#50 - Nursing Staffing with Matthew Mawby, CEO and CO-Founder at StaffHealth

Jeff Terry:
Hello and welcome. I'm Jeff Terry. Delighted to be joined today by Matthew Mawby, who is the CEO and co-founder of StaffHealth, who joins us today from North Carolina. Hi, Matthew.

Matthew Mawby:
Hello, Jeff. How you doing?

Jeff Terry:
Perfect. Thanks for joining. Looking forward to this. Hey, I wanted to start, I know a common topic of interest to our audience is the nursing staffing challenge. You live in that world. If you don't mind, let's just unpack that a little bit. What are you seeing in the staffing world? Are we still in shortage? Is it getting a little better, getting a little worse? And for the audience, we're recording this August 29th, 2022.

Matthew Mawby:
Thanks, Jeff. I mean, it's a great question that a lot of people ask on a daily basis. The fact of the matter is, is that we were in a slight nursing shortage before the pandemic. The pandemic, unfortunately, just added to that stress level of really finding nurses, keeping facilities staffed at proper levels. On top of that, there's a lot of factors that actually came in play through the pandemic that added more stress to that shortage. We're projecting, I think, to about to lose 1.2 million nurses by the year 2030. Roughly of that number, actually we have a lot of baby boomers and a lot of people will be retiring, and then choosing early retirement.

About 4.7 million of healthcare workers will retire by 2030 as well. We're talking some pretty staggering numbers here. Just to highlight a little bit on the pandemic, and I know the pandemic has accelerated and exacerbated this whole kind of field or industry, but it's changed a lot of things, Jeff. What I mean by that is people were stressed out. There's a lot of mental health issues. There was a lot of people who chose early retirement. There was wage problems. There was people who didn't want to deal with COVID during that time, and they couldn't even get a break during their shifts because the facilities were just so short staffed.

When a facility gets short staffed, just a little background, it affects every level. You have CNAs that are a support system to the nurses, and then it just goes up and up and up. When the ratios are very unsafe and you have so many patients, for one nurse, that workload is tremendous and it causes issues. It causes safety concerns. It causes liability problems. It's definitely something that we need to take head on and find innovative solutions from what we found, including technology, just to help out and to minimize these numbers, get new nurses onboarded, get new nurses interested in nursing again.

That's another thing. It goes on and on. I know we can talk about this all day long, but it's definitely an issue. Here at StaffHealth, we're obviously trying to tackle it head on as well along with everybody else. We're all in the same boat here together. That's where that's at with it.

Jeff Terry:
One thing that struck me, because we serve health systems West Coast to US, East Coast, to the US, Canada, the Netherlands, the UK, and almost all of our health systems are struggling with those shortages. I find the fact that it's so international is remarkable. I guess on my mind, you probably see a lot of data in your role, different metrics that you guys watch and things. I ask this because we all see the world through our little straw. I can tell you 10 anecdotes from the clients I serve. Do you have any sense if we've turned the corner, where we are sort of in working through this?

Matthew Mawby:
It's so tough to tell, Jeff, at this point. The reason I say that is because it's innovation and it's using a lot of technology. But when it comes to the nursing shortage, it's something that's not going to happen overnight. We need to understand that. We can put band aids on it all day long. We can find short-term solutions, but what about that long-term impact? A big part of that is getting people to be interested in nursing again, graduating from nursing school, going to nursing school actually in the first place. There's a funding out there, a lot of tuition reimbursement programs that are being offered. There are ways that schools are enticing people to join the nursing profession again.

I do think we're making headway. One of my personal opinions about it is throughout the past two years, I think that we went five, 10 years ahead almost in the healthcare space just because we were forced to find solutions and forced to put our funding and our resources in the right places. Technology is a huge part of that, especially when it comes to doing speedy staffing. Have we turned a corner? Yes, we have. Is it noticeable yet? That's very tough to tell this early on from our point of view. But with some simple solutions and listening to the nurses and what they need, that's a big factor.

Jeff Terry:
I want to get to that. But maybe as we get into that, you went to nursing school. By the way, I love nursing. What motivates me to do the work that I do is serving nurses and helping them in the work that they do. What do you love about nursing? What inspired you to go to nursing school?

Matthew Mawby:
It's a passion of mine. I mean, growing up, I was five years old when my little brother was born with major handicap issues, premature. We had to learn sign language when I was like seven or eight. He's had 80 operations. The consistent, I guess, factor that you can say throughout my life was the nursing piece of that, because the nurses are there for you when nobody else is. You are at your worst of the worst, right? I mean, you need somebody to believe in you. You need somebody to get you over that hump. That's what got myself, my family and my brother through a lot of those issues throughout life on the long-term scale.

