Two years ago, the American Nurses Association asked the Department of Health and Human Services to declare the national nursing shortage as a national crisis. Has anything improved since then?
We all know many nurses have left bedside roles at hospitals during COVID, and not just because of PPE shortages and the trauma of so many dying patients. Sometimes it’s about compensation; for hospitals, 2022 was the most difficult year financially of the COVID-19 pandemic. But nurse burnout was a problem before the pandemic, with many nurses leaving the unit floor for research and teaching.
So what are the reasons so many nurses are leaving the bedside? A few reasons for the nurse shortage include….
- Staffing levels. Thousands of nurses in New York City went on strike over frustrations with unsafe patient ratios. Healthcare industry analysts have projected that more nurses are likely to go on strike this year.
- Workloads in general are high. Nurses recently reported the highest rates of burnout at 56%, and also were the likeliest (41%) to report an intention to leave their job in the next two years.
- Workplace safety. The rising number of incidents in hospitals includes the fatal shooting of a nurse and a social worker in Texas last October.
- Psych boarding. Hospitals are also housing more patients with behavioral health issues due to a lack of beds at facilities for patients with mental illness.
- Age. Almost half of America’s registered nurses are over the age of 50, according to federal statistics, positioning the industry to go over a retirement cliff within a decade.
- Difficult workplace cultures. From bullying to stress to disrespect, 72% of nurses reported unprofessional behavior from a provider in the last year. – and many report physical and verbal assaults from patients and their families. All of this can lead to low team morale and professional disengagement.
So what will solve the nurse shortage?
Nurse recruitment and retention has no magic solution – as any hospital can tell you. So how can hospitals recruit and retain more nurses and keep them on the unit floor? Here are a few practices for both facilities and nurses themselves to put into play.
From the hospital side:
Offer more flexible scheduling options.Many nurses complain about rigid schedules and shift lengths, such as being expected to work 12-hour shifts that don’t accommodate their childcare needs or their own health conditions. To solve the nursing shortage, some workplaces are now experimenting with 8-hour shifts and even 6-hour shifts, which can help keep older nurses from retiring and offer more flexibility for nurses with younger children.
Involve nurses in decision making. Experienced nurses would like to contribute their wisdom when it comes to policies and patient care decisions; they’d also like a seat at the table with hospital leaders to make their voices heard. Many nurses have suggested that C-suite leaders actually visit the unit floor and observe real-world clinical situations to avoid making decisions that make work better in theory than practice.
Build safer workplace cultures. For decades now, nurses have complained about being expected to do the worst grunt work in the worst facility conditions of all healthcare workers. Bullying and poor staffing ratios are so common that they’ve become cliches. To effectively address the nursing shortage, leadership must hold bullies accountable, survey staff on ideas for workplace support, and redesign staffing models to lighten the load.
Offer strong mentorship and support for young nurses. The industry needs to make the nursing profession attractive for students and provide young nurses with the precepts and mentors who can help them thrive in challenging environments. That includes pairing younger nurses with experienced nurses on shift.
From the nurse side:
Embrace travel or locum tenens. The healthcare industry tends to present locum tenens benefits from the facility side. And locums staff can relieve overworked, stressed-out, and burned-out providers, it’s true. But this kind of work also offers significant benefits for the nurses doing the relieving. Nurses can work part-time to transition into retirement or balance childcare obligations, while some nurses enjoy serving in different environments to expand their skill sets. Still others take advantage of the chance to travel the country.
Take a break. Nursing can be grueling. Taking a break between assignments or even a complete sabbatical can replenish a nurse’s energies and keep the door open to returning to the bedside. Some nurses scale back by working PRN, which stands for pro re neta or “as the need arises.” These nurses jump into action whenever a hospital needs them, usually to fill staffing shortages. They retain complete control over their availability.
Balance and blend. At Tribal Health, we have nurses who also work as farmers, aestheticians, professors, and freelance writers. Sometimes those other businesses are the side hustle; sometimes, nursing is the side hustle that allows them to pursue their other professional passions. Because they don’t depend on nursing for their full income, and limit their hours, they avoid burnout and stay fully engaged when they are at the bedside.
Treating underserved communities. Some people might picture serving in a resource-poor environment as being especially draining. In reality, many nurses find playing a direct role in solving health disparities to reawaken their sense of purpose. It’s impossible to be jaded when you play a hands-on role in saving a newborn’s life or helping a patient with trauma learn to trust providers again.
Solving the Nursing Shortage Together
When a disillusioned or exhausted nurse leaves the profession, she or he is usually flushing years of valuable experience and knowledge down the drain. It’s not a decision anyone makes lightly. Retaining nurses at the bedside helps not only hospitals, but helps nurses carry their own momentum into higher levels of achievement, income, and satisfaction. But to really solve the nursing shortage will involve a radical and thoughtful commitment to change from every stakeholder in the industry.