Jay Cuesta grew up planning to go to medical school. Then, in 2000, his premature infant died at just two weeks old, and Cuesta’s vision for the future was realigned.
Cuesta told The Epoch Times that nurses were beside him and his wife throughout their ordeal. Nurses were beside them when the child they knew would not survive was born. Nurses were beside them as they grieved in the otherwise sterile hospital environment.
They were beside them through it all.
“I knew what kind of medicine I wanted to practice,” Cuesta said. “That’s the hands-on that I wanted.”
According to recent statistics, many nurses, perhaps the very nurses who inspired Cuesta, are now burnt out, fed up, and ready to quit.
A May 2021 survey of nurses by Vivian Health—an employment service for health care professionals—paints a bleak picture. Vivian surveyed 1,273 nurses across all 50 states and disciplines one year into the pandemic.
Fifty-three percent reported pessimism about the future of health care in the United States. Twenty percent said they were optimistic, and 27 percent weren’t sure.
“Nearly three-fourths report hospital morale has gotten worse in their hospital or health care facility since this time last year,” according to the Vivian report.
Cuesta earned his registered nursing (RN) degree in 2005 and is now working to become a nurse practitioner. Cuesta loves his work and plans to do it for as long as possible. According to experts, he is in the minority. Cuesta agrees with that assessment.
“A lot of (nurses) just said, ‘We’re going to retire early,’” Cuesta said.
Burnout a Major Issue
Robert Rossetter is the chief communications officer for the American Association of Colleges of Nursing (AACN).
“Since the pandemic, we are seeing more reports about nurse dissatisfaction due to burnout, insufficient staffing, and poor working conditions, which may lead to more nurses leaving the profession,” Rossetter wrote in an email to The Epoch Times.
According to Cuesta, as their neighbors locked down and worked remotely early in the pandemic, health care workers put in overtime and pressed down concerns about spreading the sickness to their friends and families.
According to the 2021 Vivian survey, 83 percent of respondents felt their mental health had been affected by pandemic-related stress. Forty-three percent felt their employers did not address their mental health concerns.
Ronnie Cubley has been an RN for almost 30 years. He said many of his fellow nursing veterans are just tired.
“Staff desperately need work-life balance and won’t stay without it. Throughout the U.S., many nurses are doing accelerated retirement,” Cubley wrote in an email to The Epoch Times.
Cuesta said the issue extends beyond the physical demands of increased hours. He said that for most nurses, the intangible rewards of nursing were just as important as the paycheck. But as overtime pay increased, the more abstract rewards diminished. The feeling that they might not be doing enough was left in their place.
Cuesta said seeing his patients in the grocery store or elsewhere is common. Having helped them through some of the more challenging experiences of their lives creates a lasting bond.
“It’s very rewarding. It’s nice to see people in Walmart who want to give you a hug. That’s why I do it,” Cuesta said.
“When you’re taking care of your neighbors, you want to do a good job.”
But, when a nurse runs from one bed to the next with little time between, it’s easy to begin feeling as if they are short-changing those neighbors.
“It really makes it more difficult to provide good quality, consistent care,” Cuesta said.
Consequences of Understaffing
A New England Journal of Medicine report indicates Cuesta’s concerns are well-founded.
In March 2011, the journal published a study on the effects of insufficient nurse staffing on patient mortality. The study was done by a team led by Jack Needleman, a professor in the Department of Health Policy and Management at the University of California–Los Angeles.
According to the article, the mortality risk for patients on understaffed units was approximately 6 percent higher when compared with fully staffed units. Researchers also found increased mortality risk when a nurse’s workload increased due to high patient turnover.
Cubley expressed the same concerns as Cuesta. He said he has personally seen the impact of the pandemic.
“So many nurses left the profession during the pandemic because of burnout with overwhelming stress caused by excessive workloads,” Cubley said.
But not all nurses left the profession. Some just quit their jobs. The increased pressures on work and family life drove many nurses to find higher-paying jobs. Many became travel nurses.
