The U.S. Nursing Shortage is at Crisis Levels
What do we do about it?
Anyone who knows or loves a health care worker knows what an enormous toll the Covid-19 pandemic has had on these individuals. The pandemic has driven health care workers to record high levels of burnout, with 60% to 75% of clinicians reporting symptoms of exhaustion, depression, sleep disorders, and PTSD. According to a survey by Morning Consult, a marketing research firm, almost 1 in 5 health care workers quit their job during the pandemic.
Nurses are equally — if not more — stressed than doctors. The American Association of Critical-Care Nurses found that 66 percent of acute and critical care nurses have thought about quitting nursing entirely since the pandemic began. Now, more than one-third (34%) of nurses say it’s very likely that they will leave their roles by the end of 2022, and 44% of these individuals cite burnout and a high-stress environment as the reason why.
The United States is already facing a severe nursing shortage. According to the president of the American Nurses Association Dr. Ernest Grant, the nation will need an additional 1.2 million nurses by next year to meet the growing demand for their services and to replace those leaving.
The problem is so severe that Grant recently wrote to the U.S. Health and Human Services Secretary Xavier Becerra, asking him to declare the nursing shortage a “national crisis” and calling for federal help.
Chronic understaffing and unsafe nurse workloads are major contributors to nursing burnout. For example, by around the end of March 2022, 28% of nursing facilities reported at least one staffing shortage. Of the approximately 14,000 nursing facilities participating in this survey, 26% reported aide shortages and 24% reported nursing staff shortages while just 3% reported clinical staff shortages.
It is important to note that aides and nursing staff are reporting the greatest shortages. In case you’re not familiar with medical lingo:
- An aide is defined as a certified nursing assistant (CNA); their job is to oversee overall care needs, including assistance with personal care needs and ensuring that each resident’s plan of care is being followed.
- Nursing staff include registered nurses (RNs), licensed practical nurses (LPNs), and licensed vocational nurses (LVNs)
- The clinical staff includes physicians, physician assistants (PAs), and advanced practice registered nurses (APRN), and they are responsible for primarily overseeing medical needs.
The reason this distinction matter is that in order to solve the crisis we are experiencing in the health care workforce, we must understand what groups are dissatisfied and why. If we don’t, the shortage will become dire: McKinsey analysts estimate that by 2025, the U.S. may have a gap of between 200,000 to 450,000 nurses available for direct patient care, equating to a 10 to 20 percent gap.”
Burnout isn’t just a personal issue for nurses — it is a persistent threat to public health. Decades of research have shown that each additional patient in a nurse’s workload is associated with poor patient outcomes, including higher odds of dying and hospital readmissions, as well as poor nurse outcomes including burnout, job dissatisfaction, and intent to leave.
For those that may argue that the pandemic stress on hospitals and nursing homes is declining so nurse burnout will as well, I’m one step ahead of you. The nursing shortage didn’t start with the pandemic.
In April 2022, researchers at Penn School of Nursing found that high rates of burnout and intent to leave existed before the first Covid-19 patients ever entered U.S. hospitals and nursing homes. An analysis of survey data collected from December 2019 through February 2020 reveals that more than 40% of RNs reported high burnout, 1 in 4 were dissatisfied with their job, and 1 in 5 planned to leave their employer within one year (1 in 3 among nursing home RNs).
The finding that nurses in hospitals and nursing homes experienced poor working conditions, high burnout, and poor patient safety and care quality even before the Covid-19 pandemic even started is a sobering reminder that our goal should not be to return to the pre-pandemic “normal.” Our system was never working. Like most things, the pandemic didn’t start the problem — it only brought it to light.
Our goal should be to innovate the care delivery models we have in place to reduce the burden on nurses. Newer technology can alleviate some of the burdens; for example, Somatix’s patented SafeBeingᵀᴹ solution that enables Remote Patient Monitoring (RPM) has been shown to reduce 30-day hospital readmissions by 17%.
To maximize nurses’ time and energy, utilizing predictive analytics can allow healthcare providers to ensure optimal resourcing, as AI-powered wearables can clean massive volumes of patient health data to notify nurses when a patient’s health is deteriorating. Going forward, healthcare providers, insurers, and policymakers should consider enabling such change through digital, clinician, regulatory, and labor union collaboration. It is up to all of us to solve this problem. After all, our future depends on it.
