Health care systems throughout the Inland Northwest are working against the effects of burnout on their staff, who continue to fight the COVID-19 pandemic.

Bryan Fix, chief human resources officer for the Washington and Montana regions for Providence, formerly Providence Health & Services, says employee retention has become a more pressing problem for the organization.

Turnover at Providence has increased each month since the COVID-19 virus was detected in the Spokane area, he says.

“Before the pandemic, our turnover rates were far below the industry average when we would track it on benchmark surveys,” Fix says. “Today, our total overall turnover looks a little more like the industry average, and that industry average is not a small number.”

As of Oct. 13, there were more than 1,600 open positions in the Spokane-Coeur d’Alene area listed on the websites of the area’s four largest health care employers—Providence, MultiCare Health System, Eastern State Hospital, and Kootenai Health. That figure includes clinical and non clinical positions.

As of the Journal’s December 2020 list of the largest employers in Spokane and Kootenai counties, those four health care entities employed about 12,900 people in Spokane, Stevens, and Kootenai counties. 

According to the National Healthcare Retention & RN Staffing Report, a survey conducted by national registered nurse recruitment company NSI, Nursing Solutions Inc., the average U.S. hospital turnover rate last year was 19.5%, up 1.7 percentage points from the 2019 turnover rate, an increase of almost 5 percentage points from the 2010 hospital turnover rate of 14.6%.

Many veteran health care workers have left the industry after reaching their burnout limit, Fix says. There aren’t enough people entering the industry to keep up, he says.

Matt Allore, executive director of human potential for the Inland Northwest region for MultiCare Health System, says the health system has been getting more creative in responding to staffing needs.

MultiCare, in an effort to reduce some of the load frontline workers are carrying, has introduced a new program it calls Helping Hands.

“All of our salaried staff members in support positions have been asked to volunteer some of their time in support of our hospital operations during this most recent delta (variant) surge,” Allore says. “Someone from accounting can’t help give an IV or administer medications, but they can help deliver a food tray or keep our facilities clean, sterile, and safe for everybody.”

The program has been fairly popular, with hundreds of employees throughout MultiCare participating, Allore says.

“That’s one of the big things we can do to help with the burnout of the entire pandemic—addressing our workforce challenges and doing so aggressively,” Allore says.

Fix says health care workers have continued to endure a “heightened state of response” throughout the waves of confirmed COVID-19 cases and hospitalizations.

“As we go through these waves, it’s that whole feeling of managing change again,” Fix says.

According the Spokane Regional Health District’s daily COVID-19 updates, as of October 13, 163 people in the county were hospitalized due to the virus. 

Allore says health care workers have been working against the virus long after they had assumed it would be under control.

“It’s been challenging because the pandemic continues and endures, long after everyone thought it would,” Allore says. 

He adds, “You can get a little lost in the day-to-day amidst this pandemic, as a health care worker. You can start to lose your connection to purpose.”

Allore says MultiCare has relied heavily on its existing support programs for employees.

“The emotional needs throughout the pandemic have been served by programs like a crisis intervention team called Code Lavender, which supports employees after a patient dies or a traumatic event that can tax emotions occurs in the workplace,” he says. “We’ve also got our employee assistance programs, which offer free confidential counseling referral services to our employees.”

Providence offers similar counseling services for its employees. Fix says he took advantage of this program last year.

“It was a bit of a country music song,” Fix says of his own experience. “It started with my dog dying at the beginning of the pandemic, and then my father died, and then my grandfather died. I was so frustrated with the pandemic and trying to cope with all of those family changes and stress. I used it for probably six months, and it helped me through.”

Fix says counseling and behavioral health services also are available to the family members of Providence employees.

Recently, two of MultiCare’s nursing leaders in Spokane have started bringing in their dogs, which are in training to become therapy dogs, to the front lawn of Deaconess Hospital each week.

MultiCare also encourages its employees to support each other, Allore says.

“We have a system on our intranet that employees can use to send each other thank-you notes back and forth,” Allore says.

MultiCare is running a drawing for its employees in which each appreciation note enters both the sender and recipient of the thank-you note for rewards. Prizes include a spa day, a golfing getaway, or a zipline adventure. 

Allore says MultiCare also tries to boost spirits through smaller gestures. MultiCare recently implemented Thankful Thursdays, which Allore says provide “a little something extra” to cheer up its employees. For example, one Thankful Thursday featured grab-and-go ice cream treats available in the Deaconess Hospital cafeteria.

“The way we phrased it in our employee message was that ice cream’s not going to solve everything in the world, it’s not going to make the pandemic go away magically,” he says. “But it does help you take five minutes and smile, because everybody likes ice cream.”

Financial bonuses and incentives have been part of Providence’s pandemic response since the early days of the pandemic, Fix says.

“We were doing things like pandemic pay to keep people’s paychecks whole,” Fix says.

In a bid to attract qualified employees, Providence has launched an employee-referral program that runs through the end of this year, Fix says. Providence employees who refer qualified employee candidates receive a bonus of between $1,000 and $5,000 if their referral is hired, depending on the position.

The program has seen some success, Fix says; about 8% of Providence’s new hires now come from the referral program.

Providence has provided pandemic bonuses to all employees at different points during the pandemic, Fix says. In September, all Providence employees received a $1,000 pandemic bonus.

Employees in some jobs, such as critical care nursing and respiratory therapy, have been receiving additional incentives for picking up extra shifts.

“That can make an individual a lot of money,” Fix says. “As we’ve gotten further into the pandemic, though, some of those folks have said, ‘we appreciate the incentives for these extra shifts, but it’s not about the money anymore, we just want a break.’”

A break is tough to find when there aren’t enough employees to go around.

“There are more jobs open than there are qualified applicants in specific job categories,” Fix says. “We may have an equal number of openings to the number of applicants, but they’re not all fully qualified. The whole industry is feeling that.”

Allore says MultiCare is working to create its own employment pipeline by offering a certified nursing assistant program. The organization also plans to offer a similar program in phlebotomy.

“A certified nursing assistant can be trained in six to eight weeks,” Allore says. “We started a program last April in which we sponsor the education for nursing assistants. We hire these folks on day one. We pay for their training; we pay for their hours in training. We ask for them to commit to (working for) us for a period of time after that, which we feel is very reasonable.”

Allore says it’s important for MultiCare to fill open positions with qualified candidates quickly to lighten the load shared by existing MultiCare employees.

“Our existing staff need to be able to take their time off,” Allore says. “We need to be fully staffed so that our people can rest and recharge, maybe get away to the lake for the weekend and fill up their hearts and their minds again.”

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