Human Resources: Staffing After the Downturn

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A recession and yet-to-be-defined healthcare reforms are challenging hospitals. That doesn't mean hospital HR leaders can't project what their future staffing needs will be.

When the nation emerges from its most severe recession in 70 years, so too will reemerge the focus on healthcare staffing shortages. This refocusing will come at a time of great anxiety as the ongoing—but as yet undefined—push for a major overhaul of the nation's healthcare delivery system clears, which will also prompt hospitals to reevaluate the skill sets that employees will need.

Bill Woodson, a senior vice president at Sg2, a Chicago-based healthcare intelligence company, says many hospital executives aren't making big plans until the economy improves. "There is a lot of caution and uncertainty, and that has changed the management mindset of most senior teams around the country," Woodson says. "For better or worse, it has kept them very focused on the windshield of this year's and next year's budget cycles."

Jeffery Payne, vice president of the American Society for Healthcare Human Resources Administration (ASHHRA) and vice president of human resources at Lakeland (FL) Regional Medical Center, concedes that the 851-licensed bed, nonprofit hospital does not have the degree of problems that plagues other hospitals. There are few nearby competitors for staff, and there is a "steady stream" of nursing recruits from two local colleges. But, like many hospitals, LRMC has slowed its hiring of nurses lately, and Payne says that could exacerbate the nursing shortage when the economy recovers.

"Nursing graduates were coming out with a promise of a job, but there aren't many offers now, so they're like, 'What was that all about?'" Payne says. "The fear is that this might dissuade people who are going into the pipeline, that maybe this promise of employment for life won't be there. So the pipeline might shrink at a time when it shouldn't."

With that in mind, LRMC has established a flow pool for graduate nurses, similar to substitute teachers. "At least it says when things settle down we might have openings for you again," Payne says. "The problem with that is they are assigned to many different areas and they don't get to build a lot of the departmental camaraderie."

Marilyn A. Dubree, the executive chief nursing officer at Vanderbilt University Medical Center in Nashville, says the economic slowdown provides an excellent opportunity for hospitals to reassess what their staffing needs will be. Change is coming, and even if the details aren't yet finalized, she says, providers must adopt the culture of change.

"You don't stick your head in the sand. You'd feel so out of control, to say, 'I'm just going to wait and see what happens,'" she says. "No one exactly knows what healthcare reform will look like, but you can speculate on some of the things that might happen. If you think healthcare reform is going to be looking at the continuum of care as opposed to episodic care, are you prepared to do that? Using these months to get prepared for what is likely to happen is very important."

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