“When you get one opening for a nurse or aide, you may think it isn’t a big deal, but then you get two, three, four, and more. I suggest that one opening is a crisis, and we should plan for how we’ll handle this,” said Cindy Fronning, RN, CDONA, FACDONA, master training/director of education at NODONA. She suggested addressing staffing in your emergency preparedness plans with a few possible elements:

Plan for scheduling creativity. “When I was a DON, we hired strategically for very busy hours. We knew that early mornings and afternoons were very busy times, so we would schedule more staff during those times. We advertised for people who wanted part-time work but needed some flexibility to deal with family responsibilities and other issues,” said Fronning. By being flexible with scheduling and staffing, you can have a larger pool of professionals and fewer shortages.

Have a plan for staff’s families in an emergency. Have an area set up with toys and games, mats, and blankets where staff can bring their children if there is a hurricane or other natural disaster. Give staff gift cards and box meals so their families can eat while they are at work. “This might enable people to feel more secure coming to work and worry less about their families,” said Fronning. However, she stressed that if you bring kids into the facility, you have to designate a responsible party to watch them.

Identify ways you will get employees to work during a disaster. Will someone transport them? “One plan we have is using snowmobiles during a blizzard. These kinds of creative options can help ensure you have adequate staff during a crisis and ease their worries about how they’ll get to work,” she said.

When possible, triage. Know who lives where and is most affected by a disaster. Plan for contingencies if these individuals can’t come, will need help getting to work, or will require special support.

Prioritize cross training. Identify what roles everyone can fill (besides their own) during a disaster or staffing shortage. Provide additional training as necessary. Maintain an updated list of these alternate roles so you know who to contact if, for example, you need someone in the kitchen preparing meals.

Conducting a tabletop exercise for how you would deal with a staffing emergency can be “a real learning experience,” said Fronning. This can help you identify innovative ways to improve staffing or issues that are causing people to leave. The result can be creative ideas such as taking old med carts and turning them into rolling snack or gourmet coffee stations.