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Post-Pandemic Health Care Challenge: Nurse Shortage

June 27, 2023

Smiling multi-ethnic medical professionals are standing in a corridor in a hospital.
Jennifer Nooney

The health care workforce—physicians, nurses, and allied health professionals—has experienced cyclical shortages in the U.S. over many decades. Short-staffed facilities increase the workload of existing employees, leading to burnout and turnover. More importantly, low staffing levels compromise patients’ access to care and the quality of care they receive. Health workforce shortages increase existing inequities in access to care and health care quality in rural and economically disadvantaged areas. Localities, states, nonprofits, and the federal government operate numerous programs designed to bolster the health care workforce, but challenges remain.

Lingering Impact of COVID-19 on the Nursing Workforce

Nurses were hit particularly hard by COVID-19. As the largest health profession, including over 4 million professionals, nurses provided most of the direct care for COVID-19 patients during the pandemic. Nurses faced high levels of COVID-19 transmission risk, longer hours, and emotionally exhausting circumstances with patients and their families. At the same time as hospitals endured nurse staffing shortages, nurses in some other health care settings saw closures and limitations on routine care. In the aftermath of COVID-19, researchers and policymakers are just beginning to understand the impacts of the pandemic on nurses and the larger health care system. Nurse turnover during the pandemic was staggering, with nursing joining other professions in the “Great Resignation” that occurred during and after the pandemic. Questions remain about how well the nursing workforce is bouncing back post-pandemic, and what nurse supply and demand will look like moving forward.

The nation continues to experience issues with the distribution of the nursing workforce. Some communities offer less desirable employment opportunities for nurses, so some areas may still face workforce shortages even when the nation’s overall nurse supply is adequate. The Health Resources and Services Administration (HRSA) operates programs designed to improve the distribution of the health care workforce and increase nurse supply in medically underserved areas.

What Westat Is Doing

Westat is undertaking a comprehensive evaluation of HRSA’s Nurse Corps Loan Repayment Program and Scholarship Program, explains Jennifer Nooney, PhD, who is leading this evaluation. These programs offer loan repayment or scholarships for qualified nursing education expenses in return for a 2- to 3-year service commitment in medically underserved communities or accredited schools of nursing. Westat is assessing whether the program expanded access to care in underserved communities and how long participating nurses stayed in these communities (or schools of nursing) after their service obligations were complete. The Nurse Corps program received supplemental funding to expand the number of participants in the program during COVID-19. Westat’s evaluation also assesses the impact of the expanded funding on the number of participants and access to care for patients. This work will culminate in an overall assessment of the program’s return on investment and recommendations for improvement.

Westat offers content expertise to help the health care industry meet health workforce challenges through rigorous research on topics such as supply and demand, the workforce education pipeline, the changing nature of work for health care professionals, and burnout and turnover. We also support robust program evaluations providing insights that can be used to improve interventions and boost the health workforce of tomorrow.

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