Hospitals are scrambling to hire nurses as virus rages
In a near repeat of last fall, Wisconsin hospitals are again scrambling to find nurses to meet a wave of COVID-19 patients.
A recent job alert from one health system said it was in “critical need” of nearly 200 nursing staff, while other hospitals are offering $15,000 hiring bonuses.
The good news: Unlike during last fall’s surge, most nurses are now vaccinated and protected against the illnesses that sidelined hundreds of them at a time.
But because of a shortage of nursing teachers that prevents qualified applicants from getting schooling, health system administrators need more nurses even at the best of times.
Now, they say, their existing staffs are exhausted by a seemingly neverending pandemic, and feelings of burnout are compounded by having to treat patients who could have avoided serious illness if they had only gotten the vaccine.
That experience is “mind-numbing,” said Dr. Gregory Brusko, chief clinical officer for Ascension Wisconsin, who said he’s never seen so many people leave health care as he has in recent months.
Bellin Health’s chief nursing officer, Laura Hieb, said more nurses are also now choosing temporary jobs that offer higher hourly pay and the opportunity, between jobs, to spend time with their families.
“They made it through a big part of the pandemic and they may say, ‘You know what? I’m not going to work as many hours as I did in the past,’ ” she said.
The delta variant continues to run rampant throughout the U.S., and the Wisconsin Hospital Association reported Thursday that more than 800 residents were hospitalized with COVID-19 – a level not seen since January, before vaccines were widely available.
Three in 10 of Wisconsin’s hospitals were at peak capacity, according to the state health department, as were more than half of intensive care units.
Even if new cases subside, Wisconsin’s health system administrators know it may be weeks before current infections run their course and the need for nurses lets up.
Beyond that, even, Wisconsin needs more nurses.
Hospitals everywhere compete for a shrinking pool of nurses
A posting from Marshfield Clinic for an experienced critical care nurse comes with a $5,000 bonus, and in Milwaukee, experienced nurses will get bonuses up to $6,000 from Froedtert.
Hospital Sisters Health System and Bellin Health in Green Bay are offering bonuses up to $10,000 for critical care and ICU nurse positions.
Nurses with at least one year of experience can receive a $15,000 signing bonus from Aspirus Health Care, based in Wausau in Marathon County, one of the Wisconsin counties with the highest proportion of hospital beds filled by COVID-19 patients, according to data from the University of Minnesota.
ThedaCare sent out a call last week for nearly 200 nursing and nursing assistant staff on the Wisconsin Emergency Assistance Volunteer Registry, or WEAVR, an online registration system for health professional volunteers willing to serve in an emergency.
The notice, which said the health system was in “critical need” of assistance, sought 120 registered nurses and 75 certified nursing assistants for a month minimum across ThedaCare’s hospitals throughout northeastern Wisconsin.
ThedaCare’s chief human resources officer, Maggie Lund, said Thursday that 14 nurses and 19 total health care workers had responded so far to the WEAVR request.
Bellin has returned to using temp agencies to fill positions after backing off from them at the beginning of the year, Hieb said, as well as working with Bellin College to recruit recent graduates by offering tuition reimbursement.
Hieb said more nurses across the country are choosing to work for temp agencies, which may be more attractive as the pandemic goes on because of the work’s short-term nature and high pay.
Even as overloaded hospitals lean on the agencies, though, they are competing for the same pool of nurses, which isn’t enough to cover the demand.
“Some of the pressure relief buttons we had before ... aren’t as readily available now,” said Dr. Jeff Pothof, chief quality officer at Madison-based UW Health.
Ascension Wisconsin hospitals are able to pull from other states because they’re part of a national health system, Brusko said, but even that has grown more difficult as hard-hit Southern hospitals suck up resources.
Advocate Aurora Health, Marshfield Clinic and Hospital Sisters Health System wrote in statements that they’re using a variety of incentive programs, partnerships with local colleges and other strategies to boost their workforce. None disputed that staffing shortages are causing strain on hospitals.
Staffing shortages are an old problem made worse by COVID-19
Staffing didn’t just become a problem when the coronavirus hit. Wisconsin’s health care workforce is aging, and older employees are retiring faster than they can be replaced, according to a 2020 report from the Wisconsin Hospital Association.
Nurses, perhaps more than other health care positions, are always in short supply. Wisconsin health systems said ICU, critical care and medical-surgical nurse staff were among their most urgently needed.
The main problem is in the pipeline, said Linda Young, dean of the College of Nursing and Health Sciences at the University of Wisconsin-Eau Claire.
Low faculty numbers and not enough sites for clinical rotations mean nursing schools must cap their admittance far lower than the number of qualified students actually applying. In Eau Claire, the school admits 43 students per semester, turning away at least as many more, Young said.
More than 80,000 qualified applicants to U.S. nursing schools were turned away in 2019 for those reasons, according to the American Association of Colleges of Nursing. The country is projected to be short more than 500,000 registered nurses by 2030, found a 2018 forecast from the United States Registered Nurse Workforce Report Card.
