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New Mexico hospitals continue to struggle with pre-existing and new workforce challenges as a result of the COVID-19 pandemic

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New Mexico hospitals continue to grapple with workforce issues exacerbated by the strains the COVID-19 pandemic placed on the health care sector.

Lawmakers this week will hear about those hospital workforce predicaments during Health and Human Service Committee meetings Sept. 14-16 in Gallup. A New Mexico Hospital Association presentation slated for the first afternoon outlines some of those challenges, which include hospitals that remain busy with sicker patients who delayed care during the pandemic, coupled with competition among New Mexico and US hospitals for staff.

New Mexico hospitals, the report says, employ 8,000+ bedside nurses, 50% of doctors in the state and 758 primary care providers, but all continue to face workforce shortages.

Christus St. Vincent Regional Medical Center Human Resources Director Sandra Dominguez tells SFR the hospital has a higher vacancy rate than it did prior to the pandemic. “As with any employer,” Dominguez says. “Right now, everybody’s struggling to find qualified staff.”

While the most recent US Bureau of Labor Statistics jobs report published earlier this month reported a rise in health care employment of 48,000 in August, overall employment in health care nationally remained below its February 2020 by 0.2 percent.

The nursing shortage predating the pandemic remains a critical area of focus. Last month, New Mexico began distributing $15 million to higher education institutions across New Mexico to expand nursing programs, with Gov. Michelle Lujan Grisham’s office announcing the distribution of funds as one of several actions taken to address ongoing nursing shortages.

Christus President and CEO Lillian Montoya says the hospital is encountering an unemployment trend she characterized as “the great upgrade” versus the so-called “great resignation,” wherein people are using this time to consider changing jobs and locations. And for people who decide to try Santa Fe, they encounter the city’s ongoing challenges with affordable housing and childcare. Montoya says one of the hospital’s “biggest challenges” is meeting the needs of a young workforce:

“You have more younger people working at the hospital, they come to the community or want to stay in the community. And if they don’t have a partner in their age demographic, or a home, they’re not as likely to stick around,” she says.

To that end, the hospital sponsors events such as Santa Fe Wine & Chile Fiesta and Music on the Hill.

“It’s really selfish, because I want to get my people out to meet people so they stick around,” Montoya says.

Both Dominguez and Christus Chief Nursing Executive Monica Leyba say while the nursing shortage pre-dated the pandemic, several new factors continue to reverberate. One was the increased need for traveling nurses to fill staffing shortages.

Pre-pandemic, Leyba says, “almost all of our positions were filled with our with our own core team,” with perhaps 20 traveling nurses. Now, they have more than 100, she said. Experienced nurses chose to travel in some cases, she said, because they received higher wages doing so.

“We’re trying to bring down the traveler rates so we can come to some sort of stability from a financial standpoint,” she says, “as well as at the bedside, just the clinical nurse stability.”

In some cases, nurses left the state to be closer to their families so they could have help with childcare, she says. A “high number” of nurses decided to retire. And many of their newest nurses who have just graduated, finished their schooling during the pandemic and are onboarding without clinical experience.

“So now we’re having to kind of catch up and help them transition into caring for [patients] because their training was just a little bit different,” Leyba says.

To address hiring shortages and provide support to staff given the high level of trauma health care workers experienced as a result of the pandemic, Christus has held job fairs, Dominguez says, at which they try to do same-day offers when possible. At a recent event, approximately 100 people attended and the hospital was able to hire 35 people. For non-clinical and some administrative roles, the hospital has created some remote options to provide flexibility to employees. The hospital also provides assistance programs to health care workers still grappling with the emotional and psychological impacts of the pandemic.

“For our frontline staff, certainly the pandemic took a toll on our nurses and our doctors,” Dominguez says. “Our spiritual care team is a very dynamic team on the frontlines working with our healthcare staff and listening to their concerns.”

Both University of New Mexico Hospital and Presbyterian Healthcare Services officials say they, too, are dealing with comparable issues.

University of New Mexico Hospital Chief Human Resources Officer Sara Frasch tells SFR via email its vacancy rate is “higher than we have ever seen, and it is about double what it was pre-pandemic,” with nurses, case managers, behavioral health techs, patient care techs, drivers, night shift staff and IT staff as some of our most difficult-to-fill positions.”

To address shortages, UNM also has being holding virtual hiring events, and has also “increased our orientation class size and broadened our recruitment ad services. We have also resumed in-person hiring events in which our unit leaders attend to talk in real-time with candidates,” Frasch says.

As it has at Christus, Frasch writes that the pandemic changed both “the work environment and our workforce” at UNM. “Our stalwart team members seek more flexibility and support than ever before. The pandemic opened up more opportunities for nurses to take short-term assignments traveling and gain new experiences. That affected our workforce, both in number and morale, because when these team members resigned to travel it made us more dependent on temporary workers. Temporary workers allow us to continue to give excellent care to New Mexicans, but they are not core staff who have developed strong relationships that are part of our culture.”

At Presbyterian, Janna Christopher, director of clinical recruiting, Presbyterian Healthcare Services, says their facilities are seeing “an increase in job opportunities and a decrease in clinical applicants this year compared to previous years. We have also seen this trend in health care organizations across the country.” Supply and demand for clinicians in the state “has always been a challenge,” Christopher writes, and Presbyterian also has “experienced difficulties with attracting new talent to New Mexico pre and post pandemic,” including nurses, physical therapists, respiratory therapists, radiology techs, paramedics and EMTs.

Presbyterian has been “focusing on various strategies to increase our applicant pools, including expanding our social media presence. We also focus on recruiting through virtual and in-person job fairs and offer a range of employee referral bonuses for clinical positions,” Christopher writes, in addition to offering nursing residencies and fellowships.

“For health care staff across the country, as well as at Presbyterian, the pandemic has been incredibly challenging,” Christopher says. “They have had to navigate through uncertainty, ever-changing guidelines and treatments, and more. Many employees say it’s the strength from their team that has gotten them through these difficult times. In addition, staff who are not based in clinical settings have adjusted to working remotely. As we begin to move away from some of the most difficult times of the pandemic, we are focused on helping employees recover and thrive.”

The New Mexico Hospital Association presentation scheduled for Sept. 14 outlines several legislative proposals to address workforce shortages, including creating licensure reciprocity for veterans with medical experience; making licensure more efficient; funding a respiratory therapist pilot project; funding for school-to-work nursing programs; establishing a state trust fund for hospitals and health care; and making state funding permanent for nursing programs.