Tx for Staffing Crisis? Nurses Suggest Better Pay, Training, and National Licensure (For a Start)

Tx for Staffing Crisis? Nurses Suggest Better Pay, Training, and National Licensure (For a Start)

Cross Country Healthcare , Inc., a leading provider of staffing solutions for healthcare clients, has released the results from a nationally represented survey of nurses and nursing students showing that the COVID-19 pandemic has introduced long-lasting negative perceptions of their future careers. The survey, conducted in partnership with Florida Atlantic University’s Christine E. Lynn College of Nursing, identifies root causes of the current stressors among healthcare professionals and provides actionable areas to help improve nursing satisfaction, career outlook, and mental well-being.

Pain Points

The survey reports that:

  • Nearly 37 percent of nurses identify as being burned out, stressed, and/or overworked.
  • 32 percent of nurses are very/completely satisfied with their occupation, compared to 52 percent prior to the pandemic.
  • 29 percent of nurses say their desire to leave the profession is dramatically higher now versus pre-pandemic, noting the nursing shortage and inadequate staffing levels as top contributors to the low satisfaction.
  • 66 percent of nurses expressed some level of consideration to leave the profession, signaling long-term impacts on our health system post-pandemic.

“On one hand, this research shows us that the pressures for nurses under COVID-19 are significant and likely long-lasting,” said Henry ‘Hank’ Drummond, PhD, MDiv, BA, RN, senior vice president, chief clinical officer at Cross Country Healthcare. “On the other hand, the data is very clear in outlining specific areas that we can improve, and Cross Country Healthcare is making every effort to support our nurses by addressing these challenges.”

Crisis Highlights Need for Pay Raises, Better Cross Training—and Getting those Holdout States to Join the National Licensure Compact

The survey also pinpointed areas of change that nurses believe would positively affect the profession. These include incorporating new staffing approaches and increasing wages. For instance:

  • 97 percent of polled participants agree, and 81 percent completely agree, that increases to pay rates and other incentives would attract and retain nurses.
  • More than half (58 percent) agree that telehealth should be a cornerstone of care delivery
  • 85 percent believe that we must improve cross training to adapt to crisis events.
  • Additionally, the majority of nurses (85 percent) strongly believe national licensure, a multistate license that would allow nurses to practice across state lines, would have greatly benefited the country during the pandemic. (At present, 38 states have enacted NLC multistate licensing or have legislation pending. Holdouts include New York, Connecticut, the District of Columbia, Hawaii, and several northwestern states).
“Our nurses need solutions, many of them outlined in this research, that will ease burnout and reduce stress, as well as help them enjoy long-term and satisfying careers.”
Safiya George, PhD, APRN-BC, FAANP, FAU Christine E. Lynn College of Nursing
Safiya George, PhD, APRN-BC, FAANP, dean of <a class=

Florida Atlantic University’s Christine E. Lynn College of Nursing.” width=”488″ height=”325″ /> Safiya George, PhD, APRN-BC, FAANP, dean of Florida Atlantic University’s Christine E. Lynn College of Nursing.

“Our nurses are the backbone of the healthcare system and if too many leave or decide not to pursue a career in nursing, the consequences would be catastrophic,” said Safiya George, PhD, APRN-BC, FAANP, dean and professor at the Christine E. Lynn College of Nursing at Florida Atlantic University. “Our nurses need solutions, many of them outlined in this research, that will ease burnout and reduce stress, as well as help them enjoy long-term and satisfying careers.”

Cross Country Healthcare has long provided mental health outlets to its healthcare professionals. Specifically, during the pandemic Cross Country Healthcare launched a dedicated mental health hotline and offered a licensed clinical social worker so that employees and clinicians can safely and openly express their emotions and have an immediate resource for assistance.

“Having recently worked in the hospital setting, I can tell you how difficult this time has been for nurses and other healthcare staff,” said Michael Skovira, MBA, MPAS, PA-C, chief medical officer at Cross Country Healthcare. “These findings reinforce the importance of our existing resources and will help our organization design novel and informed long-term support solutions for our valued nurses.”

