nurse staffing shortages, nurse shift fill rate, nurse workforce

How to improve nurse shift fill rates

January 15, 2023

Staffing shortages have a significant impact on the Australian healthcare sector. Healthcare organisations are still reeling from the effects of the pandemic. Many nurses left their jobs altogether, while others grapple with stress and burnout.  Staffing shortages have forced hospitals and healthcare facilities to look into alternatives to fill their shift gaps. One of the most pressing issues for healthcare organisations is how to improve the shift fill rates. How can hospitals improve shift fill rates? What are the most effective tactics for healthcare organisations to employ that will help attract more nurses to on-demand shifts?  Read our blog to find out what tactics are effective and how you can implement them into your shift fill rate solution.

Australian Nursing Workforce Supply and Demand

Before we dive into the ways to navigate these challenges, let’s examine the data we have presently. We need to understand better the implications for the sector. Health Workforce Australia (HWA), a government health organisation, conducted modelling on supply and demand in the nursing workforce in 2014. They predicted a staff shortage of 85,000 by 2025 and 123,000 by 2030 across all sectors, including acute, aged care, critical care, emergency, and mental health. HWA was abolished in 2014 and no modelling study has been conducted recently. The pandemic has also radically changed workforce dynamics for nurses: a survey of 200 nurses conducted by uPaged in December 2021 showed that 26% had changed the way they view nursing as a career choice.  

The Australian Bureau of Statistics seasonally adjusted figures for the May 2022 quarter revealed 26.7% job vacancies in the healthcare and social assistance industry. There are over 68,900 job vacancies in the sector; vacancies have increased from 8.2% to 26.7% between February 2020 and May 2022. McKinsey’s Women in the Workplace 2021 report found the pandemic took a huge toll on women: 1 in 3 women are now considering downshifting in their career or exiting the workforce entirely — up from 25% of women who felt this way only a few months into the pandemic. A uPaged Nursing Workforce Survey of 203 nurses from Q4 2021 has shown that only 15% wish to be employed on a permanent basis in the future, with 12.87% opting to leave nursing altogether, and 20.47% seeking casual work as their primary source of income. 

Hospitals need to cope with nurse staffing shortages

Covid-19 has reshaped the healthcare sector. The way of working has changed, telehealth is on the rise and nurses expect more flexibility in their careers. The pandemic has also left nurses on the verge of a breakdown, with over 42% of nurses less willing to work than before. Increased workload, work-life balance and burnout are the most common reasons for this. According to a 2020 study from the International Council of Nurses, 90% of national nurse associations were somewhat or highly concerned that severe workloads, insufficient resources, burnout, and stress associated with the pandemic were causing more nurses to leave or want to leave the profession.

ICN estimates we will need up to 13 million nurses to fill the global nurse shortage gap in the future; created due to existing shortages, an ageing workforce and the aftermath of Covid-19.

So how can healthcare facilities cope with these problems strategically?

#1 – Empathic leadership and career advancement options

Vulnerability, authenticity, and empathy are the fundamental elements of leadership. These qualities build trust and foster a sense of community in workplaces.

Nursing the nurses is even more important after the pandemic. You might have seen the saying, “You can’t pour from an empty cup” or “Put your oxygen mask on first.” Caring for others comes naturally to nurses, but they often forget their own mental health. This can take an emotional toll on nurses, leading to compassion fatigue and the inability to provide empathetic care. 

The onus is on management to foster a support system enabling nurses to express their struggles and take a break when needed. Empathetic leaders can make their workplace a better place. If the atmosphere is nourishing, nurses will ‌vent their feelings and also have more to give to their patients. Supervisors can rearrange shifts, reassign them to another department, give them a break or even direct them to HR for additional help. However, if they feel unvalued or bullied, they will burn out faster and eventually end up leaving the organisation.

Fostering camaraderie and positivity in the workplace is one way to address this problem. Another way is to understand the staff better and help them advance their career. Nursing is a vast profession and staff must have career advancement opportunities to explore their areas of interest. Mentorship programmes, transition to management or administration or pursuing specialised courses are a few things facilities can offer to retain talent. Nursing doesn’t just require experience and skills, it also requires a great deal of emotional intelligence. Moving to a new department or role can offer challenges and revive their passion for the field.

#2 – Automated Shift Fill Solutions

Scheduling shifts and organising rosters is a complicated process. It also takes a lot of time and resources. In healthcare facilities, where it is a 24 x 7 gig, scheduling shifts can be a nightmare. Unlike other sectors, shifts cannot just go unfilled. Automating this process removes the logistical challenge of scheduling shifts. Nurses and other healthcare practitioners can view and apply for shifts in real-time. If a shift goes unfilled, platforms such as those offered by uPaged can identify and contact potential replacements in seconds. This frees up time and allows hospitals to save money and focus on delivering patient care effectively.

#3 – Shorter shifts can be a boon to the nurses 

While the concept of 8-hour versus 12-hour shifts is debatable, shorter shifts can help your nursing staff immensely.

Several studies report nurses working 12+ hour shifts have fatigue, slower reaction time, and patterns of sleep deprivation. Sleep deprivation can have overarching short-term and long-term effects on cognition, motor skills and emotional state. Hypertension, anxiety, psychiatric disorders, diabetes, and stroke are just a few issues caused by chronic sleep deprivation. 

