WASHINGTON—A groundbreaking new report bringing together data and testimony from frontline healthcare workers details crippling shortages across the healthcare industry, revealing dangerous conditions for patients and healthcare professionals alike, exacerbated by profit-driven corporate leadership in the healthcare field.
According to the report, nurses and other healthcare workers are exhausted, burnt out, anxious and leaving the profession in droves, a trend that began long before the COVID-19 pandemic and can be addressed with a series of key interventions and policy recommendations outlined in the document.
The numbers show that since the beginning of the pandemic, nearly 1 in 5 healthcare workers have quit their jobs. Of healthcare workers who stayed in their jobs, nearly 1 in 3 have considered leaving at one point. And between 2020 and 2021, the total number of registered nurses in the workforce declined for the first time in more than five years. Many described workplaces where they were routinely exposed to increasing levels of workplace violence; patient loads stretched to unprecedented and unsafe levels; and an overall sense of exhaustion, moral injury and distress at the demands of their job—a job they love doing but say they cannot continue without additional support from their employers.
“Healthcare professionals knew long before COVID-19 that working conditions had been deteriorating for years,” said AFT President Randi Weingarten. “Then came the pandemic. For nearly three years, they’ve worked under unprecedented challenges—while for-profit institutions made record profits. Many healthcare workers are emotionally exhausted and heartbroken from trying to care for your patients under impossible conditions. Understaffing is the core problem, which leads to other horrible conditions like crushing workloads, mandatory overtime, extended shifts lasting 12 to 16 hours, constant fatigue, worker injuries and skyrocketing rates of violence against healthcare workers, making hospitals one of the most dangerous places in America to work.”
“But let’s be clear: This is a crisis of the healthcare industry’s own making. The problems driving the ‘great resignation’ are fixable. They stem from a corporate healthcare industrial complex that puts profits over patients.”
Data proves that this is a patient safety crisis. Adding just one additional patient to a nurse’s workload results in a 7 percent increased risk of a patient dying within 30 days of admission and a 48 percent increased risk of a child being readmitted to the hospital within 30 days.
“The consequences of this chronic understaffing can be deadly, but the problem is solvable,” added 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.”
The report includes a menu of proven strategies, a road map at every level—national, state, sector and facility—to address this full-blown crisis:
Improving recruitment (and diversity in the workforce), with strategies like high school career and technical education programs, apprenticeships and nursing bridge programs.
Expanding targeted financial aid and loan repayment programs, including the National Health Service Corps and the Nurse Faculty Loan Program.
Enacting federal and state laws mandating safe staffing ratios for the whole care team, putting safe staffing requirements into governmental regulations, and negotiating safe staffing levels in collective bargaining agreements.
Banning mandatory overtime through a wide-ranging approach: federal and state legislation, regulation and collective bargaining agreements.
Pushing Congress to pass the federal Workplace Violence Prevention for Health Care and Social Service Workers Act, and working with state legislatures on greater safety protections.
Pushing for pandemic protections in federal law, such as an Occupational Safety and Health Administration standard and the Centers for Medicare & Medicaid Services emergency preparedness rule.
Advocating for funding and programs to support health professionals’ mental health.
Working at the federal and state levels to increase oversight of mergers and acquisitions in the healthcare industry, including the impact on patient care.
Making shared governance part of the collective bargaining agreement—like the partnership between Kaiser Permanente and our Oregon Federation of Nurses and Health Professionals and other unions.
And last but far from least, championing the right of healthcare workers to form unions, and fighting employer union-busting tactics.
“If you’ve had any conversation over the last 24 months with a frontline healthcare worker, you’d hear the deep frustration and anger with their employers and the sheer mental, physical and emotional exhaustion,” said John Brady, AFT Connecticut vice president and co-chair of the AFT RN Program and Policy Council and the Healthcare Program and Policy Council. “I’ve heard countless heartbreaking stories from our members, like one nurse in Connecticut who was assigned to 11 patients at once. This is not only dangerous to healthcare workers, but it leaves the patients they care for exposed to further injury and illness. It’s high time we put patients and our own frontline heroes over profit and demand the safe patient limits they deserve.”
“The COVID-19 pandemic revealed a healthcare system woefully unprepared for crises, exposing chronic understaffing in our nation’s healthcare facilities that existed well before the pandemic,” said Anne Goldman, a United Federation of Teachers vice president and co-chair of the AFT RN Program and Policy Council and the Healthcare Program and Policy Council. “What’s worse, as the report details, is that the long-standing crisis is completely of healthcare employers’ making, and a direct result of their decisions to put revenue ahead of patients and frontline caregivers’ well-being. Our hope is that this report helps frame the national discussion about the staffing crisis and provides a road map to fixing the chronic problem.”