By Deborah Jeanne Sergeant
Nightingale College estimates the current nursing shortage at an 8% deficit for registered nurses and 20% for LPNs. The supply of new nurses minted this year will still leave RNs with a 10% shortage andlicensed practical nurses with a 20% shortage.
A variety of factors have long since fueled the shortage, including massive numbers of retirements, since approximately one million RNs are older than age 50. Burnout also affects the number of nurses. During the pandemic, 20% of all healthcare workers, including nurses, left healthcare, which exacerbated the shortage that existed before COVID-19. Overall, the career’s stress, shifting schedules (especially at hospitals) and long hours also contribute to burnout.
Meanwhile, the demand for nursing climbs as aging baby boomers require more care for age-related chronic conditions and acute health issues.
“We’re definitely making strides,” said Danielle Barry, nurse recruitment manager at Highland Hospital. “There have been different programs at the hospital, state and college level to encourage people to go into nursing. It helps decrease the shortage.”
One of the short-term answers for the nursing shortage has been employing “traveling nurses,” nurses who work for an outside agency for temporary assignments of the nurse’s choosing, often in locations away from their hometowns.
Barry said that travelers have been used “more than we would like.”
Travelers fill roles, but cost hospitals substantially more. Taking traveling jobs means better pay and a chance for workers to see different parts of the country. But they don’t have insurance. And hospital morale can suffer.
Barry said that statewide programs such as CPT (Career Pathways Training) provide state funds to people attending qualified nursing programs free in New York with an obligation to work as an LPN, RN or BSN nurse at a CPT facility for three years. More information is available at www.healthcareersnow.org/cpt.
“You can get into an accelerated program if you have your bachelor’s degree,” Barry added. “University of Rochester and SUNY Brockport have the accelerated program.”
Many people who would like to study to become a nurse face not only financial barriers regarding tuition, but the need to continue to work while studying. Barry said that Highland has a program where people can work part-time as a patient technician while receiving full-time pay and benefits while they attend nursing school with tuition assistance.
In addition, Highland and other hospitals are working at recruiting high school students to healthcare roles. Many young people have not considered nursing as a career.
“This is a great option; you can do so much in nursing,” Barry said. “You don’t have to stay in one place. There’s inpatient, outpatient, home care and virtual. You can make drastic changes in your life as a nurse without a lot of additional education and you can’t do that in a lot of professions.”
Many medical specialties permit nurses to learn on the job beyond their basic nursing skills.
Victoria Record, senior vice president associate chief academic affairs officer and president of the College of Health Careers at Rochester Regional Health, expressed enthusiasm about the local nursing schools’ output but she cautions that the volume won’t be enough to reduce that nursing shortage. “It’s the system capacity and pipeline volume.”
Nursing schools turn away more than 65,000 qualified applicants from nursing school annually, according to the American Association of Colleges of Nursing because schools lack both sufficient educators to teach them and, for teaching hospitals, the slots at their facilities for their students’ clinical residencies.
“Salaries for faculty aren’t as high as for nurses,” Record said. “We think about shared roles. Maybe they can work a few shifts a month while teaching. We are certainly looking at those new approaches for our own school and our academic partners too.”
She said that for clinicals, the “pipeline is full right now. For fall admission, more than 1,000 applications were received for two programs and I accept only 200 students, based on our availability like classroom space, clinical space and the faculty to support that.
“My colleagues in academics are experiencing those same constraints.”
The industry is shifting to simulation models, as New York permits 30% of clinical experience may take place in these environments. Rochester Regional Health has maxed out its simulation environments.
Another factor in the nursing shortage is retention and workforce attrition. As more nurses move to other careers or other organizations from one healthcare organization, those tough-to-fill spots remain unfilled and can cause the hospital to reduce its capacity and have fewer beds open since they lack sufficient caregivers to staff them.
Record said that within their first few years at a hospital, 30% of RNs leave. In some settings, that figure can be as high as half.
“We see these retention issues in areas that are high stress like ICUs and emergency departments,” Record said. “A lot of people don’t manage that well.”
To improve retention, Rochester Regional Health asks its workforce about what’s important to them. Answers such as creativity in shifts, better workflow and using technology to help do their jobs are all areas in which the health system can help improve morale.
Record also said that academic partnerships are also helping create “grow-your-own” solutions to staffing as healthcare organizations are working to train employees from within and paying tuition to attend nursing school.
New York’s Healthcare Workers for Our Future Scholarship (www.governor.ny.gov/programs/healthcare-workers-our-future-scholarship) “provides a two-year scholarship to approximately 500 selected recipients covering tuition, room and board and other related expenses in an approved program of study at any approved New York state public or private college or university.”
The degrees included cover the career path of registered nurse, respiratory therapist, clinical laboratory technologist, radiologic technology and surgical technology.