This Might Hurt a Bit: the Chronic Nursing Shortage is Now Acute

If the nursing shortage is bad now, chances are it’s going to get much worse.

“Hospitals were having difficulty finding nurses to fill positions before the pandemic,” notes Kendra McMillan, MPH, RN, Senior Policy Advisor for Nursing Practice and Work Environment at the American Nurses Association (ANA). “In fact, according to the US Bureau of Labor Statistics, 175,900 RN openings were projected each year through 2029, when we factor in nurses leaving the workforce for reasons such as retirement. Unfortunately, the pandemic’s demand on the healthcare system has further exacerbated a long-standing projection that has burdened our nursing workforce.”

*Kendra McMillan, MPH, RN, ANA Senior Policy Advisor for Nursing Practice and Work Environment*

Doctors and nurses are overworked, thanks to chronic staffing shortages made worse by a pandemic that drove thousands from the field, writes The New York Times. On the West Coast, “the nursing shortage affecting the whole nation is impacting the Northwest region as well,” according to an article in The Bulletin (headquartered in Bend, OR), quoting a Kaiser spokeswoman.

“Finding experienced nurses has always been a challenge in Southern California,” according to Cherie Fox, RN, MSN, CCRN-K, Executive Director Acute Care Services, Providence Mission Hospital, Mission Viejo, California. “Following the COVID-19 pandemic, we are seeing nurses retire, move out of the area, and reduce hours, all of which has amplified our staffing challenge just a bit.” Fox led the initial team that opened the COVID ICU and telemetry units during the pandemic. She recently coauthored a paper in Critical Care Nurse detailing Providence Mission Hospital’s COVID response.

And a recent study found that nurses are reporting large declines in their mental health. More alarming, nurses, especially those who are younger, are feeling less committed to the profession.

Multiple Solutions

To address the growing crisis, hospitals are pursuing multiple solutions, including hiring travel nurses. “I’ve talked to several emergency departments across the country that are having those issues where they’re having to have temporary nurses come in to the emergency department,” says Ron Kraus, MSN, RN, EMT, CEN, TCRN, ACNS-BC, Emergency Nurses Association president and Emergency Department Clinical Nurse Specialist at Indiana University Health Methodist Hospital.

*ENA President Ron Kraus, MSN, RN, EMT, CEN, TCRN, ACNS-BC*

Providence Mission Hospital has also made use of travel nurses and offers a referral bonus to current caregivers. Fox notes that nurses are taking time off while others are getting ready for vacations. “While the time off is needed and approved, it does add further to dependence on traveling nurses.”

“Hiring bonuses, tuition reimbursement, and loan repayment are examples of incentives offered to nurses to boost recruitment and retention efforts,” notes the ANA’s McMillan. But, she adds, hiring bonuses don’t support efforts to retain nurses who are already employed in the organization.

“Nurses are facing longer shifts and are working more consecutive shifts to meet the persistent demands on our healthcare system” notes McMillan. The nurses who remain are burned out physically, mentally, and emotionally.”

The ENA, notes Kraus, is focusing on helping hospitals create a healthy work environment. Having a healthy work environment that empowers nurses, while supporting their needs, helps to overcome fatigue and moral distress, notes Fox.