December 21st, 2020 | Valerya Poltorak, General Manager, Sterling Healthcare & Life Sciences

Healthcare Hiring in the Depths of Covid-19: Competing for Candidates

Covid-19 mask

You do not need to be in Healthcare to know that this is an overwhelmingly difficult time for frontline workers and the healthcare systems that support them. Full hospitals and staff shortages are making headlines in every mainstream news outlet.

We have been trying to dig deeper, though, to understand what it is really like to be hiring—and attempting to retain—clinicians right now, and how the landscape has changed since the first surges in March. We have talked to a number of clients in the past month about what they are facing, and what is working the best in attracting candidates and getting them to where they are needed as quickly as possible. I wanted to share some of the things we have learned. I am hoping they can help your organization, or perhaps spark ideas of how each of us might be helpful in this crisis. We are all in this together and it is not just hard—it is impossible—to do it alone.

The Situation

While December doesn’t feel exactly like March, the changes are not generally for the better. As a leader from a large Healthcare Staffing client told us, “There are not enough clinicians to go around, but we’re finding new ways to attract people to the marketplace, to make it attractive to get into the fight—and it’s just not enough. Everybody’s exhausted, everybody’s tired…. But we’re doing our part to try to make a difference and every little bit helps. Every time we can get someone out there—that’s the difference between somebody living and somebody dying. That’s a stark reality.” He adds, “work/life balance is a real challenge, mental health is a real challenge.”

For everyone, everything has only intensified over the last six weeks. Talent acquisition leaders are hearing daily about new waves of candidates needed. There is also the added complexity of suddenly adding staff to manage the Covid-19 vaccine rollout to workers, which—while anticipated for months—has become a reality quickly with rapid developments over the past few weeks. On the day the Pfizer vaccine was approved by the FDA, one of our clients told us that she had just learned that she had to fill 40 vaccine management roles within 10 days, with no requisitions or candidates yet.

Meanwhile, healthcare workers are exiting the workforce, either short-term or permanently, and by choice or by necessity. As a talent acquisition leader from a large university health system told us, “More candidates in the spring were willing to join the war with Covid, but there are more considerations now for the candidate pool, with health and wellness for themselves and their families.” There is widespread burnout after over nine months of the crisis. As April Hansen, RN, MSN, and executive vice president at Aya Healthcare, said in a recent article by the Center for Infectious Disease Research and Policy at the University of Minnesota, “I am concerned about burnout and the mental health of the nurses and care providers working today who are living more loss and trauma in a week or month than they may have seen in their entire career. I don’t think we can underestimate the reality of turnover.”

Workers—on both the front lines and recruiting teams—are out sick or caring for sick family members. As of the end of November, Carris Health Rice Memorial Hospital in Minnesota reported that 1,400 people—more than 10% of the staff—were out with Covid, quarantining, or caring for family members with Covid. With no child care or school available, and the impossibility of bringing kids to work with them on the front lines, parents are challenged to work. Others have retired, or simply left the healthcare workforce permanently.

Talent acquisition teams have the sense that they are doing the best they can, working around the clock, but it is just not enough. The United States was already short on clinicians before the pandemic, with only 0.4% unemployment for physicians and 1.1% for registered nurses at the beginning of 2020. Serena Bumpus, the director of practice for the Texas Nurses Association, told ABC News that in Texas alone “as of now we are short about 30,000 nurses.” A December 15th Los Angeles Times article reports that California has “so far acquired just one in 10 temporary contracted positions needed to treat surging caseloads.” Hospitals are relying on Staffing firms to supplement their own staff—registered nurse travel demand increased 44% in November alone, and continues to rise—and this means hospitals are often competing with Staffing firms for talent.

Among our clients who operate residential communities, whether for seniors or adults with developmental disabilities, there had been optimism that they would have an influx of candidates for their high-turnover positions, given Covid’s impact on the economy. However, “we just can’t bring the people in,” one of our clients tells us. “It’s been one consistent challenge since March.” The pool of candidates is limited.

Some of our clients have redeployed their office staff to move them over to frontline work—or have warned that this may be necessary if patient counts continue to rise.

What’s Working in Talent Sourcing

The situation would be far worse, however, if healthcare hiring teams were not so innovative and resilient. They have implemented many improvements to talent sourcing and hiring that have brought new staff on board at rates never seen before. We have heard that while they are expediting and streamlining hiring, in general their approach is less chaotic than they were in the spring. They are using tools and processes, not hiring without a candidate formally applying… just making it as easy as possible to apply and minimizing the hoops a candidate must jump through.