And that's why it's so important for nursing right now at the bedside. We want to carry that passion for nursing along everybody that we staff, all the nurses that we have and we see and touch, or whatever it may be. It's a make or break when these patients are just at their worst or their worst and it's just encouraging and it's needed.

Jeff Terry:
I love that statement, nurses are there when nobody else is. That's the nature of the beast. Certainly if you're an inpatient, there's always nurses and that's looking after you and what tremendous work they do. Thank you for that. Clearly this is a big problem. Lots of people are working on it. There's policy issues and incentive issues, all sorts of things that are playing out, but StaffHealth is trying to help as well. Would you mind describing StaffHealth, the work that you guys do and what it is that you bring that's distinctive?

Matthew Mawby:
Here at StaffHealth.com, we help facilities who are in need of staffing solutions, especially short-term staff. We do offer long-term and travel as well, but we're here to help... We're about speed here. Let me start with that. If you're short staffed at your facility, we want to send people in as fast as possible. Let's say if you have a nurse that showed up, got tested for COVID, for example, and was asymptomatic and got sent home, well, that's one nurse down that you are for that whole shift. Your ratios are crushed. We developed an app called NurseShifts. We listened to the nurses. What did the nurses want during all this?

They wanted work-life balance. They wanted wage increases. They wanted to be paid faster. They wanted flexible scheduling. A lot of these nurses have children, childcare issues the pandemic sprouted, right? Everyone was short staffed. Early retirement as well, that led to a lot. But overall, we're here to find and be part of that solution to offer very fast services for when these facilities need it the most. That's why our app offers that nurses can pick up shifts that they want, when they want. They can work when and where they want. We offer same day pay so they can work a shift, get paid hours later.

Communication is a big one. We offer communication between us, the nurses, the client, which is the healthcare facilities. We're trying to use technology to our advantage and really be a solution rather than a burden to these healthcare facilities that really need help.

Jeff Terry:
You guys provide the app, and then the nurses are able to register in there. Do you also then work with the providers so that your app is the broker between them?

Matthew Mawby:
Absolutely, Jeff. We take it out of the administrator's hands, right? Because all this takes time and cost money. When you're talking about recruiting, then onboarding, vetting, collecting credentials, you're talking about sometimes it takes three months just to onboard one person for a permanent role. Here at StaffHealth, we have people that do this. We have a team that does this every single day. We're doing all that for you. We're vetting these nurses. We're trying to find the best cultural fit for your facility, your healthcare facility, reliable people. Like I said, it's speed before is that let's just say, Jeff, you need a nurse right now or maybe you need one for tonight.

We can post that on the app, and we have a database of 98,000 nurses who we could reach out to, and then we will fill that position fast. We'll get the credentials over so you have them immediately through the app, and then you guys are there. You don't have to sit there on the phone, call. You don't have to have your director of nursing sit there and make calls all day. It's taking that gap out, and that gap is time. Time is money. It's really minimizing that. It works tremendously for all healthcare facilities that we work with.

Jeff Terry:
I can see the value of that, making it easier, more frictionless, particularly in that scenario, I need a nurse for tonight who's credentialed, who's available. You mentioned something very interesting. I don't know that I've come across before, which is you're vetting them for credentials and reliability and flexibility of scheduling, but also for culture. That's really interesting. Do you mind sharing how you do that?

Matthew Mawby:
We all have challenges and some of the challenges that we've seen in this, I guess, industry, when you have people from the outside going inside to an internal facility who may have a group of people they've worked with for 20 years, right? Anytime you have someone new come in, the dynamic changes a little bit. Our goal is to send the right people in so that dynamic changes very minimally or not at all. If we can learn a facility's culture, what they need, what they believe in, what their values are, what kind of people they want to hire, we can use that to our advantage and actually vet people for those skillsets or values or whatever it may be.

Therefore, it causes more of a seamless entry of a new candidate, a new nurse going into a facility, and it gives them the chance to hit the ground running, right? I mean, I'll be honest, there's been bullying. There's been jealousy issues. There's been, "Hey, who's this new person, all of a sudden for this one shift? How much are they getting paid? What do they do? Where do they come from? Are we being fired? What is it?" There's a million things that could go on that really could disrupt the floor of a facility. We've seen it in the past with us. We've seen it with other facilities, other companies.

We've seen it across the board. We're really trying to minimize that to make it effortlessly as possible so people just have a good vibe in the facility, because that means a lot to these people. It really does.

