One of the biggest challenges facing hospitals during the pandemic is workforce shortages – specifically beside nurses. This crisis started before COVID-19 and will continue after – fueled by a myriad of developing issues. One constant is that we face an increasing need & a decreasing supply of the hospital nurses who are critical to providing the lifesaving care that patients need every day. Estimates show we will need one million new Registered Nurses by 2030.
Dr. Peter Buerhaus, who joined Chip on this episode of Hospitals In Focus, called COVID-19 the “perfect storm” when it comes to widening the workforce crisis.
“This has hit the nurse workforce and hospitals unlike any situation in the past. It is because it did drive up the demand for nurses, particularly nurses at a certain skill level, while at the same time decreasing their supply. To me this was like pouring fuel on both the supply and demand.”
Dr. Beurhaus is a nurse by training who now dedicates his career to researching the economics of the nursing workforce. His most recent research was published in Health Affairs titled “Nurse Employment During The First Fifteen Months Of The COVID-19 Pandemic” and detailed critical information about the country’s nursing infrastructure. A short summary of the findings was outlined by Montana State University.
During a wide ranging and engaging conversation, Chip and Dr. Buerhaus discussed the cyclical nature of nursing shortages, dove deeper into the issues COVID has magnified, and look to what hospitals and policymakers can do to alleviate some of these challenges.
They started by looking back at past shortages – one of the most prominent being in the late 1990’s when there were 126,000 open positions. Dr. Buerhaus says Johnson and Johnson stepped in to create a national campaign that promoted the profession.
“It raised the profile using positive portrayals of nurses. It inspired many people to want to become nurses, and this campaign was sustained over a number of years. And that was something we had not seen in prior shortages that made a huge difference.”
Dr. Beurhaus says it is once again time to “rebalance the messaging.” He told Chip, “I believe that way too much of the current imagery – the tweeting, the media coverage, the social messaging, the texting, et cetera – about nurses and about hospitals is just frankly dreadful. It emphasizes unprecedented shortages, all their negative effects. I feel we’ve had enough of this. And if we don’t begin to counterbalance with more positive portrayal of nurses, we risk decreasing entry into nursing education programs and failing to grow the workforce that we need over the decade.”
There is also concern that nurse retirements will with a dearth of needed, lifesaving experience.
“We will be replacing these retiring nurses with younger, less experienced nurses. And we could be experiencing sort of a qualitative shortage – not enough nurses with all the knowledge and skill needed to take care of increasing numbers of older people who will be requiring hospitalization, who are very medically complicated patients. We will need to be find ways to replace that retiring baby boom generation at a time when we really need that knowledge and skill.”
Dr. Beurhaus also discussed the growing reliance on travel nurse agencies during the COVD-19 crisis.
“We’ve seen the travel industry involved in prior shortages. There’s nothing new about this, but the degree has been extraordinary with the pandemic. I think that we were caught up in this situation when so many hospitals have such a desperate need for nurses and given the high earnings, a nurse can make, as a traveler, many nurses have been willing to become travelers and earn higher earnings…But ultimately, I think we’re going to have less travel nursing as we get past the current surge. So I don’t think that this will be a long term situation to the degree that we have it today.”
Chip and Dr. Buerhaus concluded the conversation discussing how hospitals, nurses and policy makers can forge a successful path forward.
“Maybe we will find that point where we can have hospitals and nurses together in the same room, reflecting on the past two years – discussing what worked? What did we learn from it? What was positive and what wasn’t? What are the strengths that we found out about ourselves? What are our weaknesses?” The he added, “I think that a policymaker, a legislator, someone working on Capitol hill, seeing the economics of the nurse labor market, how dependent hospitals are on nurses, knowing the public has high trust and high public opinion of nurses – they need to grasp the truly unprecedented impacts that COVID has had on hospitals and nurses. It strikes me that it’s in society’s interest that government and payers find ways to help to reset relationships and grow a strong workforce.”
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