Photo Credit of Black Hole: By User:Alain r - Own work, CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=1150148
I was talking with the Chief Nursing Officer of one of our local healthcare systems last week about job opportunities for new nursing graduate nurses that I teach. The numbers she told me were startling:
“Normally, we have about 1,000 applicants for 200 nursing positions. Right now, we have about 20 applicants for those same 200 nursing positions, and all the applicants are new graduates.”
The nursing workforce has evaporated – thus, my image of the black hole. Where have they gone?
The last 20 months of the COVID-19 pandemic have stressed the global healthcare system in a way that we all knew would eventually come but hoped we would never actually see. Surge after surge, the rise of virus variants, the difficulties with vaccination mandates and the frustration of seeing people die from what is now considered to largely be a preventable illness…these factors have taken a toll on our workforce.
At the beginning healthcare providers were rolled up their sleeves, worked extra shifts, built temporary hospitals, and traveled to distant sites where surges were happening. One can only sustain that momentum for so long before you start to wonder if it is worth it.
Travel nursing companies now offer benefits in addition to their usual paid housing, high hourly rates, and sign-on and completion bonuses. Benefits in travel nursing were unheard of, but for many people was the missing piece that had prevented them from traveling before.
Where does this leave us? We know hospitals are chronically short-staffed now. In my own local county, ICU bed utilization was at 119% yesterday, and it has been over 100% for more than a month now.
A friend asked me what that number really means, and I explained it this way: Assume the hospitals in the county have 100 staffed (a key word to note) ICU beds. If the utilization is 119% today that means they have created about additional 19 staffed ICU beds to take care of patients needing that level of care. For someone who has never worked in a hospital, the concept of “beds” is not intuitive – we can designate a unit with intermediate care-level beds to be ICU beds, for example.
Who is staffing those beds? Certainly, there are staff who have stayed, but we are also seeing more travel nurses filling in gaps, which come at a high cost to the hospital.
I worry about my nursing students who are graduating soon. We know from emerging research that this group of students feel less confident about their nursing knowledge and skills as they transition to professional nursing practice than prior groups of graduates. They are entering a work environment where staff are caring for more patients than usual and there is less consistency among the staff. I worry that some will not receive the mentorship and support they need to make the successful transition. I don’t fault the staff or the hospital in this; they are working under unprecedented stress, and it takes significant time and energy to work with a novice nurse.
I am hoping for better days ahead. We are a resilient group and perhaps when conditions improve some nurses will return to the bedside.
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