Providers Face Hiring Crunch As Nursing Workforce Recovers

Healthcare delivery organizations could not hire as many nurses as they needed during the COVID-19 pandemic because of nursing workforce constraints, according to a new Health Affairs study.

The healthcare industry faced a short supply of nurses during the first fifteen months of the pandemic, researchers from Montana State University found using national data from federal government surveys. From April 2020 to June 2021, total employment decreased by 20 percent for licensed practical nurses (LPNs), 10 percent for nursing aids or assistants (NAs), and 1 percent for registered nurses (RNs) compared to the previous five quarters (October 2018 to December 2019).

The nursing employment trend was a sharp departure from the pre-pandemic area when researchers calculated a steady increase among RNs from 2011 through 2020. LPN and NA employment was relatively flat during the era, they also found.

The decrease in nurse supply was largest among RNs who were 50 years or older, with this population of nurses seeing a 5 percent decrease in employment during the start of the pandemic. Meanwhile, the drop in employment for LPNs was largely driven by a higher proportion of these nurses employed in residential facilities, researchers said.

Physician offices, outpatient care centers, and home healthcare agencies also saw the greatest drop in overall healthcare employment, including in their nursing workforce. Meanwhile, hospitals experienced a modest -2 percent decline in employment during the pandemic. Hospitals are the largest employers of RNs, researchers stated.

Fortunately, the nursing workforce has generally bounced back from the early pandemic period, with some notable exceptions, the study showed.

Generally, unemployment levels for nurses fell back to pre-pandemic levels for RNs and LPNs, researchers reported. However, RNs and NAs who were Asian, Black, Hispanic, and members of other racial and ethnic minority groups faced higher unemployment compared to non-Hispanic, White nurses in the second half of 2020 and into 2021.

Nursing homes also continue to feel the impact of the pandemic on their nursing workforce, according to the study. Total employment remains over 10 percent below pre-pandemic levels.

Healthcare delivery organizations are still facing a shortage of nurses despite this new data showing returning levels of employment among RNs, LPNs, and NAs. Some hospitals have even had to shut down units because of the combination of nursing shortages and a new COVID-19 surge with the Omicron variant.

“Given the falling employment of LPNs and NAs, as well as RN employment that has plateaued after decades of steady growth, the important question for the longer term is whether these trends will continue,” researchers stated in the study.

The most recent surge in COVID-19 could spur another wave of retirements among older nurses, industry experts warn. In fact, about 660,000 RNs who worked through the pandemic period are Baby Boomers, and the vast majority are slated to retire by 2030, researchers said.

They also expressed concerned about lower application numbers to four-year nursing schools. Applicants to these programs grew by just 1.5 percent in 2020 versus 4.5 percent and 8.5 percent the two previous years.

“As a consequence, these exit and entry questions bear careful watching,” researchers warned.