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More than one in four nursing positions in Pennsylvania were unfilled in late 2021

In this Thursday, Aug. 19, 2021, photo, the staff works inside the Emergency Department at Asante Three Rivers Medical Center in Grants Pass, Ore.
Mike Zacchino
In this Thursday, Aug. 19, 2021, photo, the staff works inside the Emergency Department at Asante Three Rivers Medical Center in Grants Pass, Ore.

Widespread medical provider staffing shortages are challenging hospitals’ ability to keep up with demand, according to a new survey from the Hospital and Health System Association of Pennsylvania.

The shortages of doctors, nurses and nurse assistants preceded the COVID-19 pandemic but grew worse during the past two years, as hospitals dealt with several surges of patients sick with the virus.

More than one in four registered nurse positions were vacant as of November and December, according to the survey of nearly 70 medical providers that are members of the health system association. That’s up from 21% in 2019.

Among nurse support staff, 45% percent of jobs were empty. Need for those workers, which include positions such as certified nurse assistants and personal care assistants, has risen 13% from two years ago.

Open positions for clinical nurse specialists, who typically have more training than nurses, rose from 15% to 32% over the two-year span.

The survey results add numbers to recent warnings from health care executives, said Jeffrey Bechtel, health economics and policy vice president at the association, which lobbies for state policies.

“This is a problem that existed before the pandemic, the pandemic really made a difficult problem even more severe, and we’re really focused on the solutions,” Bechtel said.

Those solutions often involve money, and Bechtel applauded the state legislature and governor for recently granting health systems $225 million to retain workers.

Long-term solutions to the issue are complex and include things like expanded use of telemedicine, student loan debt relief, worker incentives and making it easier for practitioners to get licenses, Bechtel said.

Health systems have responded to the need for nurses by hiring temporary workers from nurse staffing agencies. For example, Geisinger and Penn State Health were able to lower vacancy rates to around 20% using staffing agencies, according to executives there.

However, those agencies also significantly raised their rates, a concern for hospitals, the report states.

Nurse union PA SNAP said that nurse-patient staffing ratios are another step needed to prevent worker burnout.

“Recent reports by the non-partisan Joint State Government Commission found that for every patient added over four per nurse, the risk of death increases dramatically,” the union said in a statement provided by a spokesperson. “Chronic understaffing also increases medical errors, patient complications, and caregiver burnout.

“Nurses are fleeing the bedside because they don’t want to risk their patients’ safety or their license by working in unsafe conditions. We need minimum safe staffing standards to stop nurses from leaving the bedside, and to give them a reason to come back.”

The health system association opposes legislation to mandate those ratios. That bill has been held up in the state House Health Committee for a year.

The report also detailed a striking rise in violence against health care workers.

Sixty-four percent of hospitals reported “a significant increase” in violence against front-line staff. Among emergency room staff, 77% of hospitals said there was a significant increase, while 70% of hospitals said medical-surgical staff faced similar upticks in violence.