Author: Phoebe Do
It is common knowledge to the general public that medical professions, including nursing, are in high demand. However, few are aware of the dangerous outcomes of having a shortage of healthcare providers. The overworked and sometimes underpaid members of our medical fronts combat numerous issues in order to provide treatment and care to patients. Despite their exhaustion and frustration, workers continue to battle through for their sick patients. With the battalions of medical staff dwindling, the staffing crisis of hospitals is growing bigger than the public could have predicted.
Why are hospital staff leaving?
Hospital staff members, like anyone in the workforce, crave a work-life balance. A quick web search on job-hunting sites, such as Indeed, indicates that full-time nurses typically work 8 to 12 hour shifts and between 30 to 40 hours a week. Similarly, part-time nurses work 30 hours a week or less. However, with the California Department of Industrial Relations setting the maximum legal number of working hours a nurse may take in a week to 72 hours, it is not uncommon for understaffed hospitals to require their nurses to work overtime.
Additionally, nurses are notorious for working night shifts, causing some to experience even greater social life disparity, which of course affects the health of nurses. As a result, many healthcare workers are now opting for shorter work hours, early retirement, or resigning from their positions. These decisions are driven by various factors, including concerns about mental health and a desire to spend more time with family. According to the National Institutes of Health’s 2020 study, over 50,000 nurses have left the workforce following the COVID-19 pandemic, causing a staggering 3.3% decrease in the U.S. nursing population. Even before that report, the U.S. Department of Health and Human Services had already reported a shortage of 150,000 healthcare facilities employees. Evidently, the COVID-19 pandemic made the already diminishing nursing workforce decline at a much steeper rate. Reasons why nurses are leaving can be answered by the 2022 National Nursing Workforce Survey, which concludes, “high proportions [of nurses] feeling emotionally drained (50.8%), fatigued (49.7%), burned out (45.1%), or at the end of their rope (29.4%)”, multiple times a week. Clearly, the pandemic’s new and more strict hospital policies alongside the sudden influx of sick patients left workers overworked. The resulting combination of extreme stress, fatigue, and burnout, ultimately precipitates to a smaller hospital force.
Furthermore, smaller staffed nursing communities also have difficulty training new nurses. Because there are fewer available nurses, the precious time and manpower it takes to find, hire, mentor, and finally launch new generations of nurses becomes more costly. Not to mention, many nurses are switching to competing hospitals with the lure of better compensation and shorter work hours. As a result, hospitals are beginning to pay higher, much deserved wages to their medical staff in order to retain workers. Regardless of better pay, hospitals are still quickly losing staff members from their already small battalions. To no surprise, this perpetual cycle of not having enough medical leading to having enough fewer medical staff again only continues to take a toll on both the patients and medical staff.
The Effect on Pediatric Patients
Fewer hospital workers results in poorer quality of healthcare. With a smaller medical force, more patients are assigned to each staff member, leading to divided attention and less time focused on treating each patient. Examples of a diminishment in patient care include:
Longer Wait Times:
Although more patients may be assigned per healthcare worker, there is a legal limit before having too many patients becomes a serious health risk. Because of this limit, many hospitals are unable to house, care, and treat patients to its capacity due to staffing shortages. Thus, much needed hospital beds are left empty and patients in need of care are left in the waiting room. The situation has become so dire that “nearly a quarter of 116 beds are empty” at the TaraVista Behavioral Health Center, according to its CEO, Michael Krupa. Krupa further cites his labor shortage as a main contributor to the new patient limit.
Increase in Medical Mistakes:
Mistakes inside a hospital can be deadly. Hospitals with a high nurse to patient ratio risk fatal mistakes, leading to a higher morbidity rate. According to the Keck School of Medicine of USC, the scarcity of healthcare providers is enough to constitute a public health crisis with, “shortages in certain areas [leading to not] enough doctors or nurses to provide emergency care, treat chronic illnesses, or deliver babies.”.
Increase in Patients:
With a decrease in the quality of care for patients, it is likely for many to fall ill again due to poor treatment. In other words, patients can experience recurrent illnesses and require admission in a hospital once more to take up another hospital bed, time, attention, money, and more manpower. In addition, medical staff themselves may become part of the patient ward from illnesses related to high stress, burnt out, or poor mental health. It would be much more efficient and beneficial to public health to hire more healthcare workers to treat the sick.
One sector desperately needing nurses is the pediatric intensive care unit, or ICU, as it is a “highly specialized [and] difficult to recruit role”, reported by Katie Boston-Leary, director of the American Nurses Association nursing program. The lack of medical professionals specializing in the ICU is frightening for the health of newborns and children. Hospitals simply cannot function without available nurses to monitor, administer medicine, insert feeding tubes and catheters, set up IV lines, and facilitate the hundreds of other responsibilities tasked. The CEO of the nonprofit healthcare company ECRI, Dr. Marcus Schabacker, laments, “the margin or error in [pediatrics] is smaller…their body system, organ system, just has much less margin for error”. With approximately 22% of hospitals suffering from staffing shortages, hospitals are becoming exponentially more desperate for more employees, according to the U.S. Bureau of Labor Statistics.
Possible Solutions
Emotional Support:
Even the small things we can do as patients, family of patients, and outsiders make a difference, such as writing thank you cards, donating snacks, or simply being patient and understanding of their situations. These little kindnesses are the tiniest way we can demonstrate our appreciation to medical workers. On a larger scale, hospital administration can better support their staff by increasing access to mental health counselors and resources to 24/7. Giving nurses regular breaks in rooms separate from their work environment can provide a calming, comforting, and warm atmosphere that would also combat the mental health issues of hospital employees.
More Efficient Hiring:
In the age of technology, hospitals should utilize more technology in order to streamline the hiring process. One suggestion by Dr. Kenneth Campbell of the Tulane University Online Master of Health Administration Program, is making the process remote. This could include submitting resumes digitally, conducting interviews remotely using programs such as Zoom, and hiring qualified candidates on the spot. For example, if returning or retired workers are willing, why not allow these individuals with expertise to come back. Any alteration to the hiring process in order to quicken its pace would significantly impact the growing deficiency of medical employees.
Listening and Inputting Worker’s Feedback:
Similar to surveying patient satisfaction, hospitals should also gather input from the staff members. Methods of gathering feedback could include a suggestion box or holding more staff meetings where suggestions are welcomed. In any case, hospital staff are the most familiar with the shortcomings of a hospital. Thus, workers are one of the best sources of feedback on how to improve systems within a hospital.
Increasing Diversity:
The 2019 American Hospital Association reveals, 89% of hospital CEOS are white and 60% of hospital management boards are white. Undoubtedly, there is a lack of racial and ethnic diversity within the medical field. The lack of diversity in decision-making within hospitals can result in reduced representation for minority healthcare workers and patients, hindering their needs from being adequately addressed.
By recruiting individuals of a plethora of backgrounds, hospitals may better treat their own varied patient populations.
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