By Melissa Powell, COO of The Allure Group
Even before the COVID-19 pandemic began, there was a shortage of registered nurses (RNs) in U.S. hospitals. With the Delta variant still raging, there is an urgent need for more frontline healthcare workers, including nurses, now and in the future. Despite the fact that nursing is the largest healthcare profession in the country, low salaries in combination with burnout, lack of work-life balance, and stress that is related to dual roles as parents or caregivers are the main reasons that nurses leave their jobs. Burnout contributes to more than 50 percent of workforce turnover in all industries, and many healthcare facilities are understaffed, leading to chronic understaffing and an out-of-balance nurse-to-patient ratio. The US Bureau of Labor Statistics reports that more than 500,000 RNs will retire by 2022, leading to a shortage of 1.1 million nurses across the country.
To combat the flow of nurses leaving the field, some healthcare facilities are offering improved employment contracts that include higher hourly rates and contracts with travel-nursing companies. Some RNs are also going back to school to obtain nurse practitioner certificates, which offer higher salaries and better benefits. NursingCAS, a service of the American Association of Colleges of Nursing (AACN), provides a centralized nationwide registration for nursing students, and federal and state agencies and universities are offering incentives like tuition reimbursement to encourage students to join nursing programs.
Another solution is retention bonuses that help RNs feel valued by their employer and boost morale and foster loyalty. Also, offering current staff merit, service, and recruitment bonuses can improve caregiver staff engagement and satisfaction. Increasing the number of ancillary staff to support nurses, such as nurses’ aides or care technicians, can lessen burnout and give RNs more time to devote to quality patient care.
A 2021 Frontline Nurse Mental Health & Well-being Survey by Trusted Health, a company that applies digital technology to staffing needs such as travel nursing, conducted an online survey in March 2021, gathering responses from more than 1,000 nurses, 80 percent of whom said they provided direct care to COVID patients. Trusted Health conducted a similar study in 2020. Nurses reported declines in their mental health, and younger nurses said they felt less committed to the profession.
To address retention issues, the survey offered the following recommendations:
- Focus on culture changes like strategies to address bullying and incivility, education and coping mechanisms for compassion fatigue, and comprehensive support for nurses who are experiencing acute mental health issues,
- Rethink nurse staffing; Millennial and Gen Z nurses want more flexibility around their careers and the ability to try different things.
- Identify and create new opportunities in less acute settings or away from the bedside for those who want it.
Advances in healthcare technology like electronic health records (EHRs) and telehealth—especially during the pandemic—can often make life easier for frontline healthcare workers, but technology can be a double-edged sword. While information technology is intended to streamline nurses’ tasks, “click fatigue” is real, and often nurses spend more time updating electronic charts than actually caring for patients. These extra duties can contribute to burnout.
At the same time, EHRs and other technology can be invaluable in allowing healthcare providers to collect and share data, review patient histories, and get to know new patients. EHRs can also enable nurses to access patient records quickly and efficiently to avoid duplication and improve care. The use of speech-recognition technology in nursing documentation is growing, allowing nurses to dictate patient information to charts rather than manual input, giving them additional time to devote to patient care. And electronic scheduling platforms make it easier and more convenient both for patients and healthcare providers, allowing them greater flexibility in organizing their schedules.
The Allure Group, which manages six skilled nursing facilities in New York City, is successfully using technology to ease some of the burden on overwhelmed healthcare providers in its facilities. The company’s Vis a Vis remote patient monitoring (RPM) solution provides virtual house calls to patients transitioning between care levels, and Allure’s PadsInMotion bedside tablets help keep residents in touch with family and loved ones who cannot visit as often as they would like.
COVID-19 has brought about many changes to the way healthcare is delivered, minimizing the risk of staff exposure to ill patients, preserving personal protective equipment (PPE), and minimizing the impact of patient surges on facilities. Telehealth can provide care to patients while helping to reduce transmission risk. These systems also allow patients to update or upload their medical and insurance information before an in-person or telehealth visit.
To help nurses and other clinicians combat burnout, there are a variety of free resources for healthcare workers. The American Nurses Association website offers a COVID-19 resource center as part of the Nursing World Well-Being Initiative, with free tools and apps to support the mental health and resilience of all nurses, including a nurses’ guide to mental health services. The guide covers the symptoms of emotional and physical stress, while also providing advice as to when to seek support from professionals and peers, and how and where to seek mental health treatment. Another resource for nurses suffering from COVID fatigue is SHIFT Talk, a podcast by nurses connecting with other nurses that addresses issues like burnout, health inequity, and PTSD.
Some solid advice for weary nurses includes practicing self-care and mindfulness, including regulating shift schedules and taking regular breaks as much as possible, and striving to avoid overloaded responsibilities. Experienced nurses are quick to encourage nursing professionals to build strong relationships with co-workers and others outside of work; a supplemental support system is important to provide comfort as well as a distraction to harried front-line workers.