In the wake of the pandemic, the nursing field has continued to suffer large-scale burnout and a wave of retirements. An estimated 100,000 registered nurses have left the field since 2020 due to Covid-related stress, according to the National Council of State Boards of Nursing (NCSBN), accelerating the chronic understaffing crisis that already strained hospitals and healthcare organizations pre-pandemic.
The remaining nurses are caught in a vicious burnout cycle, forced to bear an ever-increasing burden as their colleagues quit or retire. A survey by AMN Healthcare found that about a third of nurses intend to quit their jobs due to the stress of the pandemic, and the NCSBN reports that a whopping 600,000 nurses plan to leave the field within the next four years due to stress, burnout and retirement.
Yet, the demand for care continues unabated. Nurses are absolutely core to the day-to-day functioning of any hospital system, especially in the post-Covid environment. To bulk up nursing staff and keep up with care delivery demands, many hospitals have had no choice but to rely more heavily on transient staff to bolster their workforce.
The Cost of Addressing the Nursing Shortage
Hiring travel nurses has helped many overwhelmed hospitals mitigate the effects of the nursing shortage. According to the American Hospital Association, the average hospital currently spends 40% of their nursing budget on travel nurses, a far cry from the 5% they spent pre-pandemic. Travel nurses have always worked at a premium but the national increase in demand has also driven up prices dramatically. The average hospital’s contract labor expenditure costs rose 257% between 2019 and 2022—and at least 100,000 travel nurses were hired in the U.S. during this time period. These travel nurses are fulfilling a dire need for hospitals desperate for nursing staff, but the cost is significant to hospitals already struggling to make ends meet.
The growing reliance on travel nurses illuminates a cybersecurity issue as well. Travel nurses require immediate access to a hospital’s digital systems, applications, and networks to effectively and securely care for patients. However, providing this access is often done manually, with IT teams creating accounts for each user based on the access privileges they need. This is a time-consuming, tedious process. It can take up to 3 months for practitioners to get onboarded with all the appropriate access privileges they need, and considering the contractual nature of the job, those nurses may well be nearing the end of their time at the hospital by the time access is granted. It’s not uncommon for travel nurses to arrive at a hospital for their first shift without having access to the electronic health record (EHR).
To provide access, it’s often easier for overwhelmed residential staff to simply jot down a password on a sticky note to allow travel nurses to log in under a colleague’s credentials, presenting significant security risks. When organizations don’t have the proper tools in place to streamline clinician interactions with technology, hospitals experience significant productivity delays, and workarounds as clinicians are still expected to care for patients despite not having the proper tools to streamline the process. Ultimately, this results in a diminished return on the travel nurse investment.
How Hospitals Can Maximize IT and Travel Nurse Investments
Considering that travel nurses are being hired to fill a critical resource gap, it is essential they have all required access privileges to the EHR and other critical applications to get to work caring for patients immediately. In addition, it’s essential they are able to access these technologies securely and efficiently. With inefficient processes for provisioning and deprovisioning, authentication, and access, cybersecurity and productivity will suffer. Healthcare’s digital environment is growing increasingly vast, complex, and vulnerable. Cyber attacks are steadily becoming more dangerous, sophisticated and frequent. For twelve years in a row, the healthcare industry has had the highest average data breach cost of any industry, with cyber attacks costing healthcare organizations an average of more than $10 million dollars.
As healthcare organizations look to make strategic decisions with their limited IT and cybersecurity budgets, it is important to look for opportunities to implement solutions that address both cybersecurity and productivity. Not only is this important to maximize travel nurse investments, but also to improve residential nurse satisfaction and productivity.
Enabling Clinicians with Digital Identity
While the problems facing the healthcare industry are complex and layered, there is a multi-faceted solution. Digital identity technologies provide an opportunity for healthcare organizations to improve both clinician onboarding and the way clinicians access applications and critical systems. By implementing a digital identity strategy, healthcare organizations can tackle these issues with one dynamic approach.
By using an identity governance solution, healthcare IT teams can automate clinician onboarding through role-based user account provisioning. With just a few clicks, a travel nurse (or any other clinical staff member) can quickly get set up with all the necessary accounts and access privileges needed to do their job. This eliminates the need for manual on-boarding while making it easier to off-board users once they leave the organization, reducing the security risks of inactive credentials being compromised.
Another key component of a digital identity strategy is access management. As mentioned, security requirements like complex passwords and multifactor authentication (MFA) can slow down clinicians trying to access the EHR while caring for patients. With a proximity ID badge tap or biometric single sign-on solution, clinicians can seamlessly tap their ID badge or swipe their fingerprint onto a reader to log in to the EHR and other applications. This results in significant time savings for clinicians, giving them more time to focus on patient care while improving security. By implementing these solutions as part of a holistic digital identity strategy, healthcare organizations can provide travel nurses with access to the exact systems they need and ensure that those systems are strongly protected from cyber attacks.
It appears that the nursing shortage will likely become even worse in the coming years. This means that healthcare organizations will continue to rely on expensive temporary staffing solutions to meet ever-growing care delivery demands. As hospitals continue to invest in travel nurses as well as their own clinical staff, they must also invest in technologies that can provide swift and secure access to applications and systems. Travel nurses can provide incredible support to healthcare organizations, but ensuring they can deliver high-quality patient care is reliant upon the hospital’s ability to reduce onboarding friction to empower staff to hit the ground running. Identity management eases the way forward for nurses, temporary or not, to focus on what matters most: providing exceptional patient care.
About Dr. Sean Kelly
Dr. Sean Kelly is the Chief Medical Officer (CMO) and Sr. VP of Customer Strategy for Healthcare at Imprivata, where he leads the company’s Clinical Workflow team and advises on the clinical practice of healthcare IT security. In addition, Dr. Kelly practices emergency medicine at Beth Israel Lahey Health and is an Assistant Professor of Emergency Medicine, part-time, at Harvard Medical School. Trained at Harvard College, the University of Massachusetts Medical School, and Vanderbilt University, Dr. Kelly is board-certified in Emergency Medicine and is a Fellow in the American College of Emergency Physicians.
