At a time of unprecedented upheaval for our health care workforce, leaders could be forgiven for focusing on how to chart a path back to a pre-pandemic 'normal.' But when it comes to workforce strategy, there is no 'return to normal.' The sooner leaders embrace the hard truths underlying this reality, the sooner they'll be able to effectively address them.

Case study: How Centura repositioned its EAP to boost everyday workforce well-being

Hard Truth #1: It's unlikely that your workers are going to build a career within your organization. In fact, it's increasingly not even on their radar.

Even before the "Great Resignation," younger health care workers were already thinking about their next job. A study of workers in 2019 found that the average 25- to 34-year-old has worked as many jobs as the average 50 year-old has within their entire career.

Our take: The mandate for workforce recovery

Today, the average health care worker has a shocking abundance of employment opportunities, such as: life sciences firms, virtual clinics, Minute Clinics, digital health startups, agency/staffing firms, and medical device manufacturers. In many cases, the pandemic has only increased the availability of health care employment opportunities outside of the traditional provider space. With this perspective, it would be career-limiting of any health care employee to contemplate a life-long career within a single employer.

What you can do to address this hard truth

We have no choice but to re-align our recruitment and retention strategies to reflect this shortened timeline. If our employees are only thinking three years ahead, we must frontload career development opportunities into the first year of employment.

Increasingly, we must target passive candidates to create a permanent pipeline of potential employees. And above all else, we as employers must keep an ongoing pulse on what our competitors across the entire health care ecosystem are offering in terms of benefits and work flexibility, so that we in turn remain competitive.

Hard Truth #2: It can be done remotely. Maybe you think it shouldn't be done remotely. That's fine. Many of your workers don't care.

This brings me to our second hard truth, which is around new expectations related to workforce flexibility. In many regards, the pandemic has been an enormous experiment about what jobs, tasks, and responsibilities can be done remotely.

The resounding answer has been "more than we ever thought possible two years ago." Much of the conversation today, whether related to site-of-care-shifts or hybrid work strategy, is about what should be done remotely. This is a conversation worth having, as long as we recognize that it comes with a built-in opportunity cost.

It's estimated that 20-29% of health care jobs can be done remotely. All health care workers have witnessed the telehealth boom in their own industry and, regardless of whether they personally benefited from it, are well aware of the unprecedented rise in remote work across all industries.

Health care workers are more aware than ever before of employment options that may better match their work-life balance or family needs. In fact, of nurses who left their employer in 2021, 56% referenced the intensity of their workload and 46% referenced family needs as influences to their decision to leave.

What you can do to address this hard truth

So as you contemplate strategy on site-of-care, organizational culture, and real-estate footprint, bear in mind that in-person work now comes at a cost. Your employees want a compelling answer as to why they need to do this work in-person—and it's likely that they will soon want an equally compelling salary and benefits package to match.

Hard Truth #3: Connection to mission won't compensate for what is a tough—and sometimes terrible—industry to work in. Let's start being honest about it.

Most health care workers enter the field at least in part from a desire to help others. Over the years, whenever we've talked about boosting resilience or building engagement, we've focused on reconnecting staff to that caring mission.

If we're being honest with ourselves, a large reason for this focus on connection to mission is because it was one of the few things we could control. We couldn't pay more, we couldn't staff up, we couldn't reduce workload—but at least we could remind staff about the real, powerful impact their work had on patients and society.

But now, two years into the pandemic, the genie is out of the bottle. Violence against health care workers from patients and their families, already an issue before the pandemic, has risen dramatically. The initial groundswell of support for frontline workers from the general public gave way to indifference, to neglect, and increasingly to outright hostility towards health care practitioners. In tandem, as unvaccinated patients fill ICUs—prompting incredibly difficult ethical cases about treatment rationing—moral distress is on the rise. Connection to mission is no longer enough to keep staff going.

What you can do to address this hard truth

The solutions here are not easy to achieve. They come with trade-offs and will take time. They must begin with a reckoning about medical education writ large and about whether it should more accurately reflect the compromises and realities of operating in short-staffed, high-volume settings. Health care employers need to prioritize employee safety and well-being as foundational elements of the employee experience.

This means immediate and significant investment in security and employee well-being resources, even at a time of uncertain finances, because if you can't keep your workforce safe—physically, mentally, and emotionally—then you won't keep your workforce.

Hard Truth #4: How we worked before the pandemic no longer provides a template for how we will work post-pandemic. We're entering a time of re-invention.

If we can't rely on connection to mission as the foundation of engagement, then we have no choice but to address how to make working in health care a less difficult, more palatable proposition. Easier said than done, right?

But the fact is that the pandemic has exposed all that is rotten in the state of health care. And as we look towards the future, the argument "this is how we've always done things" no longer holds weight. We have to ruthlessly innovate if we want to maintain an effective health care workforce. That means that while the answer to the question 'why we work in health care' remains sacred and unchanging, the answers to 'how we work in health care' are all up for discussion.

Take nurse staffing for instance. Almost every acute care site in the world relies on the traditional "3-12" shift schedule of three shifts of 12 hours per week for an RN. For years, we've seen evidence that this schedule is debilitatingly exhausting in the long-run, adversely impacts the quality of patient care, and doesn't offer flexibility to mid- and late-career nurses.

Yes, moving away from this system represents an unprecedented logistical nightmare, but it also represents an unprecedented opportunity to reinvent workforce flexibility in a field that previously had close to zero.

What you can do to address this hard truth

Only if we have the boldness to question the core elements of our old workforce strategies, will we be able to create a sustainable health care workforce for the future. It is an unenviable task. But if we can no longer 'return to normal,' it's the best option we've got.

We have three on-demand webinars that aim to help your organization address these hard truths:

• The first covers global insights on shifting the site of care and features case studies from organizations that engaged their workforce and maintained care quality while shifting default access points to new sites or modalities.
• The next on-demand webinar surveys the physician landscape in the wake of the Covid-19 pandemic and the preceding years of consolidation, innovation, and disruption. We will unpack the host of forces that are shaping the future of physician practice and loyalty, including policy, politics, private sector players, and more.
• Finally, we explore the evolving employer-employee compact and the evolving state of what health care employees expect from their employer, and vice versa, across the coming decade. We will discuss the forces that are shaping these rapidly evolving expectations and how organizations can respond to position themselves as an employer of choice for 2031.