The US health system already had a nursing shortage before the pandemic began, say both Boston-Leary and Hansen, who adds there was a permanent 100,000-person vacancy.
ICU nurses especially have a large turnover, not only because of the alarm fatigue but because of the desire to have better schedules, lower risk, or career advancement. Before the pandemic, new nurses were rarely placed in the ICU. But now, to help address the deficit, internships, preceptorships, and residency programs have been put in place to ensure a continued flow of workers.
No pipeline is enough during the pandemic, Boston-Leary says. To help remedy the pinch in ICU and other departments, some nurses have graduated early to join the workforce, patient care techs took on additional work, and nurses have transitioned to new areas. No matter the amount of innovation, though, she says the numbers just don’t work.
Cindy Firkins Smith, MD, Carris Health co-CEO, adds, “The difference between this and a natural disaster is the time it entails. … A hurricane hits or a tornado hits, and it’s a huge disaster. But it hits and it’s done, people react, take care of it, we recover and go about our normal business. This has been going on for months and continues to go on.”