By James X. Stobinski, Ph.D. RN CNOR CSSM(E) CNAMB(E), Director of Education
In this column, I would like to comment on an article on nurse staffing shortages by Don Sadler published May 1 in OR Today magazine. My compliments to Mr. Sadler for putting together a very readable article on the important topic of nursing burnout. This is a relevant topic for all nurses, but also a worthy subject for our patients and those who we care for as nurses. The OR Today format facilitates easy access to this general interest article on a most timely topic.
The article refers to data from the annual OR Manager survey of 2023.[1] Increasing surgical volume and staff shortages are now beginning to limit surgical capacity at some facilities. Such limitations have implications for access to care but also has a negative impact on facility revenue. Burnout and staffing shortages are linked and compound each other. Extra workload resulting from staff shortages contributes to burnout which ultimately can cause more staff to leave the facility in a downward spiraling effect.
There were already spotty shortages of nurses prior to the tumult of COVID, but staffing shortfalls accelerated during the pandemic The current staff shortages have been well-documented by organizations such as the National Council of State Boards of Nursing (NCSBN). An aging workforce, consistent heavy workload and less than ideal nursing work environments are all contributing factors. A mature nursing workforce also leaves many nurses with challenges such as assisting with the care of their own children and possibly caring for aging parents.
In the perioperative environment, the background is a bit different but still complex and multifactorial. Perioperative nurses typically have long careers in the OR and are less likely to transfer to another nursing specialty. Saver, writing in OR Manager, reports that currently surgical volume is steadily rising but staff turnover rates and vacancies remain stubbornly high at near historic levels.[1] Respondents to that 2023 OR Manager survey also noted that recruiting for both surgical techs and perioperative nurses remains problematic.[1] Staffing shortfalls may necessitate more call assignments and longer workdays which can foster burnout and continue the downward spiral.
Staffing challenges do present some opportunities and a window to try new things. Vangie Dennis, in the Sadler article, offers suggestions on building a talent pipeline for perioperative nurses. Initiating expanded clinical ladder levels to reward nurses who develop their skill sets to scrub and circulate and for nurses who can cover multiple roles in perioperative services is a progressive solution. Such remedies are a throwback to the historical roots of OR nursing in years past.[2] A recent article in Becker’s Healthcare strikes a similar note in workforce development and pay differentials to decrease costly locum tenens expenses.[3] Each of these examples address staffing needs but also offer professional development enhancements which may ultimately facilitate retention.
The historical survey data presented by Saver offers an important retrospective, but perioperative specific burnout is worthy of further study. Surgical services continues to have spotty shortages in central processing, anesthesia providers, perioperative and perianesthesia nurses as well as surgical technologists. Technological advances, time pressures and financial constraints may all contribute to burnout in this fast-paced work area. There is a paucity of perioperative specific research on staffing shortfalls. This is fertile ground for further research to include qualitative studies to generate a more complete picture of environmental factors contributing to burnout and attrition of perioperative staff.
There are diverse reasons that nurses leave the profession, but especially concerning is the issue of early-career nurses who exit. Next month, I will discuss recent research on the reasons for nurses leaving the profession.
References
- Saver, C. (February 27, 2024). A look back: 10 years of staffing data show scope of challenges for OR leaders. https://www.ormanager.com/a-look-back-10-years-of-staffing-data-show-scope-of-challenges-for-or-leaders/?failed_auth=anhzdG9iaW5za2k%3D
- National Council of State Boards of Nursing, Inc. (April 13, 2023). NCSBN Research Projects Significant Nursing Workforce Shortages and Crisis. https://www.ncsbn.org/news/ncsbn-research-projects-significant-nursing-workforce-shortages-and-crisis
- Becker’s Healthcare (January, 2024). The Workforce Management Playbook: How Mercy is Empowering Nurses, Saving Premium Labor Costs + Improving Care.
