Managers Struggle to Cover Shifts During Pandemic-Fueled Nursing Shortage

Terry Prowse, MSN, RN, a Clinical Services Manager at the University of Arkansas Medical Center (UAMC), was relieved when most of the nurses on his units continued working throughout the first and second waves of the pandemic, but that trend began changing in 2021.

Resignations surged as nurses received offers from travel agencies for more than double their current hourly rates. Others who were exhausted and overwhelmed started leaving the bedside for roles in employee health, school nursing, and endoscopy.

Terry Prowse, RN

“When hospitalizations increased due to the Delta variant, we had five resignations in one week and no new applicants in the pipeline,” Prowse said. “It’s stressful trying to fill the gaps in staffing.”

There are eight vacancies among the 54 nursing positions in Prowse’s units, which includes a COVID-19 unit and medical-surgical unit. After work, he is frequently scrambling to fill vacant shifts by offering overtime or asking other managers if they can spare a nurse for a day or night.

Nurse managers throughout the country are reporting similar stories of nursing staff shortages, and results from a national survey of 1,000 nurses suggest numbers may continue to dwindle. Two-thirds of the respondents reported feelings of depression and a decline in physical health since the pandemic began, and nearly half felt less committed to the profession than before the pandemic.

The decrease in commitment was most pronounced among nurses under 40. Organizations such as the American Nurses Association (ANA) warn that that the severe lack of nursing staff could have long-term repercussions for the profession and the health of the nation.

In a recent letter to the Department of Health and Human Services, the ANA urged the administration to declare the nursing shortage in the United States a national crisis and take steps to address the problem.

At UAMC, the nursing shortage has been exacerbated by the loss of staff who support registered nurses, such as patient care technicians, nursing assistants, and environmental services staff — many of whom left the hospital to pursue jobs at employers such as Amazon and Costco that offered higher pay and lower risk of contracting COVID-19.

“Instead of focusing primarily on clinical decisions and tasks, nurses are also emptying urinals and trash cans, feeding patients, and getting patients to the bathroom,” Prowse said.

To better support nurses who are working under these conditions, Prowse has increased the frequency of communication with the people he manages. “Nurses need to know what we are doing and why,” he said.

He holds staff meetings more often to answer questions and sends email updates regularly. Additionally, the hospital recently started offering $10,000 retention bonuses to nurses who had at least three years of full-time experience at the facility. Nurses who worked extra shifts received overtime rates as well as incentive pay.

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