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What Administrators are Thinking and Doing to Address the Nursing Shortage – 2023 Healthcare Executive Report

Jun 13 2023

Nursing professionals know better than anybody how the nursing shortage is affecting healthcare.  You know what it’s doing to morale, you’re worried about what it’s doing to patient care, and you’re wondering what can be done to address the situation.  

You’re not alone in your concern.

This week, Incredible Health releases its 2023 Healthcare Executive Report, an anonymous survey of executives from 100 hospitals and health systems conducted in May of this year. We asked these employers to give us their honest feedback and opinions on nurse staffing, which all agreed is one of the most pressing issues facing their facilities. 

Their answers provide real insight into what’s happening in the C-suites of some of the nation’s largest health systems, as well as in academic medical centers, regional systems, and community hospitals. We’ve compiled the most important information gathered from the report to let you know what hospitals are planning to do to attract nurses, including:

  • Creating more desirable shifts for nurses
  • Providing more educational resources and career development opportunities
  • Improved compensation models

Perhaps the most important thing for nurses to know is that the executives who are running the hospitals are well aware of how dire the continuing (and worsening) nursing situation is. 

  • 94% of health system executives who participated in the survey describe the severity of the nursing shortage in their facilities as critical 
  • 68% of health system executives who participated in the survey said that they do not have adequate nursing staff to manage another large-scale health crisis

While health systems are continuing to feel the effects of the pandemic, many of which have been exacerbated by inflationary pressure, there’s no question that the nursing shortage is at the top of their list of concerns. They acknowledge a disconnect between their nursing workforce and their administration when it comes to recruitment, and that challenge is combined with diminishing retention rates, a disproportionate percentage of nurses with less than five years of experience, and a growing need for nurses in specialty areas.

To answer these challenges and address critical gaps, the executives acknowledge having turned to travel nurses — in fact, 93% have used them to an astonishing degree: when asked what percentage of their nursing staff is temporary, 25% of participants answered between 6 and 15%, and another 25% said between 16 and 25%. While almost all (97%) said they plan to prioritize permanent nursing staff over temporary staff, 55% admitted to having increased the number of travel nurses their health system or hospital used in the past year. 

Today’s nursing professionals have different expectations than those of the past, and administrators say that they are working hard to meet those needs. The survey revealed that more flexible scheduling is the top request that they receive, with more compensation a very close second. Both older and younger nurses want more remote work opportunities, while younger nurses are extremely interested in career advancement and specialized roles. Different hospitals are responding to these shifting needs in different ways: most respond by increasing compensation for staff nurses (26% of respondents) and offering sign-on bonuses (35.4% of respondents) for new hires. But despite work-life balance being the top request of the very nurses they want to hire, hospitals admit that changes resulting in more flexible scheduling and improved patient-to-staff ratios are lagging behind, with just 11.5% offering the former and 15.6 working toward the latter. 

The admitted disconnect between what hospital executives are offering and what nurses want is resulting in the continued crisis, and it is difficult to say when that gap will be closed. Though 70% of administrators point to nurses quitting the industry all together or retiring for the nurse shortage, almost 60% say that there aren’t enough new nurses entering the field. 

With so many nurses leaving their employers and a dearth of new nurses graduating, experience and qualifications are the top things that hospitals say they are looking for when they’re hiring, and that is especially true for nurses in specialty areas. There is a significant overlap in the nurse specialties that executives say are most critical to their health system and the ones they have the hardest time hiring, with Med/Surg nurses, Emergency Department nurses, Critical Care nurses, and OR/Surgical nurses presenting the greatest challenge. Nurses who take advantage of their current employers’ continuing education and tuition reimbursement perks will find themselves of significant value where they currently work as well as at any future employer.

If you’d like to see the full 2023 Healthcare Executive Report, you can find it here. 

If you’re a nurse looking to improve your professional standing and advance your career, start by accessing Incredible Health’s suite of free services here.

