The time is Sunday night, August 1, 2021. The place is Lyndon B Johnson Hospital, Houston, TX. The nursing shortage has come to a peak. There are 130 patients in the emergency room waiting to see the doctor. The hospital was forced to declare an “internal disaster” and put the emergency room on “drive-by” status, halting ambulance traffic to the emergency room as the wait times increased to 24 hours.
The nursing and healthcare worker shortage has been a prediction for multiple years and in the emergency room and ICU it is a fact. These shortages have been manageable in the pre-COVID world, but now they are presenting safety issues that cannot be ignored. Straining the system are the retirements, those who left the profession and those who matriculated into administration and education. Mix that in the cocktail with burnout from COVID and speculation begins on what will happen next.
During the last COVID surge, the state sent additional nurses who were hired with federal dollars out of the Coronavirus Local Fiscal Recovery Funds. There have been no indications that monies or help is coming now. The severity of the shortage at LBJ Hospital was only known because an emergency room doctor emailed his state Senator about the situation there.
There is no easy answer to the shortage of healthcare workers. COVID burnout is taking its toll on everyone. Health care workers are angry at what they see as unnecessary daily trauma and death. The reasons these shortages exist is attributed to the retirement rates of healthcare workers growing rapidly. Over half of the current RN workforce is over 50 years old. In radiology, the age of the workforce is even older and respiratory care therapists have been decimated through the past several years by cuts in reimbursement for services. The aging population in the US continues to drive demand for services and utilization of facilities. Major cities tend to always need more healthcare workers with most city hospitals having dozens if not hundreds of positions available. Geography also determines where nurses live and where the training programs are located. The number of nurses licensed to practice compared to the total population of the state gives an indication of how well prepared a state is to take care of patients.
The shortage of healthcare workers has been simmering for years, but the pandemic has magnified the importance of having a well-trained workforce. As we enter another surge of COVID variants and the politicization of the vaccine, many of our patients will suffer. Unfortunately, no one has stepped forward to invest in clinical personnel. It’s a lot of work, and is very expensive, and generates many administrative hassles. Return on investment? Not so much.
We have already entered another competition for personnel with our local, state, and national hospitals. Mass vaccination sites have disappeared, testing sites require an appointment, and support from the federal government has not appeared. We are on our own. Crisis pay rates are in effect.
Where is this going and when will it end? Stay tuned and watch closely.