As COVID-19 surges, hospitals scramble to find staff amid exhausted workforce

Dive Brief:

  • Demand for temporary healthcare staff is on the rise again as systems across the country face a record number of COVID-19 cases. Staffing firm Aya Healthcare reported a 57% increase in demand for travel nurses over the past 30 days and posted 24,115 open positions as of Monday.
  • Open “crisis nursing” positions increased 291% over the past 30 days, and account for roughly 22% of Aya’s open nursing jobs, April Hansen, EVP of workforce and clinical services said Wednesday. “This means I don’t have three, four or five weeks to wait. I need these people like yesterday in order to take care of the patients and the heads that are in my beds right now,” Hansen said.
  • Systems in certain states are upping their rates to attract the nurses they need quickly, but supply is limited. Physician burnout leading to early retirement and COVID-19 infections among healthcare workers add additional challenges.

Dive Insight:

The latest surge in COVID-19 cases, which is producing a record in hospitalizations that exceeds even the beginning of the pandemic in the U.S., is coinciding with staffing shortages at hospitals in hotspots brought on by staff burnout and illness.

The five states with the highest travel nursing demand for Aya right now are California, Texas, Florida, Minnesota and North Carolina, though supply is not limited regionally, Hansen said.

“You can’t post a job in Arkansas and think that you’re only competing with Alabama and Louisiana, and perhaps Georgia,” Hansen said. “If you’re in Arkansas, you’re competing with Oregon, you’re competing with Massachusetts, you’re competing with Texas.”

Jefferies analysts noted the unprecedented demand and expect it to continue well into next year, but cautioned that the developing supply shortages are making an increasing number of vacancies trickier to fill.

To attract the nurses they need, systems in a handful of states have come out with payment rates higher than what had previously been established as the market clearing rate based on volume and demand, Hansen said.

ICU nurses are in particularly high demand, “meaning that the higher level acuity and the higher trained clinicians are what is in the most demand nationally,” Hansen said.

There’s also a growing need for operating room nurses to help some hospitals catch up on lucrative elective procedures that were derailed earlier this year, though those positions can be tough to fill, Hansen said. And fewer travel nurses specialize in OR compared to other specialties.

States like Utah are seeing increasing hospitalizations threatening to strain hospital resources, Andrew Pavia, chief of the division of pediatric infectious diseases at the University of Utah School of Medicine said during a media briefing hosted by the Infectious Diseases Society of America on Wednesday.

“This doesn’t have to do with running out of respirators or ventilators, yet,” Pavia said. “It just has to do with the fact that to help somebody survive an illness like this requires a great deal of care from very skilled people. And as we have to spread those resources thin, care gets not as good.”

And burnout among the healthcare workforce isn’t helping.

These folks have been working flat out for eight or nine months now, and now after almost three months of surge, they’re exhausted, they’re stressed. Many of them have become ill themselves,” Pavia said.

In the absence of a robust federal response to the pandemic, along with some states’ reluctance to enforce mask mandates or social distancing requirements, physician groups themselves have taken to pleading with the public to take proper precautions.

Oklahoma State Medical Association President George Monks took to Twitter this week to state the area was facing “record positive infections and unprecedented numbers of patients who need hospital care.”

He added: “This is not fearmongering, this is reflecting the reality we currently face and plea on behalf of our physician members, many of whom are at the forefront of this battle, asking our state and municipal leaders to take action that curbs this intensifying health crisis.”

In North Dakota, staffing shortages are so dire that officials passed an order allowing healthcare workers to continue working on a COVID-19 unit if they’ve tested positive for the virus, so long as they’re asymptomatic.

Early in the pandemic, hospitals faced intense financial pressure to reassess their workforce amid depleted volumes. Some redeployed nurses to help with COVID-19 testing or telehealth needs, though many issued furloughs or layoffs.

Hansen said clients told her they’re seeing an increasing number of early retirements, but also “clinicians leaving this practice and seeking a different specialty that was just a bit more stable.”