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Three years since COVID got here, health care remains changed

The US Senate Health, Education, Labor, and Pensions Committee recently held a hearing examining health care workforce shortages. Mon. Bernie Sanders, I-Vt., chairman of the committee, said the lack of health care workers would result in many patients not being able to get access to health care.

“We simply in our nation do not have enough doctors, nurses, nurse practitioners, dentists, dental hygienists, pharmacists, mental health providers, among other medical professions,” Sanders said.

In response to the shortage, area hospitals are working to address employee burnout, attract new talent, and fill gaps with other means, including innovation with telehealth options.

The American Hospital Association said their members also contract with outside agencies to fill gaps, but they say prices with those agencies have risen dramatically from what they were prior to the pandemic.

“Staffing shortages in health care are the norm across the nation,” said Doug Houghton, Kettering Health’s director of talent. “Professions which are in short supply include nursing, imaging, respiratory and other clinical, patient-facing roles. We see increased innovation to meet patient needs with the shortages we experienced from the pandemic. Medical centers are exploring new staffing models, the use of technology, and even different types of roles to serve communities.”

Burnout in health care

Health care workers have been particularly hit by burnout, which is described as a type of work-related stress that causes exhaustion, reduced performance, and alienation from work-related activities, according to the National Institutes of Health.

“Burnout is something that is prevalent in the health care industry,” said Stacey Lawson, systems vice president and chief human resources officer at Premier Health.

A National Academy of Medicine report said between 35% and 54% of US nurses and physicians had symptoms of burnout. Physicians with burnout are also twice as likely to leave their job and five times as likely to leave medicine altogether, the report also said.

“Research has shown there has been an increase in burnout and stress and fatigue in many health and human service professions. That was already a concern prior to the pandemic. The pandemic made it worse,” McGee said.

Joe Fiorita, a retired nurse from Dayton, told the Dayton Daily News that after 35 years in the profession, he was dealing with burnout at the same time the pandemic hit. Fiorita was a recovery room nurse, and he was furloughed for two weeks early in the pandemic when a pause on certain surgeries was put in place.

“They really shut everything down. They stopped all surgeries except for emergency surgeries,” Fiorita said.

Fiorita said he was already looking at retiring when he turned 65 years old, but prior to the pandemic, he had been considering staying in health care but changing to a less demanding position.

“When the pandemic happened, it just kind of accelerated and emphasized my desire to retire,” said Fiorita, who retired in April 2021.

Addressing burnout

Burnout has become more prevalent among the health care industry, and hospitals say this is something their leaders are taking seriously.

“In the last three years, I think we have asked more of our clinical care givers and of our hospital employees holistically,” said Sarah Hackenbracht, president and CEO of the Greater Dayton Area Hospital Association.

Lawson said some of the ways Premier Health is responding to burnout is promoting a work-life balance.

“When employees are off, they’re off,” Lawson said. Additionally, she said they are looking at other means of support, such as through employee assistance program counseling and providing child care benefits for employees.

Temporary labors

Hospitals have also contracted with outside nursing agencies or traveling nurses to fill gaps during surges of illness. But with that comes increased labor costs.

A report from the American Hospital Association says the hours worked by travel nurses as a percentage of total hours worked by nurses in hospitals grew from less than 4% in January 2019 to over 23% in January 2022.

Although travel nurses are often the bulk of contract labor, similar trends have affected specialties and departments across hospitals. As a result, contract labor as a share of total labor expenses rose 178.6% from 2019 to 2022. Akin Demehin, senior director of quality and patient safety policy of the American Hospital Association, said the prices of those agencies have also gone up since the beginning of the pandemic.

“Having those temporary staff is important, it is critically important to maintain access to care in communities,” Demehin said. “At the same time, the more unfortunate part of that has been some of the behaviors and approaches by the staffing agencies themselves.”

Several staffing firms reported significant growth in their revenues to as high as $1.1 billion in just the fourth quarter of 2021, tripling their revenues and net income compared to 2020 levels, according to the American Hospital Association.

Pandemic accelerated worker shortages

A shortage of health care workers was already being anticipated before the pandemic due to the age of the workforce. In 2017, the majority of the nursing workforce was close to retirement, with more than half age 50 and older, and almost 30% age 60 and older, Demehin said.

On the physician side, the Association of American Medical Colleges said the US could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in both primary and specialty care.

“Given the overall aging of our population, there would simply be a need for additional folks in the health care workforce,” Demehin said. “I think what the pandemic served as was a profound acceleration of the challenges facing the health care workforce.”

Health care facilities are looking at retention when it comes to current employees, along with examining internal and external pipelines for talent and working with workforce development specialists.

In terms of retention, hospitals are meeting their employees where they are, Hackenbracht said, addressing the needs of those caregivers, such as discussing different shift options or shifting to administrative roles so that those employees don’t leave the profession.

The next generation

There is also a need for new health care professionals entering the field to hit the ground running.

“We also still need to keep ourselves focused as a community on the future of how care will be provided and training the next generation of our health care workforce to be ready and prepared to jump in when we bring them out of school so that they’ re really ready to engage with the clinical care team as opposed to bringing them in and then giving two to three years, four years, for them to get up to speed,” Hackenbracht said.

Local nursing students getting set to graduate have spent much of their time in college dealing with COVID, including their time gaining clinical experience from the field.

Elisabeth Novak and Carissa Johnson, who are both seniors at Cedarville University, shared with the Dayton Daily News how they were drawn to the nursing field.

Novak, who is originally from La Porte, Indiana, became interested in nursing after having a family connection to it as both her mother and grandmother were nurses.

“Overall, I was looking for a profession that I could make an impact in, and I think that was the biggest driving force of me choosing nursing,” Novak said.

For Johnson, nursing was also something she always wanted to do.

“I just always had a passion and a desire to be in health care,” said Johnson, who is originally from Illinois.

Novak and Johnson each described how they got clinical training while the COVID pandemic was in full swing. Novak said she looked forward to working alongside nurses already in the field to help support them.

“It confirmed that this was a field I wanted to go in,” Johnson said.