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Attracting, retaining talent amid the travel nurse surge

Rural hospitals have been grappling with significant staffing shortages for some time, compounded by the Baby Boomer generation retiring, the COVID-19 pandemic, and burnout. Then the travel nursing surge hit.
As hospitals leaders scramble to secure nurses to care for patients, we have seen increased salaries and a bidding war over nurse talent that have driven the average nurse pay rate up. This has hit rural health care facilities particularly hard, where often budgets can no longer compete with larger health care systems.
“It was the spinoff of that that no one saw coming: These rural hospital nurses would then leave their permanent positions to take these travel nurse jobs,” says Earl Dalton, Health Carousel chief nursing officer, who has more than 25 years of acute hospital experience. “So all of a sudden it’s like: How do we support our facility partners through all these collisions of staffing problems?”
The American Nurses Foundation and Joslin Insight recently released the results from a survey that studied the continued impact the pandemic has had on America’s nurses. This is one of several new industry surveys that shed light on the current state of nurse staffing.
Below are four things rural health care facilities can learn from the newest survey data, along with expert analysis to help with attracting and retaining nurse talent amid this staffing crisis.

1. Travel nurses will continue to be a successful strategy
Nearly 9 out of 10 nurses indicated a staffing shortage at their organization, according to the American Nurses Foundation survey, which had more than 22,000 nurses respond. “The nursing profession is at the height of the nation’s workforce shortage,” ANF says.
The nurses were asked about solutions that have had a positive impact on their work environment. The No. 1 response: Recruit travel nurses. Sixty-two percent of nurses agreed. A staff shortage can lead to a decline in quality measures, workflow disruption, and patient dissatisfaction, as well as low morale among employees and increase in turnover rate, Dalton says. Hiring short-term staff like travel nurses can be a critical strategy to cover gaps, protect patient care, and decrease staff turnover.

2. Create more flexible scheduling options
It is not uncommon for nurses in rural facilities to work long shifts or block schedules – one week on followed by one week off. “That’s not an attractive option for all nurses,” says Dee Kilfoyle, Health Carousel business development director. “More recent nursing graduates prioritize flexibility and a work-life balance.”
When asked what would improve work satisfaction, more than a quarter of the nurses surveyed chose “support my work-life balance.” One pediatric nurse in San Diego, Calif., says, “If my organization would just allow me to take my breaks and have lunch, I would be happy.”
In a recent survey by the American Organization for Nursing Leadership, 42 percent of nursing leaders identified flex scheduling as a possible solution to staffing crises. Finding ways to allow nurses to have more control over their schedule can boost nurse satisfaction and reduce turnover.

3. Use predictive forecasting to set your quarterly staffing plan
“It’s more critical than ever that rural hospitals proactively predict their staffing,” Dalton says. “It takes time to fix the potholes in the road ahead.” Dalton advises hospitals to begin quarterly predictive staffing reviews to analyze census to staffing ratios.
Most health care facilities only look at true vacancy, or how many positions exist in the budget vs. how many of those positions are currently vacant. The key, Dalton says, is to consider operational vacancy. Operational vacancy factors in not only vacant positions but also the employees who are unavailable to work a shift for various reasons, such as vacation, maternity leave, or active duty.
“If you can predict yet another road bump that’s coming into your future, you can be ahead of filling that with temporary labor or, if it makes sense, full-time labor,” Dalton says. A proactive approach like this is particularly important in rural settings, he adds, because it can take longer to arrange the hiring and lodging for short-term staff.

4. Create a culture of gratitude and appreciation
Seventy-five percent of the nurses who responded to the American Nurses Federation study reported feeling stressed, frustrated, and exhausted. Only 19 percent of nurses under age 35 feel their organization cares about their well-being, according to the same survey. Recent research shows that symbolic awards — like congratulatory cards or public recognition — can significantly increase morale, performance and retention, according to the Harvard Business Review.
Dalton agrees that recognition is powerful. Nursing leaders can get creative in how they express this, but it can be as simple as a handwritten note or thank you card. “Those things are worth their weight in gold and really cost nothing but are so incredibly impactful and powerful to a nurse,” he says.
Timely and specific feedback is best, Dalton says, such as mentioning something specific the nurse said or did that day, even something as simple as a procedure done correctly. Dalton recommends adopting a scorecard model, where nursing leaders track how often they are recognizing nurses daily or weekly.

5. Partner with the right staff agency
Reaching, vetting, and hiring talent is a skill — ​​and not one that many hospitals have in house. Partner with the right staffing agency for national reach to find high-quality talent.
Dalton offers five key checkpoints for vetting potential staffing firm partners:
  1. Learn about the firm’s true recruiting capability. How many people will specifically be assigned to help your hospital?
  2. Ask about their marketing strategy. How do they plan to reach selected audiences?
  3. Do they have clinical competency? How important is that to their firm?
  4. What is their digital presence and reach?
  5. How will the partner support logistics, including the relocation of nurses? This can be particularly critical in rural settings, where the housing market has created challenges for hiring nurses.
NRHA adapted the above piece from Health Carousel, a trusted NRHA partner that offers three unique recruiting brands for short-term and long-term staffing solutions.

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