What Nurses Earn
Travel nurses are RNs who work for staffing agencies and temporarily fill vacant positions. Travel jobs are popular because they typically pay more. The nurses get to do the bedside care they love and avoid much of the administrative work a full-time nurse at a hospital must do.
According to NursingProcess.org, travel nurses can make between $32 and $86 per hour, averaging $56. Most positions include a living stipend, and some cover other expenses. During the pandemic, the average travel nurse’s pay leaped into triple digits, luring many nurses into that field.
According to the U.S. Bureau of Labor Statistics, the national average salary for registered nurses is $77,600 annually, or about $37 per hour.
Many staff nurses were upset with hospital administrators who paid high rates for temporary travel nurses instead of hiring local nurses or paying existing nurses more.
According to the Vivian survey, 78 percent of respondents said their job search priorities changed. If they would give up aspects of the job they loved, they wanted at least to be compensated. Sixty-six percent of the survey respondents ranked pay as the most important factor.
“Eventually, at the end of the day, we have to take care of our families,” Cuesta said.
But compensation is only a current issue. Administrators say compensation will work itself out through supply and demand market forces. Another more crucial problem is on the horizon, experts say.
Labor Deficit
The Bureau of Labor Statistics projects the registered nursing workforce will grow by 6 percent in the next 10 years from 3.1 million in 2021 to 3.3 million in 2031. This is an increase of 195,400 nurses. However, the Bureau expects the demand for nurses to increase to more than 203,000 annually.
Generally, this demand would be met by nursing programs at colleges and vocational schools. But nursing schools only turn out a fraction of the new nurses needed. Rossetter said this isn’t because no one wants to be a nurse.
“Annual data show that thousands of qualified applicants are turned away from nursing schools each year because schools reach enrollment capacity,” Rossetter wrote in his statement.
Simply put, the United States needs more nursing instructors.
According to the AACN, the average nursing instructor earns about $65,000 annually, which is less than a working nurse brings in. With most registered nurses being over 50, a wave of retiring nurses will take their experience with them.
As baby boomers retire, health care providers expect continued growth in the demand for nurses that younger, inexperienced nurses will partially meet.
Cuesta said that when he started his career, some of the most important lessons he learned came on the job from experienced nurses. He said he has tried to follow that example by teaching the younger nurses he encountered. But, just as patient care is more rushed, the increased workload will make it harder to mentor new nurses.
Cuesta said he and his colleagues are concerned the current situation could result in an experience deficit.
Sarah Szanton is the Johns Hopkins University School of Nursing dean in Baltimore. In February, she told the U.S. House of Representatives Committee on Health, Education, Labor, and Pensions, that the situation is dire, but some things can be done.
“Our nation is perilously short of nurses,” Szanton told the committee. “The average age of registered nurses is 54. We need people to become new nurses, and we need to retain current nurses.”
Experts Say Solutions Available
Szanton said the Future Advancement of Academic Nursing Act (FAAN Act), introduced in the last Congress, would go a long way toward solving these problems.
The FAAN Act would authorize the Health Resources and Services Administration to award grants to nursing schools to increase their capacity to respond to enhance nursing education programs. The FAAN Act would prioritize programs at historically black colleges and universities and other minority-centered schools.
Testifying before the same committee, Dr. Leonard Seoane, chief academic officer for Ochsner Health in New Orleans, agreed.
He said his organization had 1,200 open positions, including physician and nursing jobs, and their staffing costs had increased 900 percent during the pandemic. He said Ochsner Health is exploring partnerships with universities and medical schools to form apprenticeship programs to recruit and train new medical staff.
“But to scale them, we need support from our universities; we need support from our community colleges; we need support from our governments. I do think it’s a partnership,” Seoane told the committee.
Cubley and Cuesta say such programs can help if they are correctly implemented, and soon. According to Cubley, the health care system can’t continue to rely on temporary staff and overtime pay.
“As a nation, we must invest in the nursing workforce beyond band-aid solutions,” Cubley said.