April 2024 | Point of View

The nursing labor shortage myth: Why healthcare needs fewer superheroes and more teams

Healthcare leaders need to rethink skillsets, not headcounts

The nursing labor shortage myth: Why healthcare needs fewer superheroes and more teams

Across the healthcare industry, leaders and analysts can’t seem to stop talking about a crisis with no immediate solution: a severe shortage of nurses. With an aging patient population whose demand for healthcare services is only projected to grow, how can the industry prevent this problem from spiraling out of control? Simply filling vacancies will not solve this problem; instead, healthcare leaders must rethink care team structure and fully understand the key drivers of nurse job satisfaction.

Healthcare leaders can significantly reduce the nursing shortage by enabling their nurses to prioritize what they do best: providing top of license clinical care. West Monroe’s analysis shows that up to 50% of traditional inpatient bedside RN tasks can be performed by LPNs, CNAs, PCTs, and/or virtually. Many other studies, including those performed and cited by National Nurses United, also support that today’s perceived shortage is a misconception.

Complementing bedside nursing teams with additional staff that have diverse skillsets will allow more top-of-license practice from the existing RN workforce and decrease time spent on non-clinical tasks. Additionally, diversifying the skillsets–and backgrounds–of the bedside care team can remove barriers to equitable healthcare, as it is well known that patients receiving care from providers with shared backgrounds improves their clinical outcomes.

In this article we will cover key aspects required for healthcare leaders to make this strategic shift, including:

  • Where nursing talent is bogged down by tasks below their licensure
  • Steps healthcare leaders can take to tap into a more effective labor model by expanding hiring to a more diverse care team
  • How this diverse care team can lead to widespread benefits for the healthcare system, from improved patient outcomes to increased employee satisfaction to a strengthened financial outlook

How we got here: The current state of the nursing crisis

As the population continues to age, the incidence of chronic conditions will further rise—with a projected 8% increase in adult inpatient days over the next decade. This demographic shift, paired with the continuing aftermath of the COVID-19 pandemic, has significantly burdened healthcare facilities and their clinical staff who are struggling to keep pace with the growing demand for care. 

On top of patient care needs rising, in today’s current model, nurses are bogged down by non-clinical administrative tasks, with more than half of nurses reporting at least two hours per week spent on scheduling alone. The fallout of these compounding factors? High turnover and vacancy rates among nurses, heightening the challenges faced by the healthcare industry. The national turnover rate for registered nurses is currently 18.4%, an improvement from 22.5% in 2023 but still treading above pre-pandemic levels (closer to 16%). While the vacancy rates have almost achieved pre-pandemic levels, and currently at 9.9%, there is still a significant gap between population health care needs and the available workforce to meet those needs. 

A key component to combatting nurse burnout: Align responsibilities with expertise

The prevailing narrative of a nursing shortage masks a deeper concern: inefficient utilization of a highly skilled nursing workforce. Clinical, operational, and financial inefficiencies are becoming the catalyst for eroding job satisfaction and heightened burnout. The solution lies not in extracting more labor from nurses—nor in the allure of an automation silver bullet—but in a strategic realignment of the care team. Shifting tasks that are not at the top of registered nursing licensure to a broader, more diverse healthcare team can lighten the load on nurses, allowing them to focus on what they do best while also cultivating a more inclusive care team reflective of the patient population.

Hospital leaders hold the keys to several actionable strategies that can shift bedside care teams’ roles toward more specialized tasks. Potential strategies include: 

  • Empowering nurses through ongoing leadership development: Prioritizing development of managerial skills will allow nurses to delegate effectively and foster a culture of trust and teamwork.
  • Clarifying roles and career growth paths for all bedside staff: Redefining bedside roles with clear advancement and compensation growth opportunities can make their work more rewarding and engaging, improving retention. 
  • Refining staffing models: Establishing innovative staffing strategies that accommodate virtual options and flexible shifts while diminishing dependency on agency nurses will lead to a more beneficial scheduling system for all. 
  • Leveraging predictive modeling and staffing tools: Utilizing digital tools that can quickly predict expected patient volume and acuity while aligning staffing levels accordingly to reduce the impact of demand surges. 

By implementing these solutions, healthcare leaders can realign nurse tasks with their clinical expertise, prevent burnout, lower operational costs, and rejuvenate the nursing profession. This strategic shift promises a work environment where bedside teams are empowered, patient care is optimized, and the workforce is more reflective of—and responsive to—the community it serves.

Innovative staffing solutions in healthcare workforce

A retail pharmacy wanted to redefine its operations to run more efficiently—and more cost-effectively. They struggled with rising costs and a growing number of abandoned prescriptions due to lengthy wait times. As we dug into their operations, we found that 49% of tasks performed by pharmacists could be performed by technicians, allowing them to better leverage their employees, improve customer experience, save money, and drive revenue.

Tapping into a more diverse labor model to benefit everyone

In the pursuit of better healthcare delivery and improved patient care, one solution stands out with the promise of numerous benefits: diversifying the bedside care team. Healthcare organizations stand to gain on multiple fronts by expanding their hiring framework to encompass a broader spectrum of professionals. This innovative care team model is not only a pathway to cost reduction but also a leap toward a more inclusive and versatile approach to patient care. 

Key to this model is the integration of a wider range of staff roles, with varying levels of training and areas of focus. Thinking strategically about incorporating these roles will allow for a more comprehensive patient care experience while also supporting nurses in a much-needed pivot back to their core competencies and career value proposition. Such an adjustment could optimize the entire operational framework of healthcare delivery. 

One of the most profound benefits of this expansion may be in the fostering of a more diverse care team. This diversity—encompassing factors such as gender, race, ethnicity, and lived experiences—can create a care environment that more closely mirrors the community it serves. Patients tend to resonate with care delivered by those who share similar backgrounds and unique experiences. Accomplishing the care model shift we are recommending can foster inclusivity and cultural competence essential for addressing more nuanced health needs of a diverse patient population. Improved connections with their care team can significantly enhance patient trust and satisfaction, encouraging increased engagement and adherence to treatment plans. Ultimately, embracing a more diverse labor model not only strengthens the operational and financial foundations of healthcare institutions but also elevates patient care to new heights—marking a pivotal step toward a more equitable and effective healthcare system. 

Re-imagining the team delivering value, an example outside of healthcare  

A leading food service distributor wanted to redefine how its workforce was deployed across its operations to improve productivity, worker safety, and throughput. We implemented process and technology changes that improved efficiency by 25% across the organization. What’s more, because the changes we made were fair, attainable, and offered added incentives to employees, they were well received by both the employer and employees. We also understood the requirements of the labor union so that our standards have never lost in arbitration in our 16-year partnership with the distributor. 

Conclusion

In surveying the need to transform healthcare's labor landscape, traditional solutions will no longer cut it. Leaders must think on a long-term time horizon, advocating for a strategic overhaul that prioritizes skill allocation, reduces dependency on expensive agency labor, and embraces a more diverse workforce. The call to action is clear: Rethinking old staffing models and building anew with a more patient-centric and cost-effective care delivery team. Is your organization ready to answer that call?

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