How North Bay hospitals are tackling the nursing shortage made worse by the pandemic

The demands of the nursing profession made the national stage during the pandemic, resulting in a mass exodus of nurses and creating a snowball effect to a long-standing national nursing shortage.

"The pandemic was a game changer," said Daniel Kelly, chief nursing officer for Providence's 17 hospitals across California, which includes Santa Rosa Memorial Hospital, Petaluma Valley Hospital, Healdsburg Hospital and Queen of the Valley Medical Center in Napa. "The pandemic caused people to really think like, ‘Do I want to work in this profession and risk my life and come home and give my family a disease and one of them could die? And so that gave people great pause."

The pandemic worsened a nursing shortage brought on by burnout, stress, retirements, and not enough faculty to match enrollment needs, according to multiple nursing associations and research studies.

According to the National Council of State Boards of Nursing, approximately 100,000 registered nurses left their jobs over the past two years, and over 610,000 plan to leave by 2027.

The greatest need is for registered nurses, according to the nursing industry, so to help fill those vacancies, health care systems such as Providence are taking a more holistic approach.

"When we talk about nursing, we talk about the whole family, and nurses’ jobs are made a whole lot easier when we have nursing assistants," Kelly said. Providence, based in Renton, Washington, has more than 50 hospitals across the seven states where it has medical centers, which also include Alaska, Montana, New Mexico, Oregon and Texas.

A recent job fair resulted in Providence hiring 19 nursing assistants for Santa Rosa Memorial Hospital, Kelly said.

As a result, the hospital has few openings left for nursing assistants, which it also refers to as care partners.

"Not all the positions filled are full time, many are part time and/or per diem, as many of our care partners are in nursing school," Kelly said. "We employ over 100 care partners, so while hiring 19 is significant and exciting, it is not large considering the total number."

But Providence aims to recruit nurses in several ways, including through its clinical academy, an accredited program of the American Association of Critical Care Nurses and through partnerships with junior colleges and universities, he said.

Santa Rosa Junior College has an associate degree in nursing program, and places graduates in Sonoma County hospitals, including Providence's Santa Rosa Memorial Hospital and Petaluma Valley Hospital, as well as Kaiser Permanente and Sutter Health's area hospitals, said Katherine Magee, director of the college's associate nursing program.

Magee said SRJC is fortunate to have enough nursing faculty, and a high level of interest from students — but capacity is limited. She recently finished sifting through nearly 500 student applications for 120 spots.

Providence also has its own university, which offers advanced nursing degrees at the bachelor's and master's levels.

Those educational offerings, which include tuition assistance, also serve to retain nurses who feel stagnant or may want to move around among the nursing specialties.

"We have what we refer to as "stay conversations," Kelly said. "We talk to them to say, ‘What do you like about being here? What can we do differently? What do we do well?"

"We have lots of opportunity within Providence," Kelly said. "And when you have 53 hospitals, you have the ability to transport people all over the place."

That kind of bandwidth isn't available at NorthBay Health, but that doesn't mean its efforts are any less aggressive.

On May 11, during National Nurses Week, NorthBay held a "nursing recruitment mixer" for its two Solano County hospitals: NorthBay Medical Center in Fairfield, and NorthBay VacaValley Hospital in Vacaville.

The mixer drew about 75 job seekers who interviewed with staff nurses and nurse managers, according to NorthBay. The event was considered successful and expected to result in several hires.

In December, NorthBay brought in licensed vocational nurses (LVN) and associate degree nurses (ADN) to help offset the shortage of registered nurses, according to Heather Resseger, vice president and chief nursing officer.

Resseger started her nursing career as an associate degree nurse.

"We come out very technically savvy, we're ready to go, we have that skill set," she said. "They serve a really purposeful role in allowing our acute care nurses to go and have their break and their lunches and keep the patients safe with their (own) skill set during that time."

NorthBay draws nurses from several nursing education programs it partners with in the region, including Pacific Union College in St. Helena and Blake Austin College in Vacaville, she said.

The health system is also reaching out to Solano County high schoolers through its nurse camp, which will run this year from Aug. 1–3. This year's camp will have about 30 juniors and seniors.

"They’ll do three days on-site to see what it is to be a nurse, and see health care firsthand," Resseger said. "We actually have several nurses who went through our nurse camp."

"We've worked so hard the past year on staffing stabilization throughout the organization," Resseger said. "By August, my women's and children's department should be fully staffed, knock on wood."

Competitive hiring packages are among the nursing recruitment efforts at Sacramento-based Sutter Health, which operates Sutter Santa Rosa Regional Hospital and Novato Community Hospital.

"More positions are eligible for sign-on or relocation bonuses, and employee referral bonuses are also being offered for hard-to-fill nursing roles," said Lisa Gammon, chief administrator and chief nursing executive for Novato Community Hospital.

Sutter is also actively working to keep contract and travel nurses it had employed during the pandemic, a much more doable proposition now that demand has dropped.

That is helping the two Sutter hospitals get closer to filling open nursing positions.

"With the recent reductions in vacancy rates, plus an increase in applicant rates that we’ve seen with the nursing workforce, our staffing has stabilized, and we are well positioned to serve our patients and communities," Gammon said.

Sutter also offers its nursing staff growth and development opportunities through internal education, training and coaching, she said.

And, like Providence, Sutter has its own university.

"Part- and full-time benefit eligible employees are entitled to annual tuition reimbursement," Gammon said.

MarinHealth recently renegotiated its contract with the California Nurses Association that includes a 16.5% wage increase over the next three years, according to Andrew Apolinarski, chief nursing officer.

"This not only helps us to retain great nurses, but also helps us increase our ability to recruit qualified nurses by adjusting the starting compensation for qualified nurses newly entering the organization," he said.

MarinHealth also uses temporary agencies and traveling nurses to fill shifts on an ongoing basis and, like NorthBay, hires associate degree nurses to augment staff, he said.

It also partners with nursing school programs, including nearby Dominican University, and offers tuition reimbursement, he said.

In addition, MarinHealth has started a new graduate program "that allows young nurses to gain experience," said Apolinarski.

"As a small community hospital, sometimes it is a lot more challenging to find nurses because they can really pick and choose wherever they want to work," said Jessica Winkler, Sonoma Valley Hospital's chief nursing officer. "(But) we are very, very fortunate here. The nursing shortage hasn't really hurt us."

Even so, like most medical centers, Sonoma Valley Hospital use temporary agencies to fill urgently needed shifts. About five years ago, the hospital began using CareRev, one of several app platforms for gig workers.

The CareRev app lets hospitals adjust pay rates according to shift needs. For example, hospitals can pay lower rates for popular shifts and more for harder-to-fill shifts like overnights and holidays.

"We’ve been very successful with them," Winkler said. "CareRev vets the nurses … so we can see their resume, where they've worked and what kind of experiences they've had."

Winkler noted that one of the benefits for nurses who work at Sonoma Valley Hospital is that the environment isn't as stressful as larger hospitals, which require intense levels of nursing care for the sickest patients.

Nursing is not for the faint of heart, Winkler said, explaining the demands of the profession are multilayered: physically, mentally, spiritually, academically, technologically and emotionally.

"People don't understand what goes in to nursing and how challenging it can be," she said.

Cheryl Sarfaty covers tourism, hospitality, health care and employment. Reach her at [email protected] or 707-521-4259.

Editor's note: This story corrects the name change of NorthBay Health.