In 2020, after years of steady decline, the rate of infections acquired in hospitals suddenly jumped. The Centers for Disease Control and Prevention (CDC) reported that bloodstream infections alone rose 47 percent.
The cause, according to CDC investigators, was the combined effect of hospital staff shortages and high patient caseloads, both due to the COVID-19 pandemic.
This is one example of how the pandemic worsened existing staffing problems and affected patient care, says Dr. Kenneth Campbell, assistant professor and interim program director for the Online Master of Health Administration Program at Tulane University.
But the crisis also offers opportunities for new strategies to keep and attract staff, says Campbell. “Post COVID-19, we have to really take a different approach to how we retain employees. The relationship between healthcare leadership and employees has changed forever.”
Hospital Staff Shortages Before the Pandemic
Even before COVID-19, healthcare facilities were short on workers, according to the U.S. Department of Health and Human Services (HHS). Among registered nurses alone, at the start of 2020, the nation had a shortage of 150,000.
One reason was an aging workforce that was heading into retirement. The average age of an RN is 50, according to the latest HSS figures.
Stressful working conditions were another factor, Campbell says. Administrators paid too much attention to revenues and health outcomes, and too little to staff morale.
Performance metrics and the ability to pay the bills are important, he says. “But we cannot do these things with a compromised workforce, so we have to take care of our employees.”
Hospital Staff Shortages During the Pandemic
In the single month of March 2020, healthcare employment dropped by 1.5 million jobs, according to the U.S. Bureau of Labor Statistics (BLS).
Even after many jobs came back, up to 22 percent of hospitals nationwide continued to suffer staffing shortages, reported HHS. In January 2022, five states had more than 50 percent of their hospitals short-staffed.
“COVID showed us our weaknesses in a variety of areas,” Campbell says, and lists several contributing factors.
- Employee safety: Early on, personal protective equipment was scarce. By July 2020, 172,844 healthcare workers had contracted COVID, and 743 had died, according to the CDC.
- Shortages of beds: “Intensive care units were taken, and emergency rooms were packed, so it created bottlenecks of care,” Campbell says.
- Low health literacy: Employees had to explain the disease and vaccines to uninformed patients, reducing the time they had to care for others.
- Unvaccinated workers: In September 2021, 30 percent of hospital workers were still unvaccinated, according to HHS, reducing the numbers available to work around COVID-19 patients.
- Burnout: A 2022 survey by healthcare employment firm Incredible Health found that 34 percent of nurses planned to leave their jobs by the end of the year, with 60 percent of those leaving the profession altogether.
Strategies to Relieve Hospital Staff Shortages
In the short term, hospitals addressed staffing gaps by hiring temporary nurses, known as travel nurses, to take temporary positions in short-staffed facilities.
Long term, however, the solutions to hospital staff shortages are much more nuanced. They include providing more employee support and making hiring easier, Campbell says. He suggests a wide array of strategies.
“We have to become healing organizations for our employees,” he says. He suggests setting up calming stations: rooms where staffers can take mental breaks for up to 30 minutes.
He also recommends making mental health counselors accessible to hospital workers — not just when they’re at work, but 24/7.
Campbell suggests relieving financial stresses by offering onsite child care and assistance to help pay back student loans. Such aid, he says, can give a hospital an edge in the competition for workers.
Hospitals survey patient satisfaction, Campbell notes. Why not do the same for hospital staffers? He also advises setting up electronic platforms, on which staff can point out problems and recommend solutions.
Technology can help hospitals streamline the hiring process, he suggests. An applicant should be able to apply and submit paperwork online, be interviewed virtually over Zoom, and be hired on the spot.
Bringing Back Retired Workers
Hospitals can bring back retired workers part time, Campbell says, if they offer shorter shifts and options for working from home.
“We have to create pathways specifically for them,” he says. “We cannot just let that expertise sit out there. We need it back in our organizations.”
Diversity: Another Solution to Hospital Staff Shortages
A different sort of staffing problem is the lack of racial diversity in management, Campbell says. He points to a 2021 survey by The Leverage Network that found 87 percent of hospital board members were white.
“One of the reasons that we have these staffing shortages is because we have failed to diversify our leadership,” he says.
By working to make staff more inclusive, he suggests, hospitals could both relieve shortages and diversify their management pipelines.
Tulane is doing just that, he notes: Its Master of Health Administration (MHA) program recruits students of varied backgrounds to become future leaders in health care, some of them from other countries. It is convenient for offsite students, because it is online and offers flexible hours for taking classes.
If we “really begin to educate this generation of students, we really can make a difference,” he says. “It’s one way to open the door to a more multiracial and multicultural diverse society who want to be in health care.”
Explore a Career in Health Administration
Relieving the chronic problem of hospital staffing shortages will require bold healthcare leaders. A degree program, such as the Tulane University Online Master of Health Administration, is designed to equip students with the skills and knowledge to address such issues.
The program combines instruction from renowned faculty with a 900-hour residency, which students can complete in their own geographic locations. Learn more about how the Tulane MHA program can lead to a rewarding career, helping solve some of the most important problems of our healthcare systems.
American Journal of Infection Control, “COVID-19 Vaccination Coverage Among Hospital-Based Healthcare Personnel Reported Through the Department of Health and Human Services Unified Hospital Data Surveillance System, United States, January 20, 2021-September 15, 2021”