DiversityNursing Blog

Jefferson Health, a DiversityNursing.com “Proud Partner”, is excited to reveal the growth of its Nursing SEAL Team, a groundbreaking initiative designed to tackle staffing shortages while offering Nurses enhanced flexibility and valuable experience.

The Nursing SEAL Team, which stands for Service, Excellence, Advocacy, and Leadership, was inspired by the concept of an elite special forces unit. Initially launched in 2022 with 25 Registered Nurses, the program has grown to encompass over 150 highly experienced, full-time Nurses who deliver care across Jefferson’s acute care hospitals.

“We recognize the importance of identifying innovative solutions to address Nursing workforce and staffing challenges,” said Daniel Hudson, MSN, RN, CENP, Vice President and Associate Chief Nurse Executive, Jefferson Health. “Our Nursing SEAL Team has proven to be a successful solution that has resulted in greater flexibility and improved Nurse satisfaction, while continuing to ensure that our patients receive the highest quality of care.”

Nurses on the SEAL Team are assigned to a variety of departments, such as medical/surgical, telemetry, critical care, and emergency services, ensuring that a broad spectrum of patient needs are met. Every two weeks, team members are reassigned to the hospital and unit that requires the most support for each shift. These assignments are determined using proactive scheduling data and insights from Nursing workforce leaders.

Nurses are strategically positioned ahead of time to cover for colleagues on leave and to bolster departments with high vacancy rates or those that typically see a surge in patient admissions. Of the more than 150 Nurses on the SEAL Team, a significant 60 percent or more are assigned to night or rotating shifts, where the need for additional support is often greater.

“The Nursing SEAL Team has been a tremendous support to all levels of our workforce. The average SEAL Team member has nine years of Nursing experience which brings a wealth of knowledge and clinical expertise to support new to practice Nurses on their units,” said Andrew Thum, DNP, ML, RN, NE-BC, Director, Nursing Workforce Operations, Jefferson Health.

Since its launch two years ago, the Nursing SEAL Team has garnered consistent positive feedback from its members. In addition to providing greater flexibility and better staffing, the initiative has significantly decreased the dependence on agency Nurses, achieving an impressive 95% reduction.

“Nursing workforce optimization requires a multi-faceted approach to meet the ever-changing needs of our care teams. Our Nursing SEAL Team is one of many ways that we continue to engage, retain and recruit highly qualified and experienced Nurses,” said Kate FitzPatrick, DNP, RN, NEA-BC, FAAN, Executive Vice President and Connelly Foundation Chief Nurse Executive Officer, Jefferson Health.

Jefferson’s Nursing SEAL Team is part of the organization’s comprehensive strategy for Nursing workforce optimization. Additional initiatives include the Virtual Nurse Program and Nurse Emeritus Program.

Source: Jefferson Health

Nurse gig shifts refer to temporary or short-term Nursing assignments that are often offered through staffing agencies or online apps. These shifts can range in length from a few hours to several weeks or months and are often taken by Nurses who are looking for flexible work arrangements or who want to supplement their income.

Gig shifts can be beneficial for both Nurses and healthcare facilities. Nurses who work gig shifts have the flexibility to choose when and where they work, and they can often earn a higher hourly rate than they would in a traditional full-time position. Healthcare facilities can use gig shifts to fill staffing gaps or to cover unexpected absences, ensuring that patient care is not compromised.

According to The Wall Street Journal, embracing gig apps is one way hospitals and health systems are looking to provide flexibility and fill vacancies. This includes Providence Health.

Providence added gig Nurses last year and has filled 13,000 shifts for Nurses and other medical roles, Mark Smith, who oversees workforce analysis, staffing and optimization for the organization, told The Wall Street Journal. He also told the publication the health system plans to expand gig work from 12 hospitals and Nursing homes to 19.

“We make sure the Nurses who work through the app are thoroughly vetted and have the licenses and certifications required to work on the Nursing unit they’re receiving training to work on, just like our own caregivers do,” Smith explained. “At Providence, we’ve found that Nurses taking assignments through the app fill six shifts per month.”

