By Holly Webster, PCCNP
Special Guest Columnist
I believe that the pandemic — now going on 2 years — is amplifying the underlying problems that many nurses face, and are spoken about in a recent New York Times video. Along with crazy, unsafe staffing, RN’s have actually been laid off in a number of hospitals because hospital revenue has decreased, due to the decrease in surgical procedures and other procedures usually performed. And in some instances, there have been pay cuts associated with the decreased revenue, though I don’t know how widespread this is.
There are currently nearly 4 million RN’s in the country; approximately 15% are unemployed for various reasons (many are getting to retirement age now — 25% of RN’s — by 2025) but, in the last 2 years, it’s the pandemic-related work conditions that are causing attrition. I can’t imagine working in the ICU’s that are operating above capacity (80-85%). Patients that should be 1:1 care are now sharing a nurse with 2 or more other patients.
Financial Bottom Line vs. Patient Care Safety
Hospital administrators must balance the financial bottom-line with patient care safety, and it sounds like the nurses interviewed for this video work in environments where the administrators have gone off the rails. But I wonder how common this is. With decreased staffing comes increased patient safety issues — medication errors, infections, falls etc — a hospital can’t run for long when these events start happening.
I can imagine the desperation, fatigue, and anger of the RN’s who have worked through the pandemic. I only had a taste of this situation: in 2009 I was a pediatric ICU nurse practitioner during the H1N1 epidemic that lasted about 3-4 months. My 44-bed PICU housed up to 62 patients; normally I would manage 7-8 myself but, in that era, it was more like 12+ critically ill patients. Can’t imagine doing that for 2 years.
As for the staff nurses — 1:1 nursing didn’t exist for most of the patients; it was more like 1:3-4 which is really high for a pediatric unit with high acuity. Unsafe for both patients and nurses.
A Shortage of More Than a Million Nurses by 2030
I have some hope that we will be past this pandemic by the end of 2022, segueing to “endemic.” In the meantime, it seems to me that nurses are in a good bartering position. Some hospitals are actually paying extraordinary salaries (short-term arrangements, though). The supply:demand factor weighs in favor of the nurses now, and likely in the future.
There will be a shortage of 1+ million nurses across the country by 2030, if not before then. The problem is that in 2020, 80,000 qualified applicants to nursing schools were turned down because of decreased faculty numbers, with no solution in sight. It’s a serious issue facing our country.
Holly Webster, PCCNP
Holly is a retired pediatric critical care nurse practitioner, who practiced in a large PICU in Salt Lake City for 35 years. She graduated in 1971 with a B.S.N. from the University of Michigan, and 1980 with an M.S. in Pediatric Nursing.
After completing post-masters work to become a nurse practitioner, she started her NP work in the PICU, creating the first Pediatric ICU Nurse Practitioner program in the country. To balance the demands of her work, Holly has been an avid skier, tennis player and, more recently, has become a devoted grandmother!
She has published articles and chapters focused on pediatric critical care issues and, after retirement, published her book, Mousetraps: Tales of a Second Mouse. Currently, she is working on an historical fiction novel. She has two adult children living in SLC, and currently lives with her husband and near her grandchildren.