Healthcare workers are the second most likely profession to burn out, right up there with lawyers and restaurant workers. This is especially true in rural hospital settings where shortages are common. Shortages cause more burnout, causing employees to look for work elsewhere, creating even more shortages.

And in November, again healthcare took a giant hit, with quits increasing in several industries. The largest of these came in hotel and food services (+159,000) followed by healthcare and social assistance (+52,000) with transportation, warehousing, and utilities (+33,000) in a not too distant third according to the Job Openings and Labor Turnover Survey (JOLTS) report.

What does this mean to rural hospitals, and what can be done about it?

Why Are Healthcare Workers Leaving in Droves?

What happens when you take a job that is often overlooked and under appreciated, and then add a global pandemic with significant health risks? You get a mass exit of workers looking for a change in profession.

Nursing and other healthcare positions come with a lot of transferrable skills. With an employee-hungry market out there, dozens of industries are looking for those skills. And with the Zoom town boom, those employees in small towns looking for remote work are already set up for potential success.

And you can’t blame them. Nurses who witnessed death on an epic scale during the height of the pandemic have even been diagnosed with post-traumatic stress disorder. That’s not to mention friends and family who denied the seriousness of the COVID-19 pandemic, and communities who refused to take the steps necessary to flatten the curve.

The Cost of Staffing Shortages

What’s the real cost of staffing shortages? Well, when faced with an overwhelming amount of work and not enough people to do it, hospitals commonly resort to a few costly strategies:

• They pay overtime. Unfortunately, overtime doesn’t just cost money – it increases burnout and results in a higher quit rate. This is especially challenging in a rural environment, where hiring a replacement can take weeks or months.
• Hospitals use staffing services, temp workers, travel nurses, and other contract employees. Compared to regular employees, this is extremely costly. Travel nursing means the hospital pays for housing and even a per diem for meals in some cases. Temp staffing always costs more and should be considered a short-term option. But those terms are getting longer.
• Adding insult to injury, your regular staff become resentful of how much more the travel nurses they're working with are making for doing the same job. You can inadvertently trigger them to consider taking on travel roles of their own, and increase the outflow of your own people. In some cases, hospitals are forced to rehire their people through the same travel nursing agencies, at a much higher premium.
• Hospitals move to critical care standards. What most people don’t understand is this means minor procedures–in other words, those that are not life-threatening–get postponed or even canceled indefinitely, hospital stays are shortened, and lower-risk patients are sent home or told to find care elsewhere.

These are just a few examples, and for someone in a rural area, going to another hospital or doctor may mean long drives, hotel stays, and more. And if the hospitals in a nearby larger town or city are overwhelmed? Patients are left with nowhere to turn.

What Can Be Done to Slow the Great Resignation in Healthcare?

Clearly, there is a problem. The question is, what can be done about it? There are no easy answers, but here are five potential solutions:

• Talk to employees about their biggest pain points. Why are people leaving their jobs or looking for something else? Burnout can be treated, but once the burnout point is reached, it’s too late. If possible, offer solutions to prevent burnout and promote employee wellness both mentally and physically.
• Use temporary labor to help prevent burnout rather than to fill staffing holes. Bring on temporary labor early if possible. It is better to have a travel or temp nurse or doctor on call to give your staff time off than to have them fill a hole while you try to replace someone who quit. Need budget help? FEMA and other government groups may help in rural areas with funding, and you can also turn to your state or community for grants and other funding sources.
• Offer self-care-oriented benefits. These benefits can include everything from paid counseling and therapists on-site to gym memberships, mandatory days off, and more. Yes, this can be difficult when you are short-staffed, but losing a staff member will mean greater costs and challenges in the long run. Be proactive rather than reactive.
• Have a clear strategy. It’s astonishing the number of rural hospitals and care centers that don’t have a clear staffing strategy. Again, this is about being proactive rather than reactive. It’s not just about recruitment, but also about retention.
• Make better use of technology. Make sure you're automating tasks wherever possible. While this sometimes makes your staff nervous, it doesn’t have to. New technology is emerging in healthcare all the time. Use it to perform mundane, everyday tasks to keep your staff free from burnout and fatigue.

These potential answers are broad strokes for a large problem, and each one is much easier to write about than to implement. However, the staffing shortage did not happen overnight, nor will it be fixed quickly. The pandemic and the Great Resignation have just highlighted problems already present in the system.

In the short-term, it’s critical for rural hospitals and other healthcare facilities to determine what to do to maintain care levels without becoming financially insolvent the same time. They will need to do this with an eye toward tomorrow to avoid creating a situation where they are simply continuously sticking their fingers in the dike as more and more holes develop. Otherwise, the problem-solvers themselves may burn out, and the crisis will simply evolve and deepen.