Among the apps hospitals are adopting are ShiftKey, which lets Nurses bid for shifts, and CareRev, which lets hospitals raise and lower their rates for different shifts. 

However, there are also some potential drawbacks to working gig shifts. These can include inconsistent work schedules, lack of benefits, and a lack of job security. Nurses who work gig shifts may also miss out on opportunities for professional development and career advancement that are more readily available in traditional full-time positions.

Overall, whether or not you should pursue gig shifts depends on your personal goals and priorities. It's important to carefully consider the pros and cons of gig work as well as research potential employers and platforms before accepting any assignments.

Hospitals are hiring or accepting volunteer teens and young adults as a long-term strategy to help combat shortages in the healthcare industry. 

Research shows, exposure to various healthcare fields is crucial to the development of career interests for adolescents and young adults. 

Earn while you learn programs give high school students the opportunity to gain knowledge in the field and make a better wage than the average part time jobs students often take.

These programs offer roles such as:

• Food Services
• Transportation
• Manage Gift Shop
• Medical Library
• Patient Support
• Environmental Services
• Administrative Support
• Translator

According to Becker's Hospital Review, Mount Carmel launched its inaugural patient-facing role for those 16 and older: a student support associate position.

Student support associates work as part of the care team, with a multi-skilled technician. The younger workers can help with tasks such as bathing patients, taking patients' vital signs and restocking equipment. 

"We did elect to have specific criteria that students coming to us are actively enrolled in a Nursing program or a pre-Nursing program throughout their high school [career], so that we are really looking to support and foster their interest in long-term career growth and positioning them well to continue to work for us after they graduate from high school and ultimately matriculate into a Nursing program or another allied health program," Mount Carmel Regional Director of Talent Acquisition Rachel Barb told Becker's.

Volunteer programs help plant the seed and further educational opportunities for young adults.

Inova Fairfax Hospital in Virginia offers a volunteer Summer program where teens get to learn about different positions in the hospital and get hands-on experience at the hospital’s simulation lab.

Dr. Steve Narang, President of Inova Fairfax Medical Campus says to volunteers, "We are taking care of human beings, and this is just a gateway whether you want to be an accountant, whether you want to be in security, whether you want to be in IT or whether you want to be at the bedside. There’s a job for you in healthcare.”

Abrazo West Campus Hospital in Arizona hosts a volunteer program with interactive workshops.

“In those workshops, they have someone’s undivided attention, so they have a surgeon, a specialist, a radiologist that’s up there, and they tell them everything from A to Z, salary, challenges, rewards, education, the best career paths to take,” said Barry Worman, Director of Volunteer Services.

As we start the new year, we take a look at trends we expect to see in the Nursing field. Many health experts agree staffing has been and will continue to be the top healthcare issue.

Nurse Shortage

Many factors play into the staffing crisis like the pandemic, retiring Nurses, and high rates of burnout.

Rhonda Thompson, DNP, CNO and SVP of Patient Care Services at Phoenix Children's Hospital told Beckers Hospital Review, "The nursing shortage affecting health systems nationwide will continue to be a challenge in 2022. This has a greater impact than just unfilled positions and scheduling sufficient nurses based on a high patient census. It also means our experienced staff nurses are investing a great deal of time onboarding and training newly licensed nurses, in addition to their own daily bedside care responsibilities. To solve this, it will take collaboration and commitment from our health systems, staff, and academic partners."

According to the U.S. Bureau of Labor Statistics, about 194,500 openings for Registered Nurses are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.

Increase In At-Home Healthcare

The COVID-19 pandemic created a demand for at-home healthcare that continues to grow.

According to Forbes, the Home Care Providers industry is among the fastest growing healthcare industries in the United States. "Industry revenue, according to IBISWorld, has grown at an annualized rate of 2.2% to $96.9 billion over the past five years."