More about the survey

The survey, conducted in partnership between Cross Country Healthcare and Florida Atlantic University’s Christine E. Lynn College of Nursing, collected 570 responses between May and June of 2021. The results showcase a robust and comprehensive audit of the new post-pandemic landscape of nursing from the perspective of current nurses and nursing students.

Hear Us Out Campaign Reports Nurses’ COVID-19 Reality

Hear Us Out Campaign Reports Nurses’ COVID-19 Reality

Newswise — American Association of Critical-Care Nurses (AACN ) has launched Hear Us Out, a nationwide effort to report nurses’ reality from the front lines of the COVID-19 pandemic and urge those who have yet to be vaccinated to reconsider. In response to the surge of the delta variant, a dramatic increase in younger Americans dying and the Food and Drug Administration’s first full approval of a COVID-19 vaccine, AACN is advocating on behalf of the acute and critical care nursing community, as the profession and healthcare systems are being pushed to a breaking point.

“We don’t want to scare the public, yet we are obligated to paint an accurate picture of life and death with COVID-19 in an ICU,” said Beth Wathen, AACN president. “COVID kills, and the death is a difficult, tragic and lonely one. By engaging in an honest dialogue, we hope to help Americans understand the consequences of what is now a preventable disease.”

Hear Us Out mobilizes nurse voices and outlines the dangers of COVID-19 surges for the community at- large. The campaign will include videos of nurses sharing their experiences taking care of patients with COVID-19 and materials that guide those who have been vaccinated to engage in constructive conversations with family and friends who have yet to be vaccinated.

Media reports show that in regions with low vaccination rates, healthcare systems may be unable to provide care for patients hospitalized with COVID-19 as well as those with cancer, heart attacks, strokes and other health emergencies. This challenge will only worsen until more people are vaccinated against COVID-19.

As the situation escalates, nurses are leaving hospital settings or the profession altogether in record numbers. The sustained and extreme demands of caring for unvaccinated, hospitalized patients are taking their toll. A recent AACN survey of more than 6,000 acute and critical care nurses quantified the impact of the past 18 months on the profession:

  • 92% of nurses surveyed said they believe the pandemic has depleted nurses at their hospitals and, as a result, their careers will be shorter than they intended
  • 66% feel their experiences during the pandemic have caused them to consider leaving nursing
  • 76% say that people who have yet to be vaccinated threaten nurses’ physical and mental well-being
  • 67% believe taking care of patients with COVID-19 puts their own families’ health at risk

“Nurses leaving the profession will bring our healthcare system to its knees,” said Amanda Bettencourt, AACN president-elect. “You or your mother, brother, child or dear friend may suffer alone without a nurse beside them providing care. This is the last thing we want to have happen. It is avoidable, and it is the public who can help take the pressure off our overwhelmed nurses at the bedside.”

If this trend continues, the future of healthcare is at risk. The nursing shortage in the U.S. will intensify, having been an issue long before the pandemic. The Bureau of Labor Statistics projected nearly 200,000 nurse openings each year through 2029, including retirements and workplace exits. Now, survey data indicates that more nurses than projected are likely to leave the profession due to their pandemic experience. Inadequate staffing will lead to additional challenges in the coming years, raising the risk of increased mortality and complications in hospitalized patients.

Visit HearUsOut.com for more information on AACN survey findings and how to become an ally to protect both the public and our nurses.

Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.

American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; www.aacn.org; facebook.com/aacnface; twitter.com/aacnme

Nurses are Leaving the Profession, and Replacing Them Won’t be Easy

Nurses are Leaving the Profession, and Replacing Them Won’t be Easy

The fourth wave of COVID-19 is exacerbating the ongoing crisis for the nursing workforce  and has led to burnout for many nurses. As a result, many are quitting their jobs in substantial numbers all across the country, with 62% of hospitals reporting a nurse vacancy rate higher than 7.5%, according to a 2021 NSI Nursing Solutions report.

