RN Survey Hints at More Patients Per Provider and Fewer Bedside Nurses

The American Association of International Health Recruitment (AAIHR) is out with a new survey featuring responses from 1,000 nurses from all over the country. The results show just how much has changed since the start of the COVID-19 pandemic, and these providers are feeling the heat in more ways than one. The AAIHR is using the report to send an urgent message to lawmakers, health networks, and facility administrators that the U.S. needs more nurses now.

Burnout and Higher Nurse-Patient Ratios

The AAIHR is all about making sure the U.S. has enough providers to keep up with growing demand for healthcare services. The organization estimates that we will need 203,700 additional RNs every year to keep up with demand, and that around a million providers will retire by the year 2030.

According to the survey out today, 60% of respondents said that nurse-patient ratios have risen to unsafe levels over the past year.

Shari Costantini, RN and President of the AAIHR, said in a statement, “The availability of nurses was the preeminent concern for hospital administrators long before the coronavirus. But one year into the pandemic, the confluence of a historic staffing shortage with unprecedented workforce demands and emotional burnout is leaving patient bedsides unattended in virtually every pocket of the country.”

In addition, 78% of respondents said that the coronavirus has strained staffing in their units to “unsafe levels.”

Of the 60% that said nurse-patient ratios have increased, 83% reported a workload increase of two or more patients; 39% of all respondents reported a patient workload increase of three or more.

We know that worsening nurse-patient ratios undermines provider and patient safety. It can also worsen patient outcomes, especially when providers don’t have enough time to look after everyone in their care. The AAIHR added that the National Institute of Health has found that increasing a nurse’s workload by just one patient can lead to a 7% increase in patient mortality.

Ninety percent of respondents said their patients would benefit from having additional nurses on the floor, and 25% said they cannot provide adequate care to their patients.

The Beside Exodus

The survey paints a bleak picture of the future of bedside care in the US. A full 36% of respondents said they have or are considering leaving the bedside arena.

Bedside providers are among the most in-demand in the country. They spend more time with patients than any type of provider. They are also responsible for the more personal aspects of care, such as dressing, bathing, eating, and other essential tasks that often go unnoticed.

The AAIHR reports that if a third of bedside nurses decided to leave the profession, the U.S. healthcare system would essentially crumble unless “a massive pipeline of qualified talent is made available to healthcare providers.”

The pandemic, along with safety and health concerns, are pushing more providers away from bedside care. In fact, 59% of respondents said that they knew of a colleague in their unit or hospital who contracted the virus and became seriously ill; 20% said they personally knew a nurse who died of COVID-19.

What is the HWRA?

The AAIHR is one of the main proponents of the Healthcare Workforce Resilience Act, a stopgap healthcare proposal that would reserve previously unused visas for qualified international nurses to attract more talent to the U.S., so facilities and providers have the help they need to care for the population at large.

A bipartisan group of U.S. Senators, including Dick Durbin (D-IL), John Cornyn (R-TX), Patrick Leahy (D-VT), Todd Young (R-IN), Chris Coons (D-DE), and Susan Collins (R-ME), introduced the HWRA in Congress last week. The AAIHR believes the bill would recapture and reallocate 25,000 previously issued but unused immigrant visas for nurses and another 15,000 for doctors.

Costantini commended the bill, saying:

“Even before the coronavirus outbreak, the United States was projected to suffer a shortfall of 200,000 nurses. Now, with healthcare workers representing as much as 20 percent of all new infections across the country, clinician staffing has become a public health crisis of its own. This is a thoughtful, targeted solution that puts America on a war footing with the coronavirus by ensuring our hospitals have the front-line clinicians we need to treat historic levels of critical care patients at hospitals all across the country.”

The organization adds that there are thousands of qualified, experienced RNs and medical providers overseas that have passed the required background checks and English proficiency tests but are not able to enter the U.S. due to a green card freeze initiated by the State Department.

If the HWRA becomes law, every provider would have to meet certain requirements before emigrating to the US, including proof that they have graduated from an equivalent international medical program.

The survey is a wake-up call for everyone in the country. Unless the U.S. can recruit and retain a new generation of providers over the next few years, many nurses will likely have to care for more patients than they can handle.