The Great Resignation in Health Care and Academia: Rebuilding the Postpandemic Nursing Workforce : Nursing Education Perspectives

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DEPARTMENTS: Message From the NLN Chair

The Great Resignation in Health Care and Academia: Rebuilding the Postpandemic Nursing Workforce

Poindexter, Kathleen

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Nursing Education Perspectives: 7/8 2022 - Volume 43 - Issue 4 - p 207-208
doi: 10.1097/01.NEP.0000000000001003
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The consistently shifting and turbulent postpandemic waters are continuing to be difficult to navigate and are disrupting efforts to chart a clear course toward restabilizing our health care and academic work. The nation is experiencing a new era known as “the great resignation” (Parker & Horowitz, 2021). More than 5 million workers have quit their jobs, sometimes their entire careers, since February 2021 (Weldon, 2022). An additional 4 million workers resigned monthly during the second half of 2021 (Rosenberg, 2022). The majority of workers who resigned from their positions cited low pay, lack of respect, and no avenue for advancement as their reasons for resignation, adding the pandemic as a significant influence in their decision-making process (Parker & Horowitz, 2021).

The health care industry is one of the hardest hit, reporting losses of 20 percent of the workforce over the past two years, including 30 percent of the nursing workforce (Weldon, 2022). Overall health care employment is down by an estimated 500,000 workers (Altarum, 2021). Several factors contribute to a health care worker’s decision to resign; however, the most frequently cited reasons are burnout, exhaustion, a desire for greater flexibility, and work-life balance. Nurses also report insufficient staffing, not feeling valued or listened to, desiring emotional stability, and seeking higher wages as reasons for resigning from their positions.

Escalating nurse turnover rates lead to a further decrease in morale and job satisfaction, as well as increased rates of burnout in the remaining workforce (Grainger, 2021). Low staffing adds to the workload of the remaining nurses, who are often assuming role responsibilities normally completed by a full complement of RNs and support staff, further exacerbating the problem. The American Nurses Association (n.d.) predicts that there will be a shortage of 1.1 million nurses within the year.

The economic toll on health care organizations financially struggling from the pandemic is staggering. Organizations are paying an estimated $24 billion annually above what operating costs were prepandemic (Lagasse, 2021). Overtime hours have increased by 52 percent, and agency labor costs are up by 132 percent (American Hospital Association, 2021). The problem is even greater in rural areas, accounting for 60 percent of the workforce shortage (Health Resources and Services Administration, 2022). The costs to our health care systems are high and unsustainable. As the shortage continues, resources are shifted to recruitment, with, for example, large sign-on bonuses (Perna, 2021), at the expense of retention activities and recognition of dedicated staff. The problem is taking a heavy toll on health care. The extent of the workforce shortage is a current public health crisis that demands immediate attention.

Academic environments are also experiencing labor shortages because of the great resignation. The National Education Association reported approximately half of all educators were likely to resign or retire early (GBAO, 2022). Higher education job postings have recently increased by 16.5 percent for the education sector (Varghes, 2022). Reasons for educator resignations were reported as high workloads, stress, and increased levels of burnout (GBAO, 2022). The shortage of support staff and difficulty recruiting and retaining research assistants add to the workload and significantly slow research activities.

The nurse faculty shortage, well documented before the pandemic, will continue to intensify because of the exodus of nurses leaving the profession. According to the National League for Nursing (2021) Deans’ and Directors’ Survey, 178 full-time faculty across 317 National League for Nursing member nursing schools resigned or retired early, with a stated reason of COVID-19. Currently, only 1.9 percent of the nursing workforce holds a doctoral degree, compared with the 58 percent of faculty vacancies that require a doctorate degree (American Association of Colleges of Nursing, 2020). Faculty salaries also lag, as much as 30 percent behind those of their peers in clinical positions holding similar degrees and qualifications.

A shrinking nurse workforce reduces the pipeline for recruiting future faculty and reduces the number of nurses who may be interested in pursuing graduate education. State boards of nursing and accrediting bodies may require faculty to hold advanced degrees as well as specialty certification in the areas they are assigned to teach. Depending on the program, some candidates may also be expected to have some teaching, clinical, and research/scholarship experience. Nurses who are seeking positions with higher pay may be deterred from considering an academic position.

The health care and academic environments are intimately interwoven and dependent on a well-qualified, diverse nursing workforce prepared to address the health care needs of our nation and global community. Simply stated, education and training of a nursing workforce in numbers sufficient to meet population health care needs requires collaborative academic-clinical partnerships, well-qualified faculty, clinical nurses (preceptors), and available clinical sites for experiential learning opportunities. Growing workforce shortages, heavy workloads, and financial pressures are reducing the number of available clinical sites, as well as qualified clinical nurses to serve as preceptors, compromising optimal student learning opportunities. As new graduates transition into the workforce, health care agencies are reporting the need to increase orientations and skills training to compensate for limited clinical exposure during the pandemic, adding additional demands on scarce resources.

The rationale for this message is to convey the magnitude of the scope of workforce labor shortage across all industries. Continuing to use a business-as-usual approach to educate our workforce may further burden academic and health care agencies and perpetuate an ongoing negative cycle. A common thread driving resignations across all organizations is the feeling of being devalued and burned out, with excessive workloads and lack of support. The formation of innovative and creative academic health care system partnerships has the potential to codesign revised care delivery models that may provide one approach to successfully navigate through this postpandemic voyage.

Organizations can leverage their current resources to reduce workloads for clinical staff, share opportunities for advancement in careers, recognize employee expertise, and provide authentic experiential learning opportunities for students. Depending on their level of training, students and faculty can partner with nurses and staff to provide for quality patient care needs as students work to master clinical competencies in preparation for transition into practice.

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