Worsening Healthcare Staffing Crisis

Healthcare Industry’s Influence

Imagine a force that quietly shapes our societies, economies, and policies every day. The healthcare industry’s influence extends far beyond hospital visits or doctors’ appointments. Even if you consider settings like the school nurse or a MinuteClinic, the true scope is far greater. It’s more like an octopus with tentacles reaching in many directions, shaping other institutions, government policies, and ultimately impacting your life far more than you might expect.

Let me give you some insight into its influence. Below are examples describing how healthcare organizations or professionals have influence.

Examples of Influence

Healthcare professionals:

• Lobby for changes to laws that create barriers for equal access to resources for individuals with medical or mental health conditions. They seek to educate lawmakers about the impact of laws that create obstacles for people with disabilities or medical or mental health limitations.
• Educate and train current and future healthcare professionals in academic settings, healthcare facilities, and private organizations. They also teach families and individuals how to provide health care at home.
• Conduct research related to improvements in professional treatment options, medications, identification of new diagnoses, and modifications to existing care techniques.
• Travel internationally to deliver essential healthcare, including medical, surgical, dental, and mental health services, to underprivileged areas. These volunteer professionals specifically target underserved communities that would otherwise go without care. (e.g., Doctors Without Borders, Mercy Ship)
• Establish professional safety and competency standards supporting patient safety, and participate in regulatory agencies, committees, and Boards that monitor compliance with those standards.
• Participate in all spectrums of health care delivery: inpatient, outpatient, home health, hospital-to-home, mental health, emergency care, telemedicine, pediatric, adolescent, adult, geriatric, dental, remote, rehabilitative, primary, secondary, tertiary care, workplace, and school.

 Healthcare Professional Prerequisites

Healthcare professionals undergo specialized education and training. They are required to hold a license, registration, or certification issued by state or federal authorities. Most professions require at least a college degree. Some professionals who lack that degree but have extensive experience may be grandfathered as meeting that standard. A State Board monitors all professional groups for compliance with professional Standards of Practice and a Code of Ethics. Their roles also expose them to several risks.

Potential Healthcare Work-Related Risks

• Exposure to infectious agents such as bacteria, viruses, and fungi, including new pathogens for which little is known about their risks, transmission, and treatment. Healthcare professionals were the first to be exposed to victims of COVID-19 and EBOLA. Many of them did not survive.
• Working near hazardous drugs, chemotherapy agents, cleaning agents, disinfectants, and sterilizing agents, which carry health risks following long-term exposure.
• Physical injuries from the demands of moving and lifting patients, even with assistance devices, when patients are uncooperative, or staffing levels are below par, such as slips, trips, and falls, and exposure to infections from needle stick injuries.
• Psychological hazards from high-stress environments, emotional strain, job burnout, working multiple shifts, long hours, and a lack of support amid a high demand for output and perfection, with limited staffing.
• Violence and harassment from patients and their families, or others coming to the hospital to retaliate against coworkers or hospital administration, which can lead to physical and emotional harm, sometimes even death.

Anticipated Staffing Crisis Accelerated by COVID-19

Staffing shortages have worsened since COVID-19. Even before the pandemic, healthcare anticipated a shortage as baby boomers neared retirement. COVID accelerated this crisis and added another challenge: fewer people now want to work in healthcare. Previously, healthcare was seen as a respectable career with steady income prospects. Now, unless someone feels a true calling, they avoid the field. Cultural shifts have also reduced the number of service-oriented individuals who seek such roles. As a result, healthcare faces a global shortage. The World Health Organization projects a global shortage of 11 million healthcare workers by 2030. Some predict that, if current trends persist and interventions fail, this figure could reach 78 million.

Virginia’s Impact: 

How is Virginia affected? In the table below, I show projections for common healthcare titles in Virginia. Unfortunately, many allied health positions lacked data. Only professional titles had information available. Column 1 is the number of professionals we have today. Column 2 shows the projected number of professionals we will need in 2030 based on projected population growth. The positive or negative number indicates how many professionals we expect to have above or below the number we expect to need. The first percentage shows how close we are to having 100% of what we need, compared to the second column, which shows how close the United States is to having 100% of what it needs.

Shaded titles are expected to have a 20% staffing deficit by 2030. (i.e., their % of staff available is 80% or below) Health Resources & Services Administration, HRSA Health Workforce Health Workforce Projections

8.9 Nurses Available to Provide Care per 1000 People in Virginia Today

Currently, in Virginia, we have 77,420 employed nurses for an estimated population of 8,811,195. That means 8.79 nurses per 1,000 people. Virginia has a 0.9% nursing employment rate, below the national average. Nursing enrollment is down, but not due to a lack of interest. In 2023, schools turned away 65,000 qualified applicants because of a faculty shortage. In Virginia at that time, nearly 2,000 full-time faculty positions in nursing programs were vacant.

Nursing turnover keeps climbing. Causes include burnout, bullying, incivility, high nurse-to-patient ratios, and first-year “blues.” Over 1 million nurses are expected to retire by 2030. Patient needs are rising as the population ages. By 2050, 23% of adults may be 65 or older, with more chronic conditions and a greater need for nursing care.

References:

American Association of Colleges of Nursing (AACN)

Health Resources & Services Administration, HRSA Health Workforce Health Workforce Projections, April 25, 2024