IN-DEPTH: America’s Nurses Are Burned Out and Ready to Quit; Hospitals Nationwide Brace for Shortages

A medical staff member takes a short nap in nursing station in Houston, on Dec. 14, 2020. Go Nakamura/Getty Images

Jay Cuesta grew up planning to go to medical school. Then, in 2000, his premature infant died at just two weeks old, and Cuesta’s vision for the future was realigned.

He told The Epoch Times that nurses were beside him and his wife throughout their ordeal. Nurses were beside them during the birth of the child they knew wouldn’t survive. Nurses were beside them as they grieved in the otherwise sterile hospital environment.

They were beside them through it all.

“I knew what kind of medicine I wanted to practice,” Cuesta said. “That’s the hands-on that I wanted.”

According to recent statistics, many nurses, perhaps the very nurses who inspired Cuesta, are now burned out, fed up, and ready to quit.

Registered nurse Jay Cuesta (L) is shown at work with some of his fellow nurses in this undated photo. Courtesy of Jay Cuesta

A May 2021 survey of nurses by Vivian Health—an employment service for health care professionals—paints a bleak picture. Vivian surveyed 1,273 nurses across all 50 states and disciplines one year into the pandemic.

Fifty-three percent reported pessimism about the future of health care in the United States. Twenty percent said they were optimistic, and 27 percent weren’t sure.

“Nearly three-fourths report hospital morale has gotten worse in their hospital or health care facility since this time last year,” according to the Vivian report.

Cuesta earned his registered nursing (RN) degree in 2005 and is now working to become a nurse practitioner. Cuesta loves his work and plans to do it for as long as possible. According to experts, he’s in the minority. Cuesta agrees with that assessment.

“A lot of (nurses) just said, ‘We’re going to retire early,’” Cuesta said.

Sutter Health nurses and health care workers hold signs as they participate in a one-day strike outside of the California Pacific Medical Center Van Ness Campus in San Francisco on April 18, 2022. Justin Sullivan/Getty Images

Burnout a Major Issue

“Since the pandemic, we are seeing more reports about nurse dissatisfaction due to burnout, insufficient staffing, and poor working conditions, which may lead to more nurses leaving the profession,” Robert Rossetter,  the chief communications officer for the American Association of Colleges of Nursing (AACN), told The Epoch Times in an email.

As people locked down and worked remotely early in the pandemic, health care workers put in overtime and downplayed concerns about spreading the illness to their friends and families, Cuesta said.

According to the 2021 Vivian survey, 83 percent of respondents felt that their mental health had been affected by pandemic-related stress. Forty-three percent felt that their employers didn’t address their mental health concerns.

Ronnie Cubley has been a registered nurse in southeast Oklahoma for almost 30 years. Courtesy of Ronnie Cubley

Ronnie Cubley, who has been a nurse for almost 30 years, says that many of his fellow nursing veterans are just tired.

“Staff desperately need work–life balance and won’t stay without it,“ Cubley wrote in an email to The Epoch Times. ”Throughout the U.S., many nurses are doing accelerated retirement.”

Cuesta said the issue extends beyond the physical demands of increased hours. He said that for most nurses, the intangible rewards of nursing are just as important as the paycheck. But as overtime pay increased, the more abstract rewards diminished. Left in their place was the feeling that they might not be doing enough.

Cuesta said it’s common for him to see his patients in the grocery store or elsewhere. Helping them through some of the more challenging experiences of their lives creates a lasting bond.

“It’s very rewarding. It’s nice to see people in Walmart who want to give you a hug. That’s why I do it,” Cuesta said.

“When you’re taking care of your neighbors, you want to do a good job.”

But when a nurse runs from one bed to the next with little time between, it’s easy to begin feeling as if they are short-changing those neighbors.

“It really makes it more difficult to provide good quality, consistent care,” Cuesta said.

Consequences of Understaffing

Cuesta’s concerns are well-founded, according to a New England Journal of Medicine report.

In March 2011, the journal published a study on the effects of insufficient nurse staffing on patient mortality. The study was done by a team led by Jack Needleman, a professor in the Department of Health Policy and Management at the University of California–Los Angeles.

According to the article, the mortality risk for patients in understaffed units was about 6 percent higher than in fully staffed units. Researchers also found that mortality risk increased when a nurse’s workload increased because of high patient turnover.

Nurse Amber Kirk wears personal protective equipment as she performs range-of-motion exercises with a COVID-19 patient in the intensive care unit at Sharp Grossmont Hospital amid the coronavirus pandemic in La Mesa, Calif., on May 5, 2020. Mario Tama/Getty Images

Cubley expressed the same concerns as Cuesta, saying he has personally seen the effects of the pandemic.