At-home healthcare has many benefits. So much so, last year a bill called the Choose Home Care Act 2021 was presented to Congress. If passed, this would give patients the opportunity to leave the hospital and recover at home with a mix of expanded skilled Nursing, therapy, personal care, telehealth services, and more.

Prioritizing The Well-Being Of Healthcare Workers

The pandemic has pushed an already stressed-out career field to its breaking point. Nurses are facing high rates of burnout and compassion fatigue.

Compassion fatigue is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.

According to J. Maben and J. Bridges (2020), the pandemic has led Nurses to experience the highest level of stress that has ever been recorded compared to other professions.

Healthcare organizations and leaders have the opportunity and the responsibility to support and prioritize their staff's mental and physical well-being.

These healthcare workers have given so much of themselves they have nothing left to give and yet they are still showing up day after day under impossible circumstances. But for how much longer?

Nurses want to feel valued and safe in their work environment. Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care.

Nursing School Online

The pandemic forced Nursing schools to provide their classes online to avoid the spread of the virus. Many institutions have continued the online learning option for some of their programs.

According to a report from Inside Higher Ed, about 60% of colleges and universities do plan to keep some of their undergraduate programs fully online.

Online schools provide a great opportunity for Nurses who are looking to advance further in their education, but don't have the time to physically attend classes between shifts.

The School Nurse shortage is not a new issue. The pandemic highlighted the importance of having School Nurses. As schools across the nation open back up,
concerns are again rising.

The US Centers for Disease Control and Prevention (CDC) recommends schools have one full-time Nurse for every 750 students.

The latest data from a study, published in the Journal of School Nursing in 2018, found approximately 39% of schools employ full-time Nurses and about 35% employ part-time School Nurses, while 25% do not employ School Nurses.

With out School Nurses, teachers and staff with no medical training would be responsible for providing care such as dispensing medication, managing allergies and asthma, and monitoring blood glucose levels.

Not only are School Nurses responsible for providing care, they also play a vital role in the management of COVID-19 safety protocols and updating staff and parents.

According to a survey from the National Association of School Nurses (NASN), 78% of School Nurses say they took time to review data to see new trends in COVID infections. The survey shows 43% of Nurses spent time updating and developing school health policies and nearly half said they were spending time answering phone calls from parents and the community.  

“I spend most of my day dressed up as a ghostbuster in personal protective equipment,” Rhonda Cranford, a School Nurse at Northside Elementary with 34 years of experience, shared. “I’m answering the phone constantly with questions regarding isolation and quarantine. I spend hours documenting and sending emails. Ninety-five percent of my day is consumed by COVID activities.”  

Many schools have a tight budget and can lack the funding needed to hire a School Nurse.

Laurie G. Combe, NASN President said, “When budgets are tight, administrators make decisions to hire Teachers over Nurses, but what many administrators don’t understand is that having a Nurse on staff can actually save dollars."

A glimmer of hope arose in May when the Biden administration announced the American Rescue Plan. The Plan includes dedicated funding of at least $500 million to hire School Nurses to help schools safely reopen and remain open for in-person instruction.

It’s important to remember there is a Nursing shortage across the country. School districts are competing against healthcare organizations for Nursing applicants where wages in hospitals and other settings tend to pay more.

Between the Delta variant, mask protocols, and vaccine mandates, schools need Nurses now more than ever. 

Nurses are a critical part of healthcare and make up the largest section of the health profession. According to The American Nurses Association (ANA), more Registered Nurse jobs will be available through 2022 than any other profession in the United States.

As predicted by health officials, the United States is seeing surges of Coronavirus cases from the holiday season. As health systems and hospitals deal with the surges, they are worried about finding enough medical workers to meet the demand.

“What we see now is just the beginning of the post-Thanksgiving peak,” said Eric Toner, senior scholar with the Johns Hopkins Center for Health Security. “It’s going to be huge, and it’s going to be awful.”

The problem is especially dire in intensive care units which are overcrowded with a record number of critically ill patients.

