Like many healthcare professionals, Gloria, a Texas-based nursing student and CNA, developed a passion for healthcare as a child. And like many healthcare professionals, Gloria started to feel particularly burned out after the COVID-19 pandemic.
It was that burnout, combined with the fact that Gloria was studying for her BSN, that led her to follow her sister’s advice and try the ShiftKey app, a technology platform that independent professionals use to directly connect with facilities that need to fill open PRN shifts. (PRN is a Latin phrase that means “pro re nata,” which essentially translates to “as needed.”)
For Gloria, the ShiftKey app has been indispensable: “I don't think I would be able to work full-time and go to school at the same time. But with the ShiftKey app, I can choose to work at night during the week or work the weekend. It’s helping me to build my career.”
Technology companies like ShiftKey are changing the way healthcare facilities and licensed professionals connect to get PRN shifts filled. They’re quietly revolutionizing the healthcare workforce in the process — especially when it comes to healthcare professional burnout.
Healthcare professionals are burning out in record numbers, but why?
In an advisory published in 2022, the Department of Health and Human Services defined burnout as being "characterized by a high degree of emotional exhaustion and depersonalization and a low sense of personal accomplishment at work."
Burnout is common in many industries, and its prevalence in healthcare was popularized (and exacerbated) during the COVID-19 pandemic. But as the world has settled into a long-term relationship with COVID-19, the focus on mental health for healthcare professionals has settled into the background too.
That doesn't mean burnout has disappeared. The professionals who care for us in our most vulnerable moments are, on the whole, vulnerable themselves.
The HHS advisory states that 50% of health workers reported symptoms of a mental health condition.
Gloria says: "You get burned out a lot. And just coming from COVID, we had to work, like, so many hours. So you get burned out, and at the same time, you're thinking, 'If I don't go, who's gonna be there today?' So you just keep going."
She’s not alone.
Of 9,500 nurses surveyed by the American Nurses Foundation, more than 34% said that they were “not” or “not at all” emotionally healthy. Forty-seven percent said that they were considering leaving the industry because of the negative toll on their mental health, and 41% said they were leaving because of workforce shortages.
Surgeon General Vivek H. Murthy suggests that although healthcare professional burnout has personal consequences, it isn’t a personal issue. It’s due to systemic issues, such as “inadequate support, escalating workloads and administrative burdens, chronic underinvestment in public health infrastructure, and moral injury from being unable to provide the care patients need.”
How healthcare professional burnout affects patient care
Burnout is a cycle that perpetuates itself: As more nurses burn out, more leave the industry, which leads more nurses to burn out.
A McKinsey study reported that “insufficient staffing levels, seeking higher pay, not feeling listened to or supported at work, and the emotional toll of the job” (all factors in burnout) contributed to healthcare professionals’ decisions to leave the industry.
The exodus is already causing a nursing shortage:
- In 2022, the U.S. was short more than 1 million nurses.
- 52% of nurses plan to leave clinical practice; 63% of them are under age 35 (American Nurses Foundation).
- In the next three years, Mercer projects that the shortage of CNAs, medical assistants, and others will exceed 3 million.
- McKinsey estimates that by 2025, the U.S. will have a 10% to 20% gap in nurses available for direct patient care.
According to Dr. Murthy and other industry experts, industrywide burnout could lead to a public health crisis: If healthcare professionals continue to burn out at the current pace, fewer patients will be able to get the care they need. And they will pay more to get it.
From burnout to work-life balance — how some healthcare professionals are creating better outcomes with PRN shifts
Some healthcare professionals are breaking the burnout cycle without leaving the industry by leveraging technology and PRN shifts.
PRN shifts help facilities maintain the coverage they need when there would otherwise be shortages, like when full-time healthcare professionals call out or go on vacation, or a sudden or unmanageable increase in the demand for beds.
Since healthcare professionals choose when to pick up PRN shifts, they can use them to gain the flexibility that contributes to work-life balance.
One ShiftKey user, an independent professional named Austin, says that he’s surprised by how much energy he has had since beginning to pick up PRN shifts — enough to start a business on the side.
“When I had a 9-to-5 job, even though it was like a 6-to-10 job most days, I wasn't able to have a life outside of that. And when you're able to make your own schedule, you're able to come up with so many ideas. It allows you to understand that there are other ways to make money. It really does open your mind up.”
