HCA Healthcare looks to address staffing shortage with purchase of Galen College of Nursing

It’s been a rough two years for Doug Goodman.

The vice president of human resources for HCA Houston Healthcare quarreled like his colleagues in other hospital systems scrambling to staff hospitals amid a shortage of nurses.

Trying to solve the puzzle of providing topnotch health care in an ever-changing personnel landscape, his hospital system may have helped him and the entire Gulf Coast area with a novel idea—they bought a nursing school.

With the purchase of the majority stake in Galen College of Nursing, one of the nation’s leading schools, the region could in the next three to five years see an influx of up to 1,500 graduate nurses each year to help feed the fragile workforce.

“HCA Healthcare is committed to being the premier career destination for nurses,” said HCA Healthcare’s senior vice president and chief nurse executive, Jane Englebright. “Galen’s graduates will help us nurture a pipeline of next-generation nurses and nurse leaders to deliver effective, evidence-based, innovative care to our patients.”

While the purchase was complete in January 2020, Goodman was happy to announce that Galen executives in conjunction with HCA Healthcare real estate teams are currently pouring over demographic information to determine the location of the first Galen College of Nursing in Houston, one of the largest markets in the country.

“This is really exciting for us here in Houston,” he said.

“In the fall of 2023, we will have a Galen brick and mortar school here in Houston. In that program, we will have LVN’s, an LVN to RN bridge, and an RN to BSN bridge. Our goal is to have approximately 1,500 students on campus,” he said.

He speculated that there would be some ramp up before they hit the target of 1,500, but with the huge need in the Gulf Coast area, he didn’t feel like it would take long.

Graduates will generally be free agents able to work wherever they want, but Goodman said they hope to build a relationship worthy of a large majority of them staying with HCA.

“They will have access to our leaders, sit in on Q&A sessions, training education and get a sense of the type of leader that we hire. Then they’ll want to work here,” he said.

With several campuses spread across the nation, the strength of the network and connections for graduates will be robust.

HCA Healthcare Gulf Coast has 13 hospitals spread across greater Houston and three in South Texas—Corpus Christi, Rio Grande, and Valley Regional Medical Center.

Within the Gulf Coast Division alone, Goodman said they have approximately 6,000 nurses.

Becker’s Hospital Review in 2020 listed HCA Healthcare as the largest health system in the nation with 186 quality quality.

Scarcity before COVID

The nursing shortage around the world and in the United States was already in a crisis mode before COVID-19. For years, health care leaders and community college presidents petitioned the Texas state legislature to allow them to add a Bachelor of Arts degree in nursing. In 2003, the legislature granted a pilot program to three community colleges allowed them to offer up to five degree programs in applied science and technology fields. State universities resisted, fearing competition, duplicity and the quality of degrees that would be conferred on students from those programs.

In a policy brief penned for the Education Commission of the States by Mary Fulton in February 2020, she reported “about 130 public, two-year institutions awarded bachelor’s degrees in 2016-17,” but Texas legislators were still resistant and not until June of 2017, did Gov. Greg Abbott signs the legislation allowing all community colleges across Texas the ability to offer up to five degrees. Lone Star College was among the first to graduate their first flight of RN to BSN candidates in August of 2021. The college had scripted a tough, academic calendar that was compressed from two years into only one with three lengthy semesters to meet the expedient need in the workforce.

Unfortunately, it’s still not enough. The workforce need was aggravated when COVID-19 struck, sending many health facilities into crisis mode.

Poaching talent

Nursing shortages are nothing new to the health care system.

“We’re on par with the rest of the country with experiencing nursing shortages and turnover,” Goodman said.

However, losing talent to other facilities or programs around the city wasn’t a big problem until COVID and the lure of more money.

While the health system suffered attrition because of nurses who offered COVID-19 themselves, the shortage was further exacerbated by leaving for opportunities to travel around the country during the height of the pandemic to work in hot spots.

“It was giving some of our nurses and other health care workers the ability to do short term assignments, and to make a lot of money,” said Goodman. For some, he said the amount of money was life-changing and at the least, significant.

“What we saw was that once a nurse took on one of those travel positions and was used to making that type of money, and during such a condensed period of time, we began to see a trend that they felt no need to come back and work the rest of the year,” he said. They kept renewing those short-term contracts. That was the case during 2020 and 2021.

The departures didn’t end there.

Health care systems also saw attrition with physically and mentally exhausted nurses who experienced depression and anxiety, forcing many to reevaluate their life and career.

“Houston being the fourth largest city in the country boasting the largest medical center in the world, we are always a target for those contracting travelers to do assignments around the country. It’s been challenging and we’re certainly feeling the aftermath,” Goodman said.

The HR exec said they recruit heavily in Houston but also have an enormous presence outside of Houston as well. This summer they will host 80 nurses from their international partnership—still, a drop in the bucket for the need not only in their system, but in others across the country.

Changing course

At one point, health systems around the country were set to follow the recommendation of the Institute of Medicine who in 2010 issued “The Future of Nursing: Leading Change, Advancing Health” report. The paper highlights the need for change in nursing education and recommended an increase in the number of registered nurses with a bachelor’s degree in nursing to 80 percent by 2020. With COVID, that initiative fell by the wayside. Most hospitals and HR directors were scrambling to a workforce present to deliver health care in the worst situation they had kept in their lifetimes.

“We realized we didn’t have the talent, and the supply so we had to be very creative,” he said. That meant hiring anyone whether it’s a bachelor’s prepared, a master’s prepared, or associate degree nurse.

“Even if we hire an associate degree nurse, within HCA they’re still going to provide great clinical care and expertise for our patients,” he said.

The system also offers reimbursement benefits, flexible scheduling, and partnerships with accelerated bridge programs.

“Even though we had to modify the type of colleague we hired, it’s still helping us in a time where we saw high demand with low supply. Now we can give back to these individuals where they can cultivate relationships with us. The sky’s the limit within this company,” he said confidently.

Settling down

With the pandemic and COVID numbers in decline, Goodman said they are in a better place for now.

“I can tell you that since the beginning of January, we have seen month over month reductions in our RN turnover. It’s going to take a while to get up to where we were, but we have the leaders, and we have the resources in play to be able to do that,” he said.

He estimated that the Gulf Coast region had the largest turnover in the division than any other in the company, but despite it, they retained number one in employee engagement surveys.

“I think the labor market has been totally disrupted across the country. It’s going to take probably about three to five years for us to be able to rebuild, and the reality is, things just aren’t going to look like they did, pre-pandemic for anyone,” Goodman said.

Goodman, who’s been with HCA for 15 years, said that without a doubt, the last two years have been the most challenging. But, the way health care will look in the future is exciting to him.

“I’ve kind of been recharged and rejuvenated. We’re going to have to be more creative and think of alternative ways to take care of our patients.”

dtaylor@hcnonline.com

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