Melissa Fischer, CEO of NurseRegistry, was recently a guest on the Recruiting Daily Podcast.
We are thrilled that Melissa had the opportunity to speak with William Tincup from Recruiting Daily and discuss nurse staffing retention best practices, career opportunities for nurses, and the key to keeping nurses engaged.
Listen to the Interview below:
IN THIS ARTICLE
Recruiting Daily Interview Transcription
This is RecruitingDaily’s Recruiting Live Podcast where we look at the strategies behind the world’s best talent acquisition teams. We talk recruiting, sourcing, and talent acquisition. Each week we take one overcomplicated topic and break it down so that your three-year-old can understand it. Make sense? Are you ready to take your game to the next level? You’re at the right spot. You’re now entering the mind of a hustler. Here’s your host, William Tincup.
This is William Tincup and you’re listening to the RecruitingDaily Podcast. Today, we have Melissa on from NurseRegistry. And our topic today is “best practices to keep the nurse workforce happy,” which, good God, we could probably talk all day about this, but we’re gonna try and keep it to about 30 minutes or so or less. So why don’t we do introductions first, Melissa, would you do us a favor and introduce yourself and NurseRegistry?
Absolutely. Thank you for giving me this opportunity to chat with you, William. I’m Melissa Fisher. I’m a nurse. I’m the CEO of NurseRegistry. NurseRegistry has been around since 2009. We’re based in the San Francisco Bay Area in Palo Alto and we focused on finding opportunities for nurses within the state of California currently. But yeah, we’re a good old fashioned nurse’s registry, so we kind of track different nursing opportunities around the state and help nurses to find them.
You know what I love about nursing, it’s on the recruiting staffing side of things, is you can build a matrix, you know? In terms of, you either got a degree or not, you either have specific certifications or not, you either have so many years in it or not. Like it’s a big giant, you know, something you can do and excel.
Exactly. Very much so.
Software developers – not as easy by the way. You’re either an RN or you’re not. Okay, you either got 12 years of experience and certification, or you don’t, like, it’s easier that way. I don’t know if you see it the same way.
Well, you know, there’s so many different things, there’s so many different things to keep in mind for nurses. I came to work at NurseRegistry as kind of a newer nurse myself. I had only worked in a, you know, a couple of positions and just the breadth of opportunities for nurses out there, you know, outside of what you think of in nursing school, which is I’m going to work in a hospital or you know, the glamorous roles, an ER nurse or a labor and delivery nurse, and, you know, welcome new life into the world every day. You know, of course, that some people get to land those opportunities, but there’s so much nursing out there that the community needs, that different entities need. And kind of, again, just getting those opportunities in front of nurses is what we’ve been doing and what we continue to try to do.
So before we get to happiness, I did want to ask you a question around demand because I used to say this bit pre-COVID, I’d say listen, we don’t make enough nurses to fill the open positions that we have now, much less in the future. So like, we need more nurses, somehow, some way. I don’t know how we’re gonna manufacture them, but we need more. First of all, that might not have been true. So we’ll just leave that out there, is that me being myself and it’s an anecdote that just was not based on data, just my opinion. But we’ve also been through hellish last four years with COVID. What’s kind of the most sought after in California? What do you see kind of the two or three nursing positions that have just like, it’s really, really hard to get the supply right on those nurses?
Well to your point, I would cosign that. There’s kind of this continual nursing shortage that we see, and it’s kind of better or worse, but it always exists. At different points during the pandemic, it was different, but I would say honestly, probably the toughest hit sector were like long-term care, skilled nursing facilities, managing outbreaks, you know, losing just chunks of your staff at any given time. Those facilities were in really tough positions, really, really tough positions because, like you said, it’s, you know, there’s only so many nurses out there. You can’t wave a magic wand and create more nurses. It’s a multi-year, highly skilled path to get in and get working nurses out there. So it’s been tough. But to answer your question, that was probably what we saw was hardest hit over the pandemic, were those, you know, long-term care that their needs are just constant. They don’t stop. They don’t end. There’s no respite.
