By Arne Owens
As the COVID-19 pandemic spread across the country in early 2020, hand-made signs began popping up at the entrances to hospitals and other health care facilities reading “Heroes Work Here!” These frontline nurses, doctors and other healthcare staff did, indeed, become heroes when emergency rooms and intensive care units filled up, death rates soared, and families despaired. Their commitment to their patients and communities kept hope alive.
But serving on the front lines of the pandemic and sacrificing their own physical and mental well-being for the sake of others, while dealing with endless hours of life-or-death situations took a toll on our healthcare workers. Today, two years after the onslaught of COVID-19, hospitals and other healthcare providers are facing dire labor shortages as practitioners leave the healthcare field. More must be done by our federal and state leaders as well as colleges and universities, medical societies, nursing associations and many others to support our healthcare system.
Many healthcare workers are leaving due to burnout from the negative effects fighting the deadly pandemic had on care. A National Institutes of Health study found that nurses newly entering the profession are quickly burning out and turning over for new jobs. A Kaiser Family Foundation and Washington Post poll meanwhile found that three out of ten healthcare workers are considering leaving the field and another six out of ten said COVID-19 has taken a toll on their mental health.
But the healthcare worker shortage predates COVID-19. The issues of a rapidly aging nursing workforce combined with inadequate spaces in nursing schools to fill the gap has been a problem for many years. Projected retirements of hundreds of thousands of seasoned nurses in the near future along with persistent shortages of primary care physicians, indicates the single greatest barrier to high quality healthcare for all Americans will be a rapidly shrinking healthcare workforce. The impact is already being felt by hospitals, community health clinics and nursing homes nationwide.
So what can be done? There is no single solution or “silver bullet,” so a collaborative effort involving the full range of healthcare stakeholders will be required.
At the federal level, nursing education grants available through the Health Resources and Services Administration of the U.S. Department of Health and Human Services (HHS) should be expanded, especially for those willing to practice in underserved areas. Funding for Graduate Medical Education, or GME, through the HHS Centers for Medicare and Medicaid Services (CMS) should be expanded, targeted especially at incentivizing more medical school graduates to go into primary care as physicians. Congress should also abandon efforts to reallocate remaining dollars meant to help hospitals recover from COVID-related financial shocks – such as the Provider Relief Fund – to pay for big spending bills currently under consideration.
At the state level, where governmental action can have the greatest impact, there are opportunities for legislatures to increase funding for nursing education grants and for increased spaces in nursing schools at public universities. State governments are also well positioned to serve as convening authorities, drawing in the full range of healthcare stakeholders from both the public and private sectors for the purpose of collaborative effort, strategic planning and coordinated action to address specific challenges within the state.
State governments are also the regulatory authorities for a broad array of health professions, issuing licenses through state agencies, boards of medicine, boards of nursing, and other entities that enable practitioners to practice in their respective states. Entering into interstate licensure compacts that enable doctors and nurses to practice across state lines would be a prudent measure. This is especially helpful in the expansion of telemedicine for the purpose of delivering care in shortage areas. States can speed up the internal bureaucratic processes for reviewing and granting an applicant a license to practice as well.
Yet government isn’t the only solution. Healthcare systems, hospitals, clinics, and physician practices that blanket the nation must do their part as well. Connect with local high schools on career days to give graduating students a vision of serving in the healthcare industry. Build from within by creating mentoring programs, offering more internships, and establishing in-house training programs to provide certified nurse aids a pathway to becoming licensed practical nurses, to help address staffing shortages. Doing more to instill pride in a healthcare system or hospital brand, such as recognizing staff who have sacrificed and given so much, will help with morale. In sum, there is no substitute for leadership and good management that is focused on the most important resource in any enterprise—the people.
There is so much that can be done, and the time for action is now. Our nation’s healthcare workers deserve better and as fellow Americans we must make sure our government and public officials are empowering our nation’s hospitals and healthcare facilities to support their essential employees and their work.
Arne Owens is a former deputy assistant secretary with the U.S. Department of Health and Human Services and former Chief Deputy Director of the Virginia Department of Health Professions.