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Nursing shortages threaten hospital norms. A new leadership council can help strengthen the caregiver pipeline

A photo of UNC REX Hospital in Raleigh.
Alan Wolf
UNC Health
A photo of UNC REX Hospital in Raleigh.

During the pandemic, Dr. Padma Hari noticed a disturbing trend. The cardiologist at WakeMed Heart & Vascular said patients were so sick, they needed one-on-one care, exacerbating a shortage in nursing staff.

“Typically in the ICU, you have like one nurse for every two patients. But because of the protocols where you had to isolate a nurse, you could not do that. So, the ratio changed,” she said.

Shortages in nursing staff aren’t unique to just WakeMed — they’re happening all across North Carolina. That’s why the North Carolina Department of Health and Human Services and the North Carolina Department of Commerce are starting the Caregiving Workgiving Strategic Leadership Council aimed at strengthening the pipeline of caregivers in the state.

NCDHHS Secretary Kody Kinsley said the group has members from multiple state agencies and higher education institutions, including the UNC System and the North Carolina Community College System.

“This is a workforce that not only is about economic development and output in North Carolina,” Kinsley said. “The healthcare industry is massive and has a lot of impact from an economic perspective, but we also know that there's a double value here — you can't have a healthy North Carolina unless you have a workforce that helps make that possible.”

A UNC Sheps Center study projected a shortage of over 12,000 registered nurses and 5,000 licensed practical nurses within the next decade. Research from the Paraprofessional Healthcare Institute — a nonprofit group that works to promote quality direct care jobs — placed North Carolina No. 47 out of 51 states including Washington, D.C. in terms of how well its public policies support direct care workers and how those workers are faring financially.

Cynthia Straka, a registered nurse and nursing supervisor at UNC Rex Hospital in Raleigh, said a decline in nursing staff could be attributed to the costs of going to college for a bachelor’s degree in the field and inadequate compensation. Straka said that hospitals have been using travel nurses — nurses who travel to work in temporary positions — to fill in the gaps.

“The problem with travel nursing is that when that contract is up, then you're right back where you started and that position is an open position,” she said. “And sometimes when that staff leaves, whether it's a travel nurse, or even regular staff when they give their notice and they leave, it can be anywhere from probably three to four months before you have somebody hired in that position.”

Courtney Schile, a registered nurse and assistant nurse manager at Duke University Hospital in Durham, said she wants to see the council promote a positive image of nursing and nursing school.

“I think if the council really wanted to figure out how [to bring people into nursing], they would go into schools and figure out what made those nurses or nursing students get into it, or even go to hospitals and talk to new grad nurses and say, what made you decide to go into nursing?” Schile said.

A spokesperson with the NCDHHS said the council will use data and expert input to develop strategies to improve recruitment, retention and wages for direct care workers.

Meanwhile, the North Carolina Chamber Foundation — a statewide business advocacy organization — and the North Carolina Center on the Workforce for Health have launched a public-private partnership with the goal of recruiting and retaining talent in healthcare. That partnership seeks to identify and fill in gaps in healthcare training, create support systems to help people work through those trainings and collaborate with employers to improve retention, among other strategies.

Uma Bhat was a daily news intern with WUNC during the spring 2023 semester. At the time, she was a sophomore at UNC-Chapel Hill studying journalism and data science.
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