No, no. And obviously, the pandemic puts such a stressor on them in particular, because of just how COVID attacked. It made their lives more stressful if there is a more stressful, like year, it made it even more stressful. So if we were having this discussion in 2019, what would you say in terms of, you know, keeping your nurse workforce happy, what would have been kind of the themes back then? If you can remember back that far.
I would say it’s always pay-focused, right? And that’s again, listening to your podcast, one of the few lines that I’ve heard, you know. Obviously, people always want to get the value that they feel they’re worth, but I think pre-pandemic, it was just kind of seeing where the stars aligned in staffing, right? You know, getting the right opportunity in front of someone who says, oh okay, well I am looking for something to do on the weekends, or maybe this seems better than what I’m doing right now. During the pandemic though, it just became about sustainability and, you know, again, more of an existential, how can I exist in this career that I’ve trained and worked so hard for, and maintain my sense of self, maintain my health, maintain my, you know, my personhood when all of these pressures are on me? And that was what we started hearing during, you know, the pandemic was nurses looking for something else. You know, options for not leaving the career, but not staying in, you know, their same highly stressful position. So I would say that would be the big change was before it was, you know, let’s just see what’s out there and let’s, you know, weigh, my opportunities, make sure I’m valuing myself appropriately. And then again, during the pandemic, it just became more – it’s either this or I leave the profession. I cannot sustain at the level that I’ve been doing, you know, over the last several months or years.
It’s interesting, because it’s stress, right? And I’ve said this before, but it’s like, if you didn’t kind of reevaluate your life during COVID, then something’s wrong with you.
Very much so. No, I sign on to that as well.
So like when people say, well, I reevaluate. Yeah, yeah, so did everybody else, so did 330 million people, hopefully they reevaluated. But with nurses, what I’ve found, my sister-in-law’s a labor and delivery nurse, but she works the nightshift and she went through, I think she delivered or was a part of the team that delivered the first COVID baby in Dallas, DFW and the stress. It’s like when you see those before pictures of the presidents and then the after pictures. You can do that with nurses, you could go back to their Instagram accounts at like 18 or 19, and then come back and look up now like, whoa, wait a minute, something changed.
Absolutley, not to get too dark about it. But you know, there was a period of time there where you were hearing stories of, you know, nurse suicide. You know, again, it’s, it’s not, you know, the stress is real and it’s significant. Existential right?
Yeah, the stress of just regular in any of the different particular – there is always kind of a potentiality of life and death, right? So like, there’s that there’s that stress is going to be there kind of almost no matter what you’re doing. If you’re a nurse anesthetist and you’re a traveling nurse, you know, you’re gonna be dealing with that on a daily basis. Now, this added bonus of a global pandemic that no one can quite figure out that goes on for quite a while, technically, we’re still in it. I think that, you know, again, the decision of either stay in and find coping mechanisms, or just get out, go be, you know, go do something else, go be an Uber driver, like, just get out, do something technically not not as stressful. What are the hospitals, or long-term care facilities or the doctors, the people that are trying to recruit and retain nurses, what do we give them as advice right now of like, recognizing the shift from, you know, you can just throw money at it and you get more applicants. Yep. Sure. That might not be the case today. What’s your advice when you’re talking to those folks about, okay, this is what you’ve got to be thinking about in terms of trying to recruit and retain the nursing population?
I think the core of it is flexibility is knowing that, you know, nurses, again, the level of stress that they deal with in their everyday work life is really high, particularly depending on the role that they have and so nurses need to figure out how to mitigate that, right? So it’s either I work fewer days, or maybe I balance it, and maybe again, I change paths, maybe the hospital isn’t the right place for me right now, maybe I want to do a school nursing position, which has just exploded since the pandemic. There’s so many more school nursing needs than there were prior. You know, so again, it’s, it’s still using those nursing skills, and maybe just reevaluating where they are, but I mean, as to speaking directly to the hospitals – it’s screaming at a brick wall to be honest. They’ve built their workforce on a chronic understaffing model, for lots and lots of years and they’ve done it intentionally and the stress that that puts on the workforce is undue, in my opinion, right? It’s not the nurse’s responsibility that you’ve understaffed for years and now you need him or her there for 70 hours this week, you know, or you don’t have a job to come back to. And again, it’s, you know, it’s just a job, at the end of the day. You know, you can’t treat people as though they have no other option, because they do and again, whether it’s choosing a less stressful nursing job, or leaving the career entirely, which again, I’ve known many of my cohorts who have done over the course of the pandemic, you know, again, kind of coming to that existential realization of, it’s just a job, you know, I can get another job, and not again, you know, either have my health at risk, my family’s health at risk, or even just my sense of self-worth and value, you know. I don’t need to be told that I have to be here 70 hours a week, or don’t bother coming back, which is the message that a lot of nurses were getting, and so they didn’t bother coming back, and, you know, here we are.
