1-2 punch of worker shortage, pandemic leaves Sanford, Essentia with job vacancies over 16%

At Sanford, 18.8% of positions are vacant, while Essentia has a job vacancy rate of 16%, as the pandemic strains health-care work forces.

The exterior of the Sanford Medical Center emergency room
The emergency wing at the Sanford Medical Center in south Fargo.
David Samson / The Forum
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FARGO — Sanford Health and Essentia Health are dealing with soaring numbers of job openings as the pressures of the pandemic on health care systems are compounded by the challenges all employers are having filling vacancies.

Sanford Health has a record 1,700 job openings for its Fargo service area, a vacancy rate of 18.8%, and Essentia Health is working to fill 650 vacancies in its Fargo-centered west market, where 16% of positions are unfilled.

“That number has grown with the challenges of the pandemic and the workforce,” said Theresa Larson, Sanford’s vice president of nursing. Before the pandemic, Sanford had about 900 staff openings in its Fargo service area. It normally has 9,004 positions in its Fargo service area.

Essentia Health, which normally has about 4,050 employees in its west market, could be seeing an unprecedented number of staff vacancies, said Sarah Carlson, a senior human resources director.

“We are challenged to meet our staffing needs,” she said. “Our workforce needs are at a peak — it’s definitely impacting our organization every day.”


Administrators for both systems said they have been able to maintain patient care by redirecting some staff to hospital and other direct care roles while scaling back on certain support services, such as cafes.

“We just are funneling all our resources to patient care,” Sanford’s Larson said.

After vacancies increased sharply, Sanford’s staffing levels have reached more of a “steady state” — but administrators are searching for ways to restore staffing levels, Larson said, noting employers of all kinds are dealing with a shortage of workers.

“We have to figure out how to move out of this space,” she said. One way they are managing in the meantime is by having providers clean their own offices and "backstage" areas, leaving cleaning staff to focus on patient service areas, Larson said.

Although COVID-19 hospital admissions have fallen significantly in recent weeks, overall admissions at local hospitals continue to be very high, resulting in staffing pressures, Carlson and Larson said.

The health systems are struggling to fill openings across a spectrum of roles that include nurses, nurse’s aides, respiratory therapists, food service workers and environmental service workers.

To fill vacancies, Sanford has relied upon traveling nurses, now numbering about 400 in Fargo, compared to an average of about 50 before the pandemic, Larson said. It isn’t clear if the current job vacancy rate is the highest on record for Sanford; there were many openings when the Sanford Medical Center first opened in 2017, when Sanford hired 200 traveling nurses, Larson said.

Essentia Health
Essentia Health in south Fargo is seen from the north.
Michael Vosburg / Forum Photo Editor

Essentia is mostly using traveling nurses to accommodate growth in demand for health services, which is increasing as Fargo-Moorhead grows, Carlson said.


Compounding staffing challenges, the strains of the coronavirus pandemic, now almost two years running, have resulted in some early retirements and career changes, Larson said.

“We don’t necessarily have the pipeline to fill that,” she said. As a result, Sanford has broadened its nursing staffing efforts by recruiting foreign-trained nurses, an effort Larson said complements the standard college recruiting program.

So far, Sanford has signed 225 foreign-trained nurses from 21 countries, although none are on staff yet, she said.

“We’re very excited to see that,” Larson said, adding that all of the nurses are credentialed and will be licensed in North Dakota when they start.

Local career academies — one established in Moorhead and another being built in Fargo — will provide more opportunities to interest students in pursuing health care careers, Larson said.

“Those career academies will be extremely helpful,” she said.

In 2020-21, 955 college nursing students graduated in North Dakota, according to figures the North Dakota University system presented last week to an interim legislative committee. That figure is up almost 32% from 724 nursing graduates in 2015-16.

A 2019 survey by the North Dakota Center for Nursing, however, found 40% of nursing graduates said they planned to work outside the state, and almost half of nurses working in North Dakota said they wanted to leave the state.


The nursing center proposed a clearinghouse that would create a pool of traveling nurses within North Dakota to make it easier for hospitals, nursing homes and other health facilities to hire traveling nurses. Backers said North Dakota has a “constant churn” of nurses.

The proposal, which carried a one-time $400,000 appropriation request and was introduced during the 2021 legislative session, failed to gain support, said Patricia Moulton Burwell, the nursing center’s director.

“It didn’t go anywhere,” Burwell said, adding that legislators had other priorities. The clearinghouse would have provided an in-state solution and would offer flexibility to nurses in the state and help increase chance that they would decide to stay, she said.

The nursing center tried a pilot project with three health care facilities in North Dakota to foster a supportive workplace culture, but the effort dissolved because the three facilities were grappling with the pandemic.

“Our facilities are stressed,” Burwell said. “These nurses are stretched wide and thin. They’re burned. They’ve worked so hard for so long.”

Both Sanford and Essentia have programs to support nurses and other employees, including counseling services. Administrators at both health systems said they have been able to maintain the quality of patient care despite the significant staffing challenges.

“We do a lot of helping hands and support,” Larson said. Essentia established a well-being program for employees, Carson said.

Despite Sanford’s staffing challenges during the pandemic, “We’ve actually improved our quality scores,” Larson said, including infection control.

Patrick Springer first joined The Forum in 1985. He covers a wide range of subjects including health care, energy and population trends. Email address:
Phone: 701-367-5294
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