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Health and care: The evolution of nurse and carer staffing

Sponsored by Karo

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Mr Hugo Nolan, Director, Karo
Mr Hugo Nolan, Director, Karo

A transparent, efficient system has made it easy for healthcare organisations to fill temporary shifts with the right staff, in the right place, at the right time

The Irish healthcare system underwent dramatic changes during and after the Covid-19 pandemic, but some aspects of the system remain constant. For example, Ireland continues to struggle with a shortage of healthcare workers, and the enormous strain placed on healthcare staff – not least nurses and carers – has led to many of these vital people taking their careers along different trajectories in search of a better work-life balance.

Employers have often struggled in their efforts to secure qualified, skilled nurses and carers for temporary shifts, leading to inconvenience and stress for those tasked with providing patient care in difficult and unpredictable circumstances.

This gap in service and staff provision is being addressed by Karo, a company that utilises a team of specialist professionals who provide an online marketplace for nurses and carers to find shifts in healthcare organisations throughout Ireland. Karo operates under the principles of making it easy to fill shifts, whilst providing a quality service with choice and transparency, based on dignity and choice for all those involved.

Karo Director Mr Hugo Nolan spoke with the Medical Independent to describe how the company fills an important unmet need in staffing for Irish nurses and carers. “We are trying to stimulate the healthcare labour force by introducing the Karo platform. The concept behind it is, in a manner of speaking, to ‘democratise’ the approach to filling healthcare shifts,” said Mr Nolan. “From a healthcare worker’s perspective, whether they want to work flat-out as much as they can – within certain limits, obviously – that option is available to them. Conversely, someone may want to just do a couple of additional shifts. This could include, for example, somebody who wants to get back into the workforce, or a person who works, say, four shifts a week and wants another shift somewhere. Those options are all available.”


Healthcare workers can easily download the Karo app and upload their documentation, and the whole process is completely transparent for both the organisation and the healthcare staff member. Some 80 per cent of the bookings made through Karo are done seamlessly, without the need for any person-to-person contact, Mr Nolan explained. “We have a dedicated team who manage that whole flow, so once the healthcare workers are compliant, they have access to shifts that are in their area and they can see how much a given job will pay per hour. They can also rate employers, for example if it is the type of organisation that looks after its staff well, or if it is perhaps chaotic or understaffed, and so on.”

These are useful and intuitive options that were not previously available to healthcare staff – at the moment, prospective employees have to either go directly into permanent employment or go through an agency, which then places them in a role with that organisation. “What we are doing is giving these employees the option to choose,” said Mr Nolan.

For their part, employers can post available shifts on a daily basis and search for fully trained and carefully screened nurses and carers to fill their temporary shifts. Employees can take control of their working week, choosing when and where to work, with the choices comprising healthcare organisations throughout Ireland.

“The transparency works both ways,” Mr Nolan explained. “Workers can find shifts in facilities nearby,” he continued. “For example, they might identify 10 shifts near to them and they can see the type of work that is required – is it highly demanding, for example working with people who have intellectual disabilities, is it very hands-on, or perhaps it’s a nursing home environment, where it’s hands-on, but perhaps not as demanding.”

Employer oversight

“But importantly, from a client’s perspective, they now have oversight of the type of part-time worker that they want to come and work with them,” he emphasised. “Previously, they would give their requirements to an agency and ask them to send someone who might meet their requirements, and that decision could be subjective. What we are doing is, now the person who is booking the staff can immediately see the worker’s rating measured in stars, such as a rating of 4.8 for example, which would be a very high rating. That score is peer-rated by other organisations. They can see that person’s experience; they can see their staff file as and when needed, so they don’t have to request it from an agency. Once that person comes in and does their shift, the employer can open up a dialogue and ‘favourite’ them in the system. In this way, they can achieve important continuity – if the worker is good and they like them, the employer can keep them coming back, they can pre-arrange shifts, or they can say, for example: ‘We have 10 shifts next week. We can prioritise the ones we have ‘favourited’ and offer them these shifts before we open them up to the rest of the marketplace’.”

Karo is also a pivotal tool for nurses and carers returning to the workforce, for example for those who have become parents and who want to achieve a satisfactory work-life balance. Nurses and carers who are already in the workforce can increase their shift work hours, and once they are screened, they can have immediate access to extra shift work. For their part, employers have instant access to staff files and employment references and they can then leave a reference if they wish, ensuring trust in their shift staff and quality and continuity of care for patients.

Karo can also help with the increasing problem of staff retention, as the flexibility of the system encourages staff to stay in the industry by offering a more flexible working week.

“This type of system is long overdue for both employers and shift work nurses and carers,” Mr Nolan explained. “Every chaotic situation requires a solution – what we are trying to do is provide something that fits the situation very well for everybody… we at Karo have seen week-on-week growth and incredible client reviews.” Some of Karo’s more notable clients include many of the most prominent names in the nursing home industry, including Virtue, Integrated Healthcare, Aperee Living, CareChoice, and Beechfield Care, as well as hospitals and disability organisations, such as St Michael’s House, Camphill, the Brothers of Charity, and the Royal Hospital Donnybrook.

No agency fees

Eliminating costly agency fees is just one of the significant benefits of the system. It also allows organisations to communicate and post shifts to nurses and carers throughout the country, giving them back control over their staff scheduling. Organisations can easily keep track of their temporary staff with an easy- to-use system that can generate reports, as and when necessary. They are also safe in the knowledge that thorough background checks are performed on every staff member who signs up, incorporating relevant training and qualifications, right-to-work, and criminal history.

Mr Nolan concluded: “With Covid, among other factors, people have put value on different aspects of life, and one of these is certainly the working world. In healthcare, there has been so much movement in terms of staffing in the last two-to-three years. People are starting to choose a healthy work-life balance and may decide they only want two or three shifts per week, not just in healthcare, but also across many industries. There are conversations taking place that wouldn’t have happened two or three years ago.

“We are trying to prevent people from leaving the industry because they think there is no alternative. Instead of them working five chaotic shifts per week and thinking that working life is an ‘all or nothing’ proposition, we want organisations and shift staff to know that they can be in control of their own hiring practices and their own working life.”

To find out more about how Karo can streamline how your organisation works and save agency fee costs, visit or speak to Mr Hugo Nolan at 087 204 1094, or email

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