Written by Incredible Health Staff

At Incredible Health, it's a team effort to achieve our vision: Help healthcare professionals live better lives. Many are licensed practitioners themselves; others are simply passionate writers and leaders dedicated to providing valuable resources to nurses.

Read more from Incredible Health

STUDY: 94% of health system executives describe nurse shortage as “critical”

Jun 13 2023

Since Incredible Health’s inception, we’ve made it our mission to help healthcare workers live better lives and find and do their best work. Deeply understanding and improving the nurse experience helps us achieve our mission. Time and time again , we’ve heard from nurses that they struggle with the basics of their profession: staffing shortages, limited career advancement, limited flexibility, and compensation. We know what nurses struggle with but not necessarily why.

It’s time to find out. 

Today, we proudly unveil the findings of our 2023 Healthcare Executive Report, Incredible Health’s first-ever public study of health system executives. While our prior reports have focused on the preferences and perspectives of the more than 700,000 US nurses using the Incredible Health platform, this report dives into the thoughts of top health system executives shaping the healthcare industry.

Including input from 100 U.S. health system senior executives from both inside and outside the Incredible Health employer network, this report showcases their concerns, illuminates areas where nurses and leadership are misaligned, and highlights other areas where there remains room for improvement. 

The report’s findings strike a chord of urgency. 94% of respondents described the severity of the nursing shortage in their health systems as critical, and 68% said they do not have the adequate nursing staff to manage another large-scale health crisis. There is a silver lining: healthcare executives, specifically those charged with hiring and retaining nurses, are embracing the opportunity to change their nurse hiring and retention methods to improve the nurse experience, and ultimately patient care. 

Experience and tenure

Average nurse tenure and experience are pressing issues related to hiring. 

40% of health system executives reported that more than a quarter of nurses in their system have less than a year of experience. 

This is in stark contrast to what hospitals are looking for when hiring nurses: previous experience (43%) and qualifications (43%) are tied for the top factors they consider. 

Overall, health systems reported that 53% of nurses had an average tenure of less than five years at their institution.

Misalignment between health systems and nurses

The findings of the study reveal a large disconnect between what nurses look for in an employer and what employers offer to hire and retain nurses. 

Health system executives reported 80% of younger nurses requested more flexible scheduling, yet only 11% of health system executives surveyed actually offer more flexible schedules. Few hospitals are looking to flexibility as a hiring differentiator, and are focusing more on compensation. 

On a similar note, despite a quarter of nurses pointing to limited career advancement training and opportunities as a reason they would leave nursing before retirement, many health systems are not prioritizing these programs and opportunities as a hiring and retention method. 

Sign-on bonuses continue to be the primary method to attract nurses; more than one-third of hospital executives (35%) say they are still offering them. 

Increasing salaries for nurses (26%) and improving patient-to-staff ratios (16%) are other hiring techniques used to attract talent. 

Despite hospitals offering sign-on bonuses and higher salaries to attract talent, Incredible Health’s 2023 State of U.S. Nursing Report found that only one-third (33%) of nurses feel fairly compensated in their roles.

Generational chasm

Generational differences are impacting hospitals as younger nurses demand more from employers.

It is no surprise that nearly all (95%) health system executives have noticed generational differences within their nursing workforce in their approach to work and career growth. The U.S. nursing workforce is currently made up of four generations, from Gen Z to Baby Boomers, with an average age of 52 years, creating a wide age range which can lend to differing opinions, viewpoints, and expectations.

While over one-third (35%) of health system executive respondents point to conflicts between generations on teams, the majority of differences lie in what younger and older generations request from their employers. 

In addition to far more flexible schedule requests from younger nurses, there are also large gaps in:

  • compensation demands: 78% of younger nurses request increases vs. 48% of older nurses
  • specialized roles: 54% of younger nurses seeking specialized roles vs. 14% of older nurses
  • career advancement opportunities: 74% of younger nurses request opportunities vs. 8% of older nurses

Over three-quarters (79%) of executives pointed to a reduction in loyalty and tenure with younger nurses, in contrast to 21% in older nurses.

