OR Manager August 2023 - 6

STAFFING
BY JAMES STOBINSKI
2022 National Nursing Workforce Survey: A closer look for
perioperative nursing
n this issue, I am following up the
information I shared in the July issue
of OR Manager regarding the findings
of the 2022 National Nursing Workforce
Survey. The perioperative nursing
shortage is widespread, and what we
are now experiencing is as unsettling
and challenging as anything we have experienced
over the last 4 decades.
In the mid-1980s, we experienced
perioperative nursing shortages that
prompted changes in our orientation
processes. Diploma schools-traditionally
a reliable source of recruits to the
OR-were in rapid decline, which cut off
our pipeline of recruits with OR experience.
We began seeing an influx of BSN
graduates with essentially no perioperative
experience.
I
This was also a time of rapid, disruptive
change; the Centers for Medicare &
Medicaid Services had begun instituting
Diagnosis Related Groups, which reshaped
nursing care, and the use of innovative
technology in surgery, such as
arthroscopy, laparoscopy, and robotics,
began to increase.
Before the staffing shortages of the
1980s, it was rare for new graduate
nurses to be hired directly into the OR.
But out of necessity, we began taking
new graduate nurses. Fast forward to
today, and hiring new graduate nurses
into the OR is now commonplace. I believe
the current demographic shifts in
American nursing will prompt changes
in recruiting and retention practices just
like we saw in the 1980s.
The current shortage is vastly different
than historical trends, and thus, the
viable solutions to this shortage must
also be different. Perioperative nursing
entails supply chain management and
finance components, and with those,
there is a pressure and emphasis on
efficiency.
That pressure is often huge, which
creates a stressful environment that is
not attractive to new graduate nurses.
6
OR Manager | August 2023
In part because of increasing cost and
time pressures, the OR is routinely
rated by nurses as a difficult place to
work. The nature of the work of modern
surgery compounds our recruiting challenges.
Generational
shift in attitude
One key difference in this shortage is
that there has been a shift in attitudes
about work exacerbated by the pandemic.
As Smith and Carpenter tell us,
the pandemic has caused workers to reassess
their priorities and their orientation
to work and its place in their lives.
This reassessment is more prevalent
among younger members of the workforce,
those who are below 35 years of
age. Because we lost many older, experienced
nurses during the pandemic,
we now have more younger nurses in
the workforce. These nurses may have
a distinct perspective on work-life balance,
but it is the group who must now
fill the vacancies in the perioperative
specialty.
A survey of 100 hospitals and health
systems by Incredible Health brings out
this issue in stark relief. Most healthcare
executive respondents (95%) reported
generational differences in orientation
to work and expectations regarding
career growth. Generally, the
younger nurses have made more demands
for salary increases, were more
likely to request specialized roles, and
asked for more career advancement opportunities
than the older nurses.
Incredible Health also reported that
80% of younger nurses requested more
flexible scheduling, but that only a small
minority of hospitals attempted to offer
that option. Employers are using costly
incentives such as higher wages and
sign-on bonuses, but younger nurses
seem to value flexibility more than
higher wages. Facilities emphasize qualifications
and experience in hiring, but
the critically needed younger nurses
have less of each of these attributes.
We have a misalignment in hiring expectations
by the employers and a disconnect
between what they look for and
what younger nurses desire in the features
of employment.
Healthcare instability in the US
There is a high degree of uncertainty in
American healthcare at present, which
prompts instability in the healthcare
workforce. We have widespread staffing
shortfalls, but Gooch, in Becker's Hospital
Review, reports that 60 hospitals
and health systems are cutting jobs because
of operational challenges. Cass,
also in Becker's, provides a running
list of hospitals that are cutting departments
and services. That list now has
42 entries.
Financial challenges are forcing hospitals
to make hard choices in labor
budgets, and nursing pay is a significant
expense. Employers report a far
greater reduction in loyalty and tenure in
younger nurses; 79% of younger nurses
reportedly display this trait versus 21%
of older staff, according to Incredible
Health. All the uncertainty in healthcare
and the reality of budget challenges
further complicate the relationship between
nurses and their employers.
What does this mean for the
OR?
The changing dynamic of the nursing
workforce alters the employer-employee
relationship with an increasing reluctance
to sacrifice for the needs of the
employer.
For many years, the strategy to attract
nurses was to offer sign-on bonuses
tied to service commitments to
the facility, with an emphasis on wage
levels and benefit packages. However,
a recent survey done by Georgetown
University, summarized by Judy Mathias
in OR am, reported that young adults
placed a higher priority on the amount
www.ormanager.com
http://www.ormanager.com
OR Manager August 2023

Table of Contents for the Digital Edition of OR Manager August 2023
