Surviving Workforce Reorganization

by Laura Wisniewski

Over the past several months there have been murmurs of budget problems at your facility. You are not overly concerned, having survived hard times in the past. The department director has requested a meeting with you for this afternoon. Upon entering the conference room, you are greeted by your director and the manager of human resources. There is a stack of papers on the table, including a file with your name on it. Your gut tells you, “This can’t be good!”

There is a sudden chill in the room as you are informed, “Due to budget cuts your position has been eliminated.” It doesn’t matter whether it’s referred to as reorganization, restructuring, managed redundancy, position elimination or a staffing cut; it’s time for you to find a new job.

How is this possible in the midst of such a severe nursing shortage? This phenomenon is occurring at an alarming rate and in a variety of practice settings. In the wake of managed care and reimbursement issues, hospitals and healthcare agencies everywhere are fighting for their survival. The nursing shortage itself is one of the primary factors contributing to escalating healthcare costs. Undesirable working conditions and staff dissatisfaction have lead to unprecedented turnover rates. The cost to the organization of recruiting and training a nurse is twice their annual salary.

Non-bedside support positions are most often affected; however, no one is immune. Entire units and facilities have closed as a result of financial difficulties. After rising through the ranks into the role of manager, educator or advisor; those most loyal to the organization are finding their positions eliminated. At a time in healthcare when this specialized knowledge is most needed, it is lost to the organization.  

Directly affected by a workforce reduction are nursing leadership, the individual and those left behind. The following are survival tips for each, as well as a warning to all nurses.      

Nursing leadership

The decision to decrease staff is one of the most difficult you will ever have to make. The team will closely observe and evaluate your performance dealing with this test of leadership ability. Your actions will greatly impact staff morale.

Deliver the bad news with compassion and resist the temptation to distance yourself.

Avoid using the statement; “this is not personal” as a defense. It feels very personal to the employee.

Thank the individual for their service to the organization. Offer to write a letter of recommendation and advice on next steps. Your employee may be overwhelmed and in need of assistance.

Throughout the transition maintain a high level of visibility within your department. Listen to staff concerns and encourage input on redistribution of the workload. Your guidance will help establish priorities as your team moves forward.

The individual

Above all else, respond to the news in a professional manner. Do not say or do anything that you will regret later. Try to maintain your perspective; being downsized is not like losing a loved one or being diagnosed with a terminal illness. Take a deep breath… you will get through this. Remember, there is a nursing shortage and you will find another job. 

It is rare for healthcare organizations to provide a severance package, adequate notice or job placement assistance for nurses. Most nurses are not financially prepared to deal with a sudden job loss; for them the pressure to find a new position will be urgent. If you have saved enough money to cover several months’ worth of expenses,  you can afford to be more selective during the job search process.

The smoothest transition would be to find a new position within your organization. If  this is not an option, strategically widen your search by tapping into your network. Ask other nurses about job openings in the area. Be open to the possibility of training for a new career path in nursing.

Those left behind

Am I next? How will we get all this work done with less staff? Trust that this decision was made for the survival of the department or organization. Resist the temptation to grumble; instead offer to assist with the transition. If your director has not established clear priorities, ask which projects will require your immediate attention.

You may feel awkward and not know what to say to your coworker. It is human nature to experience a sense of relief that your job wasn’t cut. Share any information from your network about possible job openings, write a letter of recommendation or organize a small celebration of your time together as colleagues. Your support will be greatly appreciated.

The resilient career

Nurses can not afford the luxury of being concerned with only their immediate work environment. Seniority is no longer a safety net in any profession. Skill diversity, flexibility and the ability to adapt to change are essential in today’s marketplace.

Are your resume and portfolio up to date? How strong is your professional network? What education or training could give you a competitive advantage?

The current healthcare environment offers countless opportunities. It is critically important that nurses educate themselves regarding finance and reimbursement issues. Learn the language of business and become a trend watcher. The prepared nursing professional will successfully ride whatever wave of change lies ahead.