The COVID-19 pandemic highlighted the bravery and commitment of health care professionals in the face of danger and tragedy. Unfortunately, the continued stress of the crisis took a severe toll on the heroic nurses who provided invaluable care and hope to our communities. It also further exposed the crippling nurse shortage that is plaguing the health care system nationwide and in Texas and increased the call to think outside of the box to address the crisis.
Some hospitals in Texas and across the country are taking steps to address the shortage, and they’re doing it by making changes for a more inclusive and friendly environment – providing nurses with better engagement and empowerment to shape operations and improve patient care.
Addressing the causes
The nursing shortage is a long-standing challenge, but the pandemic has significantly worsened the problem. Nurses and physicians have left in record numbers, due to fatigue and exhaustion. High turnover has severely affected employee morale, creating a snowball effect that could encourage more nurses and other staff to leave. It can also have an impact on attracting new talent.
The difficulties of COVID-19 created a wave of early retirements due in part to the extended period of limited access to medical facilities for both patients and staff. Because hospitals stopped doing elective surgeries – and many patients made it a point to stay away for safety reasons – hospitals had less income and needed to reduce staff to stay afloat. A 2015 study reported that more than 1 million RNs would retire from the workforce between now and 2030. As they go, they take with them their invaluable accumulated knowledge and experience.
Unfortunately, the critical nursing shortage shows no sign of abating, and experts project that 1.2 million new RNs will be needed nationwide in the next eight years in order to address the shortage. According to the Texas Workforce Commission, there are already 23,000 more unfilled RN jobs, and that number is expected to increase 50% by 2030. What’s more, the shortage of RNs will only intensify as baby boomers age and the need for health care grows.
By Cindy Gaines, chief clinical transformation officer, Lumeon.
Reflecting on the past couple years, it’s become clear that staffing shortages have taken a toll on nursing physically, emotionally and mentally, leading to declining retention rates, inadequate resources, and, at times, concern for their mental health.
Staffing shortages are not just the result of a pandemic, but of an aging workforce. Hospitals are faced with the challenge of addressing the work environment not just in the context of a pandemic, but holistically.
Pain Points
Through the years, we have equipped nurses and care staff with equipment such as computers, pagers, tablets, and zone phones to help them connect with patients, family members, doctors, labs, radiology and outside services. This equipment is necessary for their work but has had unintended consequences. As nurses manage medications and juggle competing priorities, they are constantly bombarded with a world of distraction. This creates safety risks in the care environment.
Additionally, this technology has introduced service expectations created to support the patient and family experience. For example, a phone call must be answered within 3 rings—great customer service for the caller, but it takes the nurse away from the patient currently being cared for. At times, technology meant to support the care process has become a barrier between the nurse and the patient.
This stressful work environment is further complicated by very real staffing issues in our country. Demographic data suggests that the average median age of a nurse is 52 years old and that 20% of RNs are 65 years or older, meaning hospitals can expect gaps in staffing as this age group ages out and begins to retire. While this seems like an opportunity to usher in a new generation of young, fresh-minded nurses, nursing programs are unable to graduate enough people to supply this gap in the industry due to an overwhelming lack of resources.
These factors together have created the perfect storm of a care staff shortage.
By Rebecca Love, chief clinical officer, IntelyCare.
The news media has done an excellent job of covering the country’s ongoing nursing shortage since the pandemic began. But one problem I have with the coverage is that most of the reports suggest the pandemic and the subsequent burnout suffered by nurses is to blame for the shortage.
Let’s be clear about what we in healthcare know all too well.
Years before February 2020, when COVID-19 began to spread across the globe, a growing number of care facilities around the country were chronically understaffed. The truth is the pandemic exacerbated and brought dramatic downward pressure on an already strained workforce. The issue came to the forefront because nurses were on the pandemic’s frontlines and in the spotlight. It shouldn’t have surprised anyone that the many ways the healthcare system has failed them – going back decades – were thrust into full public view.