Temporary nurses

Travel nurses remain a band-aid solution to the nurse shortage in health systems.

Almost all (93%) health systems utilize travel nurses to keep up with patient demand, yet this is a reality that executives are eager to change, as temporary staff significantly impacts the health system’s bottom line with high costs, as well as a negative impact on the quality of patient care and culture in nursing units. 

Nearly two-thirds of respondents (75%) noted that temporary nurses make up a quarter of their nursing staff. 

Nearly all health system executives (96%) reported plans to prioritize permanent nurse staff over temporary staff. Over half of respondents are working towards this goal, as 55% did not increase the number of travel nurses within their hospital systems over the last year. 

Looking ahead

By bridging the gap of what they think nurses want and what they are actually requesting, health systems can work towards solving nurse staffing issues in their facilities.

If your hospital is looking for a better way to hire and retain nurses, click here. Incredible Health’s award-winning marketplace technology helps your talent acquisition and nursing teams hire permanent, experienced nurses in 20 days or less, save at least $2 million per year per facility, and improve nurse retention. 75% of the nation’s top-ranked health systems and 700 US hospitals trust us with finding its most important resource: top, permanent nursing talent to deliver high-quality care. 

If you’re a nurse looking to take control of your career and access Incredible Health’s suite of services for free, click here. 

You can download the visual report that includes more data from the 2023 Healthcare Executive Report here. 


Methodology

We surveyed executives from 100 hospitals and health systems in May 2023. Respondents included a mix of employers inside and outside the Incredible Health employer network. While anonymous, the survey included some of the largest health systems in the United States, academic medical centers, regional systems, community hospitals, in both urban and rural areas.

Written by Iman Abuzeid, MD

Iman Abuzeid, M.D., is the co-founder and CEO of Incredible Health, the largest career marketplace for permanent healthcare workers, with the mission of helping healthcare professionals live better lives, and find and do their best work. The company founded in 2017, has raised $100 million from top venture capital firm Andreessen Horowitz and health systems Kaiser Permanente and Johns Hopkins, and is valued at $1.65 billion, making Iman one of the few CEOs to run a “unicorn” startup (a company valued at over $1 billion). Iman is an MD, and holds an MBA from The Wharton School of the University of Pennsylvania. Iman’s immediate family has 3 surgeons, and as a doctor herself, she understands the importance of choosing the right stepping stones in a clinical career. It’s what drives her belief in Incredible Health and its potential to reliably help clinicians manage their career.

Read more from Iman

Children’s National and the HSC Health Care System Lead the Nation in Pediatric Care

Jun 12 2023

You may not think of yourself as a hero, but from the moment that you chose a career in pediatric nursing, you may as well have put on a cape and leaped over a tall building – at least in the eyes of your patients, the family members, and your colleagues too! While all nurses are compassionate, empathetic, and dedicated to the well-being of their patients, nurses who opt for taking responsibility for children take on a very special role, no matter whether they’re working in a pediatrician’s office helping with vaccinations and well visits or in an acute care setting in a hospital helping children suffering devastating illnesses or injuries, and families facing critical medical decisions. Pediatric nurses working for world-renowned Children’s National in Washington, D.C. or within their affiliated HSC Health Care System experience all of those scenarios and more, and do so in a supportive, empowering environment.

For more than a century Children’s National has been committed to the health and well-being of the nation’s children, and that mission is reflected in its commitment to providing quality healthcare for the patients seeking care within their walls and to improving health outcomes for children regionally, nationally, and internationally. As a result of their efforts and innovations, the hospital’s staff has earned a reputation for being champions for children, and the hospital itself has earned numerous accolades and awards.

