The evolving healthcare workforce: Caring for our caregivers

Key insights for your executive team

Nurses at their station prepare paperworkThe pressures that have recently transformed the American workforce have especially burdened healthcare workers. The Grant Thornton State of Work in America survey, which included responses from 800 healthcare employees, revealed that one-fifth have left their jobs and one-quarter are actively looking for a new position.

“Just half of all healthcare workers believe they are paid fairly for their contributions,” reported Grant Thornton Principal in Human Capital Resources Tim Glowa. “Half don’t feel that their voice is heard at work.”

Healthcare was seeing some distressing trends even before the pandemic:

  • The supply of workers was decreasing.
  • A lack of nursing programs starved the pipeline.
  • An aging workforce threatened to deplete it; while the average age of the American worker is 42, the average age of the American nurse is 50.
  • Workers with less training were poached by retail and fast-food businesses.
  • Workers with more training were poached by life sciences companies.

The issue was encapsulated by Grant Thornton Healthcare Tax Services Leader Mary Torretta: “I think healthcare was probably the hardest hit industry, and we’re certainly hearing it from clients. It’s a time where our country needs healthcare workers, and they’re not there.”

Consolidations, COVID-19 and other stressors Using our employee engagement calculation, 50% of healthcare workers are engaged, and 22% are highly engaged. Engaged employees have a behavioral connection to the company. They say good things about it to others, they go above and beyond in their daily work activities, and they want to stay working at that company. Employee engagement often starts to drop the minute a merger is announced, and the new organization can take a year and half to bounce back. By that time, another merger is often underway. These consolidations have resulted in larger and larger healthcare systems and thus added more layers between C-suite executives making the decisions and front-line personnel providing patient care, including physicians. At its worst, the mentality becomes Us vs. Them.

In addition, massive stresses on the industry have come by way of COVID. Grant Thornton Principal in Human Capital Services Sharon Whittle emphasized this factor: “Pre-COVID, we had a shortage of clinical folks in the healthcare industry. COVID really magnified the situation. It accelerated the labor supply shortages that we knew we were going to have anyway.”

Workers face long hours, difficult working conditions and devastating patient losses, even by healthcare standards. In their private lives, many healthcare workers are also caregivers, sandwiched between debilitated parents and dependent children. Many are single parents; others carried significant debt. Recent studies show that many are suffering post-traumatic stress disorder symptoms more commonly associated with veterans returning from war.

Fortunately, the people who are attracted to healthcare are naturally resilient and optimistic. And, even more fortunately, there is some reason for optimism.

Where does it hurt? Find and address the pain points The key to winning as an employer is to think like a marketer. The best practice is to survey employees and organize focus groups to determine what matters to them — including benefits — and levels of satisfaction. You can then estimate the probability that any given employee will leave your organization, and take appropriate steps to keep them.

Houston, we have a solution.
A large hospital in Houston was losing 35% of its nurses with between two and five years of experience just as they were entering highly productive phases of their careers.

When leadership studied the problem, they learned that these nurses were frustrated because they delivered world-class healthcare at work but weren’t able to help their own aging parents. When the hospital offered these nurses access to specialists within the system for their own parents, the nurse turnover was reduced by about half in six months. Not only did this address a source of frustration for employees, but also this benefit differentiated the employee value proposition in a significant way. It was viewed by employees as the equivalent of a 20% increase in salary, yet cost a fraction of that.
Ideally, the benefits you provide will have a perceived value higher than their cost to the organization. These benefits would also be distinctive to your organization. Currently, 23% of healthcare workers who took a new job did so because of the benefits offered (Grant Thornton’s State of Work in America). Your benefits offering can position your hospital to win the talent you seek.

The Grant Thornton study found that among healthcare workers, the top three drivers of stress are personal debt, medical issues and mental health. That’s a valuable starting point to think about the benefits that make the most sense.

Consider, for example, financial coaching for younger employees, extra payments into retirement funds for older ones, meal services for busy parents and student loan relief for recent graduates. Although hospitals can’t offer the option to work from home to all workers, you could offer longer shifts for fewer days. Given the importance of mental health, you can enhance your employee assistance programs and offer services beyond the traditional employee supports.

Getting the table stakes right includes providing competitive compensation and working conditions. Are you considering the pay equity issue of imbalances between current and new employees? You’re probably very aware by now of the downstream impact of this imbalance. When employees do leave, make the offboarding process smooth and friendly. About 15% of employees are either referrals or later returnees; treat outgoing employees as potential incoming employees — and treat incoming employees well.

Changes must be made to the healthcare worker pipeline. Thinking long-term, some organizations are beginning to introduce middle school students to the possibilities of healthcare careers. Many high school students concurrently attend college and graduate with an associate degree, making obtaining an LPN or CNA license in high school a reality. A few liberal arts schools have changed their purpose and curriculum to align for the heightened demand for clinical healthcare occupations.

Ultimately, the best recruiters are current employees who serve as raving fans, whose passion to live their natural compassion finds fulfillment in your culture. They’re the essential element of a workplace where people want to stay and where desirable candidates want to be.


Mary Torretta Mary Torretta
Leader, Healthcare Tax Services
T +1 703 847 7659

Tim Glowa Tim Glowa
Principal, Human Capital Services
T +1 832 487 1452

Sharon WhittleSharon Whittle
Principal, Human Capital Services
T +1 704 632 6884

Ashley Edwards Ashley Edwards
Senior Manager, Human Capital Services
T +1 704 632 6972