Nurses urge HHS to declare the staffing shortage a national crisis

Photo: Dean Mitchell/Getty Images

The American Nurses Association sent a letter to the Department of Health and Human Services this week asking the agency to declare the ongoing nursing shortage a national crisis, citing overwhelmed health systems and burnt out staff.

Specifically, the ANA cited the Delta variant of COVID-19 as a complicating factor that has exacerbated underlying chronic nursing workforce shortage challenges.

While the initial focus at the start of the pandemic was on equipment shortages and a dearth of ventilators and personal protective equipment, the ANA said the focus must now shift to the human resource shortage, which the group cited as "more dire" and potentially threatening to patient care.

"ANA is deeply concerned that this severe shortage of nurses, especially in areas experiencing high numbers of COVID-19 cases, will have long-term repercussions for the profession, the entire healthcare delivery system, and ultimately, on the health of the nation," the group wrote to HHS Secretary Xavier Becerra.

The group provided numbers that highlight the extent of the challenge. Mississippi, for example, has seen a decrease of 2,000 nurses since the beginning of 2021, while hospitals in Tennessee are operating with 1,000 fewer staff than at the beginning of the pandemic, prompting them to call on the National Guard for reinforcements.

At the same time, Texas is recruiting 2,500 nurses from outside the state, a number that still will fall short of expected demand; while Louisiana had over 6,000 unfilled nursing positions open across the state before the Delta variant caused a surge in cases.

According to a survey from Trusted Health, the COVID-19 pandemic has caused 39% of nurses ages 20-39 to report that their commitment to nursing has decreased.

WHAT'S THE IMPACT?

Since any solution to the nursing shortage is bound to be a complicated one, the ANA recommended crafting a response by first convening stakeholders such as nurses, hospitals, physicians, other healthcare personnel, and state and federal government officials.

The group said any workable solutions should include addressing the current fatigue and mental wellbeing of nurses, as well as strategies to retain the nursing workforce that already exists. 

The ANA also wants stakeholders to work with The Centers for Medicare and Medicaid Services to adopt new payment methodologies that "recognize the value that nurses bring to patient care." The group also wants to remove barriers to practice that some nurses face.

Other approaches advocated for by the ANA include addressing barriers that limit the number of qualified nursing students that can be educated each year; and building and maintaining a resilient workforce to meet the country's current and future healthcare needs.

ANA represents more than four million registered nurses through its state and constituent member associations, organizational affiliates, and individual members, including nurse practitioners (NPs), clinical nurse specialists (CNSs), certified nurse-midwives (CNMs) and certified registered nurse anesthetists (CRNAs).

THE LARGER TREND

Burnout among nurses, physicians and other healthcare workers was a pervasive problem even before the onset of the COVID-19 pandemic, but now that the U.S. has been living with the coronavirus for more than a year and a half, some on the front lines are starting to bow to the pressure.

This was exemplified in an April survey from the American Nurses Foundation, which found that the pandemic is causing 92% of nurses to consider leaving the workforce. Nearly half cite insufficient staffing as one of the primary reasons.

Hospitals are experiencing nursing shortages for several reasons, including the possibility that nurses could get $150 an hour to be a traveling nurse versus the $48 an hour they are paid as hospital staff.

In other cases, nurses had to choose between work and having children at home while schools were not holding in-person sessions. Some nurses who were close to retirement chose to leave while others left for work outside of acute care settings.

On top of workforce shortages, the ongoing COVID-19 pandemic has led many healthcare workers to experience strains on their mental health, including anxiety, stress, depression and loneliness.

Staffing shortages have hit coronavirus hotspots especially hard, including in Iowa, where Governor Brad Little this week mobilized the state's National Guard to support short-staffed medical facilities.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com