From Newsweek recognizing Children’s National as one of the world’s best specialty hospitals to U.S. News & World Report ranking it # 5 in the nation and #1 in newborn care, the facility sets the bar for excellence in pediatric care and in many other areas as well. Employees take pride in the hospital’s high marks from the Human Rights Campaign Foundation for its leadership in LGBTQ+ Healthcare Equality and in its receipt of a sustainability award from the D.C. Department of Energy & Environment. Perhaps most meaningful of all for the hospital’s nurses is its designation as a Magnet hospital from the American Nurses Credentialing Center in recognition of maintaining the highest standards of nursing and patient care. The hospital has received this designation three times. 

Children’s Nation was established more than 150 years ago by volunteers set on treating children who had been displaced after the Civil War. Since that time it has become a national leader in pediatric care and research as well as in community outreach and in setting local, regional, and national healthcare policy. Recognized for superlative care in all of its specialty areas, the hospital has most recently begun work on the nation’s first campus dedicated exclusively to pediatric research while at the same time delivering care through a community-based primary care network and specialty outpatient centers throughout the region. The innovations that this academic health system delivers has resulted in it being the nation’s seventh-highest NIH-funded children’s hospital.

Children’s National is one of the main sources of pediatric care for residents of Maryland, Washington, D.C., and Virginia. The hospital sees approximately 250,000 patients each year, including patients seeking care from 35 countries through its Global Services program. Integral to the care provided are the 1,602 nurses that work at Children’s National and more than fifty additional primary and specialty care locations within the HSC Health Care System. 

Children’s National values its nurses’ roles in excellent patient outcomes, and works hard to ensure that these professionals feel rewarded and supported and are provided with opportunities for development. That has resulted in their nursing staff consistently ranking above the national average in job satisfaction surveys, particularly in the areas of overall job enjoyment. In its efforts to be a place for nurses to grow and thrive, the organization has prioritized four separate areas within its staff culture:

  • Partnering in patient care and decision-making with the entire healthcare team, as well as with patients, families, and the community.
  • Fostering a culture of collaboration and respect while delivering evidence-based nursing to improve patient outcomes.
  • Leadership councils that facilitate shared nursing leadership where nurses both create and administer solutions within their unit, department, and across the entire health system.
  • Working to support nurses’ professional growth and promote professional standards and the profession itself.

Children’s National supports nursing students and recent graduates through structured clinical programs, and does the same for their staff nurses by hosting continuing education events that enhance leadership, clinical, research, and administrative skills. The facility has also created its own Simulation Learning Center where clinical skills and care procedures can be practiced and improved upon. 

Talent development is an essential aspect of Children’s National’s culture. The organization’s coaching and mentorship program was recently recognized by Helios HR with its Apollo Award, and nurses are provided with autonomy and resources that encourage the initiation of research, collaboration, professional growth, education, and shaping the delivery of care within the health system. 

Pediatric nurses who are interested in joining the Children’s National Team will find that it is a remarkable place to advance their career aspirations while delivering the high-quality patient outcomes that first inspired them to join the profession. Nurses working over 20 hours per week are compensated with an excellent benefits package that includes health and dental insurance, vision insurance, retirement plans, educational assistance, and employee reward and recognition programs, as well as life and disability insurance, employee assistance programs, leave, flexible spending accounts, parking, and more. Add all this to the exciting and rewarding work environment at one of the nation’s leading pediatric hospitals and you understand why pediatric nurses at Children’s National report such high levels of job satisfaction.

Pediatric nurses interested in advancing in their careers can begin their search on Incredible Health’s career page. In just minutes you can set up a profile and begin hearing from high-quality employers whose opportunities match your preferences. 

Written by Incredible Health Staff

At Incredible Health, it's a team effort to achieve our vision: Help healthcare professionals live better lives. Many are licensed practitioners themselves; others are simply passionate writers and leaders dedicated to providing valuable resources to nurses.