But the global pandemic has only worsened problems that have long existed within the nursing profession – in particular, widespread stress and burnouthealth and safety issuesdepression and work-related post-traumatic stress disorder, and even increased risk of suicide.Originally published in The Conversation - USE THIS LOGO


In addition, nurses need to contend with growing workloads and inadequate staffing, or not having the right number of nurses on the right units to ensure that patients receive safe quality care. Mandatory overtime is another challenge and occurs when nurses must work extra hours beyond their shift because of staffing shortages. All of these issues can lead to low job satisfaction among nurses and are likely to contribute to nurses’ leaving the profession, a trend that began well before the current pandemic struck.

Despite more awareness of the challenges nurses currently face, nurse staffing and its impact on patient safety have been studied for more than 20 years. My role as a nurse researcher and assistant professor at the University of South Florida is to evaluate the needs of the nursing workforce and design and implement programs to address them.

Here’s why the pandemic has made the nursing shortage even worse, and why I think health care leaders need to make bold changes to address the well-being of nurses – for the sake of nurses and patient care in our country.

Disruptions in health care delivery

Nurses, like many health care workers, are physically and emotionally exhausted after working in what has been described as a “war zone” for the better part of the past year and a half. One nurse on the front lines reported irreversible damage from the trauma of caring for extremely sick patients. Others are experiencing shortages of oxygen, equipment and other needed supplies to keep themselves safe and to keep their patients alive.

As more nurses leave the workforce, patient care will no doubt suffer. Research has shown a relationship between nurse staffing ratios and patient safetyIncreased workload and stress can put nurses in situations that are more likely to lead to medical errors. Lower nurse staffing and higher patient loads per nurse are associated with an increased risk for patients of dying in the hospital.

Because hospitals cannot open beds if there are no nurses to staff them, some hospitals are being forced to shut down emergency rooms and turn away patients in need of medical care. That is a problem for not only hospitals in large cities; rural hospitals are also struggling. Alarmingly, some hospitals are considering the need to potentially ration medical care.

How some hospitals are addressing the shortage

Hospitals are desperate to fill nursing vacancies. One hospital system in South Dakota is offering incentives as large as US$40,000 sign-on bonuses to recruit nurses to work in the clinical areas that are in most need. This may be a great attempt to draw nurses to an institution, but sign-on bonuses and incentives might not be enough to persuade some nurses to work at the bedside and continue contending with the current workload of the pandemic.

Another strategy to fill vacancies is the use of travel nurses. Travel nurses work for agencies that assign them to hospitals that cannot fill vacancies with their own staff. Although this can be a successful short-term solution, the use of travel nurses is not sustainable over time and it does not help retain experienced staff nurses in an organization. Travel nurses make significantly more money than staff nurses, which may lure nurses away from permanent positions and in turn increase the staffing deficit for hospitals. The average salary for a travel nurse in the U.S. is $2,003 per week, with $13,750 in overtime per year. Some nurses even accept “crisis assignments,” which can pay as much as $10,000 per week. That is significantly higher than the average of $1,450 per week ($36.22 per hour) for a staff nurse.

Focus on nurses’ well-being

For the past 18 years, nursing has been identified as the most trusted profession. Nurses are caregivers, role models, educators, mentors and advocates and have a direct impact on the health and well-being of patients. The health of the nation’s nursing workforce is fundamental to our health care industry. As identified by a 2021 National Academy of Medicine report, nurse well-being and resilience are needed to ensure the delivery of high-quality care and to improve the health of the nation.

Research demonstrates that people with higher levels of well-being have lower levels of burnout and perform better at work. Therefore, some hospitals and unions are offering resources and programs to nurses during the COVID-19 pandemic that seek to reduce stresspromote resiliency and increase well-being. We have yet to see the long-term effectiveness of these programs on the health and wellness of nurses.

While nurses are responsible for prioritizing self-care, health care organizations are responsible for creating a workplace environment in which nurses can flourish. Nurses report fewer medical errors when their well-being is supported by their organizations and they are in better physical and mental health.

