The healthcare workforce is one of the foundations of modern civilization – the knowledge that someone will be there to help you whenever you’re sick or injured is something that we can tend to take for granted in developed nations.
But such a system doesn’t just happen, and ensuring that there are enough skilled cogs to keep the machine running is perhaps the most important part of the equation.
Over the course of 2020 the healthcare workforce saw more challenges and changes than any other year in living memory. And healthcare staffing firms have played a key role in helping professionals face challenge and change.
What exactly have these challenges and changes been? And how have staffing firms supported workers during such tough times?
To get a sense of how things have changed for the healthcare workforce, it’s perhaps best to check its current temperature.
Healthcare professional burnout has been a reality for years. The industry will continue to face severe nurse and physician shortages in years to come – stats point to the fact that yearly shortages in the hundreds of thousands will be commonplace over the next decade and beyond.
And so we come to the year 2020, which has seen fit to add a splash of global pandemic to this already delicate mix. The effects were immediate, cruel, and relentless, and cases of healthcare burnout and fatigue escalated exponentially.
Nurses and physicians were tasked with taking care of many more patients than usual, who were sicker than usual. In many cases they were denied much needed time off, even over the holidays, adding further stress. If they weren't denied, they were enticed with additional pay that was hard to pass up to work countless hours, and at times without breaks.
With endless patients to treat, resources are being redirected from areas of less immediate concern, which only serves to heighten issues in the long run. A lack of orientation and training means new arrivals are thrown in the deep end. More experienced professionals are being asked to wear extra hats - there are instances of hospitals lacking CNA, unit clerk, and housekeeping professionals, leaving nurses to do admin and clean up tasks.
“I talked to an anesthesiologist in Florida a few months back,” explains Christian Hall, Regional Vice President of Consilium Staffing. “She had never worked in an ICU, but she had been tasked with running a wing at one of the major hospitals in New York. She was on a locum assignment.”
In short, new professionals are getting thrown in unprepared, experienced professionals are getting worked to the bone, and all the while both are being asked to pick up a lot of slack, doing things that other professionals would usually be tasked with.
Fatigue and burnout are the unavoidable result.
“The physical toll is one thing,” notes Cathy Vollmer, VP of Operations at Conexus MedStaff LLC, “but what about the emotional toll this all takes?”
This is perhaps most prevalent in the inexperienced professionals who aren’t as prepared for the realities of the job. “It used to be that nurses were offered the time and resources to build up their knowledge and emotional resilience,” explains Vollmer, who was an RN in another life, “but that simply isn’t the case right now.”
Add to that the fact that nurses are being asked to deal with the families without the patient, the patient without their families, and the subsequent distress on both sides. What’s more, they may not be comfortable with talking to other nurses about what they’ve seen bedside, feeling that colleagues may not have the emotional wherewithal to deal with those issues on top of their own.
This is a particularly disheartening situation for the fact that people become nurses and physicians because they want to help others. When they can’t help, and when that happens day in and day out like a nightmarish Groundhog Day, the profession becomes incredibly draining.
Hall notes that the consequences extend far beyond the human side too. “There are very real malpractice implications that come from fatigue and burnout. It’s far from ideal to have tired people making life and death decisions. Beyond the main priority of patient health, the malpractice implications are something that people are less inclined to talk about, but they should be at the forefront of everybody’s mind.”
In short, the current situation is hugely challenging. But it’s far from hopeless. In fact there are a great number of things that healthcare staffing firms can do to ensure that their workers feel supported, and as a result help as many people as possible.
At a base level a staffing firm must work with their clients to ensure placed professionals aren’t overworked. This can be a challenge when many hospitals provide such enticing incentives to those willing to pick up extra shifts, but ideally a hard limit should be imposed on the number of hours a given nurse or physician can work.
In an industry hamstrung by talent shortages, staffing firms and clients must be willing to be adaptable. If you can’t source another RN or physician, some form of ancillary support should be supplied – a lower level professional who can at least ease the burden.
Those foundational support steps taken, more human support strategies can then be built on top.
“It used to be that we’d call nurses to check their schedules or get their credentials,” says Vollmer, “but now we’re calling them to see how they're doing, to have a chat, to arrange coffee catch-ups.”
For their part, Conexus MedStaff supported their nurses in all manner of other ways:
They felt that it was important to offer a range of support options, as a mindfulness app will speak to one individual, while a coffee catch up will speak to another.
In an isolated world, the importance of tech in providing this support cannot be underestimated. Seemingly simple mindfulness and meditation apps like Headspace and Calm can provide much needed respite to weary workers. Other, more niche solutions can be even more helpful; Disappearing Doctors is a community of physicians that support one another through shared experience. Simply pointing out such a community to a placed professional can have a marked effect on their mental health.
But in an ideal world, all of these will be nothing more than temporary solutions. There is light at the end of the tunnel, and the promises of tomorrow will also help professionals to push through the challenges of today.
While fatigue and burnout will inevitably result in many professionals leaving the industry, the nurses and physicians who stay will have learned valuable additional skills. In some ways we’ll have a more highly skilled and resilient workforce.
The pandemic has seen the development of stress and fatigue mitigation strategies that will hopefully extend far beyond the virus. For nurses, a four-hour active shift might be followed by a less stressful four-hour charting or support shift, or every third shift could be as a screener. A physician can be just as valuable consulting in the ER as they are being a physical part of the front line. Such adaptability can lessen the physical and emotional load.
For most of us, 2020 has felt more like five years than one. But that has meant that healthcare professionals have gained the equivalent of five years of experience.
In an indirect way the pandemic may even do its part to address the ongoing shortage of health workers. In a job market replete with redundancy and furlough, healthcare is a constant, making it an attractive option for those out of work. And with greater visibility comes greater acknowledgement. “To see nurses, physicians, and frontline workers being exalted as such heroes, it has been amazing for that career and for those people,” says Vollmer.
The new year will bring in a new White House administration, which in turn will bring a focus on access to healthcare. Changes are likely to be made to the Affordable Care Act, improving it and making it more available. This will lead to further challenges, but of a distinctly more positive variety –a greater demand on providers purely because more people can access healthcare.
“I'm hoping that perhaps this pandemic is a wake up call that pushes us to make some reforms that will be beneficial for everybody in the long run,” Hall notes.
When we need them, will a doctor or nurse be there? For most of us this question has never crossed our minds, but 2020 has shown us that healthcare, like many other of our systems, is vulnerable in certain circumstances.
The integrity of our healthcare system must be maintained through the pandemic. Ideally it will come out the other side stronger than ever. And a significant portion of the responsibility for ensuring as much sits on the shoulders of healthcare staffing firms.
Real support can no longer be treated as an optional extra – it must be a non-negotiable.
Happily, listening to Hall and Vollmer, it sounds as though healthcare is in good hands.