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The Childcare Conundrum

Published:August 11, 2022DOI:https://doi.org/10.1016/j.mnl.2022.07.002
      The nursing workforce in 2022 is not the same workforce we had in 2019—especially demographically. Large numbers of Baby Boomer and older Gen X nurses either have retired or are retiring. By 2025, Millennial and Generation Z nurses will be over 70% of the workforce and are in their prime childbearing years.
      • Tulgan B.
      The Great Generational Shift. 2022 ed. Rainmaker Thinking website.
      Over the past year, I have been doing nationwide virtual retention workshops for health systems. So many nurse managers have told me the same thing—their younger staff are reducing hours or leaving their positions because of childcare issues. Access is often the problem, or it is too expensive in their communities. Research done by Motherly indicates that 46% of currently unemployed Generation Z and Millennial moms who left the workforce in 2021 cite childcare as their primary issue for not working.
      • Waller J.D.
      The pandemic has cracked open the childcare crisis. Here is what could help make it better. May 2, 2022. Motherly.
      The problem is not receiving the sense of urgency that it should in nursing workforce planning. A critical care director shared her experience serving on a health systems recruitment and retention task force. The task force members cited childcare as a crucial retention issue in a report to the executive leadership team. The CEO quickly responded, "We are not in the childcare business." I would contend that this CEO is wrong. A recent Health Affairs workforce research report noted that there is a 4.0% reduction in the number RNs younger than age 35 years working and a 0.5% reduction in the number of RNs ages 35 to 49 years.
      • Auerbach D.I.
      • Buerhaus P.
      • Donelan K.
      • Staiger D.O.
      A worrisome drop in the number of young nurses. April 13, 2022. Health Affairs Forefront.
      Undoubtedly, some of this workforce reduction is due to childcare issues. Many others may have geographically relocated to be closer to family members who can support them in providing childcare.
      With the average hospital RN vacancy rate now at 17% and annual turnover exceeding 27%, we cannot be dismissive of this challenge.
      NSI Nursing Solutions, Inc. 2022 NSI National Nursing and Health Care Retention & RN Staffing Report. March 2022.
      Anytime you are confronted with a vital issue that impacts nurse workforce recruitment and retention, you need to pay attention. Ironically, when Baby Boomer nurses had children, childcare was a benefit offered by many health systems. Compared to the 1980s and 1990s, few health systems now have childcare available or have partnerships with local childcare agencies.
      In this postpandemic environment, childcare has become a crucial workforce issue across all sectors of the US workforce. Many childcare centers shut down during COVID and have not reopened. Workforce shortages in childcare have limited enrollment in those that are in business. Few centers have hours that span 12-hour shifts. Fortune magazine recently reported that childcare costs have gone through the roof since the start of the pandemic. Across the United States, parents are seeing an average annual cost increase of 41% for center-based childcare providers and spending an average of $14,117 per child annually, up from $9,977 prepandemic. Up to 20% of their household income is now spent on childcare.
      • Thier J.
      The cost of childcare has risen by 41% during the pandemic. January 28, 2022. Fortune.
      Many parents find navigating the childcare landscape today complex and overwhelming.
      Some health systems are acting by establishing childcare task forces using resources such as the Chamber of Commerce roadmap for employers.
      U.S. Chamber of Commerce Foundation
      Employer roadmap: childcare solutions for working parents. March 2022.
      Options under consideration include, but may not be limited to, the following:
      • 1.
        Provide onsite childcare and back-up sick childcare.
      • 2.
        Establish resource guides and links to platforms like Otter, Wonderschool, or CareLuLu to connect parents with childcare providers in their community.
        • Hau I.
        The child care crisis: innovations to the rescue. March 3, 2022. Forbes.
      • 3.
        Use a weekend Baylor Plan schedule targeted to parents with young children.
      • 4.
        Encourage job-sharing of 12-hour shifts by parents who each work 6 hours.
      • 5.
        Partner with national childcare providers to provide flexible hours for their workforce.
      • 6.
        Include childcare vouchers as part of an employee benefits package.
      Now is the time for nurse leaders to proactively get involved by doing a demographic profile of their current nursing staff to learn how many might be struggling with this issue. Setting up a childcare center might not be realistic, but it might make sense to partner with and fund a childcare business. Nurses with young children feel pressure to make difficult decisions about family versus work. It all comes at a time when we need them more than ever. Supporting childcare could be a critical recruitment and retention differentiator. Access to excellent childcare creates job embeddedness for parents who are less likely to leave when they feel supported by their organization.

      References

        • Tulgan B.
        The Great Generational Shift. 2022 ed. Rainmaker Thinking website.
        (Available at:)
        • Waller J.D.
        The pandemic has cracked open the childcare crisis. Here is what could help make it better. May 2, 2022. Motherly.
        (Available at:)
        • Auerbach D.I.
        • Buerhaus P.
        • Donelan K.
        • Staiger D.O.
        A worrisome drop in the number of young nurses. April 13, 2022. Health Affairs Forefront.
        (Available at:)
      1. NSI Nursing Solutions, Inc. 2022 NSI National Nursing and Health Care Retention & RN Staffing Report. March 2022.
        (Available at:)
        • Thier J.
        The cost of childcare has risen by 41% during the pandemic. January 28, 2022. Fortune.
        (Available at:)
        • U.S. Chamber of Commerce Foundation
        Employer roadmap: childcare solutions for working parents. March 2022.
        (Available at:)
        • Hau I.
        The child care crisis: innovations to the rescue. March 3, 2022. Forbes.
        (Available at:)

      Biography

      Editor-in-Chief Rose O. Sherman, EdD, RN, NEA-BC, FAAN, is Adjunct Professor of Nursing at Marian K. Shaughnessy Leadership Academy, Case Western Reserve University, in Cleveland, Ohio, and is the author of The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success. She can be reached at [email protected]