Read more from Incredible Health

Acing Your Interview for a Pediatric Nurse Position

Jun 09 2023

In the face of a profound national nursing shortage, it’s easy to fall into the trap of thinking that the job you want will be yours once you send in a resume and show up for an interview. Though it’s true that some facilities are loosening some of their requirements in an effort to bring more staff on board, pediatric nurses will still need to prove themselves both professionally and personally. That’s why it is so important that you take the time to fully prepare yourself for your job interview. 

Getting ready means more than polishing up your resume and updating your LinkedIn profile. You need to anticipate the questions that will be asked, put real thought into the answers you’ll give, and practice those answers out loud. Because pediatric nursing requires far more than clinical skills, you will want to demonstrate to each person who you interview with that you have the temperament that makes you the right person for a position working with children.  

Below, you’ll find a list of interview topics. Though the questions you’re asked in an interview may be worded slightly differently than those that appear here, preparing a well-thought-out answer for each one will serve you well. 

We’ve also provided some general interviewing tips to ensure that you are fully prepared and ready to present your best possible self and win the job that you want.


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The Questions You’re Likely to Be Asked in a Pediatric Nurse Interview

#1 – Tell me a little about yourself.

This is almost always the very first question that is asked in a job interview. As tempting as it may be to chat about your love of true crime podcasts or travel, that is not what the interviewer wants to know. The question is meant to find out who you are professionally as well as personally. In preparing for this question, think about how your personality and experience have made you into the pediatric nurse who you are today. 

While it’s fine to talk about having come from a big family or about your education – or even about the sports you play or your hobbies – make sure that every answer circles back to the job and what the employer is looking for in a nurse. This means that your answer should include some of your personality traits that contribute to your professional demeanor: are you organized, empathetic, disciplined? If you can give a self-description and example of how well you work independently or of how you’re a team player, you will make a positive impression.

#2 – What made you choose to become a pediatric nurse?

Because pediatric nurses work with children from birth through young adulthood — as well as with their families — interviewers want to hear more than that you’ve loved children ever since you were a camp counselor, or even that you were inspired by the care lavished on yourself or a sibling. While those motivations are definitely important, your answer should also reflect your emotional intelligence and that you understand and embrace every aspect of the role, from the joy of helping children get well and recover to the stress of supporting family members who are unprepared for their children’s pain, prognosis, or care requirements. Your answer to this question needs to express your love of children, your empathy and compassion, your patience, and your ability to communicate clearly.

3. Why do you want to work here, at our facility?

While it may be true that you’re applying to the facility’s job because of its location, its compensation, or the benefits you’re being offered, your answer needs to reflect the employer’s interests rather than your own. The best way to prepare for this question is to do your homework: carefully read the job description so that you know exactly what the job responsibilities are and the facility’s needs, and spend some time studying the facility’s website too. The more you incorporate words about what the potential employer is looking for, directly from their job description, in your answer, and echo the facility’s description of its environment, goals, and mission, the more you will establish yourself as an ideal employee.  

All that being said, there is nothing wrong with tooting your own horn a bit here too. By talking about the facility’s reputation for quality of care, collaboration, integrity, or other positive characteristics, and say that this is what you’re looking for as you advance in your career, you are crediting yourself and your own personal and professional attributes at the same time that you are complimenting the potential employer.

4. Pediatric patients are often less accommodating than adults, and their parents may be scared or resistant as well. How do you manage patients or family members who are anxious, frightened, nonverbal, or in some other way unwilling to work with you? 

The more experience you have as a pediatric nurse, the more likely you are to have a long list of examples that demonstrate your patience and empathy for fearful, frustrated, and noncompliant patients. Be ready with one or two of these stories, making sure that when you are recounting them you are making clear your respect for the patient’s feelings and the calm and effective way that you communicated and convinced them to participate in the care that was needed.

5. How do you handle high-pressure patient situations? What is your process when you’re faced with the need to make a quick and important decision regarding a patient? 

