Dear Friends,

COVID-19 has been a disrupter to everything we once considered normal. Things are different now. What would have taken years to adapt to expanded use of technology has fast-forwarded. Who would have thought we could do business around the world while never leaving our desks? Who would have thought telehealth would become a credible way of providing healthcare, especially to people for whom an in-person visit with a provider was difficult? Telehealth has transformed the concept of "access to healthcare" for some people. These are all relatively positive outcomes of the pandemic. However, we have many systemic challenges in the transformation triggered by COVID-19 in our country, as seen in the travel industry, the use of office space, and the paucity of some commodities we took for granted two years ago. And, who would have thought nurses who often perceive their work as a "calling to serve'' would be a significant segment of the "Great Resignation," choosing to retire or work somewhere without direct patient/resident care? The work-life values of nurses were torn apart. Nurses worked with staff shortages as colleagues were sickened or gone. They saw countless people gasping for breath or taking their last breath, and they worried about bringing COVID-19 home to their families or aging parents. The healthcare workforce has reached a tipping point, and perhaps nowhere is it felt as much as in the nursing workforce, which is by far the largest of any healthcare profession.  

In the minds of every C-Suite executive in healthcare organizations across the country is the question of having the capacity or lack of capacity of the nurse workforce to meet the healthcare needs of their patients/residents. Recruitment of nurses is difficult, and retention is even more difficult as staff leave their positions to become travel nurses to make double or triple their hourly pay. Many nurses leave one organization to take a job as a travel nurse just down the street. According to the NY Times Magazine (February 20, 2022, p.32), the number of open travel nursing positions has increased from 5,226 in January 2019 to 36,364 in January 2022. The need for organizations to hire travel nurses to fill vacant positions across their organization is fraught with significant concerns around quality, cost and culture. Most travel nurses are highly skilled, but they may be placed in situations where the clinical care needed is not always their expertise. The skills and knowledge required for patients on surgical floors, medical floors, and oncology floors are all different. The skills and knowledge needed to care for older adults, whether in the hospital, community or long-term care, are even more specialized. The lack of a consistent and knowledgeable staff in any setting leads to a decrease in the quality of care provided and a lack of camaraderie and teamwork, which is essential to good care and organizational morale. 

Preparation, recruitment, and retention of a nurse workforce with a capacity to meet the needs of our population - particularly the growing older population - is essential for the delivery of quality healthcare. Although educational institutions preparing nurses are working to increase enrollments, the pipeline will take years to meet the goals and is limited by the dearth of nursing faculty. Healthcare organizations need to focus on retaining new recruits and experienced nurses in their facilities. Retention is closely correlated to leadership that respects individuals, embraces diversity, encourages shared decision-making, and provides guidance through mentoring and education. Providing nurses with the knowledge they need to practice with confidence builds satisfaction and results in positive outcomes for the people they serve. For this reason, HIGN has a plethora of resources available through to educate nurses in providing the specialized care necessary for older adults.