HR Trends

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How Much Can One Recruiter Take?

Healthcare Human Resource Departments have totally split personalities. On one hand they are nothing more than clerks taking orders and pushing applications to the managers and on the other hand they are responsible for 63% of the overall budget. How well they perform their profession spells whether or not the patients are satisfied, the length-of-stay is appropriate and even positive patient mortality. With that in mind, I am always surprised when a client tells me they have had to downsize their staff. An administrative assistant here, a recruiter there and soon, the HR Department of a healthcare delivery system is so thin, the hiring simply doesn’t get done. There isn’t enough time—or energy. Even if a recruiter is the most organized person in the world, the ability to stay focused, when working under that much pressure, will eventually fade. Recruiters, at some point, will start to welcome the relief of a meeting, the variety of leading a committee or attending a job fair. Applicants present and there isn’t anyone to greet them and they walk down the street. But, knowing the pressure, it is difficult to have the nerve to suggest a recruiter has not been as effective as she/he should be. After all, they haven’t been given the tools to be successful. Joan Hildebrandt, a Nurse Recruiter with the Greensboro, NC based Moses Cone Health System, wrote to ask what might be the appropriate number of recruiters and administrative staff for her 7,400 employee system. “What is the recommended ratio of recruiters to open positions and how much support staff is appropriate?” Joan asked along with the obvious “and how many recruiters should we have?” The open requisitions-to-recruiter is the easier question to answer since there are not as many variables, but there are broad generalities for both. Generally speaking a recruiter should not have more than 30-35 open positions if recruiting for professional positions—such as nursing, allied health, rehabilitation and anything requiring a minimum of a four-year-degree which is not health-science based. If a recruiter is responsible for the traditionally entry-level positions such as patient-care technicians, food service workers, technicians, office and clerical and anything requiring a high school education, they can manage an on-going work load of 60-65 positions. The difference comes in the number of candidates who present and the ability to interview more quickly. The ideal set-up for recruiting is not to have a recruiter do both types of recruiting—professional and entry-level—but if that isn’t possible, then a combination, staying with both groups parameters is recommended. For example, 15 open professional positions and 30 entry-level positions. The number of needed recruiters and the ensuing support staff must be based on a number of factors including how many applications come in, the type of HR Department (full-service or pretty much a big Post Office), the vacancy and turnover rates and even the geographic location. Generally speaking there should be 1.2 recruiters for every 1,000 employees and there should be .6 FTEs of administrative staff for every recruiter, not including the receptionist. The number of recruiters needed is directly impacted by the vacancy rate. If it is above 8% then the number of recruiters should increase to 1.6 FTEs per 1,000 employees. There is no need to increase the administrative support since their work can be ramped due to predictability. So, if Joan’s system has 7,400 employees, they should have 8.9 recruiters and 4.4 administrative FTEs if their vacancy is below crisis at 8%. If the vacancy rate is above 8% then Moses Cone should have 11.8 FTE s of recruiters along with the 4.4 administrative positions. Adequate staffing in the Human Resources Department is essential and the cost should be insignificant when compared to the cost of poor staffing in terms of patient outcomes and the cost of covering patient care hours with agency, travelers, PRN and overtime. If you have a question related to healthcare recruiting you’d like me to answer on a future blog, send me an email at