It was a way for the
They attended local college coffee-and-doughnut hours, too. And blanketed job fairs, where they tried to stand out from all the other talent acquisition teams from all the other hospital systems.
They offered to help pay for school for current employees interested in getting into nursing and for nursing students who would agree to work at St. Mary's for a while after graduation.
They offered signing bonuses up to
"We exhausted every recruitment strategy we could think of," said
So with 70 to 75 openings -- 20 at its nursing home alone -- St. Mary's decided to try something more bold.
It went to
In August and September, 13 experienced Filipino nurses joined the staff at d'Youville Pavilion, filling more than half its 20 openings. It's the closest the nursing home has been in a year to a full staff of permanent nurses.
"It will be good for our patients, first and foremost," she said. "We've used travelers (short-term contract nurses who travel from place to place), but they're only here for 13 weeks. Sometimes they extend it for another 13 weeks, but it's not the same. Having the continuity with staff, having the patient know who's taking care of them, it's big. It's huge."
It's no secret that
That's gotten some organizations worried. If pizza parties and signing bonuses aren't helping, what will?
For some it means getting more creative: partnerships between nursing schools and hospitals, salaries for students, drastically shortened training to entice second-career folks, extra money and time for nurses to pursue their own pet projects in the hospital.
For St. Mary's, it means looking outside the country.
AGING NURSES, AGING PATIENTS
Then the recession hit in 2008, and real estate values, the stock market and retirement accounts sank. Many people put off retirement.
That helped keep nurses in their jobs back then. But the economy has improved. Ten years later, nurses are returning to those retirement plans and, now in their 60s and 70s, aren't likely to put them off again.
According to a statewide study commissioned by the
"We came out of the recession with an even older nursing workforce," said
That statewide study predicts
Such a shortage has the potential to affect everything in
Even now, hospitals are struggling to fill openings.
"We are blessed to have the college as a part of our system," said
And then there's St. Mary's, which averages 70 to 75 open nursing positions at any given time. St. Mary's leaders have gotten increasingly desperate, particularly when it comes to openings at the 200-bed d'Youville, where a 20-nurse gap is big.
"We just could not entice new grad nurses to move over to senior health," Cramm said.
Because they have their choice of jobs, nurses in
'WE NEED YOU'
While St. Mary's couldn't find nurses, nurses 8,000 miles away couldn't find jobs.
Some figured their best option lay in another country.
D'Youville happened to have a couple of longtime staff members who were originally from
"They just kind of tossed it out there," Cramm said. "We started researching."
This spring, the hospital system signed with PassportUSA, an international health-care staffing agency. The agency presented a pool of 30 candidates. Relying on resumes and phone interviews, St. Mary's initially offered jobs to 14.
The nurses didn't have to take the job. Some had worked in other countries, such as the
"Before the interviews, I prayed with my husband," said
But while they could have said no to the job offers, for some it was the realization of a dream. They'd wanted to live and work in
"Even when I was a child, I already dreamed of coming here," said
One of the 14 dropped out for personal reasons. The other 13 said yes to St. Mary's.
The agency handled their work visas and dealt with the logistics of getting them to
At d'Youville, they received a hero's welcome.
"They are very hospitable here," said Moreno, 30. "We feel that we are working with family."
They come with the same kind of training and required licenses as American nurses. They speak English. They're from a country whose population is largely Catholic, so they're familiar with the essence of St. Mary's, a Catholic hospital system.
There has been some adjustment. Many of the Filipino nurses had experience with hospitals, where one nurse might be responsible for five patients. At d'Youville, which provides long-term rather than acute care, two nurses might have 40 patients between them.
"For me, I was shocked," said
Some have also been surprised by how small
"I was used to seeing a lot of people in
But while they marvel at how few people there are, they also appreciate it.
"My husband likes a quiet place where we can raise kids," Tan said.
The Filipino nurses have been embraced by many at d'Youville, especially those staff members whose jobs are made a little easier by the sudden influx of 13 new co-workers.
"I'm so thankful," said
One recent afternoon, a couple of staff members greeted three of the Filipino nurses with "Hi, girls!" as they walked down the hall. One staff member stopped Moreno to let her know her shoe was untied.
"Don't trip and fall," she told Moreno. "We need you."
St. Mary's may soon get more than those 13. Some of the nurses' spouses are trained medical professionals, as well, and are planning to join St. Mary's on their own -- possibly as nurses.
"Soon, all of our husbands will start working here," Moreno said.
The nurses will stay at St. Mary's for three years under contract. After that, they can go somewhere else through the international staffing agency, or they can stay on at St. Mary's. Just a month in, some are already talking about staying, raising their children in
This is a kind of pilot for the hospital system, but Cramm can already see more international hiring in St. Mary's future -- and maybe not just for its nursing home.
"Because it's worked out remarkably well at this point," she said. "Obviously we're still in the early stages, but if it continues to be so positive the way it has been, I am confident this will be a strategy we'll use again."
MONEY, TIME, A PODCAST
Of the largest hospital systems in
EMHS also recruits internationally, using staffing agencies to connect with nurses from
"We're always looking locally, but the necessity, at this point, is that we look not only outside the state but outside the country," said
But while St. Mary's and EMHS are the only large hospital systems in
For nurses who are already on the job, Ponti,
"I heard that loud and clear from the staff," Ponti said.
In July, Ponti also began running "Monday Mornings with Mary-Anne," coffee-and-doughnut hours held in different parts of the system every two weeks to give nurses an easy way to ask her questions, raise concerns or generally feel heard in a way they may not have felt in the past.
"'This is working, Mary-Anne, this isn't,' as an example," Ponti said. "This is an opportunity to connect."
At MaineGeneral, officials have started a summer internship program that pays student nurses to job shadow in operating rooms, cancer care, long-term care and other areas. The goal: Get students excited about finishing their nursing degree and about all the possibilities at MaineGeneral.
MaineGeneral also gives current nurses time to pursue their own quality improvement projects, like finding a way to stop patients from falling or eliminating bed sores. The hope is nurses will feel more fulfilled and engaged and will advance in their careers.
And maybe the
"It's a win-win because they get that incentive, but the organization benefits because projects all contribute to high-quality care," said Chief Nursing Officer Jennifer Riggs.
Nursing schools, too, are looking for innovative ways to address the state's nursing shortage.
Earlier this month, leaders from the
System leaders said some of their plans, including expanding science labs and nursing simulation spaces, are pending voter approval of a
"Many people have established lives and they're not in a position to just devote every (bit of) energy to get themselves educated," said
The school also plans to slash the time that military medics, paramedics and others with medical experience have to spend in school to become registered nurses. Starting next summer, those who complete a 10-week course can skip the entire first year of college.
The school is also considering reducing the time it takes to earn a bachelor's degree in nursing for those students who already have a bachelor's or master's degree in another field.
"What we educate them about is not the general education, the core gen ed, as much as it is the clinical," Bissell said.
Many in nursing say no single effort will solve
"I am 100 percent convinced there is nothing
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