The world is already short 14 million nurses, and burnout and fatigue — especially that brought on by Covid — aren’t helping. Any possible fixes will take time and, possibly, political will.
Healthcare’s talent shortage was one of several questions pondered Wednesday by top executives from five large staffing firms at Staffing Industry Analysts’ Healthcare Staffing Summit in Houston. And it’s not a new challenge.
“This is an issue that’s been happening for 20 years,” said John Martins, president, CEO, Cross Country Healthcare.
There are only 13 million nurses in the world, but 27 million are needed to achieve equilibrium with number of people getting access to healthcare, Martins said, citing statistics from the World Health Organization. The world is short 14 million nurses.
In the US, the Bureau of Labor Statistics data shows there are only 3 million nurses, and only 1.7 million of those are in acute care.
Martin also pointed to data showing a US nursing shortage of 400,000 today in acute care at the bedside, and other research points to a shortage of as many as 1 million nurses in 10 years. Cross Country’s own survey of 1,800 nurses found a high percentage saying burnout and fatigue are causing nurse shortages.
“At Cross Country, we say we want to be helping the whole labor solution, not just contingency labor,” Martins said. “And us as an industry, that’s really what we need to do. How are we going to help solve the long-term issue? How are we going to help upskill clinicians? How are we going to help increase the supply?”
The industry needs to look at engaging and retaining current nurses, upskilling and increasing supply, he said.
Another idea: International nurses could be one piece to solving the puzzle, said Liz Tonkin, CEO of MedPro Healthcare Staffing.
“If you look at other countries, the golden ticket is to come to the United States,” Tonkin said. “Part of our issue in the United States is we’ve made immigration so difficult.”
Making it easier for foreign nurses to get here, possibly offering a specialized visa, will help, though it won’t solve everything. Tonkin noted about 10% of nurses in the US are foreign-trained, but taking some steps could bring it up to 20%.
Still, international nurses aren’t an immediate band-aid, she said. Bringing in an international nurse is a multiyear process.
A different take on the problem came from Alan Braynin, CEO and president of Aya Healthcare.
“I think it’s a misnomer to say there’s a nursing shortage,” Braynin said. “There’s a shortage of nurses wanting to work at the bedside. And there are some legitimate solutions that can be put on the table, but it takes change in the way we think about the problem. I really don’t think the problem is in the downstream of education and training. You have a leaky bucket. You have people going into the profession and then leaving the profession fairly quickly, and, clearly, there is a lack of equilibrium given how much nurses get paid and the difficulty of the job.”
Braynin said the government is uniquely positioned to solve this problem by increasing reimbursements for nursing.
“I think we have to look at the legacy of nursing the profession — the fact that it was predominantly, and still is predominantly, a ‘female profession’ — and I would bet that if most of the nurses were men, then compensation levels for nurses would be different in the United States and government would take different action.”
Nurse talent shortages, of course, aren’t the only concern.
By 2034, there will be a physician shortage of 124,000 in the US, said James Taylor, group president and COO, AMN Healthcare, adding that a third of practicing physicians today are 60 years and older.
However, the physician shortage is already a problem today.
“When you think about healthcare physician shortage areas today, a fourth of our population is either denied healthcare or gets limited healthcare today,” Taylor said.
What now?
“What if we relaxed the residency of the expert people coming into our system? What if we took and gave them more money and accelerated internships and residencies?” Taylor said. “What if we had a STEM program that went into the high schools and went into elementaries that focused on healthcare? I could keep going on and on.”
The same challenges faced in the nursing space are faced in the locums space, said Robert Dickey, CEO of Medicus Healthcare Solutions.
“It was exasperating when Covid happened and it just kind of turbocharged everything, and what we saw was again — no surprise, you’ve heard this before — the burnout factor,” Dickey said. “You had an older population of doctors that worked pretty hard on the front lines and they got burned out.” A lot those doctors likely would have worked for a few more years but decided to halt or scale back quite a bit, he explained. That loss in physician numbers with an older population combined with more people having healthcare coverage due to the Affordable Care Act and the backlog of delayed elective procedures amid Covid, and “it’s kind of creating all this pressure in the marketplace,” Dickie said.
Moderator Barry Asin, president of SIA, also asked the executives about what they see ahead in 2027.
“I really hope the industry has made some inroads in the relationships and trust with hospitals because that is going to be the basis of everything,” MedPro’s Tonkin said.
AMN’s Taylor said he would like to see the staffing industry become even more collaborative and bring solutions that will make a difference inside of healthcare, taking care of the fourth of the population that doesn’t have full access.
Braynin, meanwhile, he sees a shift from healthcare staffing being a personality-driven industry to a systems-driven industry.
In an article in the November/December 2022 issue of Staffing Industry Review magazine, Cross Country’s Martins write about how the industry must take a meaningful look at nurses’ concerns. The issue goes live online Nov. 15.