State’s hospitals scramble to hire nurses

Hospital beds are full with patients, but the staff available to care for them is shrinking, and health care systems say they are paying bonuses and finding creative ways to fill empty positions, particularly in nursing.

While some Connecticut hospitals have let staff go due the worker’s unvaccinated status, health care officials here say the nationwide labor shortage has hit their industry harder.

The issue is prompting review of recruitment, training options, professional development, compensation and more, officials said.

“This year, particularly, all positions I would say have become more challenging and some difficult,” said Melissa Turner, senior vice president for human resources for Yale New Haven Health.

With “a very, very large volume” of open positions to fill, “it’s difficult to find the candidates that we desire,” Turner said. The job is “more taxing than it has ever been … The job market in general has become a challenge.”

And after 20 months of caring for COVID patients, and with more inpatients now because of delayed procedures, many nurses, respiratory therapists and others are leaving their positions, officials said.

“Patients are sicker than they have formerly been when they arrive at our doors,” Turner said. “All our COVID numbers are down but we have very high volumes, particularly in our ED’s” referring to emergency departments.

The pandemic also has given people second thoughts about their “worklife balance,” she said. “People are thinking about their lives in a different way now.”

Cathy Frierson, chief human resources officer for Nuvance Health, said in an email, “The national labor shortage has had a profound impact across the healthcare industry.

“Effectively managing staffing challenges and retaining talent has been a top priority at Nuvance Health,” Frierson said. “We are proactively implementing strategies to ensure we have the resources necessary to care for our patients and the communities we serve.”

Nuvance Health includes Norwalk, Danbury, New Milford and Sharon hospitals, as well as three hospitals in New York state.

“What is happening in the industry right now in health care, we are seeing a reset in the labor market,” said Amanda Richards, who joined Hartford HealthCare as its first chief nursing officer in January.

Hartford HealthCare includes St. Vincent’s Medical Center in Bridgeport, MidState Medical Center in Meriden and Charlotte Hungerford Hospital in Torrington.

While the employees who have been terminated from health care systems for their refusal to get vaccinated have made headlines, that is a small part of the problem, the health care officials said.

At Yale New Haven, 68 unvaccinated employees across 56 different positions had been let go as of Tuesday out of more than 28,000 employees.

At Hartford HealthCare, 109 employees were let go out of 33,000 employees and staffs of partner organizations, according to spokeswoman Rebecca Stewart.

Both health care systems said the workers could return if they were to get vaccinations.

Dr. Ajay Kumar, chief clinical officer, said 99.8 percent of Hartford HealthCare’s more than 26,500 employees and 2,200 doctors and nurse practitioners who are not employees but are affiliated with the system have been vaccinated.

Hiring and training

On the other hand, Hartford HealthCare has hired more than 300 registered nurses “in the last few months alone,” Stewart said, and Yale New Haven Health has hired 1,200.

“I’m very pleased that we have all these nurses in the pipeline,” most of whom will graduate in May and some in December, Richards said.

Connecticut is doing better than the nationwide average in available nurses, according to Nurse Journal, which counts 12.06 nurses per 1,000 people across the country. Connecticut is 15th of the 50 states and District of Columbia, with 14.75 per 1,000.

“Across the nation, everybody is suffering from a nursing shortage,” said Beth Beckman, chief nursing executive for Yale New Haven Health.

“This one feels a little different in the sense that the pandemic has certainly had a toll on people’s appetite for what’s occurred,” she said.

Many nurses have chosen jobs with a Monday-toFriday schedule “and not so much wear and tear. There’s been a migration of nurses certainly to traveler jobs,” in which they are hired for a short duration, often for higher pay, Beckman said.

Beckman said Yale New Haven is fortunate in having “a very tenured staff and a very loyal staff, people who have been here 30-40 years and have stayed with us through the pandemic.”

She said nurses also were willing to move from one hospital to others “that were overrun by surge.” “There was such a spirit of generosity around that,” she said.

Turner said the health system also responded to the limitations nursing students faced during COVID in not being able to train with patients. Much of the teaching was conducted with simulators. “We said in the summer of 2020, we have to do something differently,” Beckman said.

Yale New Haven worked with the nursing schools in the state and the Connecticut Hospital Association to create a “bridge to professional practice.” They went to the nursing schools and said, “anybody who is a senior student is welcome to join us and we’ll find a spot for you.”

The students were trained in COVID safety protocols and worked alongside professional nurses, who served as preceptors, for 60 hours.

“We taught them how to don and doff. We made sure they were N95 [mask] fit-tested. The only thing missing from this was they didn’t pass medications,” Beckman said.

Most of the students worked in the most urgent areas: critical care, emergency medicine, medical surgical units and the operating rooms.

“The preceptors couldn’t have been more thrilled with the opportunity” and the students were grateful for the experience, Beckman said.

Richards said Hartford HealthCare “developed pretty robust transition strategies” for the nurses it has hired, to “allow them the opportunities to practice in specialty areas. We’re quite unique where we have the full continuum of care,” including seven hospitals, at-home care, skilled-nursing and assisted-living facilities and its medical group.

A new “graduate nurse residency program” helps the transition to professional nursing, assigning a nurse as a “supportive mentor” to take care of new nurses’ emotional needs, she said.

“We’re focusing on the professional development of our nurses,” Richards said, including offering assistance for advanced courses. “How do we continue to grow them professionally? The focus of the work we’re doing is to elevate their professional practice.”

“For nurses, it’s not a job, it’s actually a call,” Richards said. “Our role is to support that growth and development.

She said the pandemic has helped nurses to be recognized for their critical role. “It really has been nurses on the front line of care,” she said. “It’s redefining the way we deliver care in the future.”

Hartford HealthCare partners with 15 nursing schools. “As they are equipping the nurses, we have a role to play with their clinical placements,” Richards said.

Compensation

Hartford HealthCare also has created a task force to streamline its recruitment process, to shorten the time it takes from recruitment to starting on the job.

Both health care systems have given bonuses to employees for the additional pressure the pandemic brought. Stewart said every Hartford HealthCare employee received a $1,000 bonus last week and will receive a second one, a “success share” before the holidays. A tuition-reimbursement program also has been implemented.

Yale New Haven handed out 5 percent bonuses in May 2020, though its annual performance incentives were 1 percent rather than the usual 2 percent because of the financial losses the health system suffered.

“We are aware of current compensation trends and we are in step with those trends,” Turner said. “There might be incentives for people that are responding to surge, patient care surges. We compensate well for people who are picking up shifts.”

She said the health system’s leaders showed their appreciation in other ways, including a “week of gratitude” in May, in which managers spent two hours every day for a week walking rounds with their staff and “really walked in their shoes for two hours.”

“It was tremendously successful,” Turner said. “People felt heard and seen … and it is a program we are committed to continuing.”

Since March 2020, the administration also has held regular town hall meetings, “talking about the state of the health system. … They appreciate that level of transparency,” she said.

Yale New Haven’s system includes Yale New Haven, Bridgeport, Greenwich, Lawrence and Memorial and Westerly, R.I., hospitals.