You will get sick. There might not be anyone to care for you.
You are going to get sick. So am I. There might not be anyone to care for us.
I was sitting at a board meeting, listening to members of the Federal Reserve and the Nebraska Department of Labor speak about the current labor conditions, when those thoughts crossed my mind.
If we have met, you probably know that I am mostly a "glass half-full" type of person, and someone who is 100% about getting things done. I left the meeting not scared but re-energized to continue to help healthcare employers retain their employees and eager to share with others how they can help. So here I am on the weekend, drinking my coffee and writing this short synopsis of the current state of healthcare.
I invite you to read this quick post and hope you'll join the solution so that you, your loved ones, and I can receive healthcare when we need it.
What is happening?
There are many industries and jobs impacted by a tight labor market; healthcare is one of them. To put it into context, for every open Registered Nurse job, there are only 0.13 candidates in Nebraska. Let that sink in; there is less than one person to hire. Other healthcare jobs have similarly limited talent pools to fill. This is a national and global trend, not just a Nebraska problem. The U.S. alone is expected to have a shortage of 1.2 million nurses by 2024 and an expected shortage of doctors by 2031.
Unfortunately, the problem is only getting bigger. There are several trends contributing to a healthcare worker shortage tsunami.
We are aging, and so are your doctor and nurse.
The US is aging as a whole. As we age, we need more care and the US grew older, faster, last decade. The share of residents 65 or older grew by more than a third from 2010 to 2020, and it will continue to grow as baby boomers age.
At the same time the average age of nurses in the US is 52, and the average age of physicians is 53. This means in a few years, they will hit retirement. Unless younger generations choose healthcare as a profession (and stay), we will be short-staffed.
Working in healthcare is rewarding but hard.
Which leads me to why people choose or don’t choose healthcare as a career. People join healthcare to improve patients' lives. While I have never worked in healthcare, both of my parents have (one still does), so I have lived closely with the type of people it attracts and the sacrifices they make. I could write several pages about the sacrifices I have seen my parents make, but it is sufficient to say that working in healthcare comes with long hours, high levels of stress, and most of the time, little flexibility.
One could argue that work conditions have been getting worse. As people leave healthcare for other industries or decide to make more money by becoming a traveling nurse, those left behind have more work on their plate, leading to more stress and more workers leaving. Only two out of three healthcare employees intend to stay with their employer over the next 12 months, and in many cases, they don't even last a year on the job. For example, on average 27.7% of first-year RNs leave their jobs during their first year of work.
Employees' expectations have changed.
Contributing to this exodus is a shift in the expectations employees have from work, particularly younger generations.
The workforce of today has different priorities in a job. They prioritize a job that will allow them to live a life well-lived, with time for more than work. It doesn’t mean they don’t want to work, but COVID was a wake-up moment about the fragility of life. That time to travel or spend time with family after working non-stop might not be there because they themselves might not be there to enjoy it.
It is hard for the healthcare industry to compete with the employers that can offer remote or hybrid work or pretty comparable pay but without the need for certifications or higher education. Not to mention, it is a lot less stressful to deliver packages than it is to care for another human (I would argue however, it is also less rewarding).
Economic pressures.
There is another factor contributing to the shortage: economic pressures. The costs of healthcare have gone up, but not revenues. Many hospitals, assisted living facilities, and clinics have been relying on traveling nurses to staff their operations. This is a more expensive source of talent. At the same time, Medicare reimburses hospitals less than the cost of providing care, and their reimbursement rates are non-negotiable. Medicare and Medicaid account for most hospital utilization.
This additional cost of labor and underpayment for services is compressing their revenue margins. Thus, they are pushed to trying to make the most with less staff and reducing the opportunity to make investments in their workforce. Which, of course, only leads to more burnout and more employees leaving.
Ok, so if you made it this far, you are probably thinking, “this is what it means to be a glass half-full type of person, Adriana?” Well, the good news is that solving the healthcare worker shortage is a massive endeavor, but not impossible.
What can you and I do?
Here is what we can do:
- Advocate for addressing the social determinants of health in your community. Part of solving the problem is reducing the demand for healthcare through better access to healthy foods, access to preventative care, and a walkable city, to just name a few. In Omaha NE, where I live, The Wellbeing Partners is an excellent example of an organization focused on this.
- Rethink how jobs are designed and leverage technology to free clinicians' time. This is already happening today and is only going to increase. The key will be to ensure the human touch is not lost. Another topic I could write pages about, but the key is that part of healing is being heard by another human and taking a cura personalis approach. I think what Mother of Fact is doing is a great example of making sure that human touch is not lost.
- Finally, it will require us to create better employee experiences for healthcare workers. This is one anyone that receives care can contribute to by being kind and remembering they are doing the best job they can in a many times stressful environment.
For me and the rest of the Maxwell team, it means doubling down on our work. We are excited to continue to help healthcare employers deliver an employee experience that creates joy and teams that stick around.