Nursing crisis eases, more shortages expected

Feb. 19—JOHNSTOWN, Pa. — Leaders say area hospitals have weathered the worst of the nursing shortage and have begun rebuilding the workforce.

A report last month by the Hospital and Healthsystem Association of Pennsylvania shows hospitals reduced turnover by 28% during 2023.

Vacancy rates for direct-care registered nurses dropped from 30.7% in 2022, to 14% last year, which is lower than the pre-pandemic rate of 20.5% in 2019.

The HAP report gives its member hospitals credit for "extraordinary efforts to develop, recruit and retain health professionals."

It cited raising pay, offering flexible work schedules and partnering with educators to develop the next generation of caregivers. HAP's November 2023 survey also examined the ways hospitals are evolving care and enhancing staff safety.

The chief nursing officer for Conemaugh Health System said the exodus of nurses from hospitals has slowed and stepped-up recruiting efforts began paying off about mid-summer last year.

"What I notice now is that as things are settling down," Kris O'Shea said, "we have been able to do a better job of recruiting nurses at Conemaugh Memorial."

Between hiring new nursing school graduates and bringing on experienced nurses, Conemaugh added 75 full-time nurses last year, including 45 new graduates, O'Shea said.

The recruiting success more than offset the continued departure of nurses, with a net increase of 47 nurses. That allowed the hospital to open 60 beds in the medical-surgical units, for a total of 160 staffed beds, O'Shea said. The additional beds should decrease emergency department waiting times.

Kitty Zelnosky, UPMC regional chief nursing officer and vice president for patient care services, said the UPMC network, including hospitals UPMC Somerset, UPMC Altoona, UPMC Bedford and UPMC Western Maryland in Cumberland, has also begun filling vacancies with both experienced nurses and new graduates.

"The turnover that we experienced during the pandemic and shortly after has decreased dramatically across our region," Zelnosky said. "What that means is we have seen a decrease in overall nursing vacancy rates."

Experts had been warning of a dangerous nursing shortage for several years before the COVID-19 pandemic. They said the workforce was aging out, with more nurses retiring than the nursing schools were producing graduates to fill the vacancies.

Conemaugh and other hospitals were preparing for the shortage, offering higher wages and ramping up recruiting efforts through nursing programs at area schools and universities.

"And then, of course, COVID hit, and it changed the dynamics pretty dramatically," she said.

Some of the experienced nurses left the field entirely and others left jobs during the pandemic to take positions with staffing agencies as traveling nurses. The agency nurses received higher wages by filling in at hospitals with shortages.

"Nurses took advantage of that, but it can be difficult on you from a standpoint of your home life and being away from family," Zelnosky said.

As the pandemic waned, the demand for travel nurses has eased.

"So now we are seeing nurses returning and taking positions at our hospitals," Zelnosky said.

"Some of them came to UPMC as travelers but liked our hospitals and joined UPMC."

Those travel nurses were highly recruited by hospitals, O'Shea said.

"In the hospital, having a nurse that has flexible skills is very desirable," she said. "I find that there are nurses who do like to change up what they are doing and those are the same nurses who took the risk and went to travel."

With an eye on attracting the travel nurses, Conemaugh started its own internal float pool with higher pay for those willing to work in several areas. The pool helps staff the emergency department, medical-surgical floors and the behavioral health unit.

"We give them orientation to all of those areas, and it's been quite successful," O'Shea said.

She stressed that there are still plenty of opportunities for nurses who prefer the stable environment of working in the same unit every day.

"It is good to have a mix of both," she said.

Recruiting efforts also included building relationships with nursing programs at area colleges. The region's UPMC hospitals offer tuition loan repayment of $5,000 a year and offer $24,000 Future Heroes scholarships to all Mount Aloysius College nursing students.

Conemaugh works closely with St. Francis University and University of Pittsburgh at Johnstown. UPMC Western Maryland works with Allegany College of Maryland and Frostburg State University.

Although the initial crisis has passed, leaders say the shortage isn't going away soon.

A HAP policy report released last month warns that hospitals aren't out of the woods, with health care vacancy rates still exceeding 10% for most positions statewide and nearly 30% in some small hospitals.

In 2021, a report by consultants at Mercer predicted the nursing workforce shortage in Pennsylvania's hospitals will be the worst in the nation by 2036.

The association says the state legislature can help by allowing flexibility in requirements for educators, providing more education funding to offset the earnings disparity between nurses who practice and nurse educators and expanding student loan repayment for front-line nurses and primary care providers.

Hospital leaders recognize the ongoing situation, Zelnosky said, noting that recruiting, training and workplace environment efforts remain at the forefront.

"We don't take our foot off the gas," she said. "We have to provide our communities with care."