Starting Monday, January 9, 2023, roughly 7,100 New York City Nurses went on strike at Montefiore's three hospitals. This strike is only the latest in a series of healthcare and, most specifically, nursing-related strikes. "Of the 20 major strikes tracked by the Labor Department over the first 11 months of 2022, seven of them, or 35%, were in healthcare" (Isidore, 2023).
The pandemic has further exacerbated an already fatigued healthcare system. Staffing shortages have been an ongoing program long before COVID-19 disrupted the industry. Before the pandemic, it was postulated that there would be a shortage of up to a million nurses by 2025 (Isidore, 2023). This number would now be an underestimation given the mass exodus the field has seen since the onset of the pandemic. As the aging population in the field retired, other younger workers left the field altogether in favor of new ventures.
This staffing crisis is the most significant catalyst in the ongoing strikes, as the remaining healthcare workers are left overwhelmed and overworked. A trend that is also leading to diminished patient care. As the patient-to-nurse ratio increases, healthcare workers are expected to take on more. "For example, though the norm for a standard ICU nurse may be to manage two patients throughout a shift, shortages may demand that the same nurse now take care of 3 or 4 patients" (Balasubramanian, 2022).
The increased workload and associated burnout increase the likelihood of mistakes being made by providers and decrease the level of care a patient can expect when seeking treatment. Furthermore, less staff further slows care administration, leading to longer wait times for incoming patients or the inability to keep up with the work, which may cause some facilities to close their doors to incoming patients. These effects are felt most acutely in hospitals, emergency rooms, and ICUs. Though make no mistake, the issue is not isolated to a lack of nurses; the shortages in healthcare extend to physicians, with primary care providers being one of the hardest hit sectors (Balasubramanian, 2022).
For several years, the medical professional liability insurance market has hardened as more shock verdicts are awarded to plaintiffs. The industry saw a slight reprieve in these nuclear verdicts during the pandemic due to the "Halo" effect- or the phenomenon referring to the goodwill felt towards healthcare professionals, making patients reluctant to file a lawsuit. Nevertheless, this is starting to dissipate, and we are already seeing a sharp rise in claims in the last calendar year. Unfortunately, in a stressed healthcare system, we can expect the resurgence of nuclear verdicts and an increase in claims if patients are experiencing subpar care.
In short, the growing exposure needs serious remediation to support healthcare workers, and new infrastructure must be considered to improve the future healthcare outlook. Some important considerations when rethinking the healthcare model include:
Strengthening the pipeline of new healthcare workers (Muoio, 2021)
Educating healthcare professionals has been an ongoing struggle even before the pandemic. Some years saw thousands of qualified students being turned away from further education due to a lack of training resources, whether at the clinical or staff level. The federal government has been working to build a more robust infrastructure to facilitate the necessary growth. However, this initiative will need to be helmed by individual organizations to see the results we truly need.
2. Meeting demand with nimble workforce deployments (Muoio, 2021)
Staff shortages have necessitated many facilities to rely on travel nurses or other costly alternatives to maintain the coverage they need to stay operational. During the pandemic, some facilities have begun working on more creative solutions to meet staffing requirements without paying the higher fees associated with staffing agencies. This could include pooling resources from a few local facilities to create short-term staffing agencies or "travel-at-home" programs. Going forward, further exploration and implementation of these programs could benefit the stressed system without adding as many budgetary constraints.
3. Addressing workplace culture to improve retention (Muoio, 2021)
Finally, the most important initiative to focus on is workplace culture and retention. As stated above, the pandemic pushed the healthcare industry and many workers to the brink of their capabilities. Demanding longer hours, uncertain working conditions, and lack of PPE put a strain on the system. The experience shook even the most seasoned and dedicated healthcare workers. With some opting to leave the field and those remaining still feeling the effects of the ongoing pandemic, the healthcare industry must provide the support workers need to combat burnout. There is no one-size-fits-all for combating this problem. Healthcare facilities and hospitals should be attentive to their staff's needs and work to meet them.
Balasubramanian, Sai. (August 26, 2022). The healthcare industry is crumbling due to staff shortages. Article [Website]. Retrieved from: The Healthcare Industry Is Crumbling Due To Staffing Shortages (forbes.com)
Isidore, Chris. (January 11, 2023). Health care is in crisis. New York’s nurses strike is just the latest sign. Article [Website]. Retrieved from: Health care is in crisis. New York's nurses strike is just the latest sign | CNN Business
Muoio, Dave. (December 22, 2021). 2022 forecast: 5 trends that will make or break healthcare’s labor shortages. Article [Website]. Retrieved from: 2022 forecast: 5 trends that will make or break healthcare's labor shortages | Fierce Healthcare