Hospitals in Arkansas and around the country are desperately seeking nurses to care for a surging number of COVID-19 patients, and providers fear the demand will rise during the upcoming flu season.
An estimated 23,000 travel nurse jobs are open in the country now, breaking the previous mark of 22,000 in November, said James Quick, president of Simplifi, which offers staffing services to health systems and is a division of Travel Nurse Across America of North Little Rock.
He said the patient surge started 90 days ago, and during that time the number of open travel nurse jobs nationwide increased 223%. “In the last quarter, we’ve just seen really an unprecedented spike,” he said.
The need is expected to worsen.
Last Wednesday, 1,064 Arkansans were hospitalized with COVID, an increase of 39 from the previous day.
“I’m very concerned just based on the numbers that we’re already seeing,” said Trenda Ray, the chief nursing officer at the University of Arkansas for Medical Sciences.
“You’re going to see what has been called the twin pandemic. We’re going to definitely struggle with our ongoing staffing issues.”
To attract nurses, hospitals are offering eye-popping sign-on bonuses. In March 2020, UAMS increased its signing bonus for nurses from $12,000 to $25,000. And a UAMS nurse who refers a nurse to join the state’s only teaching hospital will receive a $18,000 referral fee, up from $12,000. In both cases, the money will be paid out over three years.
Last week, UAMS had about 140 openings for nurses at the UAMS Medical Center in Little Rock, and more vacancies for nurses at other locations around the state, Ray said.
Mercy of St. Louis said it has 82 openings for nurses at its Arkansas hospitals. Mercy’s website said it’s offering up to a $20,000 sign-on bonus to bedside nurses with more than a year of experience.
During the height of the first wave of COVID, hospitals mainly needed ICU nurses, Quick said. But now the demand is for nurses to fill emergency rooms, operating rooms and labor and delivery departments.
Without nurses, hospitals “are actively having meetings and discussions about units they may close or beds they can’t operate due to staffing,” Quick said. “It already is impacting the patient experience in the sense that they can’t get health care as quickly or as conveniently.”
In addition to COVID patients filling up hospitals, patients who didn’t seek treatment last year because of COVID fears are now showing up for procedures, said Tim McKenzie, CEO of Travel Nurse Across America.
Now, “if you’re trying to schedule a surgery, anybody’s experience is going to be — it’s going to take longer,” he said.
Bo Ryall, president and CEO of the Arkansas Hospital Association, said the competition for nurses is strong between Arkansas and other states that are seeing an increase in COVID patients.
The pool of nurses is also getting smaller. Nurses who have worked “extremely hard over the last year” are suffering from burnout, and some are choosing to retire or leave the profession, Ryall said.
Other nurses are joining travel nurse agencies, where some hospitals are offering thousands of dollars a week for a travel nurse assignment, which is typically 13 weeks. Hospitals set the pay rate for the nurses. One emergency room assignment offered registered nurses $6,019 a week to work in Suffern, New York, according to the Fastaff Travel Nursing website.
Brent Beaulieu, CFO of Baptist Health, recently told Arkansas Business that some nurses had left Baptist to join a travel nurse agency. It too has had to rely on contract labor to help with patients. In 2021, contracted labor is expected to cost the nonprofit hospital system $43 million more than pre-COVID levels, he said.
McKenzie said Travel Nurse has placed about 2,500 nurses in hospitals across the country. And Travel Nurse and Simplifi have seen revenue soar in recent years. In 2019 and 2020, the companies’ revenue has increased an average of 28% each year, Quick said. And this year, revenue is expected to jump 125%, he said.
Terry Amstutz, the CEO of McGehee Hospital, said last Wednesday that there weren’t any COVID patients in his hospital. “But that will change soon, I’m sure,” he said.
The current nursing staff can cover the 25-bed hospital, but if COVID patients start to arrive, the hospital will have to use travel nurses, Amstutz said.
If that happens, Amstutz said he is concerned about the increased labor costs. “Last time, there was additional COVID money to cover some of that for some places,” Amstutz said. “But this time, so far, nothing’s forthcoming.”
Ryall, of the hospital association, said that hospitals are having to use their nurses more efficiently and effectively. “But there are just a finite number of nurses out there, and that makes it very difficult to shut down units or other services,” he said. “Because we certainly can’t stop the heart attacks, strokes and car wrecks from occurring, which those people need care just as well. So it’s a hard balance.”
Ray said UAMS has not reduced services because of the nursing shortage. Instead, some of its nurses are working overtime.
“And I worry about the long-term burden of that as well,” she said.
UAMS recently hired more than 60 nurses who graduated in May, Ray said — 40 fewer than her goal.
She said it’s difficult to know if Arkansas is graduating enough nurses because it’s difficult to know how many active nurses there are in Arkansas. “I would say we’re probably not, based on what we’re seeing,” she said.
More than one-fifth of nurses nationwide said they plan to retire or leave nursing in the next five years, according to the 2020 National Nursing Workforce Survey issued in April by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers.
Nurses also are getting older, too. The median age of registered nurses was 52, up from 51 in 2017, the study found. Nurses 65 years or older accounted for 19% of the registered nurse workforce, up from 14.6% in 2017 and 4.4% in 2013.
Simplifi’s Quick said one solution would be to add more international nurses, which were reduced during the Trump administration.
Now there’s a different administration and “such an urgent need for experienced nurses” that every health system that he’s talked to is considering recruiting foreign nurses “if not moving on it,” he said.
Still, it could take several months before those nurses are working in American hospitals, he said.
To attract nurses, Mercy is having recruitment fairs, visiting area nursing schools and using social media, spokeswoman Jennifer Cook said in an email to Arkansas Business.
She also said Mercy is encouraging more people to become nurses. “We also host several schools in the area and provide an exceptional clinical experience for them to train,” she said. This year, Mercy hired more than 50 newly graduated nurses, its largest class.
“I’m very concerned just based on the numbers that we’re already seeing. You’re going to see what has been called the twin pandemic. We’re going to definitely struggle with our ongoing staffing issues.”
– TRENDA RAY
Chief Nursing Officer
UAMS’ Ray said she would like to see more attention put on nurses. “We really do need to talk about how special it is to be a nurse and what it means to the public and what it means to our communities,” Ray said.
She said she wants to encourage people to go into nursing or return to the profession if they left.
“We’d love to have them come back and work at the bedside, whether it’s at UAMS or any of our institutions,” Ray said. “We need our nurses. We need them desperately.”