Many companies were surprised by the “Great Resignation” of 2021, which led a record 4.3 million U.S. employees to quit in August alone, whether they were struggling with burnout, their jobs were no longer meeting their needs, or for other reasons. However, a flood of pink slips is old news to those in the health care industry, which has been plagued by job shortages since before the pandemic. The situation was exacerbated as doctors, nurses and others battled COVID-19; health care executives say many of their most experienced nurses have accelerated their retirements or cut back their hours since the outbreak began. Industry leaders fear more may follow; polls suggest 30 to 50% of health care workers may reduce their working hours or quit entirely as the pandemic drags on.
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However, this crisis has led many health care execs and HR leaders to get creative in an effort to retain and recruit workers—especially older workers, who may bring decades of experience to their jobs. As industries across the corporate landscape grapple with workforce shortages, they may be wise to take their cues from those in the health world. TIME asked a handful of health care leaders about how they’ve hired and retained older, experienced workers. While specific programs and priorities varied across hospitals, certain themes came up again and again: recruiting for experience, flexibility and wellness.
Experience
One of the big problems with the nursing shortage isn’t just a dearth of nurses, executives say—it’s that it’s especially difficult to find experienced nurses who can work in hospitals’ most complex roles, like operating room positions. That’s why executives are going above and beyond not only to encourage workers to stick around, but to recruit experienced nurses anywhere they can find them. “An experienced nurse, to me, is gold,” says Claire Zangerle, chief nurse executive for the Pennsylvania-based Allegheny Health Network.
Zangerle created a program called “RetuRN to Practice,” an initiative to recruit former, often older nurses and, in partnership with the University of Delaware, get them back up to speed, in part by teaching them the latest practices. As many as 70 nurses who joined the program are now working in the Allegheny system.
In New York, Northwell Health is also recruiting retired and experienced workers; a main focus is on equity for people of all ages, says senior vice president and chief human resources officer Maxine Carrington. “You want a workforce that reflects the population, and so we have people working at Northwell of all ages,” she says. Northwell is researching and enacting changes both large and small along these lines. In January, for instance, it will launch a “blind resumé” program, wherein ages and other identifying data will be scrubbed from prospective employees’ documents. The company also plans to launch an alumni program that encourages retirees to return as teachers and mentors, and to expand its “Returnship” program—which is initially targeting female caregivers—to better enable retirees to brush up on their skills and get back to work.
Flexibility
Among the executives who spoke with TIME for this story, many agreed that, to attract and retain experienced workers, flexibility is a must. Both Zangerle and Carrington said that it’s been essential to incorporate flexible options for workers who are nearing retirement age, or who are returning from retirement.
Flexibility hasn’t always been a given in the health care industry. Zangerle notes that nurses typically work 12 hour days, three days a week—which can be physically and mentally draining, especially as workers grow older. And as employees approach retirement, their priorities sometimes shift from work to other interests, such as spending time with loved ones, traveling or volunteering, says Carrington.
As Zangerle enacted the RetuRN to Practice program, she says, she learned that nurses’ schedules were a barrier keeping some people out of work. Allegheny has since begun offering more flexible options, including shorter or weekend shifts. Older nurses are also encouraged to shift to positions that might be less physically demanding, but still draw upon their skills—such as moving from the operating room to become an educator.
While offering flexible schedules can be a management challenge, says Zangerle, doing so is helping her make sure she has enough workers on any given day. “As long as we fill the hole, then we’re good to go,” she says. “The pandemic has really pushed us to say, ‘We will tell you our needs, and you tell us what you can do,'” Northwell, meanwhile, is offering more alternatives to quitting or retiring, such as per diem and part-time options. It also runs a staffing agency and offers home health care opportunities, so workers can choose the kind of work that suits their needs.
The pandemic also prompted a reconsideration of another popular tool: working from home, including via telemedicine. Shibu Varghese, senior vice president and chief diversity officer for MD Anderson Cancer Center in Houston, said the health care industry has been slow to adopt remote work because the culture revolves around being in a shared physical environment, and leaders were concerned productivity would drop. But in fact, Varghese said, MD Anderson’s staff has been especially productive even at home, and many enjoy the flexibility of remote life. “The wellness aspect of it—where we are allowing for employees to balance their personal life and professional life together—has really allowed a lot of employees to stay with it and work through the pandemic,” he said.
Wellness
Many hospitals are also trying a direct approach to reduce burnout, a psychological factor thought to be driving many nurses out of the field. In part, that’s involved more focus on wellness, or making sure that workers’ basic needs are being met. For instance, after an Allegheny Health survey revealed that 45% of its nurses skipped meals and weren’t drinking enough water, managers created meal break calendars to ensure workers had coverage, cafeteria hours were extended and hydration stations and healthy vending machines were installed. Missed meals then dropped from 45% in 2019 to 10% in 2021.
At the Miriam Hospital in Providence, Rhode Island, administrators worked with psychologists at Brown University to ensure that nurses’ needs are being met, says chief nursing officer Anne Schmidt. The hospital has also devised wellness programs offering everything from reiki to food carts to meditation rooms. One goal, says Schmidt, is to build a culture where nurses feel comfortable seeking out help. “Resilience doesn’t come in a bottle,” says Schmidt. “It’s really: how do we normalize self-care?”