The consequences for nursing during the COVID-19 pandemic are serious and potentially long-lasting. Such are the conclusions of a major news report from the National Council of State Boards of Nursing (NCSBN).
Among the findings:
- Over the past two years, approximately 100,000 registered nurses (RNs) left the workforce during the COVID-19 pandemic due to stress and burnout. This number represents a portion of the workforce NCSBN would not have expected to leave.
- Another 610,388 RNs reported an “intent to leave” the workforce by 2027 due to stress, burnout, and retirement.
- Some 188,962 additional RNs younger than age 40 reported similar intentions.
- About one-fifth of RNs nationally are projected to leave the healthcare workforce.
“The data is clear: the future of nursing and the U.S. healthcare ecosystem is at an urgent crossroads,” says Maryann Alexander, PhD, RN, FAAN, NCSBN chief officer of nursing regulation in a press release. The research was gathered from a biennial nursing workforce study conducted by NCSBN and the National Forum of State Nursing Workforce Centers.
In normal conditions, the NCSBN would anticipate that some 150,000 RNs would have left the workforce during the last two years, due largely to planned retirements, as well as normal pursuit of education and career change, says Brendan Martin, PhD, director of research at NCSBN in an interview. But the data revealed that 330,000 RNs had departed, combining retirements and those who left the workforce due to stress and burnout.
“In terms of looking retrospectively, we were really floored by that number,” Martin says. With an aging population and an increase in patient demand related to COVID-19, “just treading water and maintaining current staffing levels isn’t sufficient. And so the fact that we have any drop-off, let alone double the number we would anticipate, was really problematic.”
COVID the “Accelerant”
The COVID pandemic, says Martin, brought to light enduring nursing workforce issues. “Many of the issues that are confronting the workforce are long-standing issues. The pandemic itself wasn’t necessarily the driver of a lot of the stress, of a lot of this burnout. It was the accelerant,” Martin says.
The research shows that feelings such as being emotionally drained, fatigued, and burned out were most pronounced in nurses with ten or fewer years of experience. That drove an overall 3.3% decline in the nursing workforce during the past two years, the NCSBN report says.
The number of younger nurses planning to leave poses a special problem suggested Martin. “We’re relying on them to essentially step into more leadership roles to form the backbone of the workforce for the next 30 to 40 years and to really mentor the folks coming up through the ranks.”
Currently, says Martin, there are about 4.6 million licensed RNs in the U.S., with a little over 900,000 licensed practical and vocational nurses.
Solutions from Many Stakeholders
Addressing this problem will take cooperation from many stakeholders, Martin notes. “The impacts of the pandemic were so wide-ranging and so widespread that there isn’t a single key stakeholder that needs to be involved,” he says. “Everybody needs to get involved because it’s about how we educate our future nurses. It’s about how we onboard our new career entrants. It’s about how we support our current workers. And then it’s also about how we leverage the expertise, the built-up knowledge, and the acumen of the older nursing cohort.”
“With intentional policy, there’s a potential to get ahead of the curve and to blunt the impact of some of the things that we’re seeing with intents to leave,” according to Martin. “But more important than that, if we change the way that we mentor new nurses entering the workforce, if we give them the appropriate support and the funding if we talk about mental health services for current nurses, I think that there’s a real potential to build a more resilient workforce. If we make this a more sustainable and enriching environment, I think we’re going to rebound. I really strongly believe that, and I think the research supports it.”
Resilience of Nurses
On a positive note, “We saw a larger proportion of licensed nurses employed in nursing and at the bedside than we have in past and recent cycles,” says Martin. “It was really the resilience of nurses, basically going into the heart of the storm, so to speak, during the COVID period. We saw that come up in the data. That’s not news to anyone. That’s long-standing, how dedicated nurses are to their craft.”
Now a freelance writer and editor, he served as a Director at Elsevier, where he was instrumental in the development of major online nursing reference and procedure products. Previously, he served as Editorial Director at Nurses.com, one of the first nursing websites, and was Executive Editor at Nursing magazine, a premier large-circulation journal.
Today, he continues to serve nurses and other clinicians by reporting on developments and trends in healthcare with meaning, context, and insight.
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