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Nurse with patient

Seeking solutions to healthcare employment issues

Employers in Washington’s healthcare sector are struggling with the employment pipeline and retainment, especially in rural areas. Representatives from the sector are now recommending introducing students to healthcare jobs earlier, developing clear pathways from lower-skilled healthcare jobs to other work in the industry and better marketing and supporting rural positions.

During a Nov. 13 meeting of the Legislative Committee on Economic Development and International Relations, stakeholders made recommendations to lawmakers and Lieutenant governor Cyrus Habib, the committee’s chair, on how to address these ongoing issues.

Bianca Frogner, Director of the University of Washington Center for Health Workforce Studies (UW CHWS), said that recent data show healthcare positions are among the fastest growing in the nation, with jobs including home health aides, physical assistants, nurse practitioners and medical assistants.

Frogner noted that most of the fast-growing medical jobs require less than a bachelor’s degree.

“Some ways to address recruitment and developing a pipeline is that we need to introduce students to a wide range of health care careers…you need to capture them in high school or earlier, and many students don’t know of those jobs or are not always aware of the opportunities.”

Frogner said there is also a lack of training opportunities in rural and underserved communities.

“It’s not just enough to take them out of the communities, we need to put them back and have them train in those places,” she said.

Healthcare apprenticeships in the fields of primary care and long-term care should also be expanded, Frogner added.

Another glaring problem is that of retaining workers.

“While healthcare has been a job engine, we know that a lot of people leave healthcare at a fairly high rate, especially at these lower skill jobs,” she said, adding that she was part of a study done by the University of California San Francisco (UCSF) which found that 50 percent of people leaving a long-term care facility were left without a job in the healthcare field. Of that 50 percent, 30 percent decided to change their industry entirely and 20 percent became unemployed.

“That is particularly worrisome for me because we know that there are jobs in demand, but they are not able to find employment,” adding that the state needs to make the pathway to healthcare clearer.

Low pay and negotiating higher pay rates with insurance companies are also major barriers to retention.

Jacqueline Barton True, Director of Rural Health Programs for the Washington State Hospital Association (WSHA), spoke to the gaps that hospital employers are experiencing, especially in Washington’s rural areas.

The Area Health Education Center For Western Washington released a report called the “Homegrown Nurse” which found a persistent need across the state for nursing at all staff levels, particularly those with associates degrees.

“Home grown is a strategy that works really well in rural areas,” said Barton True. “If you can recruit someone and train someone in a rural area, they are more likely to take a job…and stay in the rural area.”

Hospital employers in rural areas find it perpetually challenging to fill available slots for rural nurses in training programs due to high demand.

“They are having more students come to those more rural community colleges to help fill some of those slots,” said Barton True. “They then return back to where they were originally from, rather than taking those jobs in the local community, which is further exacerbating some of the supply issue.”

And finally, the distance traveled to receive training also presents challenges in rural communities. While options may exist for online coursework, some people may not have regular access to a computer or broadband.

The recruitment problem can cause hospitals to spend excessive time trying to find talent. Barton True said she knows of one hospital in eastern Washington that spent 18 months hiring a physician.

Often, those employers must look to out-of-state candidates who perhaps don’t understand the reality of working in a rural community which makes it more challenging to hold onto those employees once reality sets in. Being the only doctor in a town of 2,500 people is a tough sell for a lot of folks, she added.

“Practicing in rural areas is very different than…an urban area. You are more likely to see a broader range of cases…less likely to be specialized…and you have to do so without the same team oversight that you could get at a larger academic institution.

“We need to look at how do we fill these needs, how do we help support those physicians,” said Barton True.


Mike Richards grew up in Charlotte, North Carolina. He graduated from Duquesne University in Pittsburgh, PA with a degree in Multiplatform Journalism and a minor in Public Relations. He wrote and published articles at Pittsburgh’s NPR station covering a variety of topics.

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