You know, this mirrors what the experience I have with my sister-in-law. She works for a large hospital system here in Texas and she gets her schedule two weeks in advance. That’s it. And she has at least 20 something years of experience. And it’s like two weeks in advance? Like, that’s it? Like asking off a holiday or whatever it’s like, that’s just insane to me. And she’s like, you would not understand, because I talked to her about workforce technology and stuff like that, like, in a restaurant industry, hotschedules is a business in the hospitality industry that you can swap schedules over mobile device with like people like you can literally, you and I have the same, you know, we’re both hosts let’s say, and we can swap a shift like over our phones. Doesn’t matter as long as there’s coverage. And the business doesn’t care as long as there’s coverage. It’s all done over a mobile phone. Like literally you could just, you literally do it over the mobile phone. You want to take this shift? Yeah, good. Okay, great. Manager gets a notification. Done. Like why can’t that be done in nursing?
You know, I feel like I do hear rumblings of moving more towards flexibility and shift swapping and stuff like that. Again, kind of you know, that tight, tight hospital staffing is not necessarily my purview. So I can’t speak to it exactly. But I definitely hear rumblings that they’re moving a little bit more in that direction. You know, of course, at least among nursing teams, you know, if you work within a department at a hospital or at a, you know, healthcare provider to allow for that type of shift swapping. But you know, like you said, it’s not always as easy as you know, the post-anesthesia nurse can’t swap a shift with the pre-op nurse because they have entirely different roles and responsibilities and times that they need to be there. So you know that makes things a little trickier with a lot of, you know, nurse staffing specifically. But I have definitely heard just organically that there are moves towards a little bit more of that type of flexibility.
I mean, they’re going these, the, you know, it’s a battleship, right? The hospital systems, if they don’t change, they’re just not going to be able to get the talent. That’s, that’s what’s really gonna, that’s gonna happen is because the talent, which you named flexibility is the number one thing. Ironically, when you study millennials, and Gen Z, that’s like the number one thing on their list collectively, especially post-pandemic, if you will. That’s it. It comes down, now pay is always going to be, compensation and all that stuff, is always going to be top of the list, of course, like my niece is 28 and she works for Deloitte and flexibility is number one. She’s like, listen, I only want to come to the office one day a week, period. So you can pick the day. She lives in Brooklyn and she’s like I just want to come to the office one day a week. I said I’ll work the other four or five and like working is not a problem. I just don’t want to travel into the office. I’m so envious of her. Like, wait a minute, I wouldn’t, that wasn’t available to me when I was growing up.
What are you, oh go ahead no, finish your thought.
No, no, I was just agreeing with you again, it’s just been such a game changer over the last few years of being able to demand that type of accommodation.
Oh, I like it for nurses, but I like it for the general talent, as well. It’s like, you know, it’s, it’s actually you should be able to demand that. That should be kind of a right that you work hard and, and you should be able to, like work should be flexible. Like that’s we’re thinking like this is revolutionary on some level that it’s really not.
Exactly. We’ve seen that with our internal workforce, you know, with the people who were sweating doing the scheduling and the staffing and everything, but, you know, we’ve been able to acquire some really awesome people who, again, during the pandemic, or as things progressed through the pandemic, didn’t want to go back to their offices.
