Hospitals Can’t Keep Staffing Like it’s 1995

When we find something that works for us, we keep doing it. It becomes a familiar part of our routine. 

If you drive to work, you probably take the same way every morning. You get in the car and take the route you’ve taken for years – the route that gets you to your destination at the very time you’ve come to expect, down to the minute. But if there’s an accident or roadwork along the way, your whole day is thrown off. 

When those disruptions become an every day occurrence, it’s probably time to find a new way. But old habits can be hard to break – even when all the signs point to a need to change.

The same concept applies to the way hospitals execute their workforce strategy. Nursing leaders today are relying on staffing techniques they’ve used for decades – the same path they’ve always taken, despite the known roadblocks that throw their entire system into disarray, day in and day out. 

The problem isn’t that hospitals don’t care to update their workforce strategy. It’s that nursing leaders have been conditioned to operate reactively, filling staffing gaps as they arise rather than preparing for them in advance. 

Over the years, I’ve heard countless leaders say they feel they’ve made progress in this arena: travel nurse utilization is down, vacancies have improved, and retention is steady. But if you look closely, most of them are still scrambling to cover the schedule, and never quite able to stay ahead. They’re putting out fires without interrogating why the fires are starting in the first place. 

This mindset is deeply ingrained in healthcare, and nursing in particular. Nurses are trained to be excellent in a crisis. We’re quick to respond when alarms sound and patients crash. That instinct doesn’t go away when we step into management roles. Instead, it ends up driving workforce strategies; plugging holes shift by shift, focusing on the immediate problem rather than the root cause. 

These are reactive methods. They aren’t how you build a resilient workforce. 

Shifting to a proactive approach to workforce strategy starts with making better use of the data hospitals already have. Emergency department leaders know exactly when volumes spike and when they ebb. Yet staffing is often set the same regardless. If you know peak hours occur every evening, why not flex up during those times and schedule partial shifts to better match patient demand? When inevitable outliers occur, staff are much better positioned to solve for the 20 percent of unpredictability rather than the 80 percent of the day that is entirely predictable. 

Some forward-thinking hospitals are beginning to put this philosophy into practice. The difference isn’t just operational. It gives staff confidence that leadership is thinking ahead, not waiting until the last minute to make frantic phone calls or send a flurry of texts. This kind of preparation not only improves coverage, but also strengthens trust with the workforce. 

The irony is that many hospitals are willing to experiment with bold new ideas, yet resist far simpler changes. Virtual nursing is a prime example. For years, the idea of managing patients remotely was unthinkable. Now it’s gaining traction, with retired or late-career nurses taking on documentation and coordination duties so bedside nurses can focus on direct care. Leaders are open to piloting futuristic models like this, and that’s encouraging. But the foundations of workforce planning – how shifts are structured, how schedules are built, how resources are deployed – often remain untouched. Without a solid base, even the most innovative programs risk collapsing under their own weight. 

The stakes for getting this right are only rising. Over the next decade, changes in government funding will undoubtedly reshape how hospitals are reimbursed. Margins that are already thin will come under even greater pressure. Hospitals will need every advantage at hand to protect their bottom line while maintaining quality of care. The time to prepare is now, while there’s still time and space to figure out what works. 

Change is uncomfortable, but clinging to outdated habits is far riskier. Driving the same way to work every morning might be familiar, but it’s senseless when there are faster routes available to you. Proactive workforce strategies give hospitals the flexibility to reroute when needed, without losing sight of the destination: better care, delivered by a resilient nursing workforce.

Source: SDI Productions, Getty Images

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