Pandemic Staffing Challenges Remain a Concern

As the pandemic continues to take its toll on frontline providers, retaining and recruiting periop nurses is a daily concern for Deborah Ebert, MSN, RN, NEA-BC, CNOR, CCRN, CPAN, CAPA, associate vice president of perioperative services, and her leadership team at Memorial Hermann-Texas Medical Center in Houston, Texas.

Deborah Ebert, MSN, RN, NEA-BC, CNOR, CCRN, CPAN, CAPA
Associate Vice President - Perioperative Services, Memorial Hermann-Texas Medical Center
MFW Consultants

“We huddle daily to assess staffing, inpatient patient placement capacity, and PPE as a result of Covid, and the daily challenges of perioperative operations in a Level 1 Trauma academic center,” Ebert says.  “We are not sure what impact the pandemic will have on the future staffing for surgical services.”

Current Staffing Challenges

Many of her nurses were deployed to other units and assignments as surgical volume dipped during the summer. This led to staffing cuts and disruptions until elective surgery volumes returned.

Meanwhile, traveling nurse agencies have significantly raised their pay through Covid, enticing a number of periop nurses away from her staff—a trend she knows is impacting periop staffing across the country, as well.

Burnout from the emotional strain of caring for Covid patients and working through the pandemic is also leading some nurses to retire early or leave the profession for different roles all together.

Retention Strategies

Currently, we are providing visible leadership, intentional rounding for “pulse checks’ with staff, and giving them opportunities to vent, Ebert explains. Pastoral services have provided additional support with teas, candy carts, inspirational cards and devotionals to reduce stress and express gratitude,

“Morale is so important,” she stresses. Nurse and physician leaders have been empowered to raise any concerns they see among staff to arrange early support for those who need it.

Financial support is also a focus. Her health system recently increased referral bonuses for certain specialties/units and additional pay for dedicated Covid unit teams.

Recruitment Incentives and Challenges

Acknowledging the competition from traveler agencies, bonuses, pay scale, sign-on bonuses and attractive entry compensation packages are constantly being evaluated to prevent losing current and new hires, Ebert says.

In recruiting new nurses through mostly virtual interviewing, she says certain nuances and body language cues in the interview process may be missed. “It is valuable to have the candidate tour the facility and meet with staff in person. Virtual interviews have impacted this process.”

Looking Ahead

Ebert thinks the long-term effect of the pandemic on periop staffing remains to be seen, but she is concerned about the disruption for those areas where teams have been redeployed or furloughed, especially for nurses who are newer to periop.

For example, several periop nurses just transitioning out of Periop 101 who had previously worked in nursing floor units were returned to their previous roles during the first surge of Covid. Ebert wonders if these nurses will choose to return to periop.

Looking at the big picture post-pandemic, she says some challenges have remained unchanged depending on status of facility. For organizations that had to ramp down staffing when elective surgeries were halted, they are and will find it difficult to crank back up to more regular volume if staff have left in search of other opportunities.

For her hospital, which is perhaps the busiest Level I trauma hospital in the country, volume is still high with 90–100 plus cases a day, but staffing and inpatient post op placement remain a challenge as Covid cases continue to spike after the holidays. “It’s a constant Tetris game to figure out how we will have space for post-op surgical patients and staff to care for them.” She doesn’t see this changing any time soon.

Don’t miss hearing Deb live during AORN’s national panel discussion Leader’s Edge – Unplugging the Nurse Pipeline - on March 18. Register for free and join this important conversation.