Nurses are leaving the profession and it can be difficult to replace them


The fourth wave of COVID-19 is exacerbating the current crisis for nurses and has led to the burnout of many nurses. As a result, many are quitting their jobs in substantial numbers across the country, with 62% of hospitals reporting a nurse vacancy rate above 7.5%, according to a 2021 NSI Nursing Solutions report.

But the global pandemic has only compounded problems that have long existed within the nursing profession – in particular, widespread stress and burnout, health and safety issues, depression and stress disorder. work-related trauma, and even an increased risk of suicide.

Additionally, nurses face increasing workloads and inadequate staffing, or not having the right number of nurses on the right units to ensure patients receive safe and quality care. Mandatory overtime is another challenge and occurs when nurses have to work overtime beyond their shift due to a staff shortage.

All of these issues can lead to low job satisfaction among nurses and are likely to contribute to nurses leaving the profession, a trend that began long before the current pandemic hit.

Despite increased awareness of the challenges nurses currently face, nurse staffing and its impact on patient safety have been studied for over 20 years. My role as a nurse researcher and assistant professor at the University of South Florida is to assess the needs of the nursing workforce and to design and implement programs to meet them.

Here’s why the pandemic has made the nursing shortage worse, and why I think healthcare leaders need to make bold changes to ensure the well-being of nurses – for the sake of nurses and patient care in our country.

Disruptions in the delivery of health care

Nurses, like many healthcare workers, are physically and emotionally exhausted after working in what has been described as a “war zone” for most of the past year and a half. A nurse on the front line reported irreversible damage the trauma of caring for extremely ill patients. Others are experiencing shortages of oxygen, equipment and other supplies needed to keep them safe and keep their patients alive.

As more nurses leave the workforce, patient care will undoubtedly suffer. Research has shown a relationship between nursing staffing ratios and patient safety. Increased workload and stress can put nurses in situations more likely to lead to medical errors. Lower nursing staffing and higher patient loads per nurse are associated with an increased risk for patients of dying in hospital.

Because hospitals cannot open beds if there are no nurses to staff them, some hospitals are forced to close emergency rooms and turn away patients in need of medical care. This is a problem not only for hospitals in large cities; rural hospitals are also struggling. Alarmingly, some hospitals are considering the need to potentially ration medical care.

How some hospitals are coping with the shortage

Hospitals are desperate to fill nursing positions. A South Dakota hospital system offers incentives of up to US $ 40,000 in enrollment bonuses to recruit nurses to work in clinical areas that need them most. This may be a big attempt to attract nurses to an institution, but the bonuses and incentives for enrollment might not be enough to persuade some nurses to work at the bedside and continue to cope. to the current workload of the pandemic.

Another strategy for filling vacancies is the use of travel nurses. Travel nurses work for agencies that assign them to hospitals that cannot fill vacancies with their own staff. While this can be an effective short-term solution, the use of mobile nurses is not sustainable over time and does not help retain experienced staff nurses in an organization. Mobile nurses earn much more money than staff nurses, which can draw nurses away from permanent positions and in turn increase the staffing gap for hospitals.

The average salary for a travel nurse in the United States is $ 2,003 per week, with $ 13,750 of overtime per year. Some nurses even accept “crisis assignments,” which can cost up to $ 10,000 per week. This is significantly higher than the average of $ 1,450 per week ($ 36.22 per hour) for a bedside nurse.

Focus on the well-being of nurses

Over the past 18 years, nursing has been identified as the most trusted profession. Nurses are caregivers, role models, educators, mentors and advocates, and they have a direct impact on the health and well-being of patients. The health of the nation’s nursing workforce is fundamental to our health care industry. As a 2021 National Academy of Medicine report identified, the well-being and resilience of nurses is necessary to ensure the delivery of high-quality care and improve the health of the nation.

Research shows that people with higher levels of well-being have lower levels of burnout and perform better at work. Therefore, some hospitals and unions are offering resources and programs for nurses during the COVID-19 pandemic that seek to reduce stress, promote resilience and increase well-being. We have yet to see the long-term effectiveness of these programs on the health and well-being of nurses.

While nurses are responsible for prioritizing self-care, healthcare organizations are responsible for creating a work environment in which nurses can thrive. Nurses report fewer medical errors when their well-being is supported by their organization and when they are in better physical and mental health.

The long-term solution to the nursing shortage requires systematic changes that empower nurses and provide them with a safe place to work. Examples include implementing appropriate salaries and flexible hours, ensuring adequate nursing staff, and creating jobs that allow aging nurses to continue working in direct patient care roles so that they can stay longer in the labor market instead of retiring.

The pandemic has made more people aware of the harsh conditions in which many nurses work. But without systematic change, the exodus of nurses from the profession – and its negative impact on patient care – will only continue.

Rayna Letourneau is Assistant Professor of Nursing at the University of Florida.


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