Journal editor-in-chief interviews expert on healthcare workforce about nursing shortage

The nursing shortage in the U.S. has reached a crisis point.

While COVID-19 also continues to pose challenges, David W. Baker, MD, MPH, FACP, Executive Vice President for Health Care Quality Evaluation at The Joint Commission and Editor-in-Chief for The Joint Commission Journal on Quality and Patient Safety, reached out to an expert, Dr. Peter Buerhaus, for perspective on what is happening in the workforce and how it can be improved.

Dr. Buerhaus is a professor in the College of Nursing at Montana State University and director of the Center for Interdisciplinary Health Workforce Studies. He is a one of the leading authorities in the country on the nursing and physician workforce.

During the interview, Dr. Buerhaus noted that he believes the pandemic played a role in the decreasing numbers of nurses nationally — noting that for the first time in 1o years, there was an overall drop in employment among registered nurses (RNs), licensed practical nurses (LPNs) and nursing assistants.

But Dr. Buerhaus also said there is good news, as his team — using data from just before the pandemic started — found that the RN workforce would grow by about 1 million in 2030.

“Now, that’s the good news,” he said. “But what concerns me are factors that affect entry into the workforce and exit out of the workforce. We don't know this, but the pandemic could speed up and condense the time for RNs who were planning to retire over the decade and maybe move that up closer. So, we could have an accelerated rate of retirement in the next couple of years.”

To help stabilize the workforce, Dr. Buerhaus suggested two strategies: focusing on the positives rather than feeding into negative narratives about the current state; and becoming more aware of the implications of older generations of nurses withdrawing from the workforce.

“We've retired about half of the 1.2 million RNs born in the baby boom generation, and over this next decade were going to see the remainder of that generation leave the workforce,” he said. “And when they do leave, these nurses take with them decades’ worth of knowledge, experience, leadership, and mentorship of younger nurses.

“I think our hospitals and other institutions really need to ascertain how many RNs are expected to retire and identify the nursing units, the departments, the patient populations that could be most affected by this retirement. Share that information with hospital leaders, with physicians and other clinicians who could be affected, and seek their involvement in helping to mitigate some of the potential harmful consequences with this.”

And while more long-term answers are worked on to address the nursing shortage, Dr. Buerhaus said staff needs to work together to get through the day-to-day challenges that COVID-19 and other issues continue to present in healthcare.

“We've just got to come to work each day, and we need to help one another, support each other, understand each other, and be kind to ourselves and to others,” he said. “We're all in it together, and we just have to persevere. But I also think that it would be helpful to anticipate that there will be a time when COVID becomes more in our rearview mirror, we can get back on our feet, and we can take some deep breaths.

“And at that time, I would hope that hospitals and other care delivery organizations and nurses could come together in a very meaningful way and reflect on what's happened over the past couple of years, discuss what things really worked well, what was the process that led to good decisions, what didn't work, what have we learned about ourselves clinically and personally and organizationally, what are our strengths and weaknesses -- overall, taking an honest assessment. I believe that nurses and hospital leaders all want to get back to some sort of normal. But I don't think we want to go back to a normal that also included things that weren't working. We want to go forward forging a new normal.”

The interview can be read in full on the Journal’s website. A video of the interview also is available.