Natalie M. Powell, a licensed practical nurse from Miramar, quit her job eight months ago to join a healthcare staffing agency and has never looked back.
For years, she worked 60 hours a week in rehabilitation centers and group homes. As her colleagues burned out, left for recruitment agencies or left the profession altogether during the pandemic, she tried to fill the void by working more than 80 hours a week. She considered leaving the profession altogether.
“[You’re] stress. Tired all the time, no matter how much sleep you would have, especially because you spend all those hours,” she said. “It’s all about the patient. It’s not about your family or your children anymore – you’re caring for other people in need. … It becomes intrusive.
Now, she travels around South and Central Florida to fill temporary positions at health care facilities that request nurses from StaffHealth.com, her agency. She earns an extra $6 per hour, gets paid the same day she works, and sets her own schedule, often choosing to be with her children during the week and work weekends, she said.
It is estimated that one in five healthcare workers quit their job during the pandemic, according to data intelligence firm Morning Consult. In October 2021, the Florida Hospital Association predicted a shortage of 59,100 nurses in Florida by 2035 using pre-pandemic data. That number could now be even bigger.
Orlando-area healthcare facilities are testing new methods and technologies to fill the gaps.
AdventHealth has 266 nursing vacancies in Central Florida, including part-time and travel nursing positions, according to its website. Orlando Health has more than 600 nurse openings in the Orlando area, according to its website. HCA Florida Healthcare has a smaller presence in the area and has 27 openings, according to its website.
The Florida Hospital Association’s October analysis pointed to nursing education as a key area that needed improvement: Many of Florida’s top nursing schools turn away qualified applicants because they don’t have enough places, a problem attributed to the scarcity of nursing faculty and lack of funds for expansion.
HCA Florida Healthcare, AdventHealth Central Florida, and Orlando Health offer tuition reimbursement, signing bonuses, and career growth opportunities to attract nurses from the limited pool of graduates. Hospital systems have expanded their partnerships with nursing schools and added more clinical sites.
But adding new nurses is only part of the solution, said Teri Moore, nursing operations manager for the intensive care unit at Orlando Health Dr. P. Phillips Hospital in the Southwest. of Orange County.
“We have new nurses coming in and we’re hiring like crazy,” Moore said. “But these nurses don’t have the experience because a lot of that experience has retired, gone or worn out. And so experience is definitely something that we’re focusing on, trying to create ways to really retain experienced bedside nurses.
Matthew Mawby, co-founder of StaffHealth.com, said his company has tripled in size during the pandemic. StaffHealth.com surveyed about 300 of its nurses to ask why they switched to working for an agency: 82% pointed to low pay and 84% said their duties had increased, Mawby said.
Marissa Lee, vice president of National Nurses United and a nurse at HCA Florida Osceola Hospital, credits hospitals for their shortage of nurses.
Citing federal data from 2017 suggesting that Florida will in fact have a surplus of 53,700 nurses by 2030, Lee and his union say there are enough nurses to care for patients, but hospitals are chasing them by asking them to work in “dangerous” conditions. conditions where each nurse cares for more patients than she can handle, in addition to other responsibilities.
Burnout and fear are the problem, not a shortage, she said.
“They expect nurses to not only perform their nursing duties, but also include housekeeper, dietitian, secretary,” Lee said. “A lot of nurses left during the pandemic because they knew, ‘I can take a travel assignment. I can be in one place for 13 weeks. If I don’t like this place, I move on.
Retention may require creative thinking and more radical change to the status quo of nursing. Lee advocates, among other resources, retention bonuses and mandatory minimum staffing ratios between nurses and patients.
HCA has made recruitment and retention top priorities, said Peter Lindquist, chief nursing officer for the HCA Healthcare North Florida division.
“Unions have their own agendas; I can only speak about ours,” he said. “We care about our nurses and are taking steps to show them what we are doing to support them inside and outside the workplace. … We will continue to advance a culture that prioritizes the protection of our patients and staff, no matter what challenges the industry faces.
Along with AdventHealth and Orlando Health, HCA has offered mental health resources and is hiring LPNs and patient care technicians, as well as staff in other specialties so nurses don’t have to do jobs that could be done by someone else. Lindquist added that frontline workers help HCA make decisions, which has led to changes in staffing models and technology. The system recently invested $50 million in its nurses, he said.
Orlando Health and AdventHealth have turned to virtual nursing. Experienced and licensed nurses can talk to staff or patients through a screen and perform any tasks that can be done remotely.
That could draw nurses back into the profession who are physically unable to work in person, said Linnette Johnson, chief nursing officer for AdventHealth’s South Central Florida division.
“There are nurses there, they are retired. And from their point of view, they say: “We don’t want to work 12 hours a day, it’s long days on your feet.” But boy, they would love a virtual nursing job,” she said. “What I like about this rapid ideation, whether it’s technology or original thinking, is that I think it expands nurses’ horizons.”
AdventHealth is piloting the service at its DeLand campus, where staff say it has given them more time to complete tasks that can only be done in person and has improved patient safety.
The hospital hasn’t seen a patient drop in about two months because virtual nurses can call nurses in person if they see vulnerable patients trying to get out of bed, AdventHealth DeLand nurse Jun Baniqued said Thursday.
“I think this is the evolution of the future of nursing,” Baniqued said. “Nursing at the bedside won’t go away, but it will be enhanced by technology — virtual nursing, robotics, everything. These are things we should look forward to.
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Now that COVID-19 is no longer pushing hospitals to their limits, nurses who left to travel are coming back. Moore said about 10% of staff who left Orlando Health are returning.
Another part of many healthcare systems’ retention strategies is trying to create a community that employees don’t want to leave.
Lindquist highlighted HCA Healthcare’s charity events. For example, in December, the nurses came together to organize a Christmas party for the foster children.
Lindquist said the nurses told her, “That’s why I became a nurse, and it helped restore me as a nurse, restore my well-being, more than anything.”
At AdventHealth DeLand, assistant nurse director Jeffrey Wells said he went as a travel nurse nearly five years ago and decided to stay full-time.
“It’s fine to move or whatever, but after a while you want to find a core of people that you work with,” Wells said. “Here on this floor, we are like a family.”
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