by Melanie Bell, MSN, RN, CENP
Associate Vice President, Contract Labor
04/07/20

The modern world has not encountered a pandemic like COVID-19, which has many organizations scrambling to identify the best way to deal with the massive toll it will inevitably take on the U.S. health care system and its workforce. It’s evident this virus has a timeline all its own, so not only should you be thinking about what to do today and tomorrow to care for patients, but the impact on your organization and staff resources for months to come.

While hospitals may be at different stages of dealing with the virus, there are steps you can take now before your facility is overwhelmed. During times like these, when chaos dominates our daily lives, starting with tried and true methods can help manage periods of uncertainty. Here are five ways to identify and address workforce issues while continuing to provide the best care possible.

1. First things first. Every hospital has a disaster plan and now is the time to dust it off. A significant portion of the plan should include a workforce strategy with a skills and experience inventory of your clinical staff so you know where people are competent to float. Understand your organization’s needs and gaps, including bed capacity, staff size and flex capacity, related to COVID-19.

Whether onboarding permanent or contingent staff, make sure you’ve identified an abbreviated clearance process, along with a quick way to reassess as the situation evolves. Have a plan in place for how the staff will be onboarded, who will conduct the onboarding process and how often it will be done. Consideration should be given to whether staff will be onboarded without full background checks; and alternative steps if labs discontinue routine employment screening because they are prioritizing COVID-19 testing.

Having an agreement in place for contingent staffing is one less burden for your team to bear. For example, some programs will handle everything from sourcing staff to validating credentials and beyond. It’s important to monitor contingent staff expiration dates and have a process in place to extend in advance if you believe there’s a likelihood you’ll need the support.

2. Hope for the best, but plan for the worst. Customize your plans based on what you know now, and be flexible and adaptable as the situation evolves. Determine volume and staff needed for screening, treatment, telehealth and triage phone lines. Take time to put together guides and quick reference documents so staff has the appropriate resources. Any RN should be capable of working a triage line if they are armed with the right information.

For staff providing direct care to COVID patients, a phased plan based on the number of cases in your community works well, but it’s important to develop guidelines and thresholds now so there isn’t a need to make those decisions later. Consider whether staff should be required to self-quarantine after caring for patients with the virus. Also, ensure there is a clear plan for those staff that test positive; and if they do, include stipulations for returning to work if they are asymptomatic or have a quick recovery.  

3. Leave no stone unturned. There are staffing opportunities throughout the hospital if you look for them. Define “helping hands” roles and responsibilities now. Identify tasks that non-clinical staff can help with to minimize the load for your nurses and respiratory therapists, who will be in highest demand. Consider shifting staff from current low-volume areas, like pre-op, OR and PACU into high-volume areas according to their competency. Lastly, even if an individual is not clinically competent to work ICU, extra hands at the bedside will allow qualified staff to stretch further.

And while it may be easier to focus on the physical element of staffing, don’t forget the human aspect. Make sure to rotate shifts, conserve essential staff and be careful not to push people past their ability to remain physically, psychologically and emotionally healthy.

4. Think outside of the box. Now is the time to get creative. Consider partnering with nursing schools to utilize students in a support capacity, many schools would allow this to count as clinical hours, but you may also consider adding interested students as contingent labor. Also, after only one semester of nursing school, an individual can be qualified as a certified nursing assistant. That’s one more person to provide much-needed help.

Sadly, a large swath of the service industry is out of work right now because of the pandemic. Develop an internal training program or collaborate with a vocational school to offer an abbreviated patient care technician course that would prepare non-health care workers to work in the health care industry as support staff for the length of this crisis. If you start now, these individuals would be ready to come into the facilities when you need them most

5. Hang in there. Everyone is going to need care in some way, shape, or form during this crisis. Take care of yourself and your staff. It’s important to remember that everything now requires your clinical staff to adapt: lack of product in grocery stores, how to home-school children and managing daycare. It’s important to be supportive during this time given these additional sources of stress. 

As the reality settles in that this is a marathon and not a sprint, it’s important to remember we have faced many crises before. We all have faith in and a desire to help people – it’s the reason why we all entered health care in the first place. If we keep remembering the folk wisdom passed down to us over time, we will surely prevail.

About the author. Melanie Bell is an experienced nursing administrator with a background in labor and process optimization in the acute care setting. Prior to her career as a registered nurse, she was a business and financial analyst, working as a liaison between finance and IT. Utilizing her unique experience in the clinical and business settings, Bell has managed nursing operations through rapid expansion and new facility openings. In her current role, she leads technology and operations for the Vizient Contract Labor Management team, which supports more than 450 acute care facilities in their contingent staffing needs.