As the hospice labor pool continues to dwindle, employers are seeking to understand what their workers need to continue on in the field.
Researchers from Transcend Strategy Group have developed a stratified “hierarchy of needs” for hospice workers, based on data showing what those employees value most. Transcend found that the top priorities for hospice staff include financial security, safe working conditions, being empowered to focus on what matters, a sense of belonging, purpose and passion, and fulfillment in their work.
Safety was of particular concern, Transcend found. The company is an Ohio-based senior care research and consulting firm.
“As we think about as a shrinking caregiving workforce, the folks that we are attracting in the space have greater concerns about their safety in the home. It’s a significant area of concern for employees and a significant area of risk for employers,” Transcend President and CEO Stephanie Johnston told Hospice News. “So spending some time thinking most urgently about their processes and their infrastructure to support people while providing care in the home, that would be the most urgent factors we are seeing coming through the research.”
But a range of occupational hazards have existed since long before COVID.
In 2007, 27,400 recorded injuries occurred among close to 900,000 workers providing health care in the home setting, according to the National Institutes for Occupational Safety and Health (NIOSH).
Some of the risks include fall hazards, car accidents, needle sticks, blood-borne pathogens, physical or verbal abuse, aggressive pets in the home, latex sensitivity, and a range of others, NIOSH reported.
“A lot of the specific safety concerns voiced by employees had to do with infection risk. But I think the bigger fears were more universal, just like physical safety from harm from a frustrated patient or their family,” Dave Hochanadel, director of brand strategy at Transcend, told Hospice News. “The horror news stories that you that you see can kind of warp people’s perspective about the degree to which that happens. A lot more of it seems to have to do with that or even just dirty, unfamiliar surroundings, and entering a home environment without knowing what they’re getting into.”
Most hospices have safety protocols in place, including those required by the U.S. Center for Medicare & Medicaid Services (CMS), the U.S. Occupational Safety and Health Administration (OSHA), and various state laws.
But implementation maybe better in some companies than others. A significant number of hospices offer little safety or workplace violence training to clinicians entering patient homes, a study published in the Online Journal of Issues in Nursing found.
A large contingent of works that participated in the Transcend research also indicated that they needed a sense of belonging and a feeling of connection with their colleagues, including good communication practices.
“Second only to [safety issues] would be the component that we’re talking about clarity, and process and communication with team members,” Johnston said. “People are craving this. People are craving a sense of connectivity and control, and employers that can deliver on that will stand a better chance of attracting and retaining their best workforce.”
As contact and camaraderie began to erode due to pandemic isolation, most people in hospice started to leave their jobs, Johnston told Hospice News.
Hospice employees also value efficiency very highly, which ultimately flow into two other top concerns: the ability to concentrate on “what matters most,” as well as a sense of fulfillment. In a nutshell, hospice workers want more time to focus on their patients and spend less on administrative tasks.
Staff want an employer who will supply them with the tools and processes they need to do their work efficiently and effectively, according to the Transcend report.
Other high-ranking considerations were greater flexibility and work/life balance, support from leaders — and, of course — fair compensation and benefits that enable them to support themselves and their families.
“Far more than the overall U.S. workforce, the nursing workforce in particular is looking for meaning beyond just a paycheck. But if they’re getting stuck by something, like the fact that they don’t feel like their their basic financial needs are being met,” Hochanadel said. Or they don’t feel like they’re in a physically or psychologically safe environment, or that they’re too bogged down with poor processes, poor communication, and poor leadership. Those are all going to be barriers for them to work their way up to that apex of fulfillment and finding purpose and passion.”