A nurse made national headlines in Washington earlier this year for calling 911 during a shift. The inspiration for her call wasn’t an unruly patient. It wasn’t a physical emergency at all. It was an overflowing emergency room.
There simply weren’t enough nurses available to handle what was actually a pretty normal influx of patients. The 911 dispatcher was able to send help, but the incident proved to be more significant than a singular event that happened at one hospital. Nurses from all over the country begin to write and speak about their own experiences navigating the treacherous waters of what has proven to be a desperate nursing shortage.
Unfortunately, the situation hasn’t gotten much better. Bedside and ER nursing remains desperately short-staffed, while alternative forms of nursing are on the rise.
In this article, we examine the state of nursing and what can be done to fix the situation.
The Situation
Most people have heard by now of the nursing shortage which has been in the works for more than a decade. The problem is simple. Lots of nurses leave the profession. Not enough people come up to replace them. While Covid has taken a lot of blame for the situation, it actually began well before the pandemic.
Bedside and emergency nursing is on the decline. There are alternative forms of nursing that are gaining popularity— we will highlight a few of them below— but it is harder for these disciplines to grow when all of the attention goes to hospital nursing.
It’s a dangerous dynamic because the healthcare industry needs professional diversity. Emphasizing only bedside and emergency nursing will eventually lead to shortages in other disciplines, and the cycle will simply continue.
Below, we highlight popular alternative forms of nursing and discuss ways that the entire industry can seek a sustainable solution to the ongoing shortage issue.
Travel Nursing
Travel nursing gained a significant amount of attention during the pandemic. As a concept, travel nurses are meant to go where they are needed most. Historically, that has meant traveling long distances and being put up in temporary housing while they worked in a high-need hospital.
For example, rural hospitals often rely on travel nurses because they aren’t always able to fully staff their hospitals with community members.
However, for the last three years high need hospitals have been pretty much everywhere. Consequently, “travel” nurses have been able to find work close to home, while still commanding the significantly higher salaries that they customarily receive.
Travel nurses can fill in for a wide range of different responsibilities in the hospital setting.
Nurse Midwife
Nurse midwives assist with child delivery. This category of nursing is expected to grow at a staggering rate of around 50% in the next decade, making it an extremely in-demand career. Traditionally, midwifery has been a community tradition, in which older people living in a town would assist the next generation with childbirth and basic care. Many people don’t realize that doctors were largely uninvolved with childbirth until around the 19th century.
Midwives served to fill the care gap. Now the profession is significantly more science-based, providing high-level care for the mother, the baby, and often the entire family.
Flight Nurses
Flight nurses are involved in providing emergency care in transportation settings. For example, if a patient needs to be helicoptered or otherwise flown out to a new location for further treatment, flight nurses will be used to provide care.
Most patients receiving the care of a flight nurse are in desperate condition. Therefore, the job is very high-pressure (even more so than traditional nursing).
Flight nurses usually start by working in the hospital setting for several years. Positions are highly competitive and relatively rare. This means that people wishing to become a flight nurse usually need to get extra training, and possibly even be willing to move to find a relevant job opening.
Still, it serves as a rewarding and exciting way to work as a nurse.
Potential Fixes?
It’s important to keep in mind that, while improving retention is crucial (about half of all nurses leave the profession within their first five years on the job) it is only part of the issue. The shortage was caused not just by high turnover, but also by the fact that not enough new nurses were graduating college.
There are initiatives all throughout the country to bring new people into the profession of nursing. Michigan recently realized that they need to increase their influx of new nurses by about 6000 every year until 2028 to avoid a crisis-level shortage.
While one solution has been to look for international recruits, Michigan is looking for a more sustainable approach to getting homegrown nurses as well. Their solution? Let Michigan nursing students earn their degrees at community colleges.
Community colleges can be as much as one-tenth the price of a university education making it a significantly more accessible route for receiving an education. The current plan is to have teachers from the community colleges teach the first three years of instruction (or the equivalent of 90 credit hours) and then have cooperating university professors come in and teach the final year of instruction.
It’s a costly program, but it may prove a sustainable solution to the issue of nursing shortages. So many other solutions— improving working conditions, changing schedules, increasing compensation— fail to acknowledge the greater issue.
Of course, it’s good to treat working nurses well, but doing so does not necessarily guarantee that a wave of new nurses will come up to replace the ones leaving the profession. For bedside nursing to become sustainable again, the healthcare industry needs stable numbers of college graduates.