Jeff Terry:
Well, let me ask one last question there that you brought to mind is... I hear that question asked a lot. I'm curious your experience with it. We've always had travelers, but we've had more traveling the last couple years, which means, yeah, you do get that scenario where you could potentially have a big disparity between what two people do in the same job shoulder to shoulder are making on a given day. Not a new phenomenon, but more frequent of late. What have you seen as maybe good approaches to handle that?

Matthew Mawby:
The first and foremost approach is you got to know what you're stepping into as a nurse going into that environment. You might not want to talk about pay rate. You might not want to talk about those details that are personal to you, but these are facts that we all are facing in this industry. I mean, from 2020, 62% of nurses became travel nurses. That's a lot. It's a lot. I mean, I've seen it firsthand, people leaving healthcare systems that they've been with for years and years and years because they need the money. It comes down to money. It comes down to what's good for their family. It comes back to that flexible scheduling that, hey, I can go when I want and come back.

I have childcare. All those things determine whether an individual, a nurse, is going to go, "Hey, I'm going to go travel, or I'm going to go work for an agency, or I'm leaving my current spot." With that being said, I mean, there's a flip side to that too is, how sustainable is that in reality? Can these healthcare systems keep giving away $20,000 sign on bonuses to just be a body to fill in the spot? It's definitely a challenging spectrum that we're in when it comes to the travel nurses. And on top of that, they're needed. They're needed and that decision is in the nurse's hands now.

They have the ability to control and say, "Hey, I'm going to take XYZ amount of money because I can and I need it," and then that causes a really big bottleneck effect in our industry because... One transparent fact and honest fact is that there's very large healthcare systems that can afford that affordability, but a huge percentage of the population of healthcare facilities are nursing homes and caring for the elderly, postacute, facilities that don't have the budgets for that. Who's winning in that balance act? Is it saying, "Hey, if you have the money, you can get the better nurses, or you're getting more nurses?"

But back to the main point of your question, it's very difficult. Unfortunately, people judge. If you and I are working at the same facility and I'm making 30 bucks an hour and you come in and you got a $5,000 sign on bonus and making $60 an hour to do the same job I'm doing for the next 12 weeks, that's challenging. It's challenging. That's what brings up friction in the workforce and cultural issues.

Jeff Terry:
One technique that I saw from a health system we serve is where they do an internal traveler program where they sort of pay people the traveler rates, but they have to take the dirt and the tough shifts that people don't want to take, but they keep them in their system. I think in the end, the things you mentioned, we've got to create the right incentives.

We've got to invest in the pipelines and we've got to have systems like yours so we're getting the workforce to where they are optimally so maybe we're less dependent on travelers, because I don't think any of the health systems can afford it in the long run. I mean, the numbers you hear are staggering. You understand why they pay them, but I don't think it's sustainable in the long run.

Matthew Mawby:
I completely agree with you on that one. I mean, I see it on a daily basis. I mean, how far can we go? And then one outcome of that that we're starting to see that is even a bigger challenge for us on our side, and I'm not meaning to take any side here at all, but nurses are expecting to get paid more now. If you're working travel for a year and a half and you're making $100,000 more than you did the year before, let's say, they're expecting to get that now. How are they going to go back to where they were? We're seeing a lot of that. It's unsettled conversations per se, but it's concerning. It really is concerning. Where is that fine line of payment, of income, because wages are an issue.

Jeff Terry:
Absolutely. Well, there's no easy answers to that, but I certainly understand the phenomenon. I'm glad that people like you and a lot of other people and us to some lesser degree, but all of us are working on helping with that problem. Because there's one thing obviously for sure is we need our great nurses to be well taken care of and available. Awesome.

Matthew Mawby:
Understood. We all got to work together and bring the passion back in nursing and really get the bedside back to normal, back to where it was, if not better. I know you guys are working on a lot of technology as well. I think technology is going to be the future of our industry. It really is. I mean, I know it already is, but now in terms of staffing and keeping staffing levels and patient ratios and getting shifts covered fast, I mean, it all starts with that. We're here for that too. We're here to do part of the solution.

Jeff Terry:
Brilliant. Well, I appreciate your coming on, Matthew, and sharing your thoughts. It's great meeting you and congratulations on the work and the progress with StaffHealth.com.

Matthew Mawby:
All right. Thank you, Jeff. You have a great day. I appreciate you having me.

Jeff Terry:
You too, man. Cheers.

Matthew Mawby:
All right.

Jeff Terry:
Thank you, everyone. With that, we'll close the podcast.