Since the pandemic started, Delaware has worked to combat the nursing shortage, such as the allocation of federal money to the state’s major health systems last year to help with recruitment and retention efforts.
Now, state and federal legislators, as well as those in the health care industry, are recognizing the need to find longer-term solutions to address this staffing challenge.
With 20,000 registered nurses in Delaware alone, nurses make up a huge portion of the health care workforce. Yet, statistics from the Delaware Academy of Medicine and Delaware Public Health Association show that all three counties are seeing a shortage.
Experts say it’s due to a wide range of pandemic effects, an aging workforce − or “silver tsunami” as some have coined it − and a growing population, especially in Kent and Sussex counties.
A group of health care providers and administrators joined federal and state legislators on Thursday, Oct. 27 to discuss the nursing shortage in more detail and begin to identify solutions.
Here are five takeaways from that roundtable discussion at the Margaret H. Rollins School of Nursing at Beebe Healthcare in Lewes.
1. Burnout goes beyond hospital walls
While it may not be surprising that panelists pointed to burnout as one of the leading drivers for nurses leaving the workforce, many of them shined a light on why so many nurses may be struggling.
One of the panelists, Stephanie McClellan from the Delaware Nurses Association and Bayhealth, explained that nurses spend so much of their energy giving to others, that it’s easy for them to find themselves in a place where they feel like they don’t have anything left to give.
Then, “couple that with someone who’s maybe a single mom or single dad, who’s also combating what’s going on at home, trying to do homework, late nights, early mornings. It’s exhausting,” she said. “Burnout is a real thing, and I think that is the number one compounding factor that we’re facing in [the] workforce.”
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Throughout the pandemic, burnout and mental health challenges have risen to the attention of hospital administrators, policymakers and the general public as health care workers repeatedly faced devastating losses and increasingly sick patients.
Another panelist Dr. Nishelle Harris-Hines, who represented the Black Nurses Rock Delaware Chapter, said her daughter is a nurse and has been worried for her own safety while seeing other hospital workers die or become severely ill from COVID-19.
But many of the panelists emphasized that burnout doesn’t just come from the forces within the hospital walls. It also comes from additional pressures like the struggle to find child care or affordable housing.
Taking a different perspective, Beebe CEO Dr. David Tam gave another example: A hospital housekeeper can’t afford to live near the hospital in Lewes, so she resigns and finds a job elsewhere. This means the nurse may have added responsibilities, which only exacerbates the existing feeling of burnout.
So, Tam and others said, addressing the nursing shortage means also finding solutions to some of these other pressing systemic issues – from housing to child care to affordable health care.
A current nursing student at Beebe, Jessica Rigby, added that a focus on mental health and well-being continues to be important to her as she enters her career. She appreciates that her faculty members don’t make her feel like a number, and they take the time to recognize her mental health, such as providing lavender before exams.
2. An exodus of nurses affects mentorship, culture
Another reason nurses, especially those who may have only recently graduated and joined the workforce, may be feeling tapped out is a lack of mentorship or community.
Why? Well, it’s a cycle. Multiple panelists talked about this: When nurses leave a hospital in droves, that provider then loses institutional knowledge and people who can take those new nurses under their wings.
Then, newer nurses are left feeling like they don’t have a support system, and they may have a harder time adapting to this new kind of work environment.
Multiple people, including a recent nursing graduate, said new nurses are often prepared academically to start working in a hospital, but they usually do not feel prepared for what they’ll see on the floor or at the bedside – especially in a time when patients are arriving at the hospital sicker or with more serious conditions, and COVID-19 continues to be a threat.
Because of this, many in the health care industry advocated for a more formal mentorship system in hospitals, as well as tax credits or other incentives for preceptors, or seasoned nurses who guide new nurses during orientation.
3. A nursing workforce center could be in Delaware’s future
U.S. Rep. Lisa Blunt Rochester organized the roundtable at Beebe Healthcare’s Margaret H. Rollins School of Nursing in part to promote the National Nursing Workforce Center Act, which she introduced with three other legislators in September.
This bill would create a three-year pilot program to either establish or support “state-based nursing workforce centers,” across the country.
Many of these workforce centers already exist in other states, according to Blunt Rochester, but what they look like can vary based on the needs of the communities – meaning they could be physical brick-and-mortar locations or more like a network of organizations working together to mitigate the nursing workforce shortage.
No matter what the centers look like, Blunt Rochester said the common thread is that these centers are dedicated to addressing the shortage by digging deeper into data, providing training opportunities for nurses and determining the best practices and solutions to improve staffing.
The centers also have the benefit of being connected to one another and sharing information across the country.
4. Travel nursing can be a ‘double edged sword’
State Rep. Melissa Minor-Brown, who is a nurse by practice and works at the University of Delaware School of Nursing, said that travel nursing is a “double-edge sword.”
That’s because – as other panelists mentioned – travel nursing is highly appealing to nurses due to higher pay and often considerable compensation for living expenses. But when those nurses come into a new hospital, the non-traveling nurses often get the more demanding patients because of their familiarity with the hospital, Minor-Brown said.
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That can lead to bitterness and burnout among those non-traveling nurses.
Minor-Brown and other panelists agreed that they need to focus on solutions that will incentivize people to stay in Delaware and work, but what those strategies look like exactly isn’t yet clear.
5. Nursing schools don’t just need more students to enroll
There are young people like Rigby, the nursing student, who want to become a nurse. Rigby said she’s passionate about serving her patients, being able to help them find resources and advocating for them and their health.
The problem, multiple panelists said, isn’t in recruiting people to become nurses. It’s getting them to see it through and practice in Delaware.
Part of that solution, Minor-Brown said, comes when looking at the faculty. With younger and more diverse faculty members, nursing students will feel like they can relate to the people who are teaching them.
For Beebe’s School of Nursing, which has been named the top school for nursing in Delaware, it does actually come down to getting people in the door, according to Dr. Karen Pickard, director of the Margaret H. Rollins School of Nursing.
Once prospective students see the clinical opportunities at Beebe, they typically apply. But Pickard said it’s difficult to compete with state schools that can offer free or heavily discounted tuition. She’s hoping for more equitable incentives at nursing schools across the state.
Emily Lytle covers Sussex County from the inland towns to the beaches, with a focus on health-related issues. Got a story she should tell? Contact her at elytle@delmarvanow.com or 302-332-0370. Follow her on Twitter at @emily3lytle.