Yeah, that’s a great point. Because those offices wanted him to work like they did in ’19. And my, my counter to that was always what was so great about 2019 that we’re going back to? Like, I remember 2019, it wasn’t that great. What’s the rush? And I also believe that it’s kind of a tell in general of a bad manager. If I’ve got to see you work, then then that actually says more about me than it says about you or the person. I want to get your take on on tracking happiness. So if we know that it’s in our best interest to recruit folks and retain them, we’ve got to be flexible, obviously, comp has to be at least at-market rate, if not above market rate. Check. Got that. How do you, or how should your clients, how do they track whether or not they’ve actually hit the mark in terms of satisfaction or happiness?
Well, you know, there’s always surveys. We always try to keep our finger on the pulse of what’s going on with our nurses. We do have outside surveys. We won Clearly Rated’s Best in Staffing Talent Award for the last three years. So I like to think that we we do that piece and we do it well. It’s any of the basic human decency things that anyone wants, right? To be heard, to be valued, to be appreciated, giving them time to vent about a situation that they need to talk about because a lot of our nurses work independently. You know, for example, if it’s an entity that doesn’t normally have a, you know, is not a healthcare provider, for example, and they want a nurse to come in, again, this was an ask during the pandemic, often, right? To do screening, to help people with their self-administered tests, but we’re a financial organization, we don’t do healthcare, we don’t know anything about this. Well, you know, the nurse can come in and do that and, again, just have, take a breather, you know, it’s a less stressful, you know, lower requirement of, you know, you’re not there at the hospital, you’re not there at the long-term care facility. Again, that’s an option for nurses who want to continue that way and we try to find paths for for wherever anyone is at but that’s just it – you meet them where they’re at, you listen to their frustrations and you try to address them. If they’re, you know, their issue is, I’m, you know, just so tired of being at the hospital. Well, you know what? Perfect because that’s not our wheelhouse at all. Let me tell you all the non-hospital opportunities we have, or, again, I’m just being pushed so hard, I just want to let off the gas a little bit. Okay, fantastic. Have you considered private duty? Have you considered, again, school nursing, alcohol and drug recovery? You know, there’s a lot of positions that you can land in as a nurse. And again, stuff that I didn’t even think about as a baby nurse myself, you know, entering the workforce, because again, you just think, oh, hospital, hospital, hospital, or even, you know, for lower level nurses like LVNs, like myself, you know, a lot of those opportunities are in long-term care and are in skilled nursing. And it’s, you know, again, just kind of educating nurses like, hey, this is not the only, you know, show in town. There are other options for you. There’s ways that you can balance your life, you know. Let me hear you out and see what you want and then see what we can do to help plan that for you.
So first of all, I love that – being heard is so important. Just I mean, even if, I mean, there should be action that comes after that. So it’s great that you’re, you know, that someone asked you your opinion, you give them your opinion, but at one point you want them to take your opinion and do something with it. But the being heard thing really resonates for me. What do you think the, you know, in terms of like the diversification of nurses and all the different opportunities that one has, obviously, everyone goes through college on some level or another right? How much of this is academic that they need to do? Career center needs to do a better job of explaining all the different routes and all the different pathways? And an and or? What about community? When nurses get together, how should they be explaining and educating each other as to all the different things that are available to them?
That’s a really good question. That’s really interesting. It’s true. Nurses are definitely a cliquey bunch and there’s a lot of cross-talk about jobs and opportunities. And so I think that’s just it – is, again, you know, finding those cohorts of nurses. We do try to create a sense of community within Registry, but again, we’re virtual, we’re hands off. It’s not like, you know, you pop into the office, or you see us at the at the clinic, but we do try to stay connected, engaged with our nurses as much as possible and feed into that sense of community, which is, you know, do you know another nurse who would be interested in something like this? Because again, we are a bit of a cliquey bunch and we definitely do, it’s not a secret at all, that nurses will talk about what jobs they’re having, and what they’re getting paid on them and rightly so. I think that that, you know, that transparency is important, it’s good to know and to value yourself properly. I think that that’s, you know, some of the patterns that nurses who’ve been in the path for a long time get frustrated about, which is, you know, I see newer nurses making a whole lot more than me. How can I do that? You just have to ask for it. You just, you just have to use your voice, you know, and tell your employer what you’re worth.
