This is the first article in our four part series on attracting entry-level healthcare talent and upskilling employees. Part 2 goes over the ROI of upskilling employees and deciding if it's right for you. Part 3 goes over how to set up a healthcare employee upskilling program. Finally, Part 4 goes over how to choose a training program to upskill employees.
Healthcare systems are in crisis today.
There were staffing shortages even before the pandemic started and the added burnout once it began did not help.
We are seeing record-high job openings that remain unfilled and extremely high turnover rates that are deepening healthcare crises and threatening access to care. In fact, a survey conducted by NCSBN showed that about 100,000 nurses left the healthcare profession during the COVID-19 pandemic and 610,000 more—about one in five of all registered nurses—stated that they “planned to leave” before 2027.
Due to staff shortages, hospitals relied on temporary staff to fill holes and keep operations running. Hospitals paid 300% more on temp staff last year compared to previous years. Because of this, we’ve seen a wave of hospital closures, particularly smaller facilities and community-based clinics serving rural and under-resourced populations.
The staffing crisis also impacts the quality of care provided in emergency departments and hospital admissions and causes delays in both “elective” and “emergent” surgeries—which all have led to a reported 19% increase in adverse events.
Increasing job offer acceptance rates and retaining strong employees are some of the best strategies for decreasing hiring costs and improving patient care. Happy staff members are more likely to stick around, refer others, and step up when needed to help out other employees.
This guide goes over what entry-level healthcare workers are looking for from employers and how to effectively retain existing talent to reduce turnover and staff shortages.
Why Entry-Level Healthcare Workers Leave Their Jobs
Frequent turnover of entry-level workers is frustrating for the entire healthcare team and increases errors that not only put patients at risk, but cost the hospital resources including time, money, and labor.
There are several reasons why entry-level healthcare workers are more likely to leave their profession. These include:
- Low pay. Entry-level workers are highly likely to seek employment elsewhere due to low pay. Companies that offer competitive pay have 19% lower turnover for lower-wage employees. In addition, higher pay is associated with an increase in entry-level worker productivity.
- High workloads. Burnout is extremely common among healthcare professionals. Dealing with sick and possibly dying patients all day is difficult on its own. When compounded with other problems like high rates of workplace violence, staffing shortages, and mandated overtime, burnout can become unmanageable.
- Workplace bullying. Nursing Administration Quarterly published a study showing that 60% of nurses who leave their jobs within the first six months do so because they experienced workplace bullying. Workplace bullying is particularly common among nurses, medical assistants, certified nursing assistants, and phlebotomists, and other healthcare workers are not immune to being harassed and picked on by their co-workers.
- Scheduling difficulties. Healthcare facilities, especially hospitals and emergency service centers often require employees to work strange hours. Night shift and weekend requirements drive many employees away from the profession. Even those who work in clinics and offices may become frustrated with long hours or the inability to ask for time off.
Why Retaining Entry-Level Healthcare Workers Is Important
Despite the challenges, healthcare companies need to create a plan for improving the retention of their entry-level employees. Although these types of employees typically have less training and perform more basic tasks, they still play a vital role in the functioning of the organization.
Decreasing the turnover of entry-level healthcare employees has many benefits, such as:
- Decreased cost of training. Between money spent on training, human resources time, recruitment, and new employee incentives, it costs an average of $4,700 to train a new employee. Large facilities with high turnover rates can quickly spend tens or hundreds of thousands each year finding and training new employees.
- Save on overtime and temporary staffing costs. Data from PINC shows that the annual cost of labor in hospitals has increased by over $24 billion per year. This is primarily due to paying current staff overtime and critical pay, as well as the high cost of temporary staff.
- Reduced rate of preventable errors. High turnover is not just costly, it is dangerous. High rates of turnover in healthcare facilities are associated with increased errors and decreased quality of care provided to patients.
- Positive team-dynamics. Staff who stay around long enough to build relationships with their team are more likely to stay around long term. Teams who work together for a long time are more likely to build good working relationships, understand each other's strengths and weaknesses, and be willing to help each other. High employee retention is associated with a positive workplace culture, and a positive cycle of high retention and high satisfaction continues.
- Long-term benefits. Working hard to retain staff during their first years of employment pays off over the long term. Most workers who leave a job leave within the first two years of being hired, and those who stay with a company for five years are likely to remain loyal for the rest of their careers. Welcoming employees early and keeping them engaged during their first years of service is essential to the longevity of their careers at your organization.
Diving Into the Data: What Entry-Level Healthcare Workers Are Looking For From Employers
Here is what the data say about what healthcare workers are looking for from a potential employer:
According to the 2023 NSI National Health Care Retention & RN Staffing Report, offering critical staffing pay and increasing salaries are the most effective strategies to improve employee retention.
While it may seem difficult to justify increasing pay for staff, high turnover and hiring temporary workers is significantly more expensive than offering bonuses to current employees.
