State’s Hospitals Causing Shortage of Nurses?

Photo of Caregiver Nurse. Photo by Direct Media from StockSnap

Nurses are leaving their profession in big numbers. A report released in March by the Wisconsin Hospital Association (WHA) warned that it faces a growing shortage of health care workers.

It cited a “silver tsunami” of baby boomer nurses retiring, causing a growing shortage and called for a policies to “expand and support… occupational pathways to attract new entrants to the health care workforce.”

But just a few months earlier, the American Federation of Teachers —the nation’s fastest-growing healthcare union — released a report showing the real problem was nurses in mid-career quitting. “Nurses and other healthcare workers are exhausted, burnt out, anxious and leaving the profession in droves, a trend that began long before the COVID-19 pandemic,” the group noted.

Its report found that in 2013 the quit rate for health care workers was 1.5 per 100 workers per month. By 2023 it had risen by 66% to 2.5 per 100 workers per month.

The report found that of 890,167 Registered Nurses or RNs with an active license in the U.S., 20% are not currently employed in nursing. That includes 14% of those under 65 and 12% of those under 55 years of age.

A 2022 analysis by McKinsey & Company estimates the nation will soon be short by 200,000 to 450,000 registered nurses.

An AFT survey of those who quit found 51% cited unsafe working conditions, 50% said they were overworked or burned out, 39% blamed inadequate staffing and 37% cited unsatisfactory safety protocols.

And those under 30 were twice as likely to cite inadequate staffing as a deciding factor for leaving, a 2024 study found, with 40% citing this as the key reason.

It’s all about big corporate-style health care organizations looking to cut costs and increase revenues by requiring nurses to handle more patients, said Jamie Lucas, Executive Director of the Wisconsin Federation of Nurses and Health Professionals. “It’s about running lean and doing more with less, they are borrowing ideas from for-profit manufacturers,” he told Urban Milwaukee.

“Morale has sunk,” he noted. “Nurses can’t handle it anymore, physically, mentally or spiritually. There are so many nurses who have left patient care. It’s a manufactured crisis.”

Healthcare workers have faced increasing mandatory overtime and on-call hours, the AFT noted. In 2021 51% of RNs reported experiencing burnout every day or a few times a week, up from 27% in 2019, its report found. The overworking of nurses that began during the COVID-19 pandemic has been “normalized” ever since, Lucas noted.

Yet none of this was addressed by the WHA report.

Perhaps the one thing agreed on by both sides was the importance of nurses. “Nurse vacancy rates have a disproportionate impact on hospitals and health care teams,” the WHA report noted. “Not only do RNs make up a majority of the hospital workforce, an RN’s experience and training allows them to step in and fill a broad range of roles when other positions can’t be filled.”

But even on the latter point there is disagreement. “Hospitals are requiring nurses to do anything regardless of the their speciality,” Lucas noted, which is another way they try to cut costs.

Meanwhile, he added, “wages for nurses have not kept up with the cost of living and the cost of care.”

The latter is a particularly sore point, Lucas explained. Health care coverage for nurses typically has “a lot of deductibles. They are forced to take high deductible plans because the cost of better coverage is unaffordable.” So nurses can’t afford the health care they are providing.

The WHA claims a lack of revenue is an issue for hospitals. “Even as the demand for care increases, reimbursement is stagnant or even decreasing,” the report says.

But the federal tax forms these hospital chains file show they are flush with money, as Urban Milwaukee has reported. The national Ascension healthcare chain, a big player in Wisconsin, has built a vast financial empire, including $18 billion in cash reserves and $41 billion in investments. The Froedtert hospital chain in Wisconsin is sitting on $2.15 billion in publicly traded investments and has 11 top employees earning more than $1 million per year, with the CEO earning nearly $4 million. Children’s Wisconsin has $3.2 billion in combined net assets, including $1.2 billion in publicly traded securities and an endowment of $1.089 billion. The top 16 execs at Advocate Aurora collected $36.75 million in salary in the most recent year analyzed.

Yet these tax-exempt charitable organizations are doing all they can to cut non-executive staff and labor costs, which is not only causing an exodus of nurses, but putting the safety of patients at risk.

“The data show that adding just one additional patient to a nurse’s workload results in a 7 percent increased risk of a patient dying within 30 days of admission and a 48 percent increased risk of a child being readmitted to the hospital within 30 days,” the AFT noted.

That has led to calls for reform. States like Oregon, Massachusetts, New York and California have passed laws with mandatory nurse-to-patient ratios. Lucas and the nurses association have been pushing for a similar law in Wisconsin, but the powerful Wisconsin hospitals lobby has opposed it.

State Sen. Chris Larson (D-Milwaukee), a sponsor of the legislation, says the law is needed in Wisconsin. “Hospital executives increasingly treat frontline workers as expendable assets rather than the dedicated professionals they are,” he told Urban Milwaukee. “If we’re serious about addressing our state’s nursing shortage, we need to put our nurses in the position to succeed. Our bill would not only set safe staffing ratios, it would provide a seat at the table for nurses any time a facility’s staffing plan is created or changed.”

“It’s time for our hospitals to put people before profits,” he added. “Safe staffing saves lives.”