Nursing Shortages 

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Nurses are the backbone of any hospital or clinic, and they are often the first face that critically ill or injured patients see when there is a medical emergency.

But what if there weren’t enough nurses to gather the necessary information for medical treatment and to be that critically calm presence for the sick, hurting, or dying?

Dr. Rene Luna, who practices obstetrics and gynecology in McAllen, fears that hospitals in the Rio Grande Valley could be experiencing the early stages of this right now.

“Is there a healthcare crisis? Yes, but it was already here before COVID-19,” he said. “There was a shortage of doctors before COVID-19 and a shortage of nurses before COVID-19.”

According to Cindy Zolnierek, CEO of the Texas Nurses Association (TNA) in Austin, the shortage of nurses in every phase of the healthcare industry began between 2001 and 2003, which prompted the TNA to work with state lawmakers to establish the Nursing Shortage Reduction Program in 2003.

The program incentivizes schools to increase the number of nursing candidates to graduate.

Zolnierek said there are a number of factors contributing to the nursing shortages statewide, which include the number of baby boomers retiring and the increase of people moving to Texas from out of state.

However, the impact and lingering effects of COVID-19 have also taken their toll on the nursing profession.

“The border counties and those counties in the Valley have been those most affected by the nursing shortage,” she said.

The pandemic only made things worse. Dr. Luna — who not only runs a busy private practice, but provides services to patients at four area hospitals — said it was “all hands on deck” when COVID-19 began ravaging the local population.

Healthcare professionals worked tirelessly during the pandemic and the long hours and near-constant exposure to seriously ill patients and death began to take its toll.

“We had appropriate PPE, however we were in direct contact with the very sick COVID-19 patients almost every second of the day,” Dr. Luna said. “As time went on, and the pandemic went on, people began getting fatigued from the long hours…There was physical fatigue and mental fatigue that came from seeing people die all the time.”

The constant exposure to COVID-19 patients meant that many of those frontline nurses would themselves become sick from the virus. Some of them didn’t return to nursing when they recovered, others who could retire did and others who’d become physically and mentally overwhelmed simply left the profession.

“We are still feeling the effects of this shortage two years after the start of this pandemic,” Dr. Luna said.

Despite the ravages of the pandemic, the nursing profession has endured more than 20 years of chronic and cyclical shortages.

According to data from the Texas Center for Nursing Workforce Studies, the number of registered nurses working in the RGV increased by 26.1% between 2010 and 2019.

In February, the TNA and the American Nurses Association joined forces and called on congressional lawmakers to address these shortages.

“The unprecedented demands of the pandemic place nurses in extremely difficult positions as they work too many hours, see higher acuity of care, face staffing challenges, and experience increased workplace violence,” Zolnierek said. “The nursing workforce is straining under the weight of the pandemic, and nursing turnover and staffing shortages are widely reported.

“The proper solution is increasing the supply of nurses through support for nursing education, providing appropriate compensation and improving nurses’ working conditions.”

Zolnierek said the nursing profession still attracts a lot of candidates who want to make a difference, but as many as 10,000 each year are turned away because there isn’t space for them due to not having enough hands-on clinical experience.

Other issues that should be addressed, Zolnierek said, include the lack of retention of experienced nurses, scheduling and professional support, and the assurance of a safe working environment.

Bryan Kirk