Health care hiring crunch 'keeps getting worse' in the region, providers say

FARGO – Joe Kortes is working as a registered nurse while getting help from his employer to earn a higher degree that would help him take his career to a higher level.

Kortes, who works in orthopedics at Sanford Health here, has agreed to continue his employment for at least a year in exchange for the tuition assistance.

"This is kind of my stepping stone," said Kortes, a former licensed practical nurse who has his eye on some day becoming a nurse practitioner or teaching nursing.

For Sanford, the arrangement helps to maintain its nursing staff-a critical need in a time of what many agree is an increasing challenge to fill nursing and other health care staffing positions.

It's just one of many examples of the steps local hospitals, clinics and nursing homes are taking in response to the worsening shortage of nurses and other health care workers, an acute symptom of the region's broader labor shortage.

Other novel approaches include remodeling to gain staffing efficiencies and paying nursing aide candidates while they take their certification classes.

"We have a challenge," said Paul Richard, president of Sanford Medical Center. "We've got a current crunch, but at the same time it's an issue in the state and region."

Although many agree the need is especially great for nurses, it's been difficult to maintain staffing across the board, including in food service, housekeeping and building maintenance, Richard said.

"It is really across the board and as an industry we're not unique," he added, noting that all employers in the region are having difficulty finding workers.

The problem has become so acute that the North Dakota Hospital Association is surveying members and grasping to identify initiatives that can address the longstanding hiring problems, a top priority for health care administrators statewide.

"The No. 1 issue is workforce and the No. 1 workforce issue is for registered nurses," said Jerry Jurena, president of the North Dakota Hospital Association.

"It just keeps getting worse," he said. "This is an issue that's been out there for years, and it just keeps compounding."

Among the factors behind the health care hiring crunch:

• The retirement of the large baby boomer cohort of nurses and other health professionals, creating vacancies that need to be filled.

• Expansion of health services, including new specialties, as well as expansion of existing hospital and clinic services, creating new positions to be filled.

• Increased demand creates greater mobility for workers, making it more difficult to recruit and retain workers.

"People are just a lot more mobile in their ability to move from job to job," said Nicole Christensen, chief nursing officer at Essentia Health. "Nurses, especially, have so many more opportunities available."

"I think everything is coming together right now" to exacerbate the health care hiring challenge, said Janelle Klinke vice president of human resources for Eventide Senior Living Communities.

As a result, employers are being increasingly creative in finding ways to attract and keep employees. Part of the solution is to draw more health care workers to Fargo-Moorhead.

"Our interviews are marketing events," Klinke said. Employers are well aware that applicants often have five or six offers to weigh.

Eventide, for example, offers referral bonuses for employees who help recruit new workers. More than 100 Eventide employees are getting the incentives under the referral program, Klinke said.

Eventide also offers an incentive to pay new hires while they attend classes for certification as a certified nursing assistant, and offers tuition assistance for nurses, she said.

Beginning certified nurse assistants start at $16 an hour at Eventide; those working evening or overnight shifts earn an additional $2 an hour. Part-time staff get a premium enabling them to start at $17.17 an hour, Klinke said.

Elim Rehab and Care Center offers what it believes, based on surveys, to be top-scale pay to attract and keep staff, said Joyce Eisenbraun, director of marketing. Still, hiring is "absolutely" becoming more difficult, she said.

Rather than offer sign-on incentives, Essentia focuses more on work environment and retaining employees, Christensen said.

"We want our existing staff to feel appreciated," she said.

Sanford declined to comment on the response to its $20,000 bonus incentive for certain nursing positions, saying the information is considered proprietary.

Sanford has 150 to 200 openings to fill - including more than 100 nursing positions - and has even offered $20,000 sign-up bonuses for select nursing positions for applicants with the right background who are willing to make a three-year commitment.

In addition to tuition assistance and scholarships for qualifying positions, Sanford is exploring efficiencies that can alleviate staffing pressures.

Sanford's downtown medical center, for example, is slated for a $4 million renovation of the cafeteria, resulting in streamlining expected to save 10 to 12 full-time positions, Richard said.

Sanford now is offering referral bonuses for positions including licensed practical nurses, registered nurses, nurse assistants, food service and med tech. Sixty registered nurses and 21 licensed practical nurses have received school loan repayments.

The North Dakota Hospital Association, meanwhile, expects to have results from the staffing survey soon. Those could help point to solutions. Over the years, the state has progressively increased educational support for an expanded range of health care professions.

"We need to keep searching for solutions," Jurena said.