Health care facilities across the commonwealth are facing a nursing shortage that is expected to get worse in the coming years. Gov. Andy Beshear says hospitals currently have only about 80 percent of the staff nurses needed to handle patient loads. By 2024, he estimates the state will need an additional 16,000 nurses.
Hospital officials say the deficit, which they attribute to a range of factors, has been building for years.
“The worker shortage is not something new, but COVID certainly put a bright spotlight on the problem and certainly has exacerbated the issue,” says Kentucky Hospital Association President and CEO Nancy Galvagni.
Demographics are a key factor. Galvagni says many nurses are at or near retirement age and there simply aren’t enough new nurses entering the profession to offset the retirements. The additional hours, greater workloads, and stress of treating critical COVID patients has accelerated departures among nurses, she says. She says the labor shortage is especially acute among facilities in the state’s small towns.
“Rural communities are very concerned about losing any staff because it’s harder to recruit to rural hospitals,” she says.
Some feared that COVID vaccination mandates on health care workers might further impact staffing levels, but Galvagni says that’s not happened to any great extent in Kentucky. The bigger issue, she says, is the lure of lucrative traveling nurse positions. She says workers are leaving their regular hospital jobs to join companies that supply nurses who move from hospital to hospital, helping to fill short-term staffing gaps.
“We were competing not just for labor within our state but we were competing nationally,” says Galvagni. “That was driving up the wages, and so we were having to pay in Kentucky a national rate to try to get nurses.”
Where a full-time staff nurse at a Kentucky hospital might make $40 an hour, Galvagni says traveling nurses may make as much as $200 an hour, depending on their experience and specialty.
Assistance for Nursing Students
Last week, Gov. Beshear issued a series of executive actions to begin to address the state’s nursing crisis.
“In the midst of a pandemic, and in the midst of a shortage this dire, we’ve got to do things a little bit differently,” the governor said.
Beshear ordered the Kentucky Board of Nursing to allow nursing schools that have sufficient resources to boost their enrollments. Schools that are already at full capacity are to refer their qualified applicants to neighboring schools, and the state board will provide a monthly listing of schools that have spots available for prospective students.
But at the present time, Kentucky’s nursing schools are limited in how many students they can accept.
“We can bring in a little over 1,200 students a year,” says” Kentucky Community and Technical College System Chancellor Kris Williams. “Out of those students, we graduate over 900 students a year.”
Williams says accrediting agencies cap how many students KCTCS can enroll in its 23 different nursing programs among its 16 college campuses. She says their students face challenges that can make completing a nursing degree difficult. Some encounter financial hurdles and child care or family care obligations, whiles others face transportation issues or a lack of internet access to participate in online courses.
For those facing financial issues, Galvagni says many hospitals offer student loan forgiveness to their nurses. Williams says other employers offer tuition remission for employees who pursue a nursing degree, and the state’s Work Ready Kentucky Scholarship program provides assistance to students pursing degrees in health care.
The governor also wants nurses to be included in a frontline worker bonus he hopes to provide from federal pandemic relief funds, and he wants to offer scholarships and student loan forgiveness for nursing students who agree to stay in the state and work for a certain number of years.
To get more young people into the nursing studies pipeline, Williams says there are dual-credit options for high school students to take college-level courses that prepare them to enter a nursing program.
Support for Hospitals
As the COVID pandemic drags on, hospitals are struggling to help their nurses and other staff members deal with the stress of long hours and never-ending patient needs. LaKisha Miller, executive director of the Kentucky Chamber of Commerce Workforce Center, says many employers are afraid of losing what staff they do have.
“One of the things that we hear from our businesses constantly is around that burnout,” says Miller.
Many employers are now partnering with the Chamber and KCTCS to address the nursing shortage. Miller says she works with health care facilities to assess their needs and facilitate conversations with education partners to begin to fill the gaps. The Workforce Center also created eight regional collaboratives to pinpoint the specific nursing shortages in those areas. Miller says one of those collaboratives recently secured a $2.5 million grant from the U.S. Department of Labor to provide support services to nursing students.
“That was a big, big win for that region,” says Miller. “The employers are going to know that these students, they’re supported and they have a greater chance of actually getting to our facility.”
In addition to addressing the short-term needs of current students, Miller says the Chamber is also working to fill the talent pipeline by helping to introduce younger students to the nursing field and showing them the different career pathways available in health care.
Beyond staff shortages, hospitals are facing their own financial challenges. Galvagni says many facilities had to create dedicated COVID units, purchase special freezers to store COVID vaccines, and host monoclonal antibody treatment clinics. She says hospitals also had to borrow money to hire travel nurses and pay retention bonuses for staff. At the same time, those facilities lost revenues when elective procedures were postponed during the early months of the pandemic.
Even with early rounds of federal relief, Galvagni says Kentucky’s hospitals still have about $1 billion in losses. She says other states have already allocated some of their American Rescue Plan Act funds to help hospitals pay their staffing costs. She hopes Kentucky lawmakers will do the same thing when they convene in January.
“We don’t have any hospitals that we think are in imminent danger of closure, but we think the long-term outlook is very concerning,” she says. “The losses have continued to mount, and that’s why we are asking the General Assembly to look at providing some of those ARPA funds back to hospitals.”