Staffing Shortages and Vaccine Deadlines: The Newest Headline in a Decades-Old Struggle
When I was contemplating becoming a nurse in the early 2000s, what swayed me was a set of commercials by Johnson & Johnson. In one, a nurse sings ‘Emma, Emma, bo-bemma,’ with a little girl to distract her as she receives IV medication. In another, a hospice nurse learns about end-of-life traditions from her patient’s culture. At the time, I did not know there was a nursing shortage. I just knew these commercials made nursing seem like an amazing profession.
Back in 2002, the shortage was projected to reach 500,000 nurses by 2010 (Berlinger, H., Ginzberg, E. 2002). Even though nursing shortages occurred in the past – from the 1950s to the 1980s – the shortage beginning this century is different. With fewer people choosing nursing careers and more people living longer, many could see a looming crisis.
In response, Johnson & Johnson launched the ‘Campaign for Nursing’s Future’ which included TV commercials to promote nursing as a profession. Despite efforts like this to recruit, it takes time to educate and train qualified nurses. Meanwhile the shortages continued and today the gap remains unchanged. A more recent study projects a shortfall of over 510,000 registered nurses by 2030 (Xiaoming, Z. Et al, 2018).
Healthcare Staffing Shortages Brewed for Decades
Nursing is not the only profession experiencing shortages. There is also an estimated shortage of over 91,000 physicians (Zhang, X, et al. 2020), primarily due to growing demand from a large older population. Physicians take even longer to train than nurses – there is no magic switch to suddenly increase the supply of qualified doctors.
Seeing these trends build, some healthcare organizations made efforts to mitigate shortages. Approaches like hefty sign-on bonuses or hiring Physician Assistants were meant to soften the impact of the unfolding crisis. But these approaches only address part of the issue.
While it is important to get more people into healthcare professions, it is also important to properly leverage current providers. Since qualified clinicians are a limited resource, that resource must be managed wisely. Techniques seen in other industries, such as forecasting demand, have not been widespread in healthcare. It should not be surprising, then, that many healthcare organizations were not prepared for the disruptions brought on by the COVID-19 pandemic.
The COVID-19 Pandemic Exacerbated Existing Problems
As we approach the two-year anniversary of the pandemic, the need for qualified nurses, hospital beds, equipment, and many other items continues to make headlines. More recently vaccine mandates have come into question as to whether they will worsen resource constraints.
An article in Modern Healthcare, ‘Hospitals fear staffing shortages as vaccine deadlines loom,’ focuses on this question. The article cites ultimatums that took effect in states like New York, California, Rhode Island and Connecticut that require employees to get vaccinated or risk suspension or termination. In areas where deadlines for vaccination are approaching, some entities fear they will have to manage worsening shortages as employees choose to quit instead of getting vaccinated. This concern has been raised more often in rural areas where vaccination rates are lower.
However, it is oversimplifying to point to vaccine mandates as a source of staffing shortages. At the height of the pandemic, hospitals and nursing homes had to manage shortages due to healthcare workers getting COVID-19 themselves. The World Health Organization estimates that 115,000 healthcare workers died from COVID-19 between January 2020 and May 2021 (Joseph, A. 2021). In addition, the burnout rate among healthcare workers skyrocketed during the pandemic. Burnout has become so high that since February 2020, nearly 1 in 5 healthcare workers quit their jobs (Gooch, K. 2021). The top reason sighted was the strain they experienced due to existing shortages.
The real issue is the underlying shortage of qualified staff. Efforts to recruit students into healthcare professions is a long-term solution. In the short-term, healthcare organizations need to get significantly better at forecasting demand and managing limited resources.
The Need for Better Resource Management in Healthcare
To pull out of the downward spiral of shortages creating more shortages, healthcare organizations must make more efficient use of the resources they can control. Throughout the pandemic, disruption to supply chains and strain on healthcare systems have been constant themes. While COVID-19 will make the history books as a black swan event, some of these issues could have been prevented.
Healthcare is behind many other industries in using data-driven approaches to manage resources. Over the last decade, industries like retail and transportation implemented automated systems, such as radio frequency identification (RFID), to track and manage each element of their workflow. On the other hand, many healthcare organizations still use rudimentary resource management approaches like manual inventory counting. This became a liability during the pandemic when hospitals ran out of personal protective equipment and had no means to share data about supplies with entities who could help.
To prevent the pandemic from becoming a wasted learning opportunity, healthcare organizations can ready themselves for the future. In addition to efforts to recruit and retain personnel, they can do this by focusing on improving management of staff and inventory. It will be critical to have data-driven, automated systems – like UHF RFID – for matching resources to demand. If hospitals and nursing homes can incrementally improve how they manage limited resources – whether those are human resources, supplies, or equipment – they will be better positioned to weather the next crisis.
Resources:
- Berliner, H. S., & Ginzberg, E. (2002). Why this hospital nursing shortage is different. JAMA, 288(21), 2742–2744. https://doi.org/10.1001/jama.288.21.2742
- Gooch, K. (2021, October 4). 18% of healthcare workers have quit jobs during pandemic: Morning consult. Becker’s Hospital Review. Retrieved November 16, 2021, from https://www.beckershospitalreview.com/workforce/18-of-healthcare-workers-have-quit-jobs-during-pandemic-morning-consult.html.
- Johnson & Johnson. (n.d.). Johnson & Johnson Nursing. Discover Nursing. Retrieved November 16, 2021, from https://nursing.jnj.com/our-commitment.
- Joseph, A. (2021, October 21). An estimated 115,000 health workers have died from covid-19. STAT. Retrieved November 16, 2021, from https://www.statnews.com/2021/10/21/who-estimate-115000-health-workers-have-died-from-covid-19-as-calls-for-vaccine-access-grow/.
- Muoio, D. (2021, November 1). How many employees have hospitals lost to vaccine mandates? here are the numbers so far. FierceHealthcare. Retrieved November 16, 2021, from https://www.fiercehealthcare.com/hospitals/how-many-employees-have-hospitals-lost-to-vaccine-mandates-numbers-so-far.
- Zhang, X., Tai, D., Pforsich, H., & Lin, V. W. (2017). United States Registered Nurse Workforce Report Card and Shortage Forecast: A revisit. American Journal of Medical Quality, 33(3), 229–236. https://doi.org/10.1177/1062860617738328
- Zhang, X., Lin, D., Pforsich, H., & Lin, V. W. (2020). Physician workforce in the United States of America: Forecasting nationwide shortages. Human Resources for Health, 18(1), 8. https://doi.org/10.1186/s12960-020-0448-3
Lisa Brooks, RN, MSN, MBA
Informatics Nurse, Health Writer
Lisa Brooks is a Registered Nurse with masters’ degrees in Nursing Informatics and Business Administration. She spent 6 years of her career in bedside clinical care before moving into health technology. Over the last decade, Lisa has done everything from teach computer system classes for nurses, to lead large technology projects at healthcare companies. She is a thought leader, writer, and the voice behind Writing the Future of Health – a site that brings nursing and technology together.
