From certified registered nurse anesthetist retirements to hard-to-fill specialty roles, ASC leaders are grappling with a shifting staffing landscape.
Three ASC administrators joined Becker’s to discuss their biggest workforce challenges and the creative strategies they’re using to address them.
Editor’s note: These responses were edited lightly for clarity and length.
Question: What staffing shortage is currently your biggest concern, and how is your organization addressing it?
Debbie Ehlers, RN. Administrator and Director of Nursing at The Eye Center (Yakima, Wash.): Our biggest challenge came in April 2025 when we lost our CRNA coverage for our ophthalmic ASC. We have had solid CRNA coverage for 20 years, and our CRNA was ready to retire. She provided plenty of notice, but we tried for one year to find a replacement without success. We advertised in all of the usual places, word of mouth, locally, state organizations, etc. Finally, we made the decision to move to RN sedation. In Washington State, according to the Nursing Care Quality Assurance Commission, it is “within the role and scope of practice for the registered nurse to administer procedural sedation and to manage patients who are receiving and recovering from procedural sedation.” Our RNs are very experienced, with all at least 20 years of nursing experience. All are BLS and ACLS trained, as well as are both surgeons. All participated in the AORN course on sedation and passed the class. Prior to her retirement, our CRNA also provided additional sedation training addressing the unique needs of the ophthalmic surgical patient. A sedation competency form was developed and is utilized. After four months of RN sedation, our surgeons as well as our RN staff have determined that patients are receiving safe and quality care with compassion at our facility.
Tracy Helmer. Administrator of Tri City Cardiology Surgical Center (Mesa, Ariz.): In niche ASCs, such as cardiology, the biggest challenge is finding radiologic technologists staff and catheterization nurses. Many of these staff like to work at ASCs for the absence of call, but these types of ASCs tend to run later shifts, so the trade off is not always as palatable as they had hoped for. This makes it necessary to be creative with intangibles like culture, days off, perks and incentives when possible. We have to be exceptional at elevating our environment from competing workplaces.
Jane Whinnery. Chief Operating Officer and Administrator of Wellbridge Surgical (Indianapolis, Ind.): In our experience, the staffing issues primarily surround registered nurses and certified surgical technologists. As an ASC, it’s very difficult to compete with the salaries of hospitals as they skyrocketed during and after COVID-19. We have attempted to keep our salaries competitive, but our true approach to attracting and retaining top talent is to offer an environment that is difficult to achieve in a hospital system. For example, the staff have complete autonomy over their schedule. They self-schedule working around their home life, children, appointments etc., coordinating with their teammates to ensure coverage of the ASCs procedures. We allow flexibility during the day to leave for appointments without burdening them having to get their own shift coverage. We offer generous packages for PTO and paid holidays with increases for tenure. We’ve tried to create an environment of trust and mutual respect so that there aren’t a lot of rules or bureaucracy that are necessary in hospitals. The entire leadership team works alongside the staff during busy times, demonstrating servant leadership and that we all share in the success of our ASC.
Because of these strategies, we have had very little turnover in the nearly four years we’ve been open. This is a testament of our commitment in fostering an employee centric approach to daily operations.
