By James X. Stobinski, Ph.D., RN, CNOR, CNAMB(E), CSSM(E)
In my role as the director of education at NIFA, I strive to stay up to date on trends in American health care. My part-time work as adjunct faculty also necessitates staying current in the health care literature. To this end I have two excellent sources of information which I read daily. The OR Manager publication is an excellent source of OR specific information and surgery-related content to include a daily eLetter titled ORam. For more general health care information, I subscribe to the daily newsfeed from Becker’s Healthcare Review.
This month, I would like to share three articles from Becker’s. These very different articles share a common theme for American health care. It is a very unsettled and turbulent time for our health care system and for the perioperative nursing specialty. The labor market in general is very tight and a variety of health care professions have widespread shortages. Central processing professionals, surgical technologists, anesthesia providers and perioperative nurses are all experiencing prolonged shortages. Many experienced health care workers left employment during the pandemic; this was especially true for nursing.
Not enough workers have come into the health care professions to address that lingering shortfall and the demand for health care, to include surgery, continues to rise. The labor force participation rate has not returned to pre-pandemic levels and available workers are now more selective regarding working conditions and wages. This continued overall shortage of workers is compounded by factors highlighted in these three articles.
The first article is by Cass and tells of a hospital closure in Indiana (2023). One hospital closing is not big news, but this is one example of a larger trend of hospital closures, mainly in rural areas. As American health care continues its transition to value-based care numerous smaller facilities and some urban hospitals have ceased operations. Stories about these closures and the ongoing financial struggles of other facilities are common in Becker’s Healthcare Review. On a larger scale the accumulation of these closures will re-shape how and where Americans can access care.
Strikes and unionization efforts are becoming increasingly common as health care workers, to include nurses and doctors, are using unions to gain leverage and a more active voice. Gooch (2023) relates the details of the largest strike by nurses ever recorded in Texas and Kansas. Workforce shortages give workers more leverage in negotiations and organizing efforts are becoming more widespread as unions find more receptive audiences amongst nurses.
The third article is by Gamble, and it speaks more broadly about the cost of nursing turnover. The pandemic ushered in a concentrated period of transitions among nurses to include a historically high rate of turnover and of nurses leaving the profession. Gamble quantifies the heavy cost of that turnover to health care facilities at $52,350 per nurse. In the article, we learn that nurses working in surgical services had the lowest turnover rate of all specialties reported at 16%; far below the current national average of 22.5% annually.
We currently have a very dynamic and unsettled picture in American health care. The labor market is as challenging as I have seen in my nearly 40 years in health care. There are small bright spots in all this turmoil. I am very glad to see early career perioperative nurses expressing their views on a variety of social media platforms. Secondly, I have heard some innovative proposals to address longstanding issues in perioperative nursing. These are small but positive developments which may appear in future articles.
Stay tuned, in my column next I will have information on another issue which impacts the availability of surgical care – the state of rural health care in America.
– James X. Stobinski, Ph.D., RN, CNOR, CNAMB(E), CSSM(E), is the Director of Education for the National Institute of First Assisting (NIFA).
References
Cass, A. (June 30, 2023). Indiana hospital closing emergency department, ending inpatient services. https://www.beckershospitalreview.com/finance/indiana-hospital-closing-emergency-department-ending-inpatient-services.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=4467F0926923B3Y
Gamble, M. (April 11th, 2023). The cost of nurse turnover in 24 numbers. https://www.beckershospitalreview.com/workforce/the-cost-of-nurse-turnover-in-24-numbers-2023.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=4467F0926923B3Y
Gooch, K. (June 30, 2023). Ascension nurses to return to work after strike. https://www.beckershospitalreview.com/hr/ascension-nurses-to-return-to-work-after-strike.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=4467F0926923B3Y
