With a sharp rise in COVID-19 cases in the United States health care staff around the country are struggling to save lives – at considerable personal risk.

However, the huge influx of patients into U.S. hospitals has drawn attention to another issue: the country's nursing shortage. The Missouri Hospital Association's spokesperson, Dave Dillon, was quoted in the Washington Post as saying, "Although we have beds, those beds are just as good as the workers that you can put around them."

High-risk situation

Nurses face unparalleled obstacles because of the pandemic, including the fear of being exposed at work. Nurses are at the highest risk among infection of all health care staff because they have the most direct, hands-on patient interaction. Many of them have been reassigned to the emergency room, "COVID-19 units," or other high-risk areas.

It's turned into a very dangerous career. Last summer, more than half of the 20,000 nurses polled by the American Nurses Association said they had to reuse single-use masks or treat patients with little to no PPE. Many of the employees work 12- to 16-hour shifts. Any of those who tested positive for the virus have been forced to stay on the job to help with the influx of patients. Many who call the virus a hoax have threatened them with physical harm.

According to data from the US Centers for Disease Control and Prevention, nurses and nursing assistants make up 36 percent of health care staff diagnosed with COVID-19. The virus had claimed the lives of 213 registered nurses as of September.

In the midst of the COVID-19 pandemic, nurses have shown in front of the White House and around the country to illustrate insufficient staffing and limited personal protective equipment.

Protests have taken place in front of the White House and around the world about working conditions. The New York State Nurses Association filed three lawsuits in May, alleging unsafe conditions at the New York State Health Department and two hospitals.

The Risk Factor 

A total of 4 million registered nurses operate in the United States, with about 60% of them employed in hospitals. According to the US Bureau of Labor Statistics, the country would need 1.1 million new RNs by 2022 to prevent a nursing shortage.

Nurses spend more time caring for patients than any other health care provider, but hospitals can't work without them. Some administrators are replacing nurses with technicians or asking non-hospital nurses to work in hospitals to keep hospitals staffed during current shortages. There are life-or-death decisions: whether to treat patients in situations where medical errors are a possibility – whether to turn them away.

What Caused this Upheaval?

Demographics play a role in some of the looming issues. A nurse in the United States is on average 51 years old, and 1 million will be eligible for retirement in the next 10 to 15 years. Nursing schools are growing, but not fast enough to meet the demand.

The burden on the health-care system is increasing as the nursing workforce shrinks. The nation's 73 million baby boomers are getting older, and many of them are suffering from chronic illnesses including heart disease, cancer, and diabetes, which necessitate a high level of treatment.

A Risky and Demanding Career

Nursing is one of the most demanding occupations under normal circumstances. Workplace expectations often take priority over self-care; according to one survey, 68 percent of nurses prioritize their patients' health and safety over their own.

According to a study by the American Nurses Association, the nursing workforce has widespread health and wellbeing issues. Many nurses are overweight and don't get enough sleep; three-fifths of them work 10 hours or more a day.

Nurses are at a high risk of injury and disease because of their jobs. Moving and lifting heavy patients and supplies, as well as being exposed to infectious diseases, toxins, and radioactive contaminants, are all risks.

Around half of all nurses suffer burnout as a result of operating under constant stress. It has the potential to cause physical or mental problems, as well as drug or alcohol abuse and depression. Nurses have a significantly higher suicide rate than the public.

Nursing during a Pandemic

Nurses' well-being in the United States needs urgent attention. Nurses that are stressed, sick, and burnt out can't give the best treatment and are more likely to leave than those that have better working conditions.

However, the pandemic has made an already difficult task exponentially more difficult. It has placed health-care staff in conditions comparable to those encountered in a war zone which they were not prepared for – or needed. Consider the shock of a pediatric nurse who is transferred from the newborn nursery to a COVID-19 ward.

Over 60% of the 1,200 nurses polled said they were considering quitting their work – or leaving the profession entirely – in a national survey conducted last spring.

Reconstructing a good Nursing Force

The United States risks serious health-care system breakdowns unless serious attempts are taken to hire more nurses and improve working conditions.

The nursing shortage can be addressed in a variety of ways. To keep older, seasoned nurses working longer, options include better pay and benefits, reduced work hours, and less physically demanding roles. 

Nonprofit projects such as the "Safe Nurse, Healthy Country" initiative will help to improve health and wellness. Reaching out to young people and maintaining support for nursing education under the Public Health Service Act would help to pique interest in the field and create a more diverse workforce.

A healthy nursing workforce is vital to the nation's health and well-being. Our health-care system, as well as our lives, could be at stake.

May 12, 2023

Natasha Osei

Passionate Nurse Practitioner | People person
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