hours, leveraging technology, and focusing on the well-being of nurses. The panel also discusses the need for policy advocacy and societal initiatives to support career progression in nursing, including scholarships and loan programs.

The American Nurses Association (ANA) and other organizations have collaborated to address the nursing shortage, forming a think tank to develop quick-acting solutions. The think tank produced six recommendations focusing on building a healthy work environment, diversity, equity, and inclusion, work schedule flexibility, stress management, innovative care delivery models, and total compensation. The ANA has also developed a worksheet for leaders to score their progress in implementing these recommendations, aiming to retain and attract nursing talent.

Dana-Farber's senior vice president discusses the hospital's strategies for recruitment and retention, including the implementation of residency programs for newly licensed nurses and fellowship programs for those without oncology experience. The hospital has also focused on hiring diverse talent and adjusting compensation to attract and retain nurses. Flexibility in scheduling, financial incentives, and remote work opportunities have been introduced. The elimination of travel nurses and the creation of a float pool with incentives have also been part of their strategy, which has significantly reduced turnover rates.

The discussion emphasizes the importance of academic practice partnerships and the need for more faculty to address the nursing shortage. The concept of hybrid models is introduced, where nurses could work in both clinical and academic settings. The benefits of such models for recruitment and retention are highlighted, as well as the need for strong mentorship and professional development. The importance of leadership and culture in nurse retention is also discussed, with a focus on frontline leaders and their role in creating a positive work environment.

The conversation concludes with a look at the future of nursing, focusing on innovation and policy changes. The need for a multi-faceted approach to solving the workforce crisis is emphasized, with a call for collaboration across healthcare organizations and society as a whole. The potential of virtual nursing and the development of standards around it are discussed, as well as the importance of maintaining relationships with nurses who have left for travel nursing. The conversation ends with a call to action for nurse leaders to engage with finance departments and a recognition of the critical role nurses play in healthcare.