An article from the New Yorker stated, at least half of all states are now facing staff shortages, and more than a third of hospitals in states such as Arkansas, Missouri, New Mexico, and Wisconsin are simply running out of staff. Usually, an ICU Nurse might care for two critically ill patients at a time. Now, some are caring for as many as eight patients at once.

In some situations, patients have been transported hundreds of miles for an open bed. Some patients have been moved from Texas to Arizona as well as central Missouri to Iowa.

According to ABC News, hospitals in some states are enlisting retired Nurses and Nursing students. In Alabama, more than 120 students and faculty members from the University of Alabama at Birmingham’s Nursing school began helping with care last week at UAB Hospital.

In some states, health officers have amended orders that allow health care workers who tested positive for COVID-19, but are asymptomatic to continue working.

To free up healthcare workers, hospitals are asking medical and Nursing students, firefighters, and EMTs to administer Coronavirus vaccines.

According to Reuters, nearly 10 million doses have been delivered across the country, but only about 1 million administered due to staffing shortages at hospitals and the special requirements for preparing the shots.

Nancy Foster, the American Hospital Association’s vice president of quality and patient safety, said she’s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages.

Travel Nurses are usually a good option to help fill open positions, but the pool of available travel Nurses is drying up as demand for them jumped 44% over the last month.

Dr. Mark Ghaly, California’s Health and Human Services secretary, said the state is “lucky to get two-thirds” of its requests for travel Nurses fulfilled right now.

The main hope here is for cases to decrease by people following COVID-19 guidelines such as quarantining and wearing masks.

The United States has a massive Nursing shortage, and the problem is only going to grow. Due to an influx of patients into our health system, the retirement of baby boomers, and educational obstacles, Nursing positions aren’t being filled fast enough to keep up with demand.

By 2022, the American Nursing Association predicts the U.S. may need more than 1 million new Nurses to both care for a growing number of older Americans and replace retiring Nurses.

“I’ve been a Nurse for 40 years, and the shortage is the worst I’ve ever seen it,” said Ron Moore, who retired in October from his position as Vice President and Chief Nursing Officer for Charleston Area Medical Center.

More people have access to health insurance as a result of the Affordable Care Act passage in 2010. This has led to an increase in people seeking medical care. Another reason for the increase in patients is medical technology has advanced to the point that it has enabled people to live longer. The number of people over the age of 65 in this country is rapidly increasing. There are more Americans over the age of 65 now than at any other time in the country’s history. It’s predicted that this number will continue to grow, which means more people with health issues and more people in Nursing homes.

Students appear to have a high level of interest in a Nursing career. It pays well, has strong projected job security, and allows practitioners to do meaningful work. However, when applicants send in their transcripts, many are turned away or wait-listed. 

The problem in Nursing education is there aren’t enough teachers to educate student Nurses. Not only that, but the current faculty’s median age is in the 50s, so many of them will be looking to retire soon.

For those that do get accepted into Nursing programs, there’s the cost of schooling to worry about. Whether trying to attain a Nursing license through an associate, bachelor’s, or master’s program, the costs add up. Also those pursuing a specialty have to be prepared to devote years to their professional development. 

Grants and scholarships like the DiversityNursing.com $5,000 Education Award, can help with some of this burden, but unfortunately, there just aren’t enough to go around.

Seun Ross, Director of Nursing practice and work environment for the American Nurses Association, thinks focus should be placed on boosting resources available to Nursing schools so they can hire more teachers who, in turn, can train more students. She also said hospitals must invest in the experience of Nursing, buying cutting-edge equipment and cultivating an inclusive work culture in order to get the most out of their Nurses.

In terms of work environment, the American Nurses Association suggests introducing more flexibility into the work environment structure and scheduling programs; rewarding experienced Nurses for serving as mentors to new Nurses; and implementing appropriate salary and benefit programs.

Nurses comprise the backbone of the entire health care industry. Without them, the whole thing collapses. At every level, the quality of care and human touch necessary for positive outcomes link directly to the Nursing staff.