Editor's Note: Robyn Begley is chief nursing officer at the American Hospital Association and CEO of the American Organization for Nursing Leadership.
Hospitals and health systems across the country have been recognizing milestones that didn't exist two years ago, more than one year since we admitted the first COVID-19 patient. One year since we experienced the first COVID-19 death. One year since we ate lunch with coworkers in a break room.
Hospitals are reaching these milestones at different times because the virus reached us at different times — spreading like a wave before eventually reaching every corner of the globe.
More than one year and three vaccines later, we are beginning to emerge from our collective bunker, take inventory of our surroundings and establish a roadmap for what life looks like in a post-pandemic world.
Hospitals are one of the truly essential facilities needed for the operation of a society, and is a core component in our nation’s infrastructure — something that has been proven time and again throughout this pandemic.
To that end, a qualified, engaged and diverse workforce is at the heart of that healthcare system. This means that any threat to the stability of our health care workforce is a threat to our infrastructure — and should be central to any major infrastructure legislation.
It's true that COVID-19 has taken a heavy toll on healthcare workers who have been on the front lines of the pandemic, with many suffering from trauma, burnout and increased behavioral health challenges. Many of these nurses and other front-line workers are considering taking a break or permanent leave from the field, which could result in a significant decline in experienced caregivers.
In addition, many are also are aging out. A significant number of nurses are at — or well beyond — retirement age. Many of these nurses put off retirement so they could help their communities fight COVID-19, but as we start to return to a sense of normalcy, we will likely see them start to leave. That is why we support The Healthcare Workforce Resilience Act that would expedite the visa authorization process for highly trained nurses, who could support hospitals facing staffing shortages and ensure hospitals are better positioned to provide patient care.
And then there's the issue of education. Younger generations are more interested than ever in pursuing careers in healthcare. Google reported that the phrase "how to become a nurse" was one of its most popular search terms this year, and nursing school applications are up nationwide. Unfortunately, we don’t have the capacity in our nursing programs to even come close to accepting all qualified applicants. Salaries for nursing faculty are significantly lower than salaries for nurses with advanced degrees in clinical positions. Which means there is little incentive for a nurse to pursue a faculty position, resulting in a shortage of qualified nurse educators to help teach future generations.
The issues facing our healthcare workforce can't be left to hospitals to solve on their own. A hospital is one of the only operations in the world that can lose money even as more people seek its services. Last June — when healthcare systems were overwhelmed, they had to create field hospitals to care for patients — we estimated that hospitals and health systems would lose more than $320 billion in 2020. A study released recently estimated that hospitals and health systems would lose another $50 billion to $120 billion in 2021.
We must invest in our current and future healthcare workforce. This is why we're advocating that any legislation considered by Congress that would invest in American infrastructure address hospital workforce needs.
We are providing the roadmap necessary to support future generations of healthcare workers. Federally funded grants will allow us to expand, modernize and support schools of medicine and schools of nursing in rural, underserved areas or minority-serving organizations, as well as cultural competency training in medical residency programs and in-service training for healthcare professionals.
We're also asking for more immediate and direct help for our existing workforce, by funding educational loan pay-downs and vouchers for clinicians and other front-line workers, as well as research and demonstration programs related to clinician well-being.
The challenges facing our healthcare workforce existed before we had ever heard of COVID-19. The past year has accelerated those challenges, but it has also amplified the importance of hospitals and healthcare to the success of our society.
And while the pandemic has delivered pain and loss, it has also shed light on areas of society in need of improvement and acted as a catalyst for change and innovation. Our hope is that Congress and the administration take advantage of the lessons learned and use this opportunity to craft an infrastructure package to help protect the workforce that's worked so hard to protect all of us.