A long-looming nursing shortage — exacerbated by the near-relentless toll of the COVID-19 pandemic — means more hospitals and health systems are offering hefty sign-on bonuses and other incentives in an attempt to attract talent and fill in the gaps.

Earlier this week, UPMC was advertising nearly 800 open nursing positions and 150 in-patient care support.

Hundreds of positions came with sign-on bonuses, some up to $15,000 depending upon experience, and Allegheny Health Network was offering similar bonuses.

Excela Health’s job board shows bonuses ranging from $2,000 to $10,000 depending on the position, and officials said recently that recruitment and retention are at the top of the list across all positions.

”People think that these sign-on bonuses are going to pull people out of the woodwork that aren’t working,” said Claire Zangerle, chief nurse executive at AHN. But, she said, “it hasn’t been highly, wildly successful.”

Most bonuses depend on experience level, and those with the most experience aren’t always willing to leave their current job because accrued perks like vacation time and paid time off might not be as hefty starting out at a new employer.

The shortages — and the incentives meant to help fill them — are not unique to Western Pennsylvania. In Philadelphia, Temple University Hospital has proposed increased pay rates for nurses willing to float among departments as needed and a $20,000 sign-on bonus for experienced emergency nurses, according a recent report from The Philadelphia Inquirer.

Across the country, hospitals and health systems are offering all that they can to fill the dire need, often as covid-19 cases are surging.

In Oklahoma, OH Health is offering retention bonuses to current nurses as well as what’s being called the Weekend Program, which gives nurses 72 hours of pay for 48 hours of work if they do four 12-hour weekend shifts each pay period, according to KFOR-TV. The health system is facing a 19% vacancy rate.

In Nebraska, CHI Health is offering an extra $30 an hour to nurses who pick up extra shifts in the emergency department or women’s or

maternity units, according to KOLN/KGIN. St. Charles Health System in Oregon is offering a $10,000 sign on bonus, and the hospital is running two new residency programs to pull in new nurse graduates, reported KTVZ.

”Staffing is a major pain point for health systems right now,” said Lauren Rewers, a researcher focusing on nursing at the health care research firm Advisory Board. “It’s kind of always a pain point for health systems on and off, but at this moment, it’s gotten really acute.”

Some of that comes from the COVID-19 pandemic: in an aging nursing population, some nurses retired early out of their own pandemic health concerns, while others left to go to staffing agencies that would send them to high-paying covid hotspots.

Others still, facing the trauma and burnout wrought by the pandemic, left the industry.

{p class=”krtText”}Rewer said the full picture of the pandemic’s effect on nursing isn’t clear yet.

{p class=”krtText”}”The dust hasn’t settled,” she said.

{p class=”krtText”}She said sign-on bonuses only go so far, as many vacancies are for more experienced positions.

{p class=”krtText”}”The labor market is really tight around those positions because there are just not enough specialized registered nurses to go around,” Rewer said. “If you’re a health system, staffing is really life or death.”

{p class=”krtText”}Because those higher-level positions need to be filled with someone experienced, there is concern that the new-hire incentives and sign-on bonuses could backfire.

{p class=”krtText”}”Some of our people are ticked,” Zangerle said. “They’re like, ‘What the heck? You’re giving Jane Smith $15,000 to come here, and I’ve been here this whole time.’”

{p class=”krtText”}She pointed to retention bonuses rather than sign-on bonuses. That’s something Rewer said her firm also suggests, though she acknowledged there are pros and cons.

{p class=”krtText”}”I think now is the time for employers to think about how to differentiate themselves in their markets in ways that aren’t just offering sign-on bonuses. That could be in the form of total rewards; it thinking about, ‘Could offering childcare be a way to differentiate yourself as an employer?’” she said, pointing to virtual care and flexible scheduling as other possibilities.

{p class=”krtText”}Zangerle said it’s important to look at the reasons behind why some nurses who are licensed or license-eligible aren’t working.

{p class=”krtText”}”They’ve chosen not to work, and they’ve chosen not to work for a variety of reasons,” she said. “Why are they choosing not to work? Is it because of our health systems? Is it because we’re not paying enough? If you say no, we know we’re paying enough, is it flexible scheduling? You’ve got to have more flexible scheduling.”

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