Employees can be drawn in by companies with impressive benefits.
When applying for a new full-time position, most job candidates are concerned about not only the financial benefits, but other perks like health-promotion incentives, size of the healthcare network, availability of telehealth services, and assistance with disease management according to KFF.
Financial & Emotional Wellness
A Purchasing Power survey of healthcare professionals found that half of those who earn less than $100,000 per year have satisfactory savings or feel confident that they can manage their monthly expenses.
Helping people manage their money and make a plan for paying off debt can be just as if not more impactful than offering a higher salary.
The same survey found that 80% of healthcare employees state that financial wellness benefits and guidance are just as important as salary.
Unfortunately, healthcare workers are at high risk of workplace violence and non-fatal injuries. Healthcare workers account for over 70% of all reported workplace injuries.
Employees at healthcare organizations should feel protected while at work. This may require hiring more staff, improving security measures, and supporting staff members who deal with combative or argumentative patients.
High employee engagement scores can decrease turnover intention by 66% according to Atlantis Press.
Keeping employees engaged means that they are moderately challenged at work while being recognized for their successes. This may include allowing them to take on extra responsibilities, guiding them into leadership positions, and providing opportunities to increase their skill set.
Healthcare workers are more likely to report feeling unappreciated at work than people working in different careers according to Grant Thornton.
As more patients come in and workloads become more demanding, leadership must step up to ensure that staff knows their work is appreciated.
While staff celebrations are good for building team morale, employees are generally more responsive to individual feedback and positive reinforcement. A handwritten thank-you note or one-on-one conversation is more impactful than group thank-yous.
Strategies for Improving Employee Retention in Healthcare
Improving employee retention may seem like a daunting task, but it is a worthwhile endeavor. Low turnover rates decrease the cost of labor, improve staff morale, increase patient satisfaction scores, reduce mistakes and poor outcomes, and set your company up for a more secure future.
These are some of the best ways to improve employee retention in healthcare:
Offer Upskilling Opportunities & Paths to Advancement
It is human nature to look for growth opportunities and challenges, and employees don’t want to feel trapped in “dead-end” jobs.
National surveys show that 70% of employers want to have opportunities for upskilling within their jobs, and 93% of employers who offer upskilling or continuing education see a reduction in employee turnover rates.
In the next articles in this series, we go over how to decide if upskilling employees is right for your organization and how to do it.
Offer Competitive Salaries & Benefits
Competitive pay is one of the best ways to improve employee retention. A Harvard study published in 2020 showed that for every $1 added to an employee's hourly wage, turnover dropped by 2.8%. When the cost of higher wages was compared to the costs associated with high turnover rates, increasing pay for low-wage earners was far less expensive than dealing with high turnover.
Healthcare companies are also facing difficulties with nurse strikes, staff demanding higher pay, and having to pay travel staff to care for their patients. Ensuring that your organization pays staff fairly but competitively can prevent expensive strikes and other staffing issues.
In addition to offering competitive salaries, providing generous benefits can make staff feel valued and cared about. If you don’t already, consider adding health promotion incentives, financial guidance, legal assistance, mental health care, childcare, or other benefits that your employees will not get elsewhere.
Offer Flexible Work Scheduling
With remote and work-from-home jobs becoming more common, people are being drawn away from careers with strict schedules.
When given the option, people often feel more inclined to work from home, even if they have an office to go to. While healthcare workers are unlikely to have a work-from-home option, you can compete with remote jobs by offering flexible work scheduling.
Offering flexible scheduling helps to improve your employee’s work-life balance, improve engagement, attract better talent, and decrease turnover.
How Upskilling Entry-Level Employees Can Reduce Turnover & Improve Quality of Care
Entry-level employees and low-wage workers often feel trapped at their jobs and like they are unable to improve their situation.
Studies show that most lower-wage workers who were able to earn a higher salary did so by leaving one company to seek better opportunities elsewhere. Encouraging growth within a company and providing opportunities for advancement can make a significant impact on employee retention within an organization.
Providing opportunities for your staff to learn a new skill will do more than incentivize them to stay within your organization. A study published by MIT showed that upskilling employees can result in an astonishing 250% return on investment.
Upskilling strategies might include reimbursement for earning specialized certifications, bringing in outside sources to provide advanced training, teaching staff how to operate more advanced equipment, or supporting them in learning a new language. Mentorships and tuition reimbursement are also great ways to improve your staff productivity and retention.
More and more companies are realizing the benefits of upskilling their employees. Nearly 50% of companies offer some type of upskilling program for their employees, drawing in more motivated and engaged new hires and improving the skill set of their current staff.
The next article in this series goes over how to decide if upskilling is right for your healthcare organization, including how to determine the possible return on investment and what else to consider when determining if offering an upskilling program is right for you.