By James X. Stobinski
Although there are many registered nurse roles, there is a commonality in the work of nursing in that it is often physically demanding and emotionally draining. Another common complaint is that nurses do not feel adequately reimbursed for their work. Prior to the pandemic many nurses were not seeing large increases in wages and benefits. During the pandemic there was ample overtime opportunities, but those extra hours and shifts exact a toll and contribute to burnout. However, we are now seeing signs that base wages are beginning to rise.
One of my favorite sources for health care news is Becker’s Healthcare Review and in my daily briefs there have been frequent reports of wage increases for nurses. Some wage increases have resulted from strikes and other labor actions which have become increasingly common. Roberts, in her 2023 blog post, details the extent of recent strikes and unionization efforts among nurses. Although the idea of nurses going on strike raises complex ethical concerns and remains a divisive issue among nurses, unionization efforts and strikes are becoming more commonplace. Richard Park, in a December 20 article, tells us that, “Hospital workers remain in a favorable position in a hypercompetitive landscape for personnel against a backdrop of higher cost of living and the exit/early retirement of some skilled labor from the workforce.”
The net result of these converging factors is that wage pressures continue for hospitals. In a December 26, 2023, article Condon cites increased labor and benefit costs for the poor financial results reported by a number of health systems. In addition, Dydra in a December blog post, estimates that health care facilities will see $6.95 billion in additional wage costs as 22 states and 38 counties and cities will increase their minimum wage levels on January 1, 2024. Controlling wage and benefit costs will remain a significant challenge for health care facilities and these increased labor costs are triggering changes in workflows and staffing patterns.
An interesting development with the current staffing shortfalls has been the greater utilization of LPNs and LVNs in acute care settings which is a reversal of long term trends. There have also been a number of reports on increased attention to recruiting and retention efforts along with innovative strategies in these areas. There are also reports of health systems developing internal float pools and limiting contracts for travelers in close geographic proximity to the facility. Facilities are devoting more resources to developing a workforce with efforts extending into local communities to the level of high school classes and pre-licensure training programs.
The impact of these developments on the perioperative nursing specialty is unclear at present. I have previously written in this publication about the effect of the pandemic and on nurses working in surgery (2023). Perioperative nursing is unique in nursing because of lengthy education and training requirements. Staffing shortfalls cannot be quickly remedied if nurses must be oriented to the specialty. The 2023 AORN Salary Survey reports some easing in the number of open positions for perioperative nurses and surgical technologists, but widespread shortfalls remain (Bacon and Stewart, 2023). Condon (December 20) also reports encouraging news on health care labor shortages but cautions that significant challenges remain.
Staffing and workforce issues, and the attendant costs, will remain significant issues for health care leaders. Education and training efforts, workforce development initiatives and increased attention to retention will all be needed. While challenges remain, NIFA, as a provider of education courses, believes there are also opportunities for increasing partnerships and collaboration. Working with the perioperative nursing community we hope to be part of the ongoing solution.
– James X. Stobinski, Ph.D., RN, CNOR, CNAMB(E), CSSM(E), is the director of education with the National Institute of First Assisting.
References
- Bacon, D. R., & Stewart, K. A. (2023). Results of the 2023 AORN Salary and Compensation Survey. AORN journal, 118(6), 362–379. https://doi.org/10.1002/aorn.14036
- Condon, A. (December 20, 2023). Hospitals fill more jobs as labor pressures cool: Fitch. https://www.beckershospitalreview.com/workforce/hospitals-fill-more-jobs-as-labor-pressures-cool-fitch.html
- Condon, A. (December 26, 2023). Financial updates from 28 health systems: HCA, Mayo & more. https://www.beckershospitalreview.com/finance/financial-updates-from-28-health-systems-hca-mayo-more.html?utm_campaign=bhr&utm_source=website&utm_content=latestarticles
- Dyrda, L. (December 28, 2023). Minimum wage bumps in 22 states will add billions in worker wages. https://www.beckershospitalreview.com/finance/minimum-wage-bumps-in-22-states-will-add-billions-in-worker-wages.html?utm_medium=email&utm_content=newsletter
- Roberts, A. (October 5, 2023). Nurse Strike Updates 2023, full list. Nurse.org. https://nurse.org/articles/nurse-strikes-list/
