In nursing, this shortage has especially heightened of the last few years, as the older generation of nurses has started to retire. Moreover, the good economy is actually bad for the nursing shortage, Salka says, because either nurses go part time or retire. Another factor is younger nurses tend to work shorter hours than the people retiring.
All together, it’s led to a brutal shortage. AMN did a survey in 2017 of more than 3,000 nurses, 48 percent said it was worse than it was five years ago, compared to 37 percent in the same survey from two years prior. Salka estimated there was a shortage 200,000-300,000 nurses and about 100,000 physicians. Future projections tend to vary, but most are fairly grim – in 2015, the Bureau of Labor Statistics projected a need of more than one million nurses by 2024.
Salka sees a few solutions to the problem. For one, she notes that more than 50,000 qualified candidates gets turned away from nursing school each year. Quite simply, there’s not enough faculty to teach them. “So one thing that can be done is to try to create more nurses with PhDs and master’s degrees,” and pay them accordingly, she notes. Another solution is to keep the older nurses working.
“We have to keep them in the workforce longer without overburdening them. So how can you create flexible work schedules and give them work that’s not as physically demanding? To be lugging patients around can be very taxing on you physically,” she says.
Another avenue, especially in regards to the physician shortage, is technology. Telemedicine, Salka notes, is picking up steam, becoming reimbursed by health insurers and more doctors are getting on board with it. “It will give us greater access to care at a lower cost. And we just will have to do it in order to make do with the shortages that we’re going to be encountering,” she notes.
Diversity and approachability
Diversity is one of the core values AMN is hoping to embody under Salka’s leadership. As the company has grown in size, it’s implemented structure and programs to ensure it’s continuing to focus on diversity inclusion, she says. As an example, the company has run data analysis to ensure it’s being as equitable as it says it’s being.
“The first piece of advice I would have for people is to really put a lens of metrics on what you say you want to do. And I think that’s a mistake that people make is they have programs and nice mission statements and charters, but they forget to actually measure those statements. Start with the baseline to say, ‘Where are we today?’”
“And I think that’s a mistake that people make is they have programs and nice mission statements and charters, but they forget to actually measure those statements.”
Salka says two-thirds of the entire workforce at AMN are women and about 62 percent of its supervisors and managers. At its C-Suite and corporate director level, half of the executives are woman. On the ethnicity front, Salka says the organization has a “ways to go” and about one-third of the team is non-white.
Along with measuring diversity with metrics, Salka makes sure to interact with employees at all levels and make herself approachable. “You might have this nice little mission statement, but if you aren’t actually seeing and hearing inclusion happen on a daily basis throughout the organization, then that mission statement doesn’t mean much. And so one of the things that I do is I walk the floors a lot,” she says.
Salka credits her dad with the approachability she brings to her job at AMN. “I’m my dad’s daughter for sure, because my dad would stop and talk to any stranger on the street and strike up a conversation. And I’m the same way in and out of the office.”