January 6th, 2021 | Valerya Poltorak, General Manager, Sterling Healthcare & Life Sciences

Healthcare Hiring in the Depths of Covid: 2021 Outlook

I recently wrote about the impossibility of filling frontline healthcare roles fast enough to address the current crisis. Healthcare hiring leaders are very much having to live in the here and now to hire and retain clinicians. However, as we enter the new year, the most immediate challenges for 2021 are apparent, and the ways in which healthcare staffing is likely to change more permanently are coming into view. Today I’d like to share what I’m hearing from clients about the challenges of vaccine management, as well as some broader perspectives on what 2021 looks like for healthcare talent management.

Vaccine Management

While for months we were so impatient for a vaccine to arrive, it felt sudden when it did. The FDA approved the Pfizer vaccine on Friday, December 11, and vaccinations began for frontline healthcare workers three days later. The Moderna vaccine quickly followed suit. While these have been extremely positive developments, they have also left healthcare HR and employee health teams scrambling. According to a client of ours who is a leader at a large Healthcare Staffing firm, vaccination of American healthcare workers is “going to be a Herculean effort, it’s going to be messy, and it’s going to take awhile.”

First, some employers are grappling with the overall question of whether to require that employees vaccinate. According to EEOC guidance updated on December 16, employers can require vaccinations when they are available as a condition of going to work, but (as with other types of vaccines), employees can decline because of a disability or a sincerely held religious belief and employers must seek to offer a reasonable accommodation to the employee.

This decision comes amidst reports that there will be more people than usual declining vaccinations, even in healthcare. According to an article in the Washington Post, the American Nurses Association reported that one-third of its members were not intending to have the vaccine, and an additional third were undecided. According to the article, “The hesitancy among doctors and nurses is not the same as the anti-vaccine movement… Health professionals tend to be advocates of vaccines.” However, the vaccines’ speed to market and novel techniques, as well as perceived politicization of the process, have made some people nervous.

This seems to be what our clients are hearing and seeing as well. Many of their staff do not want to be in the first round of vaccinations. For the most part, the clients we have spoken with have been planning to offer the vaccine but not mandate it, at least not yet, and have been undertaking some internal PR to get their staff more comfortable with it. Organizations have been creating videos with internal medical experts, demystifying the vaccine and reaffirming its safety. Many organizations are now also having leaders get the vaccine publicly and talk about why they have chosen to do so. Many believe that comfort with the vaccine will grow rapidly as increasing data is shared and as vaccinated co-workers share their experiences.

There are additional challenges, though. Clients have told us that they are staggering rollout so any side effects are not felt by all members of a department at the same time. Tracking the second doses the vaccines require—and getting the timing right—will be complex. They have also had to hire vaccine management personnel rapidly at a time when hiring is already fast and furious.

Fairness and equity are also important considerations. Indeed, in the first week of vaccine availability, as healthcare leaders were grappling with how to overcome hesitations from some employees, some found themselves simultaneously under fire from others eager to have the vaccine and protesting unfairness in who was getting it first—senior leaders before medical residents on the front lines, for example. We spoke with a client who leads employment strategy and workforce planning for a nonprofit health system just before the vaccine was available, who told us that knowing they would have limited supply at first, “We’ve been really trying to bring an equity lens to who we roll this out to… not just nurses and providers,” but others critical to keeping a hospital running—custodial staff, food services, and other functions. Their vaccine distribution team had included the health system’s Diversity Council in their planning.

The Ongoing Talent Shortage

As we have spoken with our clients, there is consensus that hiring is going to continue to be a major challenge in 2021. Of course, Covid-19 cases are showing no signs of abating and the struggle to fill positions that I discussed in my last post will continue. However, there was a talent shortage even before the pandemic. With a growing, aging American population to care for, and aging nurse population retiring, the American Nurses Association was reporting prior to Covid that by 2022 there would be “far more registered nurse jobs available than any other profession, at more than 100,000 per year” and a need for 1.1 million new RNs. The experience of the past several months has fueled burnout that has led to further retirement and attrition. This means that competition for healthcare workers will continue to be fierce and wages will stay high. As the Healthcare Staffing client we spoke with put it, “We are all fighting a war for talent on a national scale, because the technology allows us to do so, and the needs of a changing, evolving healthcare market require it.”

However, the labor delivery model itself is also shifting more fundamentally, and the transformation will be accelerated by everything the healthcare profession has been through during Covid-19. This generated an interesting discussion in a recent roundtable, where there was consensus that the gig economy for nursing is here to stay. Healthcare workers are exhausted and are going to be grappling with what they have experienced. Our Healthcare Staffing client pointed out that there will be long-term repercussions on the nature of work, and “people will figure out how they want to work and when they want to work, to meet the needs of their lifestyle and family.” Given that options abound, the job security that comes with a permanent job is less of a priority.

It can be difficult for health systems—especially nonprofits—to compete with Staffing firms, particularly in compensation. What should they do about it? A client who leads talent acquisition at a large university health system talked about investing resources in engaging new employees, as they are the employees at greatest risk of attrition. Our Staffing leader had an interesting perspective—don’t end relationships when they leave—let them go take the travel job, where they can pay off student debt, perhaps spend time somewhere new, and gain professional experience. Be the gracious (and smart) employer that welcomes them back once they are ready to come home and settle down again. With such a shortage of talent, it is a mistake to write good people off when in fact you may be a better fit in the future.

The increasing importance of the gig economy in healthcare is something that my team and I are fascinated by and will be watching closely.

Another interesting topic that arose in our roundtable was about population migration. Our clients in urban hubs have benefited year after year from migration from elsewhere in the country. Over the past several months, however, employees have been moving away to be closer to home and family. Talent leaders speculated on which pattern was likely to continue post-Covid.

No Rest for the Weary

Unfortunately, the talent leaders we have spoken with do not see things getting easier anytime soon. Our client from a university health system said, “I don’t see it slowing down anytime next year… I think it’s just going to be changing needs.” Our Staffing client told us, “We’d like to think there’s a light at the end of the tunnel, but the reality is it’s going to be a long, rocky road.”

Remember, we are here to do what we can to support you as you take on the challenges of 2021. We are committed to helping you hire great talent, and to getting new hires to where they are needed as swiftly as humanly possible. Please reach out and let us know how we can help.

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