Your answer here should be an example that reflects your ability to collaborate with others where they are accessible and to act independently and decisively when you’re on your own or are the most senior and experienced voice in the room. You want to demonstrate your confidence as well as your ability to collaborate.

6. Do you ever experience burnout from the job? How do you keep your interest, excitement, and empathy alive?

This question requires honesty. You should not be afraid to admit that some days are hard, and then go on to talk about the importance of exercising self-care and how you do so. At the same time, you should make sure that your overall answer expresses a positive and optimistic attitude. It’s also a good idea to express your admiration for colleagues and the importance of supporting one another.

7. Have you ever found yourself disagreeing with a physician or parent about a patient’s care? How did you resolve that issue?

This question offers you the ability to demonstrate both your discipline and your compassion. You want to use this opportunity to talk about the importance of remaining calm, about your listening skills, and your ability to communicate clearly and effectively. At all times you want to show that you are a professional who understands that parents may not understand –  or may be afraid – of what you’re telling, and that physicians’ opinions may be based on something different from what you are seeing at patient bedsides.

8. What was your most challenging moment as a pediatric nurse?

This will be a highly personal answer. It is okay to express your emotion in this moment, as it will show the interviewer the compassion and empathy that every facility wants and needs in their pediatric nursing staff. Just make sure that your answer also demonstrates the high level of care or professionalism that you provided.

9. What was your proudest moment as a pediatric nurse?

Though this answer may involve an award or attainment of a degree or certification, it is also a good idea to talk about a patient or parent for whom your involvement was particularly helpful or meaningful.  

10. What is your biggest fault?

This question is asked at interviews for all types of jobs, and it has become common for applicants to take a positive attribute like organization or empathy and describe themselves as having too much of it. While this is a clever answer, it does not necessarily provide the interviewer with a sense of how you work to improve yourself. A more thoughtful response that reflects self-assessment will be welcomed.

Other Important Interview Tips for Pediatric Nurse Applicants

  • The old adage about having just one chance to make a first impression is absolutely true. Make sure that you present yourself professionally, dressing neatly in business attire rather than in scrubs and opting for neat hairstyling and understated jewelry. 
  • Bring along a few hard copies of your resume, even if you’ve already submitted it online. That kind of thoughtfulness and preparation demonstrates organization and forethought.
  • Make eye contact with everybody who is interviewing you. 
  • When asked whether you have any questions about the job, make sure that you have several ready – even if you think that you know everything about it and the facility.  You can ask about the facility’s culture or the activities that are provided for children; what type of volunteer or community engagement opportunities the facility coordinates; or what kind of professional development is offered to staff.  
  • After you’ve prepared, ask a friend or family member to play the role of interviewer so that you can smooth out your answers.

Every job interview represents a new opportunity, both to advance in your career and to learn about yourself. To start a job search, visit Incredible Health’s career page today.

Written by Incredible Health Staff

At Incredible Health, it's a team effort to achieve our vision: Help healthcare professionals live better lives. Many are licensed practitioners themselves; others are simply passionate writers and leaders dedicated to providing valuable resources to nurses.

Read more from Incredible Health

Watch: How Jefferson Health Builds a Strong Nurse Workforce Through Virtual and Emeritus Nurse Programs

May 24 2023

Join us for an insightful webinar with Kate FitzPatrick, EVP and CNE at Jefferson Health, where she will discuss how Jefferson Health is building a strong nurse workforce through virtual and emeritus nurse programs.

As one of the leading academic medical centers in the country, Jefferson Health has been at the forefront of innovation in healthcare. With the increasing demand for nurses and the shortage of experienced nurses, Jefferson Health has developed virtual and emeritus nurse programs to train and mentor nurses across the country.

In this webinar, Kate FitzPatrick will share how she

  • Develop virtual and emeritus nurse programs
  • Tackle the challenges when implementing those innovative programs
  • Empower the nurse workforce
  • And help Jefferson Health maintain its position as a top healthcare provider.
Written by Danny Li
Read more from Danny
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