Earlier this month, the St. Louis Post Dispatchpublished a story about the high turnover in area hospitals. At one hospital system, out of a 8,500-person staff, managers are losing 160 nurses a month, according to the paper. The story is much the same around the country. The Bureau of Labor Statistics estimates that the nation’s care facilities will be short 1.1 million registered nurses by next year. A problem is particularly serious for post-acute care facilities, which were seeing a pre-pandemic annual turnover rate of 128%.
Before the pandemic, shortages at facilities didn’t draw much attention because there was always some way to patch shifts together. Managers could hire per diem staff or travel nurses. Then, the pandemic struck and the backup resources administrators typically relied on dried up. With so many hospitals overflowing with COVID patients, few places possessed extra nurses.
One of the greatest health concerns of modern society is nursing shortages in different states across the world. The prevalence and impacts of the recent Covid-19 pandemic have taught the world that professional nurses and physicians are pertinent to providing quality healthcare services. As the pandemic continued to expand, it became evident that frontline nurses suffered the most, causing an unpredictable shortage of professional healthcare workers at such a poor timing in history. Predictions indicate that by 2030, there will be a shortage of more than 50,000 nurses in certain states.
This trend explains why nursing programs and professionals embrace technology to help in the ideal recruitment, retaining, and monitoring process. Here is how technology helps to counter nurses’ shortages in the healthcare system.
Specialty Preference Over Facility
Gone are the days when nursing and other healthcare job vacancies filled the print media pages. Around a decade ago, influential healthcare policymakers decided that the system would evolve from print journals, specialty publications, and newspapers to social media, website optimization, and email marketing. This strategy would facilitate analytical and metrical monitoring to promote nursing by specialty rather than a facility.
Electronic Scheduling
Many nursing training processes take place virtually. Several nurses get assigned to different shifts based on their competence skills and preference areas. Electronic scheduling helps solve the nursing shortage challenge by facilitating trading shifts among professional healthcare workers and establishing a stable balance between work and personal lives.
By Cindy Koppen, senior vice president of clinical solutions and chief nursing officer, Banyan Medical Systems.
Cindy Koppen
As healthcare systems become increasingly patient-centric, the nursing profession will no doubt evolve along a similar trajectory. That evolution will inevitably require a reconciliation between a consolidated model for care delivery and some existing functions within nursing that aren’t entirely aligned with the goal of delivering the highest-quality care.
To determine how nursing practices can more wholly align with the future of healthcare delivery methodologies, we must first look at the core function of nurses and chief nursing officers to see where technology can modernize nursing and unlock benefits where they’re needed most.
The primary goal of the CNO is to ensure staff needs are met while creating an engaging, open nursing culture that promotes improved quality outcomes for patients and financial outcomes for the healthcare provider. Hospital technology is a growing part of the CNO’s toolbox because it can support the improvement of clinical and financial performance, identify trends, issues, and developments as they relate to patient care. It can also evenly distribute the nursing workload, improving the work-life balance of nurses and increasing the time available to spend with patients.
Current and Future Nurse Cohort Challenges
Nurse cohorts and staffing concerns are already an issue for many healthcare organizations, but these obstacles will become more challenging as Baby Boomers grow older. A 2017 survey from AMN Healthcare found that 73% of nurses in the Baby Boomer generation were planning to retire in the next three years, and even middle-aged nurses can struggle with the physicality of the work. One 2008 study found that nurses needed to walk as many as five miles during a 10-hour shift, which also constrains time with patients and can make it difficult to deliver the highest-quality care.
In the face of mounting physical demands and less time with patients, it’s no surprise that the oldest and most experienced nurses frequently retire or move to less demanding private clinics, leaving a void that hospitals cannot fill due to the overall nursing shortage.
CNOs Can Support Nurses and Patients With Hospital Technology
Many hospitals are full of state-of-the-art technology, but few of these tools can have as profound an impact as virtual providers. CNOs can augment staff to handle the hands-off aspects of care, relieving some of the strain on on-site nurses by increasing their capacity and more evenly distributing their workloads, freeing up more of their time to focus on hands-on patient care and eliminating the need for end-of-shift overtime.
Virtual nurses are also an excellent source of collaboration and critical thinking skills — resources that directly impact patient outcomes and experiences for the better.
