Skills-Based Hiring Approach Attracts Diverse Nursing Applicants

Nursing leaders are switching to competency-based education, interviewing, and hiring to attract a larger pool of candidates with diverse backgrounds. This skills-based hiring approach is boosting recruitment and retention.

Recruiters and employers are starting to focus on what candidates are capable of and what skills they possess rather than prioritizing experience and education alone. And they’re using skills-based hiring to help.

“Like many health systems, we have transitioned to competency-based interviewing. We assess soft skills to take full advantage of the talent in today’s market,” said Yvonne Mitchell, MBA, Vice President of Talent Acquisition at Johns Hopkins Medicine.

Competency-based hiring, also known as skills-based hiring, is gaining traction in many industries, including health care. This approach focuses on candidates’ clinical knowledge, abilities, and competencies rather than prioritizing their education or years of work experience.

Not all nursing applicants “check all the boxes” for traditional requirements. Competency-based recruitment widens the pool of applicants to nurses from diverse backgrounds. “We always want to meet our standards, but we have opened our lens a little bit,” reported Kristen George, BSN, MPH, RN, CCRN, a nurse manager at the R. Adams Cowley Shock Trauma Center at the University of Maryland Medical Center in Baltimore.

As the nursing shortage continues, challenges with identifying nursing talent for current and future roles persist for healthcare recruiters. “Advertising and reviewing resumes alone cannot bridge the talent gap when care quality is a concern,” said Jennifer Seith, Vice President of Product Management at Relias,’s parent company. “Our goal at is to offer career and workforce enablement by understanding the needs of both our nurses and customers and bridging those gaps.”

“Built on a foundation of millions of continuing education course completions, our new matching technology finds nurses based on skills, competencies, and experience attained, and delivers them directly to recruiters and employers,” Seith said. “Our solution hinges on truly understanding nurses’ desires and behaviors and recognizing skills that can influence future talent mobility.”

Nurse recruiters, hiring managers, and nursing executives are embracing the advantages of skills-based hiring.

1. A wider, more diverse applicant pool

Traditional hiring practices created obstacles for some nurse applicants. “We need to increase our sensitivity — and decrease our specificity,” George said.

Previously, hiring managers looked for specific unit types. Not all nurses have two years’ experience on a critical care unit at a teaching hospital, for example. In the past, managers hiring for a critical care unit might have ruled out those applicants. “Often, we overlooked experience in other units that required a high level of critical care thinking,” George said.

Leaders are increasingly recognizing that nurses can learn technical skills on the job. “Today, most hospitals are willing to train on specialty units, both for new nurses, and nurses with very little experience,” Mitchell said.

2. Best-fitting applicants matched with the right roles

Even if the applicant doesn’t meet traditional criteria, the nurse might be a great fit for the unit. Some applicants have expertise in specific medical conditions — neurotrauma, cardiac surgery, or surgical patients, for example. An in-depth understanding of the physiology of these patient populations demonstrates an ability to cross over to other nursing specialties.

“We are trying to get the best from every person and really build a unit with people from a variety of backgrounds and variety of experiences,” George offered.

Johns Hopkins’ hiring managers still want to see basic clinical competence but spend more time getting to know candidates. They look for skills like communication, empathy, critical thinking, collaboration, adaptability, resilience, and professionalism.

“The right person for the role is critical. And that perfect person is no longer defined by how much they know — but rather how well they treat our patients, how they treat one another, how they partner when things do not go as planned, if they are flexible and adaptable, and how they communicate,” Mitchell said.

If the applicant is the best fit for the unit, that nurse is more likely to be successful. “Having the right people — the right team, the right leader — is really the golden ticket in terms of higher engagement and lower turnover,” Mitchell said.

3. Ongoing professional development

On paper, some applicants may not seem as skilled as others. They may lack experience with invasive monitoring, cardio-pulmonary bypass, or intra-aortic balloon pumps, for instance. Today’s nursing recruiters aren’t so quick to rule those nurses out.

“If they have critical thinking, good communication, and emotional intelligence, we can fix the rest. We can get them there so they can be successful in the unit,” George said.

Of course, nursing applicants don’t need to possess many individual skills, but rather a baseline. “We don’t expect everyone to come in with every advanced skill we use in the unit,” George said.

This gives nurses the chance to grow into areas of nursing they may have been overlooked for. “Simply being hired to a unit and engaging in one field of nursing does not mean one is bound to it. It should be thought of as more of a continuum,” George observed.

At Johns Hopkins, the attitude is that skills can always be taught. This approach allows many applicants to be hired who otherwise would not have even gotten an interview. Many of those applicants are now highly successful nurses. “Nurses can enter into organizations where they may not have had a chance and absolutely shine,” Mitchell said.

Once hired, nurses at Johns Hopkins can take advantage of competency-based clinical ladders. “Nurses can ascend as their skills grow,” Mitchell said.

Interviewing is revamped with skills-based hiring

New interviewing approaches support the move toward competency-based hiring. George is having success with a conversational approach where applicants answer open-ended questions such as, “Can you tell me about the most interesting patient you have taken care of?”

“We are trying to parse out those people with a passion for teamwork,” George noted. The candidate knows what the unit is really like. Meanwhile, staff members assess how well the candidate fits into the unit.

After the interview, applicants spend time on the unit. “Some of them will stay five hours. The ones that stay the longest tend to be the most enthusiastic and learning-oriented nurses,” George said.

Using this approach, the unit sees high acceptance rates for job offers. Once hired, most nurses stay in their positions for a long time. “If we can see how they work, and how they think, we’re generally pretty successful. It’s very rare that we hire someone and have a regret,” George said.

Practice-ready nursing graduates

Nursing colleges are also moving away from strictly knowledge-based education, to competency-based education. This shift gives students room to enhance their interprofessional experience while improving their clinical judgment. And in 2021, the American Association of Colleges of Nursing released The Essentials: Core Competencies for Professional Nursing Education to help define these expected skills.

“Instead of faculty delivering straightforward lectures and students studying for an exam, students must demonstrate that they meet the course objectives,” said Susan L. Bindon, DNP, RN, NPD-BC, CNE, CNE-cl, FAAN, Associate Professor and Director at the Institute for Educators at University of Maryland School of Nursing.

“One of the main benefits of competency-based education is the mitigation of bias,” Bindon asserted.

Students are all expected to demonstrate the same competencies by the conclusion of the program. “The end result is a practice-ready graduate with the confidence and competence to join the workforce,” Bindon said.

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