“So many nurses left the profession during the pandemic because of burnout with overwhelming stress caused by excessive workloads,” Cubley said.

But not all nurses left the profession; some just quit their jobs. The increased pressures on work and family life drove many nurses to find higher-paying opportunities. Many became travel nurses.

What Nurses Earn

Travel nurses are registered nurses—those with a bachelor’s degree in nursing, an associate’s degree in nursing, or a diploma from an approved nursing program—who work for staffing agencies and temporarily fill vacant positions. Travel jobs are popular because they usually pay more. The nurses can offer the bedside care they love, while avoiding much of the administrative work that a full-time nurse at a hospital must do.

According to NursingProcess.org, travel nurses can make $32 to $86 per hour, averaging $56. Most positions include a living stipend, and some cover other expenses. During the pandemic, the average travel nurse’s pay leaped into triple digits, luring many nurses into that field.

According to the U.S. Bureau of Labor Statistics, the national average salary for registered nurses is $77,600 annually, or about $37 per hour.

Many staff nurses were upset with hospital administrators who paid high rates for temporary travel nurses instead of hiring local nurses or paying existing nurses more.

According to the Vivian survey, 78 percent of respondents said their job search priorities changed. If they would give up aspects of the job they loved, they wanted at least to be compensated. Sixty-six percent of respondents ranked pay as the most important factor.

“Eventually, at the end of the day, we have to take care of our families,” Cuesta said.

But compensation is only one issue, and administrators say compensation will work itself out through supply and demand market forces. Another, more crucial, problem is on the horizon, experts have said.

Labor Deficit

The Bureau of Labor Statistics (BLS) projects the registered nursing workforce will grow by 6 percent in the next 10 years, to 3.3 million in 2031 from 3.1 million in 2021. While that’s an increase of 195,400 nurses, the BLS expects the demand for nurses to increase to more than 203,000 annually.

Generally, this demand would be met by nursing programs at colleges and vocational schools. However, nursing schools only turn out a fraction of the new nurses needed.

But that’s not because no one wants to be a nurse, Rossetter says.

“Annual data show that thousands of qualified applicants are turned away from nursing schools each year because schools reach enrollment capacity,” Rossetter said in his statement.

Simply put, the United States needs more nursing instructors.

According to the AACN, the average nursing instructor earns about $65,000 annually, which is less than a working nurse brings in. With most registered nurses being older than 50, a wave of retiring nurses will take their experience with them.

Nurses in Houston on Jan. 8, 2022. Brandon Bell/Getty Images

As baby boomers retire, health care providers expect continued growth in the demand for nurses that younger, inexperienced nurses will only partially meet.

Cuesta said that when he started his career, some of the most important lessons he learned came on the job from experienced nurses. He said he has tried to follow that example by teaching the younger nurses he encounters. But, just as patient care is more rushed, increases in workload will make it harder to mentor new nurses.

Cuesta said he and his colleagues are concerned the current situation could result in an experience deficit.

Sarah Szanton, the dean of the Johns Hopkins University School of Nursing in Baltimore, told the U.S. House Committee on Health, Education, Labor, and Pensions in February that the situation is dire but some things can be done.

“Our nation is perilously short of nurses,” she told the committee. “The average age of registered nurses is 54. We need people to become new nurses, and we need to retain current nurses.”

Experts Say Solutions Available

Szanton said the Future Advancement of Academic Nursing (FAAN) Act, introduced in the 117th Congress, would go a long way toward solving these problems.

The FAAN Act would authorize the Health Resources and Services Administration to award grants to nursing schools to increase their capacity to respond to public health emergencies and otherwise enhance nursing education programs. The FAAN Act would prioritize programs at historically black colleges and universities and other minority-centered schools.

Testifying before the same committee, Dr. Leonardo Seoane, chief academic officer for Ochsner Health in New Orleans, agreed that the legislation would be beneficial.

A nurse at Three Rivers Asante Medical Center runs to a room in the intensive care unit to help as medical staff treat a COVID-19 patient in Grants Pass, Ore., on Sept. 9, 2021. Nathan Howard/Getty Images

He said his organization had 1,200 open positions, including physician and nursing jobs, and their staffing costs had increased 900 percent during the pandemic. He said Ochsner is exploring partnerships with universities and medical schools to form apprenticeship programs to recruit and train new medical staff.

“But to scale them, we need support from our universities; we need support from our community colleges; we need support from our governments. I do think it’s a partnership,” Seoane told the committee.

Cubley and Cuesta said that such programs can help if they are correctly implemented, and soon. Cubley says the health care system can’t continue to rely on temporary staff and overtime pay.

“As a nation, we must invest in the nursing workforce beyond Band-Aid solutions.”