November 18, 2020

Down in Mississippi, a uniquely American form of music emerged over a century ago that would have profound effects on the direction of music around the world in the decades to follow.  Much of what we hear on our radios today has its roots in “the delta blues,” which lyrically emphasized the stresses and strains of making a living or stretching a dime.  The influence of this music seeped into diverse genres over the years.  It can be heard in rock and roll’s Grand Funk Railroad (“pain and blisters on my mind and hands”) and in country’s Merle Haggard (“workin’ man’s blues”).  This is because there is something universally relatable about the difficulties that we sometimes experience in the workplace.  Today, hospitals are facing their own version of work-related blues.

Troublesome Times

A news station in Salt Lake City is reporting that, due to the severe lack of nurses to deal with the current increase in COVID cases, the state is temporarily allowing non-licensed nursing students to fill critical positions in its healthcare facilities.  “Utah’s Division of Occupational and Professional Licensing will create a temporary nursing apprentice license that allows nursing students close to graduating to be put to work in hospitals and clinics, providing potentially hundreds of new health care workers to give some relief,” according to FOX 13.

The situation in Utah is just one example of what may be playing out across the country as facilities continue to wrestle with the impact that COVID is currently having on their clinical team members.  One staffing firm reported a “57 percent increase in demand for travel nurses over the past 30 days” and posted over 24,000 open positions a little over a week ago, according to HealthcareDive.

All this reinforces what news outlets throughout the nation have been reporting over the last several days.  New COVID cases are at unprecedented levels, and hospitals are scrambling to find space, equipment and personnel to address the large influx of affected patients.  The situation is made worse when one considers that many of these facilities in so-called COVID hotspots were already experiencing staffing shortages due to employee burnout and illness.  However, according to a recent report by CNN, the individual hotspots that existed previously are now merging into one large, nationwide sick zone.  As a result, many surgeries are once again being delayed and clinical staffs are being stretched to the breaking point.

A November story in the Associated Press (AP) helps to illustrate the current crisis.  It recounted the plight of a Michigan hospital that has been undergoing a significant staffing shortage.  One of the emergency room nurses punctuated the severity of the situation by noting that his colleagues were “burned out with this whole (pandemic), and some are quitting.”  As a result, this Michigan ER is operating with five fewer nurses than optimal at any given time, according to the nurse in the AP story.

Other states, beside Michigan and Utah, are seeing an increase in nursing shortages.  According to staffing firm Aya Healthcare, the five states with the highest travel nursing demand right now are California, Texas, Florida, Minnesota and North Carolina.  One analyst stated the demand for travel nurses will continue well into 2021, with particular emphasis on ICU nurses and operating room (OR) nurses.  However, as Aya Healthcare notes, fewer travel nurses have extensive OR experience as compared to other specialty areas; thus, these positions will be harder to fill.

It isn’t just nurses who are in short supply in some of the nation’s COVID hot zones.  Some professional clinicians are retiring early or moving into less strenuous specialties.  According to a survey of 3,000 doctors released this summer by the non-profit Physicians Foundation, four percent had already decided to discontinue their practice due to COVID-related reasons.  This was prior to the beginning of the second wave that is currently battering the country from coast to coast.  The presumption is that this propensity among clinicians—especially older clinicians—to consider retirement or reassignment has only increased in the last few weeks, and that trend may continue.

Looking for A Little Relief

So, hospitals are in trouble.  There is no getting around it.  At least as it pertains to those facilities in and around the COVID hotspots, staffing is becoming an increasingly problematic component of the overall care mission.  What, then, can hospitals do to alleviate this critical problem?  Specifically, how can you maintain adequate staff levels and prevent burnout?  The following suggestions may prove helpful, but are not without their hurdles.

• Hire Outside Help.  HealthcareDive reported late last week that the largest health system in Utah, Intermountain Healthcare, was set to hire 200 travel nurses as part of its efforts to deal with the challenging effects of COVID on its 24 hospitals.  So, this is one strategy hospitals will need to consider.  However, there are difficulties with this approach.  As already noted, finding RNs within certain specialties or with specific expertise may prove difficult—especially as the pandemic seems to be encroaching on a larger swath of the country.  You will need to be prepared to pay more than the going rate as demand may very well drive wages higher during this current period.
• Seek State Leadership.  Urge your state authorities to consider temporary measures similar to what Utah has done.  Getting the governor to issue extraordinary waivers allowing nursing students and medical students to provide hospital-based care may prove necessary to address the staffing shortfall.  This may require you to work with your state hospital association to draft an official request to be submitted to the appropriate agency or individual.  Your joint-voices may prove loud enough to get the government’s attention.
• Recruit Retirees.  It may be that there is a sufficient number of doctors, nurses and non-physician practitioners in your area who retired prior to the coronavirus outbreak, but who have maintained their licenses, and who might make themselves available to your facility on a temporary basis.  This strategy was used in many states during the first wave of the pandemic and should be considered once more now that the second wave is fully upon us.

Implementing these strategies may not only help to meet the immediate need created by the increase in COVID cases, but could also alleviate the co-crisis of burnout.  The more staff you bring in, the more rest you provide for those who have been overworked and overstressed for months.  Again, all this takes money, and hospitals will need to engage in creative budgeting to bring those resources to bear.  The alternatives may be to either limit patient volume or risk more defections from the clinical staff.  Many experts tell us things will get worse before they get better, so steps should be undertaken now to address the needs that are sure to lie ahead.

If we can be of assistance to you during this national crisis, please reach out us at info@miramedgs.com.  We want to do our part in helping you to chase away those “hospital workforce blues.”