Health systems have had the same workforce concerns for years. They’re scrambling to fill nursing shifts, struggling to attract and retain nurses, and spending far too much time and money on temporary staffing. Health system leaders have told me time and again they’re striving for workforce resilience, an emerging ideal that emphasizes the personal and professional wellbeing of the workforce — structurally, culturally, and on an individual level by prioritizing work-life balance.
It’s not a completely novel concept, but it’s trendy given the state of healthcare’s labor force.
However, it’s not exactly congruent with health systems’ workforce strategies. Ask the average health system leader about how they manage their workforce, and you’ll get the same response you might have received in 2005. In fact, many are still relying on the same processes to fill shifts that they did when I was a practicing nurse nearly twenty years ago: spreadsheets, phone calls, last-minute texts.
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On big campuses where innovative new technologies are being used to save lives every day, these staffing habits may seem inconsequential. But they actually signal a much larger problem: healthcare’s workforce blueprint is out of date.
Today’s nursing workforce is not the workforce of 20 years ago. If hospitals want to build a resilient workforce, they need to embrace flexibility.
Flexibility and the modern workforce
Walk into any hospital and you’re likely to see a nursing workforce that spans five generations. Each has a unique expectation for their career, and a different perspective of flexibility. It’s not just about striving for work-life balance. It’s about finding ways to build a shift schedule that works for Gen Z nurses and Baby Boomer nurses, for nurse managers and hospital executives, and most importantly, for patients.
Changes in Nurse Staffing Answer Clinician Demands
The ongoing nursing shortage facilitates high turnover rates since nurses know they won’t have difficulties finding new jobs. In order to retain and attract staff, it’s in a facility’s best interest to understand what nurses want.
Younger nurses expect technology-driven solutions that allow them to manage their schedules from the palm of their hands. Mid-career nurses balancing family and professional responsibilities want stability above all — predictable but adaptable scheduling options. Older nurses approaching retirement may want to work just enough to keep their licenses active, or serve as mentors to newer nurses.
Beyond generational preference, flexibility won’t mean the same thing for every hospital. For some, it might be an internal resource pool that enables full-time staff to float. For others, it could mean building staggered shift structures that can help rotate core staff out of a physically taxing three-on, four-off schedule. Some hospitals have begun leveraging an on-demand workforce to supplement core staff, bringing in on-demand nurses to supplement cultural workforce resilience programs.
Change is hard. Uncertainty is uncomfortable. But the reality is, the old ways aren’t working anymore. Hospitals are in a hiring hole, straining against tightening budget constraints, and depending on a workforce that expects flexibility as a given — not a perk. The time to try new things is now.
Designing a blueprint for today
If we could rethink care delivery overnight during the pandemic, why aren’t we applying those lessons now? In 2020 and 2021, health systems adapted on the fly — launching telehealth programs, restructuring shifts, and mobilizing both internal and external staffing resources.
Somehow, once the pandemic began to wane, most health systems reverted back to the status quo, back to old ways that don’t work for a workforce and industry that has undergone rapid transformation. The industry missed a key opportunity to build on those gains.
New care delivery models present perfect opportunities to experiment with flexible workforce strategies. Hospital-at-home programs are gaining traction, requiring new, flexible staffing approaches. Those that are able to tap into on-demand staffing resources will be better able to support full-time staff as they extend care beyond the four walls of the hospital. Forward-thinking health systems are testing the waters by staffing virtual nursing programs with nurses nearing retirement, and activating per diem nurses to fill the gaps left in facilities.
Many older nurses want to remain in the workforce, albeit in a much less rigorous capacity. Developing formal mentorship programs — where experienced nurses can provide guidance, training, and support for incoming nurses — can help retain institutional knowledge that health systems cannot afford to lose, while providing additional career pathways.
Health systems want to achieve workforce resilience, but the old staffing blueprint will never allow it. Those that fail to adapt their workforce strategies will remain stuck in crisis mode, scrambling to fill shifts and struggling to retain nurses in the face of a nursing shortage. But for those willing to welcome change, the opportunity is immense.
Flexibility is no longer a luxury. Today, it’s a necessity. The time for health systems to define what it means for them is now.
Photo: doomu, Getty Images
Larry Adams, RN, MSN, MBA, is a seasoned healthcare leader with nearly 30 years of experience spanning both clinical and administrative roles. Starting his career as a bedside nurse, Larry gained firsthand insight into the challenges faced by frontline healthcare professionals, shaping his dedication to improving workforce solutions and healthcare delivery. His career has since evolved to include leadership roles focused on strategic growth, workforce innovation, and healthcare operations.
He previously served as EVP Growth and Chief Nurse Executive at ShiftMed and Division Vice President of Crisis Staffing and Labor Disruption at AMN Healthcare, where he developed innovative strategies to address staffing shortages and critical workforce needs nationwide. In his current role as Chief Nurse Executive and SVP Strategy at CareRev, Larry continues to drive growth and innovation, ensuring healthcare organizations are equipped to meet evolving challenges.
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