The long-term solution to the nursing shortage calls for systematic changes that value nurses and offer them a safe place to work. Examples include implementing appropriate salaries and flexible schedules, ensuring adequate nurse staffing, and creating jobs that allow aging nurses to continue working in direct patient care roles so they can remain in the workforce longer instead of retiring. The pandemic has made more people aware of the distressing conditions many nurses work in. But without systematic changes, the drain of nurses out of the profession – and its negative impact on patient care – will only continue.

The Conversation

“Profession in Crisis”: Survey Details Declines in Nurses’ Mental Health, Commitment

“Profession in Crisis”: Survey Details Declines in Nurses’ Mental Health, Commitment

Understanding the final toll of the COVID-19 pandemic on frontline nursing will take time, but a new survey suggests that the crisis has had a heavy impact on nurses.

Nursing is a “profession in crisis,” according to the 2021 Frontline Nurse Mental Health & Well-being Survey by Trusted Health, a company that applies digital technology to staffing needs such as travel nursing. The online study, conducted in March 2021, gathered 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.

“I do think our profession’s at a blockbuster moment,” Dan Weberg, PhD, RN, Head of Clinical Innovation at Trusted Health said in an interview.

The crisis is reflected in two ways. First, nurses are reporting big declines in their mental health. Second, and more alarming, nurses, especially those who are younger, are feeling less committed to the profession.

Declines in Mental Health

“We did a similar study a year ago right in the peak of COVID and we found similar things. Nurses did not feel supported then, and it just exacerbated through COVID. They don’t feel their mental health and wellness is supported now.”

—Dan Weberg, PhD, RN, Trusted Health

For the second year in a row, the study found, nurses reported steep declines in their mental health as a result of the COVID-19 pandemic. On a scale of 1-10, nurses rated their current mental health and well-being an average of 5.7, compared to an average of 7.9 prior to the COVID-19 crisis, representing a decline of 28 percent.

What’s more, nurses aren’t particularly pleased with the lack of support from their facilities. On a scale of 1-10, nurses rated their current facility an average of 4.6 in terms of the support it has provided related to their mental health and well-being, a slight decline from 2020’s rating of 4.8.

“We did a similar study a year ago right in the peak of COVID and we found similar things,” Weberg says. “Nurses did not feel supported then, and it just exacerbated through COVID. They don’t feel their mental health and wellness is supported now.”

Mental health and wellness support need to be integrated into professional practice, Weberg says. Those methods could include ways to be mindful, de-stress, and obtain counseling. “We can embed some of these wellness and mental health support tools within the shift,” he says.

Waning Commitment

Acute care, emergency, critical care, and pediatric nurses were the most likely to report that their commitment had decreased.

Of note, nearly half (46 percent) of surveyed nurses said they were less committed to nursing due to the COVID pandemic, compared with 54 percent who say they are equally or more committed. Notably, nurses between the ages of 20 and 29 and 30 to 39 were 24 percent and 15 percent more likely to report that their commitment to nursing had decreased, respectively. Nurses who work in acute care, emergency, critical care, and pediatrics were the most likely to report that their commitment had decreased, the report says.

Of those respondents who said they were less committed to nursing, nearly 1 in 4 are actively looking for a job outside nursing or planning to retire, the report notes.

Implementing New Staff Retention Strategies

To address retention issues, the survey offers various recommendations:

  • Focus on culture over messaging. Culture changes could include strategies to address bullying and incivility, education and coping mechanisms for compassion fatigue and moral injury, and comprehensive support for nurses who are experiencing acute mental health issues, the report recommends.
  • Rethink nurse staffing. Millennial and Gen Z nurses want more flexibility around their careers and the ability to try different things.
  • Create new opportunities. For instance, hospitals need to identify opportunities in less acute settings or away from the bedside for those who want it.

Demanding a Difference

“The newer generation of nurses coming in is demanding a different experience than their predecessor, so I think that will create a shift,” Weberg says. “I think consumers are demanding a different healthcare experience, which is creating new opportunities for nurses to come in. And I think that the nurse leaders are seeing that they need to shift their thinking towards supporting the workforce a little bit differently than they have in the past.”