- Nurse burnout remains largely unchecked more than a year and a half into the COVID-19 pandemic, with nurses increasingly reporting they want to leave bedside nursing or the profession entirely, according to a new report from staffing firm Aya Healthcare.
- Nurses intent on leaving their roles are considering completely different working situations, such as office jobs, while others expressed interest in continuing their education to qualify for other nursing positions. Younger nurses who plan to leave the profession said they want to change career paths to something safer, while older nurses intend to opt for early retirement, the report found.
- Animosity is also growing between core nurse staff and traveling nurses who are often contracted to do the same work for a much higher paycheck, according to the qualitative report, which was based on interviews with a small sample of nurses.
So far, hospitals that expected to spend less on traveling nurses as COVID-19 cases abated throughout this year haven't been able to do so, with virus cases and rates for contract labor both back at record levels. And both core staff and traveling nurses are suffering from burnout, further stressing shortages and spurring some to consider leaving their jobs, according to Aya's survey.
A May report from McKinsey found more than 22% of nurses were considering leaving their jobs for another role outside of nursing or to retire.
Hospitals have struggled to find enough staff as stress and burnout run rampant, especially in places with lower vaccination rates. In response, systems have ramped up hiring efforts and boosted their benefit packages. The American Hospital Association has asked Congress to address the issue of burnout, as well as allow for more nurses to join the profession by expanding nursing schools and relaxing visa restrictions on foreign-born nurses.
From May through June of this year, Aya conducted the survey among 30 registered nurses who were actively employed in direct patient care roles in 2020, broken up into three categories.
The group interviewed 10 veteran travel nurses who took assignments before and during the pandemic, 10 new travel nurses who first worked as travel RNs during the pandemic and 10 core nurses who have not worked travel positions. Respondents had two or more years of nursing experience and actively worked in a hospital inpatient unit or emergency department.
Nurses cited being unable to deliver care that patients needed due to high volumes of patients. Prior to the pandemic, their ICU ratios were most often two patients for one nurse. During the pandemic, the ratios rose to three or four patients for one nurse, respondents said.
ER nurses reported ratios upward of five patients to one nurse, making it "virtually impossible to properly care for patients," according to the report.
Nearly all respondents reported being happier and more satisfied in their jobs before the pandemic. Veteran travel nurses were the happiest of all three categories before the pandemic, but are now the least happy. Most respondents in the groups said they want to leave bedside nursing and move into a non-patient care role, the report found.
Motivated by higher pay, new travel nurses who took their first positions during the pandemic now have the happiest levels compared with the other two groups, and most want to continue as travel nurses, the report found.
But contention between core staff and contract labor is a growing problem, especially as travel nurse rates continue at record levels. Another issue is that travel nurses are not mandated to work beyond the hours designated in their contracts, while core staff are often subject to mandatory overtime.
Core staff in the survey said they regard travelers as outsiders, and travel nurses said they did not feel accepted by the team. Half of the travel nurses surveyed said they received poor treatment by core staff nurses and were being assigned the heaviest caseloads.
At the same time, a heavy reliance on traveling nurses to fill workforce gaps isn't sustainable, according to the report.
The travel nurse market comprised 43,000 registered nurses in 2019, representing just 2% of the 3 million employed RNs that year, according to the U. S. Bureau of Labor Statistics.
"In essence, the healthcare industry relies on the 2% cohort of travel nurses to make up for the 9% nurse shortage in hospitals. This set the stage for an extreme supply and demand imbalance, which was exacerbated during the pandemic as demand for nurses skyrocketed," Aya said.