How are they finding candidates? One client told us that they have doubled employee referral bonuses for the most in-demand roles. Her organization, a revenue cycle management company, communicates frequently with employees to share open positions and let them know how they can help. A benefit of employee referrals is that new hires come in “knowing what they are walking into”—because with remote hiring, they have been finding that early attrition in frontline roles can be high.

We have heard from other clients who are having success with virtual hiring events and finding that it has been an efficient way to source candidates at scale. A talent acquisition leader pointed out that they are able to make the most of the time that leaders are pulled out of their day jobs to hire, and these events have dramatically expanded their pipeline. She believes that the broad outreach may even improve the quality of their talent.

Other clients have invested heavily in digital advertising. Level of investment, placement, and messaging are not the only levers at hiring teams’ disposal—the ad’s call to action is critical as well, one of our clients tells us. The more expediently a candidate can go from clicking on an ad to talking to a recruiter, the more effective.

Getting to an Offer

Speed to interview—and to make an offer—are intense areas of focus right now.

Healthcare talent teams have dramatically streamlined their interviews and offer process. One of our clients told us about automating and standardizing pay packages to offer enticing compensation from the start and eliminate negotiations, so recruiters could use their time elsewhere. We have heard from other clients that they have eliminated the hiring manager from the hiring process for certain positions—talent acquisition teams are managing this process themselves. Others have mentioned the importance of hiring managers proxying hiring to others, so they do not create a bottleneck. Our client from the large university health system mentioned having built a large pool of trained, go-to interviewers, so there are always enough people available for a panel at a candidate’s earliest convenience. She mentioned that texting during the recruiting process has also been helpful and has reduced “ghosting”—candidates going silent.

Speed to hire is not only an imperative for addressing the frontline need, but for staying competitive. Given the severe labor shortages and fierce competition for talent, hospitals and Post-Acute organizations are competing with Healthcare Staffing and travel nursing agencies that are offering jobs on the same day. Interviewing and extending the offer the same day are the goal. Our university client told us, “You can’t interview someone today and not make a decision until Monday. You have to make a decision today and we’ve got to start the background check today. Every minute counts.”

Getting a Candidate to Say Yes

When competition is fierce, how are organizations able to land a hire? Of course, sometimes it is by offering the highest hourly rate—which is impossible for some organizations, especially nonprofits—or having the most attractive location. However, there are other considerations for candidates as they evaluate their options.

First, safety. Organizations have found that emphasizing their commitment to safety resonates with candidates. Some candidates are looking for specific assurances that the organization has plenty of personal protective equipment (PPE). One of our clients mentioned that this is a selling point for her organization as they seek to win candidates for patient registration and similar jobs—her team emphasizes that health systems are better prepared to protect their employees than other types of companies that employ essential workers.

According to a recent HealthcareDive article, “Other factors driving where nurses are going and why include how quickly facilities are interviewing, start dates, housing availability and flexibility and ease of an onboarding process.” Indeed, our clients told us they have been working on streamlining onboarding processes, which have traditionally involved multiple teams. My team has been laser-focused on helping clients implement automation and other process improvements to ensure that background screening and credentialing go as quickly as possible.

Last but not least, culture and values can certainly be the deciding factor for a candidate with many employment options. A senior living client told us that her HR team has been partnering with PR to get the message out about their company culture, and particularly how much they care for their people and their families. To support this message, and to make themselves a viable option for talent, they have also made themselves much more flexible with scheduling than ever before. “What organizations will do to win the retention and engagement game,” our Staffing client says, “is to really focus on the mission, values, and purpose of the organizations, and the nature of the work.”

Conclusion

This year has been mind-bogglingly difficult, but my team and I are in genuine awe of what our clients—and healthcare hiring teams more generally—have accomplished. They have been resilient, innovative, and gracious, despite the constant obstacles and exhaustion. I hope that some of the ideas above can be useful to others, but I am also curious to hear what is working for you and how we can help. Please reach out directly and know we are here by your side to support you however we can.

Sterling is not a law firm. This publication is for informational purposes only and nothing contained in it should be construed as legal advice. We expressly disclaim any warranty or responsibility for damages arising out this information. We encourage you to consult with legal counsel regarding your specific needs. We do not undertake any duty to update previously posted materials.