These 12-hour shifts often end up in overtime work. And your staff may end up working over their capacity. Undoubtedly, these long shifts impact patient satisfaction rates and increase the chances of errors. It also causes job dissatisfaction and drives excellent employees to quit their job. 

The case for shorter shifts 

  • Work-life balance
  • Improved shift fill rates
  • Higher patient satisfaction
  • Reduced chance of errors 
  • Fewer workplace incidents
  • Decreases nurse burnout and compassion fatigue
  • Nurses get more time to relax and recuperate after each shift, which would significantly decrease the rate of sleepiness between each shift

“The world of work needs a wholesale redesign – of its regulations, of its equipment, of its culture – and this redesign must be led by data on female bodies and female lives. We have to start recognising that the work women do is not an added extra, a bonus that we could do without: women’s work, paid and unpaid, is the backbone of our society and our economy. It’s about time we started valuing it.”

― Caroline Criado Perez, Invisible Women

Nursing is a tough profession, and the workload can have a detrimental effect on health. The pandemic has changed the way people think and what they want to do in their lives. As frontline workers, nurses were in the war zone and now that we are somewhat out of it, the priorities have changed. Nurses want more flexibility in their lives. They could have taken many unpaid gigs during the pandemic, like taking care of their kids or elderly parents. Offering a flexible schedule will help you attract talent and foster a positive workplace environment.

Women dominate the nursing workforce. Whether they are single mothers, have children or are a carer, it is critical that the organisations understand the needs of the workforce and formulate a plan to address the issues. Engage your workforce in discussing flexible shift structures that support their health. 

Food for thought: The Chinese Academy of Social Sciences, the country’s leading research organisation, has proposed that China moves to a four-day work week by 2030, but this does not necessarily mean extended hours each day to meet a 38-hour week. And while most nurses today work 12-hour shifts to meet their weekly hours, these 12-hour shifts were only introduced ~20 years ago, replacing historical 8- and 10-hour shifts. This raises the question … were nurses who trained in Hospitals up to the mid-1980s and worked 8-hour shifts burning out, suffering compassion fatigue and being bullied as the nurses of today who train in Universities and then work 12-hour shifts?

#4 – Boost those rates of pay

One tactic that we know works to improve shift fill rates is by boosting the rate of pay. Whether you are struggling to fill a Friday night shift or an early morning shift, BOOST the rate that hospital booking managers should apply to each shift to attract the staff you need.

How does Boost work? Boost promotions help you increase the chances of filling hard-to-fill shifts.

Nurses get an incentive to work, and healthcare facilities get reliable staff easily!

You can boost the rate by 8% or 16% and enable it on weekends and public holidays.

(Take away the pressure from your permanent staff and balance your staff-patient ratios. While money isn’t everything, it certainly helps fill those empty shifts)

Boosted pay = increased shift fill rates

If you’re struggling to find nurses and get your vacant shifts filled, we’ve got a few thousand currently on the platform looking for opportunities Australia-wide, and while it’s not ALL about the money, it certainly helps.

#5 – Telehealth explosion 

Telehealth became the go-to method of getting medical support during the pandemic. Nurses were able to support patients better by providing them with assistance from their homes. These remote consultations were an efficient way to provide healthcare services to patients while keeping nurses and carers out of high-risk areas. It also enabled patients to receive quality care without putting them at risk. Better yet, innovative telehealth providers and hospitals stepped up to provide training and opportunities for nurses who had been previously unable to secure telehealth work, offering nurses career advancement and new skills.

Healthcare organisations have leveraged telehealth to improve patient care and address staffing shortages easily. It is a win-win for nurses and patients both. Nurses can work from anywhere and patients can access the services they need – whether they are living in a rural or urban setting. Although telehealth services were reduced from July 1 2022, it is here to stay for the long term. With technology becoming more sophisticated, it will reduce distance barriers and improve access to practitioners for patients. 

These ways are not the only way to increase shift fill rates. Some other ways you can increase shift fill rates include:

  • Improve the onboarding process
  • Post shifts as soon as practicable
  • Don’t cancel shifts (our data shows that while hospitals complain that on-demand nurses cancel shifts frequently, the opposite is true, with 17% of healthcare facilities cancelling shifts, as opposed to only 7% of nurses)
  • Identify ways to improve and engage with your existing talent pool
  • Utilise the technology platform offered by uPaged so you can share talent across your healthcare network or healthcare group, or use the platform to select perfectly matched nurses to fill your on-demand casual nursing shifts and term contracts. 

The uPaged solution

The healthcare facilities that are getting shift fill rates of 90% or more on uPaged are typically offering:

  • boosted rates of pay for hard-to-fill shifts
  • alternate shift start and finish times (e.g.: after school drop-off and before pickup)
  • varying shift lengths (i.e.: 4, 5, 6, 7 and 8-hour shifts)
  • welcome nurses with alternate specialisations
  • open to transferable skills and experience, and/or
  • are willing to train repeat returners in new skills

While we know this kind of flexibility isn’t going to work everywhere, now that nurses have seen how flexible other sectors can be, it’s worth thinking about a different approach to engaging top talent, especially when 88.4% of nursing talent is female, and research suggests over 50% of working women have left, or are considering leaving a job due to lack of flexibility.

Need help onboarding your facility?

Contact Alex at uPaged on 0475 232 023 or enter your details below and Alex will get in touch with you. 

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