One of the biggest challenges health care leaders are grappling with is the workforce shortage, particularly in nursing. This isn’t a new problem, so why haven't we found real solutions?

Radio Advisory's Rachel Woods sat down with Henry Ford Health System's VP and CIO Lisa Prasad and SVP and CNO Eric Wallis to discuss why we need to look at the nursing shortage as a supply chain issue and what can be done in both the short- and long-term.

Hard truths on the current and future state of the nursing workforce

Read a lightly edited excerpt from the interview below and download the episode for the full conversation.

Rachel Woods: Everyone in health care, in fact, everyone outside of health care too, seems to all be talking about this challenge and crisis in nursing. Frankly, this is not the first time that we've talked about this on this podcast, but I want to start off by giving the mic to the two of you. Henry Ford has an interesting take on the nursing crisis and some of the factors that are causing it. What is your take?

Eric Wallis: The way that we're trying to look at this in many respects is we're trying to fix a supply chain problem. We currently are about a million nurses short in this country. Recently I was at an Advisory Board presentation where we talked about the fact that nearly 500,000 folks have left the profession in the last 18 months, so it just continues to get worse.

So really, what we're trying to do is look at what our unique solutions for how do we not just try to fill the number of people, but how do we change the work? And we are so lucky to have partners like Lisa and our innovation institute that are really helping us to look for new and creative solutions that are out there in the world.

Lisa Prasad: Thanks, Eric. 100% agree with everything he said. The current nursing crisis is not a recruiting problem, so it's important for us to understand that we can't get in the mindset that says, if we can only fill all of these jobs, then our problems would go away.

That's not going to happen. It's truly a supply chain problem where we have to look at the entire life cycle of a nursing career from both the demand side and the supply side.

Woods: So let's do that, let's look at the whole life cycle. If it is a chain, what are all the possible kinks in the chain that we should be looking at? Besides just recruiting roles right now?

Prasad: As Eric mentioned, if you're looking at the demand side, you have to look at both. So, if you're looking at the demand side, there are over million vacancies right now and in addition, we need 200,000 new nurses every year going forward. And that's for a variety of reasons, not the least of which is our aging population.

Then you look at the supply side and you have Covid and the general burnout that Covid has caused. And you have the current average age of our nurse at 52 and 20% of them are planning to retire and as they retire, it's difficult for us to train new nurses. So, we're really in this cycle where we need more, but we can't do more because we have less to do it with, and that's why we call it the supply chain problem.

In fact, in nursing, I feel like we've reached a point where compensation and opportunity are not high enough to reach a stable and sufficient workforce, and therefore we really do have to look at every phase of that supply chain so that we can begin to balance out the supply and demand.

Wallis: Yeah, I would just add to what Lisa is saying—the biggest thing that I worry about is she mentioned we need 200,000 more nurses a year in a system that can't graduate that many. So, there's a whole bucket of work that's going on in the world to try to figure out how do we increase the funnel with our academic partners, but even more worrisome to me is that when you talk to and start to see some of the research that's coming out, a lot of our nurses who are even coming into the field only plan on staying at the bedside for a very short period of time because they want to move to other things.

So, one of the scariest statistics, I used to talk to graduating nursing students and say, "Hey, the average nurse stays in one job about three to three and a half years." That statistic held forever. Through the pandemic, the numbers dropped to two and a half years.

So, people really want to come into nursing, we're still seeing record numbers of folks trying to enroll in nursing programs, but I don't know that right now we have the jobs and the work matched up with what people's desires and ideas of what nursing is, or they're not matched up. So, we've got to change that and we've got to find innovative ways to make being a bedside nurse something that is desirable and people have a passion about.

Technology is one piece of that, but I think we've been really good in nursing at bringing back old things that we've done—let's try this thing again. What we haven't been really good at is trying to find new ways of doing things, new models, new support systems, etc. So that's why I'm really excited about—the challenges and a couple of the efforts that Lisa and the Innovation Institute are helping us with right now, because we're truly going and trying to seek out new stuff, new ways of working and new models of care.

Woods: And before we get to some of those solutions and new models, I do just want to pause at this moment where we're talking about a supply chain issue, but neither of you are supply chain experts. In fact, Lisa, Eric was just talking about all the work that you've done. You are a chief innovation officer. I'm not sure that I would've expected someone like you, let alone other members of the C-Suite to necessarily be talking about the nursing issue and be the one who's stepping in to come up with solutions. Why is this not just a nursing problem? Why is this a problem that the entire C-suite should be paying attention to?

Prasad: In the short-term, this has caused a real financial problem for health systems in general, so it's put a fresh lens on the problem because it's hurting the bottom line. But in the long term, this problem has been coming.

We could have seen the demographics changing from a while ago, and our whole health care system is so based on nursing care. They represent the largest professional workers of any health care system. So if you're going to look at how that is going to change, you're looking at strategy, you're looking at planning, you're looking at information technology, finance, and on and on. So, this truly is a strategic problem for health care providers—it's not just a nursing and recruitment problem.

Wallis: I've been in nursing for more than 25 years, and since the moment I walked in the workforce, we talked about the impending nursing shortage. The reality though has been that for various reason, economic downturns, other things, people have stayed in the workforce for a long time.

What changed was, with Covid, people finally stepped out, they said it's not worth it anymore. And so we saw this massive wave of retirement, followed by a massive wave of folks who said, "Hey, I can make a lot more money going off and do travel nursing."

And then, again, people just getting burned out because of the stress and the never-ending wave of really sick folks coming into our acute care settings. So, it's really different and now as an executive team, as a leadership team, we're finally being forced to figure out what are we going to do as this big chunk of the workforce goes away?