Melissa Hutchin had no idea what to expect after being called to a large conference room for an announcement along with other hospital staffers. Doctors, nurses and technician workers together heard the news they’d lose their jobs in 60 days because Texas Vista Hospital was closing.
“Being in that room was almost like what you would see on TV, with people being angry and standing up and yelling, asking their questions,” said Hutchin, a nurse for 23 years. “The anger was felt so much, you could just feel it in the air. The anger, the confusion.”
The South Side, which is home to half a million people, was left with a single, 110-bed hospital as a result of the May 1 Texas Vista closure, straining emergency response times and affecting more than 800 jobs.
But local hospitals rushed to hire Texas Vista employees, many of whom had skill sets in high demand.
Of the hundreds of workers whose jobs ended in May, Baptist Health hired 325 staff members, 152 of whom are nurses. University Health hired 45 former Texas Vista employees, 17 of whom are nurses, 10 are medical surgical technicians, and the rest are positions in the lab, pharmacies and radiology, as well as medical coders, University Health spokeswoman Elizabeth Allen said.
Many of the rest of the former staffers have taken jobs scattered across the South Texas area, said Tammy Windsor, former regional growth officer for Texas Vista Hospital, adding that there is no way to know the exact number, since there is no current staff in place to keep track of where they all went.
At the peak of the pandemic, local hospitals relied on short-term, contract labor to handle the workload caused by COVID-19 cases. Now they say they’re seeing a shift in the health care workforce back to in-house staff, rather than relying on temporary contracts to fill out their ranks.
Hutchin, who worked at Texas Vista for 12 years, said focusing on employee engagement and having retention bonuses for experienced staff would help keep employees happy in this changing employment landscape.
“I don’t think hospitals, in general, do enough retention for the nurses,” she said, adding that new hires are attracted by sign-on bonuses for two- to three-year commitments. “They don’t do anything to level out the pay of the experienced nurses or retain them.”
At one point, Baptist Health System had 300 contract nurses, but now only has 100. The addition of the 325 former Texas Vista staffers will help fill those gaps, said Kristen Lemus, chief nurse executive for Baptist Health System. University Health said it is also seeing stabilization in contract labor versus long-term labor.
“A lot of hospitals across the country are closing just because they can’t afford labor costs right now,” Lemus said. “We are seeing a market decrease in the number of contract labor nurses that both we need and are out there.”
For University Health, the workforce disruptions caused by the pandemic were the result of health care workers taking contract jobs elsewhere for higher pay, creating vacancies that could only be filled by more contract labor, Chief Medical Officer Bryan Alsip explained.
“[But] that cycle is sort of slowly winding down,” he said. “I think most hospitals have become more stable in their hiring practices.”
Hospitals across the country are experiencing the same phenomenon, like Nashville-based HCA Healthcare Inc., which manages eight Methodist hospitals in the San Antonio area.
In April, HCA Healthcare reported it was close to pre-pandemic use of contract labor, and the organization is prioritizing investing into their staff. That looks like raising wages, improving workflows and funding training programs, including the company’s Galen College of Nursing network.
At Christus Children’s Hospital, chief medical officer Norman Christopher said there’s been a decline in dependence on contracted labor and a return to the more “normal” approach to employing key clinical staff, showing hospitals the importance of recruitment and retention.
“Highly technical and skilled staff will continue to seek opportunities to work for organizations that are willing to invest in their continued professional growth,” he said. “[It] will be a differentiator as patients seek out options for care for their loved ones.”
This includes staffing hospitals with medical residents. More than 40 students in the University of the Incarnate Word School of Osteopathic Medicine residency program had completed a significant amount of inpatient training at Texas Vista Hospital. University Health hired 28 of those students. Another 15 will start in July, Alsip said.
Other factors are also affecting the workforce, Christopher said; for example, staff burnout, expectations for working from home and a stronger preference for part-time employment with more flexibility and better work-life balance.
During the pandemic, insurance companies and pharmaceutical companies created a lot of work-from-home opportunities that workers jumped at, Hutchin explained.
“I think that that’s where a lot of nurses went,” she said. “On top of the contract, contract nurses and tribal nurses make a killing. They can make up to $100 an hour. Once they started doing that, it’s really hard to go back to $40 an hour.”
Baptist Health made sure that for the Texas Vista employees it hired, the benefits evened out the costs.
“We did offer sign-on bonuses and things to help offset some of the problems they would have,” said Stephanie Talley, chief human resource officer for Baptist Health. “We honored the tenure that they have within that organization. … Their benefits and everything kicked in immediately and they were able to retain the amount of paid time off that they had.”
According to Talley, some of the former Texas Vista staffers who interviewed with Baptist Health referred others by encouraging them to apply and continue working together.
“We focused on not just hiring them, but developing a relationship. I think that started to spread,” Talley said. “Because this was pretty traumatic, being at an organization for 20 years and being told that you’re going to no longer having a job in a month or so.”
Hutchin moved to Corpus Christi to keep her management position. While she had an offer to stay in San Antonio, it had less responsibility than the job she had at Texas Vista as maternal program manager.
As a professional in the field for over two decades, Hutchin said retention bonuses for long-term staff, as well as employee engagement and health systems leveling the field by offering similar pay, would help keep employees happy.
For those living on the South Side after the Texas Vista closure, some care is still available. University Health has roughly 15 clinics or outpatient centers and one express care facility outside of Loop 1604.
Still, Hutchin worries for the community she leaves behind, now that Texas Vista has closed.
“That’s a high-risk area. It’s an underserved population,” Hutchin said. “Clinics, while they can do general daily wellness care, they can’t do trauma and emergencies. Not the gunshot wounds, not delivering a baby.”