Young chairs the legislative committee of the Administrators of Nursing Education of Wisconsin, which in the past budget cycle secured $5 million to help nurses obtain teaching degrees if they commit to teaching for at least three years. Nurses working in academia earn less than those working in clinical settings, she said.
The pandemic has only highlighted the consequences of the nursing shortage, Young said.
“Demand is even greater for more new graduates,” she said. “We’re just not able to get them out.”
More nurses retiring also means there are fewer nurses to help new ones learn the ropes in the hospital, said Connie Bradley, senior vice president and chief nurse executive at Aspirus Health.
Newer nurses are thrown into more complex environments faster than in the past because there aren’t as many experienced nurses to fill those roles, she said.
“Years ago, you wouldn’t bring novices into the (emergency department) or the ICU. Well, now you don’t have other options,” Bradley said. “You have to bring novice nurses in, and yet you have less people who are experienced to train them, so you have new nurses being trained by novice nurses.”
Nurses now juggle patients with other health needs – and they’re burning out
“Years ago, you wouldn’t bring novices into the (emergency department) or the ICU. Well, now you don’t have other options.” Connie Bradley Senior vice president and chief nurse executive at Aspirus Health
Brusko said feelings of burnout have built up over the past year and a half.
“It would be shortsighted for us to think that our nursing colleagues, and frankly (health care) as a whole, are going to somehow fairly rapidly put this pandemic in their rearview mirror once we get through this,” Brusko said.
It’s especially difficult for them in this phase of the pandemic, where the majority of people who are ill in
hospitals could have prevented it by getting vaccinated, he said.
For people at the beginning or end of their careers, the pandemic’s chaos may be the impetus for a career change or retirement, said Dr. Sarah Lulloff, medical director of infection prevention at Hospital Sisters Health System’s St. Vincent Hospital in Green Bay, in a Wednesday news conference.
Those who remain are struggling to balance an increase in COVID-19 patients with their already demanding workload of people with other health needs.
When the pandemic first started, many health systems halted elective surgeries and other non-critical procedures, which freed employees to work with COVID-19 patients. Now, they have to handle both.
At UW Health, patient volumes jumped in the spring and people were sicker than usual, Pothof said, meaning his staff was stressed even without lots of COVID-19 patients in the hospital. Now, their number of COVID-19 patients is increasing, and the number of patients with other needs isn’t decreasing.
If we don’t change course and get infections under control, our future is laid out for us in the South, said Dr. Imran Andrabi, president and CEO of ThedaCare. He pointed to a headline out of Florida last week that a patient with metastatic brain cancer in need of urgent radiation treatment was turned away from a hospital because it was too full of coronavirus patients.
“There is something we can do about that,” Andrabi said. “Let’s do our part ... otherwise I’m afraid that it’s going to have an overflow impact on our communities.”
COVID-19 vaccine mandates may cause hospitals to lose more staff
Most Wisconsin health systems are mandating that employees get the COVID-19 vaccine by fall.
The announcements of those mandates triggered small protests around the state. In Green Bay, a few dozen protested outside Lambeau Field at the Packers’ preseason game against the New York Jets. Earlier this month, protesters compared vaccine mandates to the Holocaust.
Given that staffing is already short, it’s raised the question of whether health system administrators will stick to their guns and enforce the mandates, provided some of their employees may not be willing to abide by them.
They’re also facing pressure from Republican state legislators. Senate President Chris Kapenga, R-Delafield, said health care executives requiring employees be vaccinated against COVID-19 are “bowing to the woke culture being pushed by the left.” He urged health care workers who didn’t want the vaccine not to give in because “it will be impossible for the hospital systems to function without you.”
But though it may have the potential to create staffing holes, both Pothof at UW Health and Brusko at Ascension said it was the right choice. And because most health systems are requiring it, Brusko said, it wouldn’t leave people who refuse the shot many options in their field.
At UW Health, Pothof said they’re keeping track of how many holes in each unit it would create if those who aren’t vaccinated choose instead to leave.
UW Health staff is 90% vaccinated, so they don’t have far to go, Pothof said, but he’s trying to make the case to employees why the mandate was necessary.
“The No. 1 thing we (need to) do is keep our patients safe,” he said. “It’s not good enough to do it 90% of the time.”
Vaccination rates among health care workers are high for physicians – more than 96%, according to the American Medical Association – but lower among other employees. An analysis of data from the U.S. Department of Health and Human Services from May found that 1 in 4 health care workers who have direct contact with patients hadn’t yet been vaccinated.
But hospital leaders say majorities of their staff see the benefits of the vaccine, and that’s what makes it so upsetting to treat patients who passed up the opportunity to get it.
In July, Wisconsinites who were not fully vaccinated were nearly four times more likely to be hospitalized with COVID-19 and 10 times more likely to die from it, according to data from the state Department of Health Services.
Patients’ refusal to get the vaccine is part of what’s making the current situation so brutal for health care workers, said Brusko at Ascension.
“Folks are voluntarily putting themselves at risk to get ill when there is an out,” he said.