Can technology solve the nursing crisis?

nurse, nursing

As the working population ages and over 500,000 registered nurses are expected to retire by 2022, the nursing shortage represents a crisis that requires immediate attention. The American Nurses Association cites data from the U.S. Bureau of Labor Statistics, which predicts that to prevent a further shortage, 1.1 million new nurses will be needed for expansion and to replace the retirees.

But it’s not just an aging workforce that’s causing the shortage. Experts cite a number of additional factors exacerbating the situation: nurse burnout, violence in the workplace, and an aging population — the silver tsunami —  that requires more healthcare services.

The nursing shortage is even prompting organizations to approach Congress for funding.

“In September, AHA’s subsidiary, the American Organization of Nurse Executives, members visited nearly 200 federal legislators seeking support for reauthorization and funding for Title VIII nursing workforce development programs to help address the shortage,” an American Hospital Association spokeswoman said via email.

Like with most problems that ail the industry, technology is aiming to alleviate the shortage. This includes startups like SnapNurse and NurseToken as well as Nomad Health.

Based in Atlanta, SnapNurse is an on-demand tool that enables hospitals and other facilities to find and book nurses. Here’s how it works: A nurse can sign up for the platform and begin the credentialing process. The individual uploads all required documents and is sent a set of forms to digitally sign. Once verified through the SnapNurse platform, the nurse is ready to go.

From the facility perspective, organizations can use the platform to search for a specific type of nurse. For instance, a hospital can use filters to find a nurse with a certain number of years of experience or who works in certain specialties.

Nurses can join the SnapNurse platform for free. In a phone interview, founder and CEO Cherie Kloss said the company will pay for some verifications for nurses.

She added that SnapNurse has a transactional business model. Healthcare staffing agencies often charge a markup fee that raises the cost of hiring hourly nurses. But SnapNurse eliminates that markup and is thus able to split the difference between the nurse and the hospital.

As of late August, Kloss said about 3,000 nurses use the platform.

She noted that United Surgical Partners International, which is an ambulatory surgery provider, uses SnapNurse’s technology. USPI did not immediately respond to a request for comment.

The SnapNurse platform isn’t the only aspect of Kloss’ vision. She also created a second company called NurseToken, a blockchain solution for nurse credentialing. Traditionally, nurses have to be credentialed at every hospital at which they work, which makes it difficult for RNs to work at multiple facilities. With NurseToken, nurses can set up a credentialing wallet once and unlock their credentials with blockchain each time they want to work at a new location.

“They can keep their credentials portable and any facility that wants to hire them can have the credentials instantly at their fingertips,” Kloss said.

Through the NurseToken platform, nurses can also earn cryptocurrency tokens by keeping their credentials updated and uploaded. Hospitals can use tokens as rewards to incentivize nurses to work for them.

Providers can pay for NurseToken in a few different ways — either a specific amount to access one nurse’s credentials. Or, a bunch of nurse credentials in bulk for less than what it would cost per nurse.

Other organizations like Nomad Health are adopting a route to tackle the nursing shortage. Headquartered in New York City, the startup is an online marketplace for clinical jobs. It currently lets organizations post locum tenens, telehealth and permanent doctor jobs as well as travel nursing positions. Locum tenens references doctors who take temporary clinical positions.

A hospital or healthcare facility can post a job for free to Nomad’s platform and specify precisely what it is looking for — such as a nurse with five years of experience who’s available in October and November for work in the emergency room. After posting, the Nomad platform will start the auto-recruiting process and the hospital will receive applications for the job. The facility can then engage with the nurse directly on the platform. If the relationship is good to go, they can sign a contract, track hours and make payments to the nurse directly on the platform.

From the clinician perspective, Nomad’s platform works similarly. A doctor or nurse can sign up for free and build a profile complete with their qualifications. The clinician can sift through the Nomad platform to find jobs they like and apply to multiple positions using one application.

The New York City startup charges employers 15 percent commission for locums doctor positions and a flat $10,000 fee for permanent doctors. Its website notes it has flexible pricing for travel nursing roles. Nomad co-founder and CEO Dr. Alexi Nazem described it as success-based fees.

“That means we’re not pushing jobs onto clinicians and we’re not pushing clinicians onto clients,” he said in a phone interview.

The company has over 50,000 clinicians using its platform, Nazem said.

Nomad lists a number of its clients on its website, including Iora Health and Premier Health. Iora and Premier declined to comment on their use of the company’s technology.

Both SnapNurse and Nomad strive to set themselves apart from traditional healthcare staffing agencies that rely on recruiter middlemen. Kloss declared that SnapNurse’s on-demand model lets nurses start working much faster than they would when working with a staffing agency. Nazem similarly noted that Nomad’s model is more efficient than that of an agency. Further, while onboarding lots of clinicians to facilities is important to an agency, Nomad doesn’t try to force a relationship between a clinician and a hospital when they’re not a good fit for each other.

Companies will naturally tout their own offerings and how they’re benefitting the market at large. But what does an actual nurse think of the startups’ approaches?

Nancy Congleton, a practicing RN and the author of Autopsy of the NP: Dissecting the Nursing Profession Piece by Piece, has never used SnapNurse’s or Nomad Health’s tools.

But after researching the startups, she found some aspects appealing.

For instance, she likes that SnapNurse lets organizations provide ratings for nurses. This may help some of the “bad apples” — or those nurses who aren’t always kind to colleagues — clean up their act a bit, she said. She appreciates that Nomad allows clinicians to message facilities directly and ask questions prior to taking an assignment.

Still, it appears to her as a partial solution to the nation’s nursing shortage.

“It doesn’t address the heart of the problem,” she said in a phone interview. “It doesn’t address all those other things that are causing nurses to leave the profession.”

Congleton believes there are several factors behind the shortage — lack of preparation for a tough job and mean coworkers. Not all doctors and nurses are bullies, but some can be unkind, even to brand new nurses, she said. Interacting with such individuals day in and day out may prompt a nurse to leave the profession. Finally, the often low nurse-to-patient ratio can overwhelm RNs leading to burnout.

Approaches like those of SnapNurse and Nomad Health aren’t the only way to go about finding nursing talent.

Peter Callan, director of talent acquisition and development at MU Health Care in Missouri, said he hasn’t heard of SnapNurse or Nomad. “We still get the greatest return on our efforts from traditional routes” such as referrals and recruiting at schools, he said in a phone interview. He added that his organization also relies in part on Twitter and Facebook to find RNs.

Additionally, MU Health Care runs a yearlong nursing residency program, which is primarily for recent RN graduates. The goal is to build nurses’ confidence and skill levels, as well as to increase their education. As a result of the program, the organization has seen a low turnover rate for first-year nurses.

Another way MU Health Care is addressing the nursing crisis is through various recruitment and retention efforts. For instance, it offers up to $10,000 in student loan repayment for nurses working in specific units. For those without debt, it offers a retention reward of up to $10,000. The organization has also altered its shift options so RNs can create a more personalized schedule. They can choose to work on weekdays only or weekends only, with those working weekends earning a higher pay.

SnapNurse and Nomad Health have built interesting tools to attack the crisis. In terms of adoption, though, there is still quite a distance to go. 

Photo: PeopleImages, Getty Images

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