In the United States, the healthcare staffing shortage has been a persistent issue for years. The crisis was made all the more extreme by the repercussions of the COVID-19 pandemic. With an aging population that’s expected to put increasing demands on the country’s healthcare services, the U.S. Senate held a hearing on February 16, 2023, to discuss potential solutions.
After reviewing evidence from experts, the Senate proposed various avenues to address the staffing shortages. In this article, we’ll consider three of these solutions and analyze what they could mean for the future of healthcare staffing in the United States, particularly in the home care and nursing home sectors.
The Current State of the Healthcare Labor Market
Due to mounting pressures on healthcare workers, a historical workforce crisis has emerged. The impact includes real-time short-term staffing shortages, along with a long-term talent pipeline that is not being filled. This issue is particularly affecting nursing homes and home healthcare facilities, with 61% of nursing homes limiting admissions due to staffing shortages.
There are a variety of reasons for these shortages.
Retiring Healthcare Professionals
According to data from the Association of American Medical Colleges, one-third of practicing physicians will reach retirement age within the next decade. As of 2017, over half of the nursing workforce was over 50 years old, and about a third was over the age of 60.
Of course, this phenomenon puts the healthcare industry in a tight spot — especially nursing homes and home healthcare agencies, which are already experiencing severe shortages. Retiring healthcare professionals become an even more worrisome trend as the overall population also ages and develops more chronic conditions that need continuous care.
Lack of Nursing Educators
A lack of interest in the nursing profession isn’t the cause of the lack of new nurses.
According to Sarah Szanton, Dean of the Johns Hopkins University School of Nursing, 92,000 qualified applicants applied for undergraduate and baccalaureate nursing programs in 2021. However, many were rejected from nursing programs due to a significant shortage of nursing faculty and training sites.
It is estimated that the United States needs about 2,100 more educators to train enough students to offset the severe shortage of new nurses.
Temporary Labor Issues
During the COVID-19 pandemic, many healthcare organizations had to rely on contract laborers, such as travel nurses, to fill gaps in care. Contract laborers brought many benefits:
- Provided immediate support to hospitals and other healthcare facilities that were overwhelmed with patients
- Brought specialized skills and experiences
- Reduced the workload on existing staff
However, the high use of travel nurses also had some negative consequences. The high demand for travel nurses led to increased competition among healthcare organizations, which increased hiring costs.
Hospital staffing agency hourly rates saw an exorbitant increase of some 213% as a result. However, most agencies did not pass these price increases on to the travel nurses, allowing the agencies to post 62% profit margins.
Additionally, travel nurses often lack the familiarity and continuity of care that comes with being a permanent staff member, which negatively impacts patient outcomes.
Nurse Mental Health Issues
One of the largest negative effects of the pandemic is the ongoing nurse mental health crisis, known as nurse burnout.
Nurse burnout is a physical, mental, and emotional state of exhaustion caused by prolonged and excessive stress, workload, and frustration. If left untreated, it can detrimentally impact a nurse’s health, job performance, and quality of life.
Symptoms can include:
- Exhaustion
- Compassion fatigue (cynicism or indifference to others’ pain and suffering)
- Dissatisfaction with work
- Emotional detachment
- Anxiety
- Depression
- Lack of motivation, which leads to a decline in job performance, patient care and patient safety
According to a 2021 survey from the Kaiser Family Foundation and Washington Post, almost 60% of healthcare workers state that working during the pandemic caused a decline in their mental health, and nearly 30% considered leaving the nursing field altogether due to nurse burnout.
Addressing Healthcare Staffing Shortages: 3 Proposed Solutions
To address all the current issues facing the healthcare industry as a whole, the AHA proposed several solutions that should be implemented shortly. Three of these solutions are especially beneficial for nursing homes and home health agencies.
1. Focus on Immigration
The Senate recommended that the U.S. government recruit qualified immigrants, increase the number of visas available for foreign-trained nurses, and expedite the visa process to make it easier for those nurses to work in the country. They also recommended the creation of a program to encourage foreign nurses to work in underserved areas with the highest staffing demands.
Finally, they stressed the importance of supporting efforts to increase the healthcare workforce’s diversity, such as federal scholarship programs and funding for graduate medical education (GME).
How can immigration and workforce diversity help healthcare facilities combat the current healthcare staffing crisis? While it may seem like a short-term approach to a long-standing problem, it can relieve the burden on overstressed healthcare systems.
For example, the largest proportion of workers in nursing homes are certified nursing assistants (CNAs), and it is projected that we will need to fill nearly 562,000 CNA jobs by the year 2029. Leveraging immigration and implementing DEI (diversity, equity, and inclusion) initiatives can address these gaps in several ways:
- Reduce the burden on existing staff: With an increased number of foreign nurses, you can reduce the workload on your existing staff. This lessens the chance of nurse burnout, which allows nurses to provide better quality care to patients.
- Access nurses with specialized skills: Hiring foreign nurses can also help you to hire CNAs and nurses with specialized skills. Foreign nurses may have unique skills and experiences that can benefit your patients. Additionally, they may be more willing to work in rural or underserved areas, which can help you provide quality care to more patients.
- Increase retention rates: Focusing on DEI initiatives creates a work environment that is safe and positive for foreign workers. This builds trust, employee happiness, and job satisfaction, which directly increases recruitment and retention.
2. Invest in Nursing Programs
The Senate hearing also recommended that the U.S. government invest in increasing the number of nursing educators. They could accomplish this by:
- Reauthorizing workforce development programs
- Funding nursing schools, hospital training time, and nurse faculty salaries
- Offering incentives to educators that encourage them to enter academia
- Offering incentives that encourage more students to pursue nursing degrees
- Investing in comprehensive training and continuing education programs
Ensuring adequate recruitment and development of new nurses leads to a larger workforce of nursing graduates who can meet the demands of the healthcare system.
3. Transform Workforce Models
Another solution to recruit and retain qualified, talented nurses is to transform workforce models to make them more attractive to potential candidates. One major method is to incorporate workplace flexibility into your workforce model, which you can accomplish in several ways:
- Utilizing scheduling apps to allow staff to choose when they will work
- Incorporating a hybrid workplace (a combination of on-site and remote work)
- Allowing job-sharing
- Creating part-time shifts
Flexible schedules can have numerous positive effects on your staff, including a decreased risk of burnout, greater job satisfaction, increased job engagement, and more.
Utilize Innovative Solutions to Combat Your Healthcare Staffing Shortages
It’s clear that the healthcare staffing shortage is significantly affecting the entire healthcare industry, including the home healthcare and nursing home sectors. The U.S. Senate hearing showcased the urgent need for new policies and innovative solutions to ensure quality healthcare delivery nationwide.