It’s encouraging people to know their worth, but also giving them the kind of the tools to then, you know, make their voices known. And some of that’s tethered to their performance. And then they, you know, there’s nothing worse than asking for a raise, and you think you’re awesome and your team or your boss or manager or whatever, doesn’t think you’re awesome. You can think you’re awesome as much as you’d like. However, other people have to feel that way too. So there’s some training there. There’s some training that has to go on because I agree with you and I don’t want to make it a gender thing because I know there’s data there. I know Harvard has done studies around this in terms of negotiating for salary, but it’s almost like someone has to do a good job and maybe it’s academia or maybe it’s professional communities where it’s like we just got to, you know, here’s how to negotiate. It drives me crazy that people have to negotiate for jobs, salaries, because they should be finite. The idea that a nurse has to negotiate – it’s like they are being compensated on skills and expertise. The fact that they either are good or bad at negotiating shouldn’t impact. I think it’s just a way that companies have kind of held or hid pay inequities.
No, I entirely agree and I think that again, you hit the nail on the head – nursing is still a female dominated profession even though it’s become more equitable over the years. But it’s true, you know, as a society, it is harder for women to ask for their value and to feel confident in doing so and, again, if anything changed that, it was the pandemic. Our nurses at that point, definitely knew how to start asking for what they were worth.
And some ways thank God for that. Like good. If it took a global pandemic. And what’s funny about the, it’s not funny, but what I’ve learned about paying equities, through a lot of the research, is that men are tethered in reality. This might come as a great shock to you, Melissa. This was kind of told to me as a VP of Sales role or Chief Revenue Officer role is, is that a male and a female candidate will go into the same exact role, and just kind of generalizing this bit, but it was kind of a joke, but not – is men would go in and ask for crazy stuff like I want, I want a corporate jet, I want memberships, I want to go to Augusta, you know I want six weeks off, I need a half a million dollar expense, just not nothing. Crazy stuff. Whereas women in general are more practical and more pragmatic. And, again, why that’s used against them, it just drives me crazy because it’s like, you’re buying a skillset and experiences and potentiality. But you know, I didn’t ask you at that the very first one and NurseRegistry, I want to, before we end, I want to ask you a little bit more about that. Because you said you started in nursing and then came over to NurseRegistry. So tell us a little bit more about NurseRegistry.
Well, I started at NurseRegistry in 2012. We are a true nurse’s registry. And nurse’s registries have been around for years and years and years and years. In fact, they used to be the way that many nurses, again, would find opportunities outside of the hospital system or even before, honestly, even decades ago before the hospital system was as much of a conglomerate mess these days. But again, it’s a way for people who are, you know, kind of outside of that normal realm of nursing and like I said, during the pandemic, we saw a lot of just, you know, any kind of organization who needed a little bit of extra healthcare support. There’s also private individuals who need healthcare support. There’s schools and other places, you know, educational institutions that need healthcare support. And so we help, again, get those opportunities in front of nurses who wouldn’t see them otherwise, because they’re, you know, the, our clients don’t know how to advertise in a healthcare marketplace and find a nurse. And that’s what we’re good at, is talking to nurses and letting them know about, again, here’s what we have, but we’re not – one of our mantras is, you know, we have two sets of clients. We have our client, you know, the people looking for the nurse and our nurses, you know. We care just as much about getting our nurses’ needs met as getting the clients, you know, air quotes, clients’ needs met. Because again, that’s, that was our lesson of the pandemic. That’s where we had to double down and say, we’re not, we’re not talking, we’re listening, you know. You tell us and we’ll see what we can do.
Well, it sounds actually, it sounds, first of all, the utility is obviously pretty, really clear. But it sounds like you’re having fun, too, and you’re helping people. So thank you so much for carving out time and coming on the show.
No, thank you so much for having me, William. It’s been fun. I appreciate it.
Absolutely. And thanks for everyone else, for listening and listen next time. Thank you.
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