By Ashleigh Hollowell

St. Louis-based SSM Health adopted a contract on-demand nursing model with workforce partner ShiftMed in 2023 to supplement gaps in staffing. Since then, the hospital has converted about 100 on-demand nurses into staff, said chief nursing officer Jennifer Garnica, RN, BSN.

Like many health systems, the staff at SSM Health was strained by COVID-19, which exacerbated the already unfolding issue of a nursing shortage nationwide, she explained. That prompted the need for more staff to help existing nurses manage patients and workloads.

While there can be hesitancy or resentment when bringing in outside staff or travel nurses since they are often higher paid than full-time staff, the addition of on-demand nurses to help at SSM Health was well received, she said. Unlike some other staffing agencies, ShiftMed's on-demand nurses are from the surrounding area, so many of SSM Health's current nurses knew or had already worked with the on-demand nurses at other hospitals in the past.

"I think because they have the relationship with many of these folks, it feels really supportive," Ms. Garnica said.

The staffing model is "kind of like having Uber," she said. "Maybe I paid a little bit extra for someone to drive me, but I didn't get a DUI. Sometimes it's just safer. It's on demand."

After using the on-demand nurses for a little while, it became clear to Ms. Garnica that the new staffing model was also a good opportunity to connect with nurses and recruit them. The biggest lift here, she said, is often from other staff nurses who connect with the on-demand nurses and tell them to come to SSM Health.

The health system also offers incentives like sign-on bonuses, flexible scheduling, and shift incentives.

The key piece to SSM Health recruiting over 100 on-demand employees and converting them to staff was engagement and including these nurses in conversations and treating them like staff. SSM Health has also prioritized the flexible scheduling model, which is attractive to on-demand nurses.

"We work really hard to make sure that our nurses are included in decision-making, so the more that we can get them to the table and help them feel included in decision-making around their practice helps," Ms. Garnica said. " I also do think that flexible scheduling and flexible options are key to a good retention plan… We want to be able to offer that same flexibility for our staff because life changes. Often many come into nursing as a young, single person who can work all the time, and maybe in five or 10 years, then, oh gosh, I got married, and I decided to have a family, and even next thing you know, those demands change. And what are my options so that I don't have to walk away from a profession I like?"

The core of success with this experience, though, really stemmed from finding the right partner, Ms. Garnica stressed. ShiftMed's locally sourced, on-demand nurses integrated well with the hospital's permanent staff, which made the experience feel like "you're at the table together, making decisions that benefit our patients and our nursing staff, and that's really what you want in a staffing partner," she said.

"I would just encourage folks to embrace innovation and think outside the box. I think it's hard for everyone, even me, when you've been in healthcare for two decades …it's hard sometimes to wrap your brain around doing scheduling differently or doing other things different," Ms. Garnica said. "I think as leaders and healthcare executives, we've really had to embrace that the workforce is different, and the needs are different, and I think that we have to adjust to that versus expecting folks to adjust to us."