Becky Hultberg is the President and CEO of the Oregon Association of Hospitals and Health Systems. Hultberg works with local and national government leaders, as well as business and citizen coalitions, and other professional health care organizations to enhance and promote community health and improve Oregon’s health care system. She previously served as President and CEO of the Alaska State Hospital and Nursing Home Association, and Commissioner of Alaska’s Department of Administration.
In this Q&A, Hultberg discusses Oregon’s health care workforce shortage, and actions OAHHS and other health care professionals can pursue to help attract more workers to the industry.
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State of Reform: Many states are struggling with health care workforce shortages. In Oregon’s case, can you discuss a couple reasons why it is hard for employers to recruit enough workers to fill their staffs?
Becky Hultberg: “We’re seeing recruitment challenges in just about every sector of the economy, so it isn’t a surprise that health care is experiencing these issues.
Two things make health care, and specifically hospitals, somewhat unique. First, it was hard to work in hospitals during the pandemic, and many staff left. Early on we hailed health care workers as heroes because of how hard they worked, and how brave they were under challenging conditions. But month after month that level of stress took its toll. Some retired, some transitioned to employment in other health care settings, and some left health care altogether. Our gap is bigger to fill than in many other industries.
Second, many positions require significant and very specific education and training, so it takes time to re-fill the pipeline. The workforce gap was created faster than we can fix it. One unique challenge is Oregon’s lack of participation in an interstate provider compact for doctors and nurses, which would allow hospitals to recruit providers from other states. We are one of only a few states that does not participate, and we need to continue the conversation about how Oregon’s patients could benefit from this type of flexibility.”
SOR: Is there a specific health care position that is having more trouble with attracting recruits than others?
BH: “Nurses; there was a national nursing shortage before COVID-19, but the pandemic has thrown us into a full-blown crisis. We hear from nurses across the state that the stress of high patient loads from several significant COVID-19 surges has traumatized the workforce. Nurses have shown incredible dedication during the pandemic, but as one nurse said, ‘We’re used to winning; helping patients get better. Now we’re losing.’
Too many patients have been lost, and that takes a major toll emotionally. The workloads have been relentless; after the Delta surge wound down last fall, they saw a huge number of patients return for care they had put off. Staff haven’t had a needed reprieve, and some nurses have left the profession or retired at a time when every hospital needs them. There just aren’t enough out there to hire. Our hospitals have worked very hard on recruiting and retention, but it’s an uphill battle.”
SOR: Has the COVID-19 pandemic exacerbated the problem?
BH: “Most definitely; COVID-19 created a generational workforce challenge. Hospitals report that while they’ve always had recruitment challenges, they have never been of this magnitude.”
SOR: What are some things employers can do to try to recruit more workers?
BH: “We have some outstanding people working on recruiting at our hospitals. They tell us that, while pay is always important, of course, what employees want is a culture where they feel valued, respected, and included. Hospitals and [human resource] managers have worked really hard on that, making sure that everyone feels appreciated. That helps with retention of current staff, but until we add more workers to the available pool, recruiting will continue to be a challenge.”
SOR: What role can OAHHS play in helping with the effort?
BH: “We spent a lot of time during the 2022 Legislature advocating for policies that would support our workforce by opening up the pipeline for licensed staff, including nurses. OAHHS believes we need to streamline the licensing process, which is very cumbersome and time consuming in Oregon. There was some progress made during the session creating temporary licenses, and that work will need to continue in 2023.
We supported a bill, House Bill 4106, that will create apprenticeship programs for surgical technicians that will help hospitals ‘grow their own’ staff. Moving forward, OAHHS will work on helping our hospitals keep the ability to be creative in navigating the staffing shortages, including legislation to have Oregon join interstate provider compacts, which help hospitals support both patients and current staff.
The growth of telehealth has been one of the bright spots of the pandemic, but that’s just the beginning. There is so much that is unknown, but this we do know: we are not going back to the way things were before the pandemic. We can view that as a negative, or we can look at it as an exciting opportunity to improve health care delivery.”
This interview was edited for clarity and length.