Almost 30% of nurses are considering leaving the profession

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The past two years have been difficult for nurses, and research from Nurse.com highlights the extent to which this is true: In the "Nurse Salary Research Report," 29% of nurses said they were considering leaving the profession, a steep rise from the 11% who were considering such a move in the 2020 survey.

Among the respondents, 4% said they work as travel nurses, and 62% of those became travel nurses in 2020 or 2021. Higher pay far surpassed all other reasons for becoming a travel nurse, followed by dissatisfaction with management.

Higher pay and dissatisfaction with management were also key drivers of nurses changing work settings in 2020 or 2021, with 28% saying they've changed settings. The percentage of nurses considering changing employers increased to 17% in 2021 from 11% in 2020, while the percentage of nurses who are passive job seekers – not actively looking for a new job but open to new opportunities – also increased, from 38% in 2020 to 47% in the current survey.

Part of the issue is that nursing shortages have reached crisis levels, the report found. Nursing staff shortages are nothing new, but the pandemic has made the problem much worse.

The vacancy rate for registered nurses was almost 10% in 2020, for example, almost a full point higher than the prior year. Over a third of hospitals reported a vacancy rate higher than 10%. And nurse turnover rates are increasing, standing at about 22% in 2021, compared to 18% in 2019.

It takes an average of three months to recruit a qualified nurse to fill a vacancy, a period that is expected to increase in the wake of the disruptions caused by COVID-19, data showed.

The survey found that 90% of nurse leaders anticipate post-pandemic staffing shortages, and hospital CEOs rank personnel shortages as their top concern. The American Nurses Association recently called on the U.S. Department of Health and Human Services to "declare the current and unsustainable nurse staffing shortage facing our country a national crisis."

WHAT'S THE IMPACT?

Among other findings, the survey showed that the gender pay gap among RNs is widening. The median salary for a male RN is $14,000 higher than the median salary for a female RN – a gap that was $7,297 in the 2020 survey.

Thirty percent of nurses said they never negotiate salary, compared to 18% who said they always do. Female RNs were less likely to negotiate salary either always or most of the time (31%), compared to male RNs (40%). Given the current demand for nurses and the commitment by many healthcare organizations to invest in their core nursing staff as the pandemic wanes, nurses are well-positioned to negotiate better salaries, the report found.

Some good news emerged from the survey for nurses – salaries are up for most groups. The median RN salary was $78,000, a substantial increase over the median RN salary of $73,000 reported in the 2020 edition. Median salary is up for other license types, as well, with an increase of $13,000 for APRNs and $3,000 for LPN/LVNs.

RNs who work in American Hospital Association Region 3 – which covers Delaware, Kentucky, Maryland, North Carolina, Virginia, West Virginia and Washington, D.C. – saw a decline in salary, however.

When asked if the pandemic has affected their salaries, 25% of all nurse respondents noted increases in their salaries and 9% noted decreases.

Healthcare organizations have also learned some hard lessons during the pandemic: To keep facilities adequately staffed, they've paid a premium for travel nurses, in addition to overtime and critical staffing pay. The lesson many organizations have learned is that it's ultimately more cost effective and sustainable to make long-term investments in their core nursing staff.

Healthcare leaders are taking a number of steps in that direction, offering things such as higher salaries, more flexible work schedules, sign-on bonuses and relocation packages, loan forgiveness and enhanced benefits.

THE LARGER TREND

When the ANA called on HHS to declare the nursing shortage a national crisis, it cited 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.

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; meanwhile, Louisiana had more than 6,000 unfilled nursing positions open across the state before the Delta variant caused a surge in cases.

An April survey from the American Nurses Foundation 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, in contrast to 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.
 

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