With a sharp increase in COVID-19 cases this fall and hospitals nearing capacity, health care workers nationwide are scrambling to save lives – at great personal risk.
But the extraordinary number of people flooding hospitals has shined a spotlight on another crisis: a nursing shortage.
The pandemic has created unprecedented challenges for nurses, including fear of workplace exposure. Since nurses have the most direct, hands-on patient contact, they face the greatest risk of infection of all health care workers. Many have been reassigned to the emergency room, “COVID units” or other high-risk departments.
It’s become an extremely dangerous job. More than half of the 20,000 nurses surveyed by the American Nurses Association in the summer reported having to reuse single-use masks or treat patients with little or no personal protective equipment. Many are working 12- to 16-hour shifts. Some who have tested positive for the virus have been asked to continue working to care for the glut of patients.
Some 36% of health care workers hospitalized with COVID-19 were nurses or nursing assistants, according to U.S. Centers for Disease Control and Prevention data. As of September, 213 registered nurses had succumbed to the virus.
Some 4 million registered nurses make up the U.S. workforce; about 60% work in hospitals. By 2022, the nation needs 1.1 million new RNs to avoid a nursing shortage, according to the U.S. Bureau of Labor Statistics.
Hospitals can’t function without enough nurses, who spend more time caring for patients than any other health care professional. To keep hospitals staffed amid current shortages, some administrators are replacing nurses with technicians or asking nonhospital nurses to work in hospitals. These are life-and-death decisions: choosing either to treat patients under circumstances that could risk medical errors – or turn them away.
The current and projected shortages have many causes and vary widely, with the largest shortfalls in southern and western states.
Some of the looming problem is demographic. The average age of a U.S. nurse is 51, and 1 million nurses will be eligible for retirement in 10 to 15 years. Nursing schools are expanding, but it’s not enough.
As the nursing workforce shrinks, the stress on the health care system is rising. The nation’s 73 million baby boomers are aging, with many suffering from chronic illnesses that require intensive levels of care.
Under normal circumstances, nursing is considered one of the most stressful careers. Demands of the job tend to take precedent over self-care; one study found that 68% of nurses put their patients’ health and safety before their own.
Working under intense stress causes burnout in about half of all nurses. It may spark physical or emotional ailments, drug or alcohol misuse or depression. Nurses have a substantially higher risk of suicide than the general population.
And now, the pandemic has made a tough job exponentially harder. Without serious efforts to recruit more nurses and improve working conditions, the U.S. is in danger of serious breakdowns in the health care system.
There are many ways to address the nursing shortage. Solutions include offering better salary and benefits, saner work hours and less physically demanding roles for older, experienced nurses to keep them working longer. Reaching out to youths and continued funding for nursing education under the Public Health Service Act will help spark interest in the profession and build a more diverse workforce.
A strong nursing workforce is essential to the health and wellness of the nation.
Dr. Rayna Letourneau is an assistant professor of nursing at the University of South Florida. Distributed by The Associated Press.
