OR Manager: Traveler Tightrope: OR Leaders Balance Best Practices, Reduction Strategies

Carol Tuttas, PhD, RN, clinical manager, and Dani Bowie, DNP, RN, NE-BC, senior vice president of solutions design and workforce AI, were interviewed for an article pertaining to travelers. Carol Tuttas discussed freedom and flexibility, and Dani Bowie shared how AI can help better align supply and demand.

The Wandering Workforce

Although down overall, demand for travelers is higher for some positions than others. For instance, travel nursing agency Aya Healthcare reported a 3% decrease in demand for OR RN positions and a 29% decrease for ST positions from January 1 to July 3, 2024. However, demand for PACU RNs increased by 58%. Acute care hospitals account for 91% of OR contracts.

Another is flexibility. Carol Tuttas, PhD, RN, clinical manager for Aya Healthcare, says that during the pandemic, clinicians discovered that “travel gave them control over when and where they wanted to work, improving work-life balance.” For example, travelers can take time off between assignments to re-energize.

However, travel nursing also can be stressful. The National Nursing Workforce Survey analysis found that nearly two-thirds (64%) of travel RNs reported emotional exhaustion or stress either a few times per week or every day during the pandemic. In addition, more travel RNs younger than 60 plan to leave nursing in the next 5 years, compared to non-travel RNs (33% vs. 17%). Travel nurses tend to be younger and are a more diverse group than non-travelers (sidebar, Travel nurse profile). For instance, 15% of travel RNs were men, compared to 8% of non-travel RNs.

Traveler Reduction Strategies

Although best practices are important, the general trend is to reduce or eliminate the need for travel staff. Strategies for doing so include float pools and training programs, as well as greater focus on a positive workplace environment.

In all these strategies, flexibility is key.

Creating a new float pool requires careful consideration of several factors (sidebar, Float pool tips). “To build the business case, consider your current spend for the last year, including overtime, incentive pay, and cost in travelers, and where you’re losing revenue, such as needing to close ORs because you don’t have the workforce,” says Dani Bowie, DNP, RN, NE-BC, senior vice president of solutions design and workforce AI at Aya Healthcare.

Even with a float pool, setting a buffer of 5% of the budget for travelers can help adapt to “census swings or other patterns where you’ll need staff but not a full-time employee,” Bowie says. For example, she once hired a pediatric nurse at.6 FTE, then worked the nurse at.3 in the summer and.9 in the winter to match volume trends.

With or without a float pool, technology for modeling volume and staffing can enable leaders to get creative with shift times and schedules, Bowie says. “Artificial intelligence products can help you better align supply and demand so you don’t need to rely on external resources as much.”

Float Pool Tips

Dani Bowie, DNP, RN, NE-BC, offers considerations for starting a float pool in her book “The flexible workforce handbook: Curing the nurse staffing crisis.”

Before embarking on this endeavor, ask questions such as:

• Do I have the scope for a float pool? For any more than about 50 FTEs, a manager is likely to require an assistant.
• Do I have the resources? For example, does the hospital have the infrastructure needed to support modeling? What about a scheduler?
• Can I attract staff for the pool? Consider the workforce supply in the community and any areas schools that could be partners. Leaders may also train nurses already working in other areas, such as medical/surgical, to be part of the pool.

After deciding to move forward, next steps include:

Track metrics such as number of shifts filled and make adjustments as needed.

Build The Business Case

Determine where float team staff will work (only in the OR or multiple areas, such as PACU and preoperative?).

Develop scheduling and staffing policies, such as shift lengths and times, weekend coverage, and incentives for open shifts.

Decide on a scheduling model. The model should include how to determine needs, how to share needs with staff (a commercial product can be used to automatically notify staff of open shifts via their mobile devices), and, if appropriate, how to move staff mid-shift.

Develop job descriptions and a compensation model.

Work with talent acquisitions to promote the role at job fairs and online.

Read the full article here.