Austin also says that facilities that use ShiftKey now have the PRN coverage they need.
“I've worked in so many facilities where there have been three people on the floor. Every facility that I go to that uses ShiftKey has the PRN help they need, and that's how every place should be.”
Working PRN can also expose licensed professionals to different settings, which can help them rekindle their passion for patient care.
Before she started using the ShiftKey app, Annamarie, a physical therapist assistant, was thinking about leaving the industry. Working PRN shifts brought her back to what she was passionate about healthcare for:
“I worked at a pelvic health clinic and never thought I'd see that again. And I've encountered amazing people that are talented in so many ways, and it made me reframe and question, ‘Why did you think about getting out of healthcare?’”
Annamarie also believes working PRN shifts has made her a better professional: “You know, the more PRN work I did, I realized I put myself first during the day so I could be open and a better person for my patients.”
Strategies for managing challenges and maximizing the benefits of PRN work
Everything can have its faults, and one potential drawback to working PRN is that it can be inconsistent.
Candice, who uses the ShiftKey app to pick up PRN shifts around her job, recommends networking and building relationships across facilities.
“I go to one veterans home a lot, so, the scheduler will call and say, ‘Hey Candice, I have open PRN shifts this weekend; what do you have open?’ They’ll wait for me [to bid on the shifts], which is perfect.”
Annamarie has started thinking about work a little differently since making the transition to working PRN shifts: “Full-time isn't steady either. So once I embraced that and realized, like, the work is always there, I just don't know necessarily where it's coming from, I just felt more refreshed and balanced.”
Feeling balanced can be more of a challenge when using PRN work to make a living around other commitments. But having more than one income stream is more common than you might think, and there is evidence that diversifying one’s income is a way to create more job security in the long run.
Forbes stated that, in 2022, more than 400,000 workers had two full-time jobs and 4.9% of all workers in the U.S. (more than 7.7 million) held at least two positions.
Candice, who has been a CNA for 13 years, creates balance by varying the kinds of PRN shifts she picks up: “You just have to learn how to fluctuate it. I work at a hospice, and I'm still able to pick up CNA PRN shifts on the side using the ShiftKey app.”
How to manage stress and develop a self-care routine when working PRN
The advice on how to create work-life balance as an independent professional working PRN shifts is consistent with the advice on how to create work-life balance in general. This approach can be summarized by three words: plan, prioritize and pause.
Since working PRN requires the management of relationships and commitments with many facilities at once, planning is an essential skill to learn. To facilitate the planning process, ShiftKey makes it easy to bid on multiple shifts weeks to months in advance and organize your schedule.
Most people have competing priorities. Consider evaluating yours and ranking them in order of importance to clarify what’s most meaningful to you. Work might not be your No. 1 priority, and you wouldn’t be alone in that. One hospice nurse found that working hard was one of her patients’ top deathbed regrets.
On busy days, pauses may only consist of short bouts of meditation or non-sleep deep rest (non-sleep deep rest, or NSDR, is a practice of meditation with additional benefits). Longer pauses are necessary as well: taking time off is a critical factor in maintaining mental health. Since flexibility is a hallmark of working PRN shifts, you manage your own schedule and decide when you need to take some time for yourself.
That flexibility is one of the reasons Gloria uses ShiftKey: “I could decide I don't want to work this whole week from Monday to Friday. And guess what? I manage my own schedule with ShiftKey versus being fixed to a place whereby I have a specific schedule that I can't get out of.”
Building a world where healthcare professional burnout is no longer the norm
Overcoming healthcare professional burnout requires a new conceptualization of work itself.
In a recent ShiftKey survey of more than 1,000 nurses, 63% said they prefer to be their own boss, choose their own schedule, and set their own rate.
By picking up PRN shifts on the ShiftKey app, independent professionals like Gloria, Austin, Candice and Annamarie are empowering themselves. In the process, they’re filling a critical need for skilled healthcare workers across the U.S.
Even so, it’s clear that healthcare professional burnout is a systemic issue that policymakers, facilities and professionals will have to address together. In the meantime, if you’re dealing with burnout, visit The National Academy of Medicine to find key resources that may help. And if you’re looking for the flexibility to create your own schedule and work in facilities you prefer, consider the ShiftKey app.