Increased registered nurse vacancies creates concerns post-pandemic

ALEXANDRIA, Va. -- The Virginia Department of Health reports 51.7% of Virginians are fully vaccinated. Dr. Rina Bansal, president of Inova Alexandria Hospital, is faced with a new challenge – finding nurses to work.

Alexandria Hospital visitor entrance Spring 2021, in Alexandria, Va. All photos submitted by Dr. Rina Basnal.

During COVID-19 peaks, hospitals were full of critically ill patients, and staff members at Alexandria Hospital were under great pressure and stress, Bansal said. Changing treatment protocols and the need to be fully compliant with PPE impacted registered nurses beyond when their shifts were over, Bansal said.

“This was the first time people were scared to work in the hospital,” Bansal said. “Scared they would bring COVID back home to their loved ones.”

Associate vice president of human resources, Renauldo Hawkins, Alexandria, VA.

Renauldo Hawkins, associate vice president of human resources, recognized the trauma and pain that frontline workers experienced during the pandemic. Vaccinations helped team members feel at ease, but a great number of nurses left hospital nursing. Post-COVID-19, frontline workers experienced the greatest pressure and began to evaluate whether health care was the career for them. Alexandria Hospital’s primary, post-COVID-19 challenge is filling vacant roles and getting staffing numbers back up, Hawkins said.

“Overall, this is creating a health care workforce crisis in the United States, but also globally,” Bansal said.

President of Alexandria Hospital, Dr. Rina Bansal, Alexandria, VA.

During a normal year, Alexandria Hospital had a nursing turnover rate between 15-20%, but this year, the hospital experienced a 30% turnover rate, Hawkins said. The degree of burnout nurses experienced during the pandemic increased. Nurses requested more time off to rest and recover, but this was not always possible, Hawkins said. 

With cases of COVID-19 decreasing and vaccinations available to the public, normal hospital operations are returning, Hawkins said. With a decrease in staff, it is hard to keep up with the demands of surgeries and routine procedures. Nurses are not picking up extra shifts or overtime because they are exhausted and in need of some time off, Hawkins said.

“Every time you lose a nurse, even in the past, it was hard,” Hawkins said. “But losing a nurse, now, and trying to replace that nurse is two times harder to hire another nurse back.”

Alexandria Hospital worked extremely hard to support staff members during and post-pandemic, Hawkins said. Town halls were held between executive leadership and different departments as forums to express concerns and ask questions about COVID-19. Snacks and beverages were delivered to staff members during their shifts through compassion carts. Employee assistance programs provided confidential space for staff to talk and ask for help, Hawkins said.

“We have a new appreciation for our nurses that are still here after working through the pandemic,” Hawkins said.

The intensity of the job caused nurses to turn to outpatient care or became travel nurses, Bansal said. Travel nurses were not locked into permanent roles, compared to core staff members, and this created a shift to more temporary job roles in health care. Travelers have impacted labor costs. A nurse makes $50-60 an hour, but a traveler makes $160 an hour. Permanent staff members working alongside travelers with the same job title and making more money was discouraging, Bansal said.

“Inova Health System had to raise nursing salaries in response to the increase in travelers,” Bansal said.

Alexandria Hospital has always focused on the development of their nurses through new graduate fellowship programs, but as more experienced nurses exit the profession, training new graduates is another problem the hospital is facing, said Hawkins.

“It really has been a double challenge to retain nurses while training new nurses coming in,” Hawkins said

Moving forward, the hospital will start celebrating even small victories, Bansal said. On Friday, July 2, 2021, Alexandria Hospital reported zero COVID-19 cases for the first time since March 2020.

“Even if we have two the next day, it’s a little celebration,” Bansal said. “It also shows the victory of humanity over a pandemic.”