Some of the statistics revealed at the Oregon State of Reform Health Policy Conference on October 25 were jarring and controversial even for an audience familiar with Oregon’s healthcare worker shortfall.
According to Troy Larkin, executive director of the Providence Nursing Institute, a startling 30–40% of newly graduated nurses quit the profession within the first year.
You can’t get out of that via pipeline, he said. “We must deal with retention.”
Larkin participated in two panels at the conference that was solely focused on Oregon’s healthcare workforce difficulties. She gave an outline of the potential and challenges they indicated existed. The Hilton Hotel in Portland’s central business district hosted the event.
According to Jennifer Purcell, director of the Future Ready Oregon programme at the state Higher Education Coordinating Commission, “Oregon, like most states, is confronting a big problem when it comes to increasing and supporting its health care workforce.”
The problem appears to be obvious, but the answer is not. Purcell is in charge of carrying out the workforce training and education funding package that the Oregon Legislature just approved in Senate Bill 1545.
The statute established grant programmes run by the Higher Education Coordinating Commission to fund initiatives aimed at advancing the labour force. According to Purcell, the financing will improve access to workforce development programmes and benefits as well as training in technology, healthcare, and manufacturing.
Purcell claims that the goal of the $200 million Future Ready package is to create a fair workforce system. As we continue to recover from a confluence of historic challenges and opportunities, such as a worldwide pandemic, economic catastrophe, and a cry for equality and racial justice, she said, “We’ve set Oregon on a path towards fair prosperity.”
Larkin and Purcell were on the first-morning panel, which discussed new workforce initiatives, along with Paul Gorman, the assistant dean of rural medical education at Oregon Health and Science University’s Department of Medicine. He and Larkin are addressing the lack of qualified healthcare workers in the educational system.
Gorman stated that OHSU is committed to increasing the number of diverse and competent medical professionals working in the field of healthcare through a number of initiatives aimed at reaching out to indigenous and rural populations. Gorman collaborates with initiatives like WY’east, which offers tuition-free medical education to students of indigenous descent, and COMPADRE, which offers 30 graduate medical education programmes for impoverished areas in Oregon and California.
Given the dearth of diversity in Oregon, Gorman said it is essential to broaden both the pool of applicants to medical programmes and the population that can access them. Only 14% of nurses in Oregon are men, he continued, which is “excessive” in comparison to other states.
Despite representing 14% of Oregon’s population, only 3.9% of nurses are Hispanic.
Medical and nursing schools all around Oregon have reported a drop in instructors, which makes it even more difficult to train new healthcare professionals. The workload and the money are the problems, according to Larkin.
He declared, “We don’t have enough professors.”
According to Larkin, flexible employment options are necessary to increase the workforce.
For nurses who no longer want to or are unable to undertake standard 12-hour shifts with more physical labour, he advised increased virtual nursing. Larkin also collaborates with high schools to promote job opportunities in healthcare.
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The Burnout Concern Is The Shortage Issue
New state Representative Travis Nelson, who was appointed in February to take the place left vacant when Tina Kotek resigned to run for governor, stated at the second workforce panel, which addressed retention, that he is trying to address the labour demand through legislation.
Nelson, a nurse by trade and a representative of the Oregon Nurses Association, expressed his hope that new regulations will take into account the needs of employees.
We “aren’t going to grow our way out of our shortages of health care workers,” he declared. “I believe we need to find a means to reunite nurses and other healthcare professionals who left during the epidemic, as we are aware that hundreds of them departed Oregon during the pandemic. We must devise a strategy to help them rejoin the workforce. Additionally, we need to find ways to keep the healthcare professionals who are about to quit.
According to Nelson, firms must cease treating employees “like industrial labour.” He asserted that Oregon needed more effective wellness programmes in hospitals and other healthcare facilities to accomplish this.
In-house childcare, student loan repayment, elder care, retention bonuses, hazard pay, reducing required low censors and mandatory floating, flexible scheduling, and improved compensation and benefit contracts are some of the other retention techniques he advised.
Nelson claimed that “90% of those conversations either have a staffing component, or I do not feel respected” when he speaks with nurses who are considering leaving the profession.
While Matt Calzia of the Oregon Nurses Association said the issue is mainly about retention, the staffing situation in the business is frequently referred to as a shortage.
“Do we have a turnover issue, or do we have a shortage? The union’s director of nurse practice and professional development, Calzia, stated that they have a severe turnover issue.
Calzia proposes placing more attention on the interests and specialisation of workers, nurses, in particular, to reduce staff turnover.
Whether a (radiation) tech or a nurse, he said, “We need to make sure that we’re constructing frameworks that allow employees to practise at the top of their scope and they’re not having to fill in parts where they weren’t educated or why they got into the profession.”
Healthcare organisations in Calzia are increasingly asking nurses and other personnel to perform duties outside the scope of their normal job descriptions. For instance, weapon searches.
“We never learned how to check people for weapons during our education. However, you’re going to do it even though it’s inappropriate because you’re there and in that setting. That is beyond our purview, Calzia declared.
According to Nelson, the pressure put on healthcare professionals is a symptom of another problem.
The majority of the reasons hospitals are having trouble right now, according to Nelson, are related to labour costs. “Labor expenses are out of control since so many people have quit their jobs,”
Nelson thinks that by emphasising retention, labour expenses will go down and hospitals will be better able to support employees and concentrate on patient care.
Healthcare companies are attempting to diversify the makeup of the healthcare workforce in addition to addressing faculty shortages.
Employers should be more adaptable in their standards and interview process design, according to Emily Henke, executive director of the Oregon Public Health Institute. She used her organization’s experience, which at the height of the pandemic had 600 employees, as examples.
The bulk of her staff members, she noted, lack four-year degrees, and many also lack a high school diploma. Contract tracing and vaccination appointment schedules were among the tasks. Henke stated that 30% of the staff chosen for Oregon Public Health Institute’s contract with Washington County were bilingual, and 90% were people of colour.
In order to ensure that our systems or job descriptions accurately reflected the work we wanted to be done, Henke stated, “we thoroughly studied the tasks that we were hiring for. We sought to remove as much gatekeeping from our job descriptions.
The retention issue in the healthcare industry is spreading, according to Laure McKean, head of the Oregon Health Authority’s Health Care Workforce Committee, which is causing capacity challenges at nursing and medical schools in the state.
Why would someone do that when working at a hospital would pay $30,000 more than teaching? McKeane, the director of oral health services at Allcare Health, stated.
It is well known that medical school admissions are tough, but according to McKeane, this is partly because there aren’t enough faculty members available to instruct applicants.
Bottom line, according to McKeane, imaginative solutions that go beyond the provider incentives that have been a cornerstone of some workplace retention efforts are required to address Oregon’s workforce issues.
McKeane stated, “We need to think beyond the box.
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