The nursing shortage in the United States is at crisis levels. More and more nurses are burning out and moving on.

Solutions are needed to help hospitals and health systems continue to be able to deliver quality healthcare. Many in the health IT space believe technology has a role to play.

Earlier this year, Gale Healthcare Solutions raised a $60 million growth equity investment from FTV Capital. The aim is to expand the abilities and reach of its mobile app, which is designed to match nurses with available shifts.

Gale enables nurses to search for open shifts and claim the ones they want in real time. It is a platform that pays nurses the same day, minutes after they finish work. Having this type of flexibility and same-day pay is key to boosting morale and ending the nursing shortage, which COVID has exacerbated, said Tony Braswell, CEO of Gale.

Gale, named after Florence Nightingale, now has 55,000 clinicians using its app in 40 states. It made the Inc. 5,000 list of America's fastest-growing companies.

Healthcare IT News sat down with Braswell to discuss the nursing shortage, his mobile app and the role of technology in helping ease the pain nurses are feeling today.

Q. Please describe the situation with nursing today.

A. The nursing industry is in crisis. Several factors are emerging at once. The U.S. population is aging and needs more care. At the same time, more nurses are retiring and quitting after nearly three stressful years of COVID. In Nurse.org's 2021 State of Nursing Survey, 80% of nurses said their units are inadequately staffed and 87% of nurses said that they felt burned out over the past year.

The nursing shortage is driving everyone in healthcare management – from C-suite executives to on-the-ground shift supervisors – to search for innovative solutions to meet their increasingly difficult staffing challenges. One of these is on-demand platforms, which allow healthcare facility managers to post open jobs and find nurses in real time.

On-demand staffing in healthcare is a game-changer, much like we've seen in other parts of our lives with Uber and AirBnB. The job market today is shifting to the "gig economy," with people looking to work when and where they want – and that includes nurses. Through Gale's app, nurses get control of their own schedule and their pay. This is empowering and can help reduce some of the stress they experience.

Here's the reality: More than one million nurses will be needed by 2030 to keep up with the growing demand for care. Changing the nursing industry to make it more flexible, with on-demand staffing, is one way we will retain and attract more nurses into the profession.

Q. Where did the inspiration for Gale come from?

A. It's funny how forces converge in life. Coming out of school, I was a computer science major, and my first job was coding for a company that managed Medicare claims for the state. On the side, I had this idea – starting a newspaper that would list open jobs – essentially connecting workers and companies. I published it for a few months, but quickly ran out of money.

Soon after, I got a call from a recruiting company that asked me what happened to it as they had been using it. I told them and they wound up offering me a job as a recruiter in IT. The money was better, and I needed it, so I took it.

After learning the recruiting business, a few years later I launched my own healthcare staffing firm. I went on to spend 25 years in healthcare staffing, where I relied on old-school techniques: constant calling, messaging and nagging to fill open nursing shifts. It was like being a hamster on a wheel, working hard to get the day's shifts filled and no time to grow the business.

In 2016, I was at work one day when I saw my son order a bottle of ketchup online. I thought it was ridiculous, but this was before daily orders from Amazon became so common.

When I realized he was able to get such a small item that quickly, on-demand, I knew the same approach could and should be used for a much bigger need: to help healthcare facilities find nurses. The very next day, with the help of a friend, we started exploring the concept of an app.

Less than six months after that ketchup bottle arrived at my son's door our app went live. We named it Gale after Florence Nightingale, because back in her day, she revolutionized nursing. Our vision was that we would do the same for modern-day nursing staffing.

Q. How does Gale work, and who is using it today?

A. Gale serves healthcare providers and healthcare clinicians – primarily nurses and nursing assistants. Clinicians open the app and set their availability to work. Facilities enter shift needs, and any clinician that has self-identified as being available gets an immediate notification.

They accept the shift they want, go to work, and get paid the very same day. We're now paying most clinicians within minutes after they finish work, before they even get to their car. For clinicians, the process is simple and seamless.

It's the same on the facility side. Managers enter the shifts they need filled in the Gale app and watch as they're filled in real time. But it's more than a scheduling device. They can also use the app to provide feedback on clinicians, and as a compliance tool, as they have access to clinician credentials via the app.

Nurses love the flexibility and quick pay. Facilities value a tool that can help them solve one of their biggest problems: the shortage of staff. As a result, Gale is growing exponentially, with more than 55,000 clinicians and thousands of healthcare providers in 40 states.

This year, we made the Inc. 5,000 list of America's fastest-growing companies, and Staffing Industry Analysts recently named Gale as one of the largest and fastest-growing staffing companies in America.

Our primary focus is providing care in nursing homes, assisted living facilities and other senior-care communities. However, in the past year, after doubling the size of our national clinical workforce, we've expanded services to include travel nurses and permanent employee placements, so that healthcare facilities have a suite of options to meet their staffing needs.

We also have begun licensing our software to help other staffing companies expand their service as well. We know that the more our proven technology is used, the more people will get care.

Q. How do you believe Gale helps combat the nursing shortage?

A. Through technology, Gale is working to end the nursing shortage to ensure no one goes without care. We can't magically create new nurses. I wish we could. I spend a lot of time thinking about nurse education. We've established a foundation to support nursing education, we're investing in nursing programs, but results here will take time.

For now, what we can do is use technology to connect clinicians to facilities with staffing needs. That way, every licensed nursing professional who wants to work can work. They may want to work a lot, or just once in a while. Either way, we can make sure they have the opportunity to pick up shifts that work for them. This freedom and flexibility can help prevent burnout and keep more nurses on the job.

Giving nurses same-day pay also helps. As a teenager, I worked on a tobacco farm in eastern North Carolina. It was hard work, but the best part was that we got paid every day when we were done.

Fast forward more than 40 years, I can now offer that to thousands of nurses through technology. Many nurses are living paycheck to paycheck. Having the ability to work a shift when you need money and get paid quickly afterwards is empowering.

As the gig economy grows, companies that can offer their workers this benefit are going to have a major advantage. Think about it. Technology allows us to pay bills online or to send friends money after splitting dinner. We should be using it to get people paid quickly too. You shouldn't have to wait a week or even longer.

At Gale we are leading a revolution to make nursing a less stressful and more desirable profession, with flexibility and quick pay. To achieve this, we're continuously improving our technology. We're excited to have a new chief technology officer who joined us from Google.

He came onboard because he was attracted to Gale's mission of ensuring no person goes without care. Helping people through technology is at the core of what we do.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.