Devon E. Jones, RN BSN
Pre and Post COVID-19 Pandemic
There is no nursing shortage. There are more than enough nurses to fill all open positions. The problem is nursing retention. Hospitals are not paying their staff enough to cover the consistently high-stress levels nurses are asked to work at. This was happening pre-pandemic, the pandemic exacerbated the problem. The difference between the pre-COVID-19 staff nursing retention and the post-COVID-19 staff nursing retention is the relationship between the time it takes to hire enough new employees and get them oriented to meet patient acuity demands versus the rate of nurses leaving.
Pre-COVID-19 Nurse Retention
Stress on nurses is related to short staffing causing an increased nurse to patient ratios. Most nursing units are budgeted to exactly meet their patient acuity demands. When a nurse on a unit leaves the unit will operate at a slight deficit for a couple of months until the employee returns or a new one is hired and oriented. The hospital will cover these staffing deficits by pulling a nurse from another unit to cover a shift.
For example, if Unit A is short-staffed for a shift but the patient acuity is low in Unit B, a nurse will be pulled from Unit B to cover Unit A. Some hospitals will even have a float nurse pool to account for this. This only works if there is only a slight deficit in staffing. Often, even pre-pandemic, when there are no extra nurses available to float Unit A would have to work short-staffed.
Nursing stress is also exacerbated by charting requirements, committee requirements, lack of supervisor support, and emotional exhaustion.
Hospitals do not need to respond to nursing stress because again – there is no shortage of nurses. Every year people compete to get into nursing schools, there are sometimes years-long waiting lists to get into community college programs. These schools pump out thousands of new graduates every year. If a nurse quits their hospital job due to being constantly short-staffed, management can find a replacement very easily.
Post COVID-19 Nurse Retention
During the early days of the pandemic, many nurses flat out left the hospitals in masse, a lot more nurses were out sick and/or in quarantine. This exacerbated the lack of float pool nurses causing more nurses to leave because of burnout. The hospitals have not been able to hire and orient enough nurses to replace these losses in enough time to prevent the burnout of more nurses. This has created a dog chasing its tail type of scenario. Most hospitals have hired travel nurses to help combat this but they haven’t hired enough.
Having staff nurses work alongside travel nurses creates another problem among staff nurses. The travel nurses are getting paid up to three times as much for the same work as the staff nurses. Post-Pandemic nurses are leaving staff positions in droves to work as temp nurses in neighboring hospitals.
Why don’t hospitals pay their nurses more? Hospitals are willing to pay travel nurses more during a staffing crisis because it is short-term. Once the staffing crisis is corrected, they can eliminate that extra cost by reducing travel nurses. If they pay their staff nurses more during staffing crises they can’t take that pay back down.
Nationwide strike. All of us.
Nurses would like to set the record straight on the hospital staffing crisis.
Video By Lucy King and Jonah M. Kessel