The alarm bells started sounding in 2012 – America was running short of nurses.
Now COVID has pushed the shortage to a magnitude never before seen in America.
To meet demand, the country will need 1.2 million new registered nurses by the start of the next decade, according to “The American Nursing Shortage,” a 2021 study by the University of St. Augustine for Health Sciences.
New nurses will have to come on board as experienced ones leave. Nearly half of all the registered nurses in the U.S. are over age 50, and 1 million of them are expected to retire by 2030, the study projects. The number of nursing educators is following the same track, creating questions about who will teach the students.
In Connecticut, a 2020 report by the Governor’s Workforce Council reached similar conclusions.
The state has about 50,000 registered nurses, the report found, and 52 percent are over age 50.
The need is for 3,000 new registered nurses a year, but Connecticut schools graduate only 1,900 a year, the council found.
It’s not for lack of interest in nursing. In 2019, Connecticut schools had to reject 7,000 nursing candidates – first because there was not enough faculty to teach them, and second because there were not enough nurses to supervise student hours of onsite clinical experience, according to the council’s report.
At Greenwich Hospital, Doctor of Nursing Practice Anna Cerra is living the numbers.
“During COVID we experienced unprecedented nursing vacancies,” said Cerra, chief nursing officer and senior vice president of Patient Care Services at Greenwich Hospital, part of Yale New Haven Health. “People were re-evaluating their lives. There were nurses in their 50s or 60s who had grandchildren and were afraid they would bring the virus home. They retired early.”
About a quarter of the nursing staff retired, Cerra said. A good number became traveling nurses, who work for agencies that assign them, as needed, all over the country.
“They saw what traveling nurses were getting paid, $200 an hour during the peak of the pandemic,” Cerra said.
Like other hospitals, Greenwich has relied on traveling nurses to fill staffing gaps, but “that is not sustainable,” Cerra said. The agencies provide experienced nurses who get to work immediately, but the cost can amount to millions of dollars a month, she said.
Greenwich is anticipating the arrival of 15 newly graduated nurses, once they pass their board exams. Some of them were in a Yale New Haven Health program called Bridge to Professional Practice, Cerra said.
In that program, the health network partnered with Fairfield University, Quinnipiac University, Southern Connecticut State University and Gateway Community College to educate and provide clinical experience for 500 new nurses by 2026.
The network’s Clinical Nurse Transition Program picks it up from there, providing coaches to support new nurses on the job, Cerra said.
The network also is addressing the nursing faculty shortage, she said.
“We are rounding up our staff to be faculty,” she said. “I know of at least five nurses who want to teach at the universities that are our partners.”
Besides Greenwich Hospital, Yale New Haven Health includes Yale New Haven Hospital, Bridgeport Hospital, Lawrence + Memorial Hospital in New London, and Westerly Hospital in Rhode Island.
The networks compete “aggressively” for employees, according to the governor’s workforce council report, which said the resulting “lack of collaboration” is a lost opportunity “to solve workforce deficits” regionally.
Cerra said hospitals compete for nurses by offering higher pay and more extensive benefits.
Like Yale New Haven, Nuvance Health – which has seven hospitals in western Connecticut and Hudson Valley, N.Y. – is innovating to hire and retain nurses.
Nuvance’s Norwalk Hospital is adapting recruitment practices, said Leslie Lincoln, chief nursing officer.
“We are not in a traditional job market,” Lincoln said. “The COVID-19 pandemic has influenced people’s decisions to leave the workforce, whether from burnout or early retirement. The pandemic has also changed many people’s expectations about how, when and where they work.”
Norwalk Hospital is partnering with universities to support nursing education, Lincoln said. Norwalk also is “training clinical nurses for specialty areas such as behavioral health, emergency medicine and surgery,” and for roles in nursing leadership, Lincoln said. And the hospital is “continuously examining” benefits, including pay and tuition reimbursement.
Dawn Martin, chief nursing officer at Nuvance’s Danbury Hospital and New Milford Hospital, said “staffing challenges” now are the result of “the toll the pandemic has taken on health-care workers.”
Danbury and New Milford are developing strategies to help nurses “achieve their career goals and find purpose in their work,” Martin said.
Danbury Hospital has formed a partnership with Sacred Heart University’s nursing program to attract students to specialty areas, Martin said. And the hospitals are “creating new care models” that include hiring licensed practical nurses and implementing a Baylor Shift Plan, in which nurses work 12-hour shifts on weekend days and are paid for a standard work week.
Addressing the nursing shortage is a big job, Cerra said, but the battle against COVID has many successes, and that’s a big deal.
“Now the staff is vaccinated,” she said. “Now patients are going home.”
Still, her office has created counseling and spirituality programs because nurses experienced so much suffering during COVID.
“You don’t have to have a religious denomination to be spiritual,” Cerra said. “We want to prepare nurses to meet patients’ spiritual needs, which helps meet the nurses’ spiritual needs. We think it’s important to help them be more resilient. They love it. They say it helps them in their home life.”
After all that’s happened in the pandemic, her goal now is to bring joy back to the nursing workforce, Cerra said.
“You want people to come to work happy and leave work happy,” Cerra said. “Research into what creates joy in your life shows over and over that it’s your job. Your job gives you joy.”