Nursing a pandemic: The aftermath

JACKSON, Miss. (WLBT) - Staffing shortages are an issue across several industries. But healthcare is one you may take for granted. And the pool of nurses keeps shrinking. These are the people tasked with helping to save your life. But now there’s a need to try and save them. Our investigation shows the issue is more complex than just getting creative with recruitment.

They were hailed heroes amid the pandemic. But, some voiced their concerns.

“It was so defeating to come in and have so many people that were so sick and they were dying and couldn’t be with their loved ones,” said one UMMC ER Nurse Lacey Ward in November 2020.

Some shared fears about the impact of caring for those with the contagious virus.

“You worry about going home,” said King’s Daughters Medical Center nurse Nick Smith in 2020. “You worry about being around your wife and kids.”

And it gave a sense of resolve for their purpose to many.

“Nursing is what I’m called to do,” noted Connie Williams, Mississippi Nurse Honor Guard President and Founder in 2020.

There was a nursing shortage before we even recognized the phrase “COVID-19″. But as Dr. Kim Hoover, Chief Operating Officer at the Mississippi Hospital Association explains - the pandemic made it worse.

“When the travel agencies began to recruit nurses with much higher salaries, then that really began the exodus,” described Hoover. “So they were our hospitals were already working on a fairly low margin. And so they weren’t heavily staffed. They were staffed to care for the patients. They had the beds they had.”

The Hospital Association’s Center for Quality and Workforce conducts a hospital nursing workforce survey each year. And it shows the number of open nursing positions was steadily climbing and taking a leap by 2021, a year into the pandemic. By the start of this year, the number had grown to over 3,000 vacancies.

“That’s just hospital,” added Hoover. “Yeah, that’s not really...it’s not the additional nurses that would be needed for home health, long-term care facilities, and that sort of thing.”

St. Dominic’s felt the squeeze, with patient loads exceeding what they could handle with their staff.

“We did have to bring in agency teams to help us support our mission here at St. Dom’s,” explained Thu Phan, St. Dominic’s Chief Operating Officer, and Interim Chief Nursing Officer. “In the past two and a half years, and in the current state, we do still have a mix of a few agency nursing teams and in-house contracts and full-time staff. So we’re kind of hoping to level off in terms of the nursing mix.”

The state contracted with nurses to fill in the staffing gaps temporarily. But once those contracts ended, the problem remained.

Even smaller hospitals like King’s Daughters Medical Center in Brookhaven felt the impacts and some are lingering.

“We still have some areas of the hospital that we do not have adequate staff to open back up to the floor of the hospital,” described KDMC Jaymie Heard, Chief Nursing Officer.

They’ve worked to combat the burnout.

“We have normalized back down to our normal nurse to patient ratio,” added Heard. “We have asked them to maybe take one or two additional patients from the norm pre pandemic, but we’re buffering that with some ancillary staff.”

The University of Mississippi Medical Center declined an interview on the nursing shortage topic. But sent the following statement from the Communications and Marketing department.

“UMMC, like other health systems in the state and nation, is experiencing a nursing shortage. The nursing shortage existed prior to COVID-19, but the pandemic further strained staffing levels. We have implemented several measures to retain and recruit qualified nurses, including innovative staffing models, increased compensation and increasing the number of recruiting events. The Medical Center remains committed to continuing efforts to increase our nursing workforce.”

We visited the University of Southern Mississippi to get some perspective on why reversing the nursing shortage should matter to you.

“The goal here is that we have people to take care of us, in us in a state, that’s pretty sick on the best year,” explained Dr. Lachel Story, Dean of the College of Nursing and Health Professions at the University of Southern Mississippi. And with all the complications of COVID, that’s probably only going to increase over time.”

What we learned is that there’s a bottleneck when it comes to creating a pipeline to fill these openings.

“It’s not that we don’t have enough of people that want to be nurses, it’s most often the issue is the capacity of the schools to admit them, and then to graduate them into transition them into practice,” said Story.

That dreaded word - shortage - is also an issue when it comes to nursing faculty.

“Many times nurses can make way more money and practice even before of the COVID inflation of salaries, and they can teaching,” described Story. “What we’ve seen for years and teaching is that nurses come to teach kind of almost like as a second career. They’ve been in nursing, oftentimes in 2025 years. So by the time they do come to teach, they’re probably not going to be working that long.”

At USM, they’re trying to find ways to break the cycle. First, by partnering with local community colleges to ensure that if they can’t accept a student, they’re routed to a program somewhere.

Then, they’re trying to do what they can to speed up the refill with things like an accelerated nursing program for second-degree students that will cut the time and costs in half. Oxford and Jackson are the only other places in the state where students can do that currently.

This will be the first option in South Mississippi. It ultimately gets more nurses at the bedside faster. They’re also finding ways to use qualified hospital staff as additional faculty.

Then there’s trying to keep graduates here once they get the diploma. Some clinicals that are typically done within a hospital shifted to a simulated course during the height of COVID, adding to recruitment woes.

“I feel like the clinical setting that has always been a factor that played into the recruitment of nurses, is when they would come in, they saw how the organization worked, and they want to work there,” added Heard.

The legislature weighed in on the issue this session. Passing House Bill 1005. It’s a forgivable loan program that’s funded with 6 million dollars in American Rescue Plan (ARPA) money. If nursing students get the loans---they don’t have to pay them back IF they agree to work in Mississippi for FIVE years post-graduation.

Because the state had to work out specifics of how to apply, the loans won’t be available until the 2023-2024 school year.

Something to note, Mississippi already has some similar programs that don’t have that 5-year requirement. But Dr. Hoover notes that the state still has a one-year requirement program listed on the website. Yet, there hasn’t been funding for it.

“I think the reason some of those loans, forgivable loans were not funded, is that we thought, you know, people say...well, we have enough nurses in the state of Mississippi,” said Hoover. “We get complacent. And we decide that we don’t have to fund some of these things. So rather than looking ahead, we tend to really just look at this little bit of time in front of us and so we’ve got to be aware of the supply and demand. The forgivable loans are important but that doesn’t necessarily give us nurses right now.”

Brighter days are here. That’s what one of the digital signs outside of King’s Daughters Medical Center reads. And that hope is returning for KDMC staffing, too.

“I’m starting to see a shift in them wanting to come back,” noted Heard. “I’ve actually we’ve had some open positions out there. And I’ve noticed some names. They’re reapplying for positions. So I’m hoping that you know, as long as we can normalize back to status quo, they’ll want to come back, you know, and maybe that was just something they want to do, just to experience it are, you know, they need to make some extra money, and now they’re ready to come back home.”

Until there’s more normalcy, it could continue to mean nurses caring for more patients than they once did or the hospitals not offering the full range of services you’d come to expect. But there are efforts to reverse the nursing shortage trend...it will just take time.

More than one of the people we spoke with noted a concern that the image of nursing during the pandemic may further complicate this shortage.

They’re hoping to see more marketing work done around the positive impacts of those jobs.

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