From Regulations to Realities - Nurse Staffing, Unions, and the ShiftWizard Advantage

This blog is taken from a recent HealthStream webinar entitled “From Regulations to Realities: Nurse Staffing, Unions, and the ShiftWizard Advantage.” The webinar was moderated by Sarah Enders, HealthStream’s Senior Product Marketing Manager and featured Gia Milo-Slagle, HealthStream’s Senior Product Director, Scheduling and Terri Epler, RN, MSN, Solutions Consultant Manager. 

Navigating the complexities of staffing mandates while ensuring compliance with union standards is challenging, but in this webinar, HealthStream leaders provide real strategies that can help organizations do just that.

Nurse Staffing – The Customer Mandate

Milo-Slagle set the stage by pointing out that the staffing shortages that have plagued healthcare remain prevalent across every setting and throughout the entire continuum of care. She stressed the importance of addressing enterprise-wide needs, preparing for the increasing demands from an aging population, and the challenges of aligning resources to fluctuating demand and acuity while remaining focused on delivering high-quality patient care and preserving nurse satisfaction, retention, and engagement.

Safe Staffing Mandates and Regulations

Milo-Slagle shared some of the history of staffing mandates and regulations. In 2004, California became the first state with staffing regulations. The process to implement the California regulations began in 1999 and by 2009, 14 additional states and the District of Columbia had enacted nurse staffing regulations, and 17 more states were in the process of crafting legislation. With nearly 30 states working towards staffing regulations, California remains the only state with minimum staffing ratios in place. 

While efforts to mandate staffing ratios are ongoing, a study published in June of 2023 in Nurse.org found that 79% of nurses reported that their units were not adequately staffed. The same study found that the intent to leave nursing increased from 35% in the Fall of 2022 to 40% in March of 2023.

Safe Staffing Approaches

Safe staffing is one of The American Nurses Association’s (ANA) core federal policy priorities and includes three approaches: 1. Staffing committees: nurse-led efforts to create unit-level staffing plans based on the patient population’s acuity matched with staff’s skills and experience, 2. Mandated nurse to patient ratios or standards, and 3. Mandated public disclosure of staffing levels to the public and to regulatory bodies.

The ANA supports a model incorporating nurse-driven staffing committees to support flexible staffing levels.

The Case for Safe Staffing Solutions

Milo-Slagle went on to point out that the ongoing nursing shortage is being exacerbated by a set of persistent factors:

• The population is aging and there is a rising demand to care for their increasingly complex healthcare needs.
• An older nursing workforce is approaching retirement.
• There is a shortage of nurse educators and faculty.
• The nurse turnover rate is high and expected to increase.

The high and increasing turnover rates should not come as a surprise as a July 2023 study conducted by the ANA found that:

• 51% of nurses reported feeling emotionally drained.
• 50% report feeling fatigued.
• 45% report feeling burned out.
• 31% report being required to work beyond their regular shift on a weekly basis.

In addition, 20% of all nurses are enrolled in a union. Unionization in healthcare is on the rise, particularly since the pandemic. Healthcare workers are seeking to use the power of collective bargaining to improve wages, benefits, workloads, and to address patient and employee safety issues.

ShiftWizard and Acuity and Assignment Manager

 Healthcare leaders are seeking solutions that will optimize staffing, meet staffing guidelines and regulations, and meet union requirements. Leaders need solutions that help proactively match the needs of patients with the talents of their staff. Milo-Slagle admitted that there will always be staffing challenges that arise, but being able to predict needs based on historical data and identify the credentials of the staff that will care for them is an important part of the solution. HealthStream’s ShiftWizard can help leaders accomplish.

Epler highlighted just a few of the features that users will find within ShiftWizard and how they can help address staffing mandates. ShiftWizard features a dashboard that is both intuitive and interactive. From the dashboard, users are able build a staffing matrix that will show which areas are over or under-staffed and help match patient needs to nurses’ skills. The dashboard may also be configured to show a single unit, the entire facility, or an enterprise-wide view.

The reporting is based on census data that can be refreshed as often as every 15 minutes. “ShiftWizard also uses the last two to three years of census data, applies machine learning, and is then able to predict census up to 120 days out allowing leaders to build a more dynamic schedule,” said Epler.

In addition, nurses can self-schedule using ShiftWizard which has been shown to be a significant satisfier and can contribute to a better work life balance. There is also a flexible messaging function that allows leaders to communicate with staff about available shifts or any other topics as needed.

HealthStream’s Acuity and Assignment Manager can be used with ShiftWizard and allows leaders to match a patient to a particular caregiver. Leaders can make safe and equitable assignments ensuring that the right nurse has been assigned to the right patient. In addition to the census data, nurse certification and licensure data is accessible within ShiftWizard so that leaders can feel confident in the assignments.

A mobile app for both iPhone and Android users is available for leaders and staff to be able to connect with scheduling reports and open shifts at a time and place of their convenience.