When Staffing Becomes The Number One Leadership Challenge

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Ask almost any nurse leader today what their number one challenge is, and they will tell you that it is staffing. Almost overnight, the situation has moved from sporadic shortages to a full-blown crisis in many settings. Nurse leaders are anecdotally reporting the following type of information:

We post positions for experienced nurses, and no one applies.
Nurses are turning to travel positions and agencies to increase their income – leaving staff vacancies that are impossible to fill.
The nursing staff is angry because they are now working short-staffed almost all the time.
Exhausted nurse leaders now spend much of their day on recruitment activities.
There are no experienced nurses to serve as preceptors for new graduates.
Nurses are no longer willing to work overtime in their own settings.
Travel nurses are hired at a huge expense to fill core positions.
COVID numbers are drifting up in many settings, and staff tells their leaders – we did this once but not again.
Nurse educators are overwhelmed with the number of new graduates that are onboarding.
Experienced leaders are leaving their roles out of frustration.

New staffing research done by NSI seems to support these anecdotal observations. Some key data in this 2021 report includes the following:

Nurse turnover nationally is approaching 19%, with some facilities reporting turnover as high at 65%, with the highest turnover in the Southeast and North Central states.
RN vacancy rates are now 10% nationwide.
Nurse retirements are a primary driver of vacancies, and this trend is expected to continue through 2030.
The top three clinical areas where there is turnover are Step-Down units, Behavioral Health, and Emergency Departments
PCT and Nursing Assistant turnover are at 28%.
The highest turnover continues to be in the first year of practice, with 24.1% of new RNS leaving their first position within the year.
OR, ICU, L+D, PCU, and ED positions take the longest to fill, with every vacancy taking 84+ days.
Vacancies are being filled by travel nurses, agency contracts, and internal per diem pools.
40% of hospitals want to increase the number of RNs on their staff.

A new medical-surgical nurse manager recently told me that he was scared because he does not see a clear-cut end to this crisis. He is working hard to instill hope in the staff he has but does not feel hopeful about the trends hesees. Some of the labor shifts are undoubtedly due to nurses making new life choices after the COVID life quake but certainly not all. We may be looking at a different nursing shortage than those experienced in the past. All of this happens at a time when health systems are anxious to ramp up their services to make up for 2020 losses. It is a leadership conundrum with no easy answers.

Read to Lead

NSI_National_Health_Care_Retention_Report 2021 Edition.

Launch 2021 by giving your leadership team the gift of a highly rated webinar – Nursing Leadership in 2021: Rebooting after a Life-Quake A Nursing Leadership Reboot Workshop

Read the Nurse Leader Coach – Available at Amazon and Other Book Sellers.

Now Available to Strengthen Your Leadership in 2021 – The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success