Overworked. Understaffed. Burned out. Whether they’re frontline doctors and nurses risking their own lives to treat patients amid the COVID-19 pandemic, or back-office workers managing the fallout of spiking patient numbers during a significant labor shortage, healthcare workers are facing unprecedented challenges. 

According to a Washington Post-Kaiser Family Foundation survey of healthcare workers in February and March 2021, 61% said the coronavirus-related stress has negatively impacted their mental health and 55% felt burned out. “Everybody feels the stress,” said Tim Toterhi, founder of Plotline Leadership, an HR consulting and career coaching firm.

For Human Resources leaders, these unique challenges and major disruptions require renewed focus on recruitment and retention strategies as they also grapple with what to do about vaccine mandates, among other issues. Here are some of the top HR challenges in the healthcare industry — and how to address them. 

Recruitment and Staffing

Even before the pandemic, the healthcare industry faced a labor shortage. A February 2020 report from the Keck School of Medicine at the University of Southern California cited an aging workforce with many healthcare workers retiring and the limited capacity of education programs among the reasons. Now, according to the US Bureau of Labor Statistics (BLS), the number of open jobs in the sector is only ticking up. The BLS reported nearly 1.54 million job openings in healthcare in August 2021, up from about 1.1 million in August 2020. 

To bolster recruiting efforts, it’s important to remember why healthcare professionals entered the profession in the first place, said Rafael E. Salazar II, an occupational therapist, principal owner of patient retention strategy firm Rehab U Practice Solutions, and President and CEO of Proactive Rehabilitation & Wellness, a physical rehabilitation clinic. 

Healthcare professionals want to help people, Salazar said. They’re also risk averse, choosing an industry that they’ve been told will be secure and stable because there will always be sick people to treat. “When you’re talking about recruiting employees or advertising positions, you want to have messaging in there that acknowledges that,” he advised.  

When recruiting workers, don’t just list the position’s duties in the job description; tie it back to the organization’s mission. “When we advertise for positions, that’s what we talk about,” Salazar said of his own clinic. “‘Come join a team that is working every day to help patients overcome their pain and get back to [their] normal lives.’ That [type of message] is going to [recruit] the type of people that you want.”

At the same time, acknowledge that while there will be plenty of work, it won’t always be easy. Staffing or funding shortages, even without a pandemic, can make for a difficult work environment, particularly in the healthcare industry. To counteract these stressors, pair new employees with existing ones through onboarding mentorships or partnerships, Salazar recommended. Promote these programs, which can build an atmosphere of teamwork and support, during the interview process.

Make sure to relay, Salazar said, that “even if we are going to be overwhelmed and it’s going to be heart-wrenching at times, we’re going to walk each other through it.” 

Employee Burnout and Retention

Stressful working conditions in healthcare organizations are leading to burnout and high turnover rates across the industry. Amid an already existing nursing shortage, 22% of nurses say they’re considering resigning, according to a 2021 survey from McKinsey & Company.  

At a time when healthcare workers are risking their own personal health and dealing with public mistrust of their efforts, there’s no one-size-fits-all approach to keep workers on board. But there are ways that HR professionals can support healthcare workers during these challenging times. Here are three best practices our experts recommended.

1. Make good on your promises.

If you promoted mentorship or training and development programs during the interview process, actually offer them. When staff members realize those “opportunities” were simply empty promises, it’s likely their employee engagement and job satisfaction will drop. “You have to make sure you’re keeping those promises even in the most challenging times,” stressed Toterhi. 

2. Let workers know where they stand.

Fair and transparent performance management is also critical, Toterhi said. Workers need to understand how their daily efforts are contributing toward the company’s mission and strategy. And they need to be rewarded when they do well.

Companies should have a practical way of measuring performance with clearly defined goals that are aligned to rewards, including informal recognition and more formal merit raises or promotions. Much of this work is in managers’ hands, not the HR departments, Toterhi acknowledged. So it’s up to Human Resources leaders to ensure that managers know how to fairly and transparently reward their employees, providing them with ideas for doling out both informal and formal recognition, the tools they need to reward their employees, and the leadership to see how it’s done. 

“You have to give [managers] a menu of options [and]...a little bit of training to show them how to do it,” said Toterhi. “And then, ultimately, be the example, so they have something to follow.” 

