AFT report: Healthcare staffing has reached a crisis point, but there are solutions

A new report from the AFT’s Nurses and Health Professionals division examines how staffing shortages in the healthcare industry are affecting the way many health professionals work. The study finds that nurses and other healthcare professionals are fatigued, burned out, anxious and quitting the industry in droves, because decades of understaffing has reached a crisis point.

According to the report, multiple factors are driving the staffing issue, including the corporatization of healthcare and profit motives, which have resulted in systematic underinvestment in healthcare workers’ safety and well-being, producing unsustainable work environments.

Registered nurse Edna Cortez says her goal is to provide her patients with the best care she can give, but when facilities are short-staffed, it cuts down the time she can spend with patients. Sometimes it feels like the system is pushing you to handle more patients, says Cortez, who is a member of the Washington State Nurses Association. The result is that “I have to work more quickly in order to problem-solve,” she says, and she knows that she’s not alone. “I’ve talked to many nurses who are like, if I had more time, I would have done this differently.”

Yvonne Dowell, a licensed addiction counselor for the state of Maryland and president of AFT Healthcare-Maryland, says that state healthcare facilities need more workers. “We were short-staffed,” she says, and for her that means members who may have worked in three units now must work in five units, for example. “I have to manage until we can get additional addiction counselors, and it’s the same for the nurses. The nurses are short-staffed too.”

Dowell says that mandatory overtime is used frequently, and healthcare staff often must multitask to get the job done. “With me, the lack of staff has increased my workload, and when your workload is increased, and you’re spread thin and then there’s a tendency to miss something.”

Healthcare workers, unions and advocates have been warning of staffing shortages for years, well before COVID-19, but the pandemic not only increased the problem, but also made it more widely known. “Even before COVID, there was an issue with staffing,” says registered nurse Jon Olson. “COVID just blasted [staffing issues] out of the water.”

Olson, also a WSNA member, says his rural facility often uses traveling nurses to fill in where they are needed. “The travelers really started coming in after COVID. Before that we would just work short,” he says. Now, Olson is seeing some of his colleagues leave to take on jobs with the traveling nurse agencies. “I don’t blame anybody. You hate to see them go. But without the travelers, we’d be overrun [with patients]. There would be no way to do it with the staffing we have,” he says.

The report provides a menu of proven measures, as well as a road map at every level—national, state, sector and facility—to tackle this crisis, ranging from better recruitment to implementing federal and state laws ensuring safe staffing ratios for the entire care team. 

“The consequences of this chronic understaffing can be deadly, but the problem is solvable,” says AFT President Randi Weingarten. “It’s on our nation’s healthcare employers to step up and invest in this crucial workforce by making healthcare facilities safer places to work and engaging frontline workers in collaborative decision-making. Healthcare workers must have a voice in the process and be engaged in the day-to-day workings of their facilities, especially where safety is concerned. When the people providing the care are seen, heard and respected, the patients receiving the care do better too.”

Natasha Schwartz, a registered nurse and member of the Oregon Nurses Association, believes that being part of a union can play a big part of changing healthcare facilities for the better, especially when it comes to staffing. “I’ve never worked at a hospital that wasn’t unionized,” she says, but she’s had workers tell her how different things are at other hospitals. “Traveling nurses chose to work at my hospital because it is a union hospital, and we have a lot more autonomy. We can have some form of shared governance. We are able to participate in decision-making with management. It might be difficult at times, but it also feels empowering since we can truly influence policies and behaviors at our hospital.”

[Adrienne Coles]