A Preliminary Examination of Healthcare Facilities’ Nurse Staffing Strategies to Address COVID-19 Surges

Abstract

COVID-19 surge events exacerbated many healthcare facilities' pre-existing nursing shortages. To address staff shortfalls, nurse leaders adopted a variety of strategies to supplement their workforce. To identify and assess the interplay between board of nursing (BON) emergency guidance and the strategies healthcare facilities adopted to bolster their nursing workforce during peak pandemic periods. A national survey of nurse executives, as identified by the American Organization for Nursing Leadership, was conducted. Univariable and multivariable ordinal logistic regression models were used to evaluate the significance of observed trends. Half of the 391 nurse executives who completed the survey indicated that their facility needed to supplement their RN staffing during peak periods of the COVID-19 pandemic (n = 202, 51.7%). Most relied on hiring local experienced nurses (n = 111) or some combination of travel nurses (n = 61) or support workers (n = 60) to drive a median 10% increase in nurse staffing (n = 153, range 0%-100%). A large proportion of respondents also indicated their facility simply increased the work volume and hours of their current RN staff. Respondents rated retired nurses as significantly more competent relative to licensed new nurse graduates and pre-NCLEX new nurse graduates. Although the small sample limits the generalizability of these findings, preliminary evidence suggests recently retired nurses and prelicensure nursing students may provide valuable support services in the event of another public health emergency.