3. Listen to what your employees are saying.

You can offer healthcare workers all the work-life balance and flexibility they need, and those things do matter, said Christine Miles, CEO of EQuipt, a consulting firm that specializes in helping leaders and teams communicate better, and author of What Is It Costing You Not to Listen? The Power of Understanding to Connect, Influence, Solve, and Sell. But it’s really the connection that the employee has to the mission of the organization and their engagement with others that sustains them through adversity. That’s why when employees raise concerns, they need to be heard, Miles said. 

But effective listening, she continued, doesn’t start with asking them what the problem is. Miles recommended opening by saying, “Take me back to the beginning.” This kind of open-ended prompt gives employees the chance to detail the full story about a frustrating issue. They’ll be more likely to share the facts — and their feelings — about an incident, and that’s key, Miles noted. 

“People are wounded in the workplace all the time by frustrations,” Miles pointed out. “I call it ‘death by 1,000 cuts’…[Employees will then think], ‘The relationship is damaged, and I don’t want to stay anymore.’ What we know about injury and wounds is you have to gut the wound before somebody can heal. When you peel back and uncover the emotions and feelings behind the wounds, you have a chance to resolve [the problem] and save the relationship and the employee.” 

COVID-19 Vaccine Policies

In recent months, hundreds of healthcare organizations have mandated COVID-19 vaccines for workers, with more being added all the time. And even more could follow once the US Department of Labor’s Occupational Safety and Health Administration (OSHA) develops a rule that mandates many private sector businesses ensure their workers are vaccinated or can show weekly negative COVID tests. If healthcare companies plan to enact vaccine mandates on their own, here’s what HR leaders need to do to craft the policy.

1. Work with an attorney.

The lawyer should be well-versed in the law and understand your workplace, advised Cathleen Bolek, an employment law attorney at Cleveland-based firm Bolek Besser Glesius. “If you have a workplace where everybody works in their own isolated office and only has very little interaction with anyone else, then your policy is going to be different than if you have 75 employees who work together in a call center or hospital setting,” she noted. 

With the help of any attorney, HR leaders and executive teams will also need to craft policies regarding what to do about employees who refuse to get vaccinated or who have legitimate health reasons for avoiding vaccination.

2. Consider all the repercussions.

On top of an ongoing staffing shortage, some healthcare organizations are losing even more workers to vaccine mandates. One New York healthcare organization let go of 1,400 employees who refused to get vaccinated. HR leaders need to help executive teams make a plan, whatever the fallout might be. 

“If [a healthcare organization is] going to go the route of mandating, they need to do so with a lot of forethought and with a master chess player’s perspective in mind,” said David Lewis, CEO of HR consulting firm OperationsInc. “Think about all of the dominos that will fall...and have a plan for dealing with all of those proactively.” 

New Technology

The pandemic forced a move to remote visits with doctors and a rapid increase in telehealth at its onset in the US. At the same time, new technology platforms are allowing medical providers to streamline daily workflows. These technological advances, however, while they offer many benefits, are also bringing new challenges to HR teams in the healthcare sector. 

Patient privacy is critical. Data breaches and other breaks of patient confidentiality could pose potential legal claims for a hospital or clinic. HR and IT departments need to work together to ensure the right systems are in place to protect patients, employees, and organizations, Salazar said. As a helpful guide to get you started, the US Office of the National Coordinator for Health Information Technology (ONC) has compiled this list of cybersecurity best practices and tips for the healthcare industry. 

But as healthcare companies deploy new technologies aimed at stripping away daily hassles for providers, HR leaders and executive teams need to ensure they aren’t also stripping away high-quality patient care and forgetting the human side of healthcare, Salazar cautioned.

The technology used should increase access to medical professionals, advised Salazar. “We want to make sure our policies and procedures as [they] relate to [the] technology that we’re implementing will help connect human beings and not put up a wall between them,” he said.


As the COVID-19 pandemic continues, healthcare HR teams will face incredible obstacles as they ensure medical professionals are staffed and in place to treat patients. During this stressful period, there are no quick fixes to resolving staffing shortages, burnout, or attrition. But Human Resources leaders can still help and make a difference even amid these difficult circumstances. By being empathetic and understanding, offering opportunities to build cohesiveness among staff members, and ensuring employees are fairly rewarded for jobs well done, HR departments can build strong, resilient, and engaged teams and contribute to a workforce that feels valued and appreciated for the critical, often life-saving work they’re doing, in ways that truly matter.