The nursing shortage is a pressing reality for hospitals across Washington.
A recent survey from the Washington State Hospital Association, which included responses from 80 hospitals that have 85% of the beds in the state, found that 6,100 nursing positions are vacant at these facilities.
And while there are nearly 3,000 traveling, temporary nurses working at hospitals, there are more than 3,000 vacancies when they are accounted for.
Chelene Whiteaker, senior vice president at the Washington State Hospital Association, said the results were "jaw-dropping," especially because the survey focused solely on nurses. That means other staff shortages reported among certified nursing assistant, housekeeper or other hospital roles aren't included.
The hospital association does not have nursing vacancy data to compare these figures to, but Whiteaker said "we would have never seen numbers like this."
The survey asked hospitals how long it took them to recruit new nurses.
In 2019, it took a hospital 74 days on average to fill a registered nurse vacancy. In 2021, that time increased substantially — it now takes a hospital 114 days, nearly four months, to fill a nursing job.
"When we see the demand is outstripping supply, which is what's happening with the workforce here, the time to fill positions starts increasing," Whiteaker said.
Hospitals and the health care sector broadly have warned of the departure of staff, including but certainly not limited to nurses, due to burnout and the added stress of being a health care worker during the pandemic.
The parts of the hospital most impacted by COVID-19 are also the parts of the facility where nurses are leaving more often. The WSHA survey found that MedSurg (or general medical and surgical floors) had the highest turnover rates, followed by the emergency departments and intensive care units.
Nurses in these three settings have been triaging, treating and caring for COVID-19 patients for nearly two years.
In addition to burnout, COVID-19 placed extraordinary demand on traveling nurses to help with surges of patients needing virus treatment.
"What COVID has done is created demand outside of predictable patterns, and the number of people that are going to be sick is unprecedented," Whiteaker said.
So, what's to be done? The hospital association has a renewed focus on nursing education, supporting the increase of nursing program students, as well as incentivizing instructors to teach nursing students.
The nursing shortage existed in Washington and nationally long before the pandemic began, and fixing it takes time and money.
The way to graduate more nursing students is to hire more faculty, said Anne Mason, associate dean for academic affairs at the WSU College of Nursing.
"We have more qualified applicants than spots; we don't have faculty to teach more students and clinical spots to give them experience," Mason said.
Even with the pandemic, interest in the nursing program at WSU has not declined, she added, indicating that there is still a future workforce eager to be trained.
In order for universities to accept more nursing students, they need to hire and retain more staff who will teach and make a competitive salary doing so.
The Legislature raised nursing faculty salaries at community colleges in recent years, but state universities did not see similar pay bumps.
"That's an issue we have to contend with going forward, to find a way to fund nursing faculty salaries fully and more consistently across the state," Mason said.
Students also complete clinical placements at health care facilities, which are back despite the pandemic for WSU students. Whiteaker said hospitals represented by the association are supportive of being a part of the solution, particularly when it comes to clinical placements.
Leaders in this arena were meeting regularly to discuss solutions before the pandemic hit. Mason hopes those discussions can resume soon.
"I really hope that there's an opportunity to get back to some of our discussions about how we could do this different, better and in a unique way," she said.