Nursing Shortage Impacting California Health Care Providers

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Nursing Shortage Impacting California Health Care Providers

A nurse cares for a COVID-19 patient at Providence Holy Cross Medical Center in the Mission Hills neighborhood in Los Angeles, Calif., on July 30, 2021. (Mario Tama/Getty Images)

Travis Gillmore

Travis Gillmore

8/16/2023

Updated: 12/30/2023

Health care systems across the state are struggling to meet demand due to a shortage of registered nurses and growing discontent in the field, according to a recent survey (pdf) conducted by AMN Healthcare—a health care staffing firm based in Dallas.
The report found 94 percent of nurses believe there is a severe or moderate shortage of nurses in their area, with half of them saying the shortage is severe. Nearly 90 percent say the nursing shortage is worse than five years ago, with 80 percent expecting it to get much worse or somewhat worse in the next five years.
Such significant shortcomings are derived from an aging workforce, lack of educational opportunities, and shifting health care needs following the pandemic, according to the research.
Survey responses indicate that pandemic-related stress caused many nurses to shorten their careers, with many citing social distancing and personal protective equipment requirements, staffing shortages, and potential for exposure as reasons they chose to either cut back on hours or retire.
Combined with more people seeking medical care in subsequent years, the shortfalls further complicate the health care system, according to experts.
A nurse wears an identification tag at UCI Medical Center in Orange, Calif., on April 13, 2022. (John Fredricks/The Epoch Times)

A nurse wears an identification tag at UCI Medical Center in Orange, Calif., on April 13, 2022. (John Fredricks/The Epoch Times)

Research from the University of California–San Francisco supports the survey results, showing a shortage (pdf) of approximately 19,000 licensed nurses statewide—with statistics revealing a disproportionate number of older nurses retired in recent years or intend to retire soon.
More than 85 percent of nursing professionals reported to the AMN Healthcare survey that they are considering changing jobs or potentially retiring, with only 15 percent saying they intend to stay with their current employers.
Hospital administrators ranked nurse staffing as the most pressing problem, with 90 percent of CEOs saying that shortages are their biggest concern.
CalMatters reported nursing vacancy rates in Southern California currently exceed 30 percent—as compared to 6 percent before the pandemic—according to the Hospital Association of Southern California.
Limited space in university nursing programs also contributes to the nursing shortage, with schools lacking the educators needed to provide more opportunities, say experts.
State leaders acknowledged the nursing predicament in 2005 with the passage of the California Nurse Education Initiative—designed to improve educational programs and increase enrollment opportunities.
Nurses wait outside the Burn Recovery area of UCI Medical Center in Orange, Calif., on April 13, 2022. (John Fredricks/The Epoch Times)

Nurses wait outside the Burn Recovery area of UCI Medical Center in Orange, Calif., on April 13, 2022. (John Fredricks/The Epoch Times)

Multiple health care workers in the Bay Area told The Epoch Times they’ve wanted to advance their careers and become registered nurses, but they blamed lottery systems used to determine admission at some nursing schools for the delay in their progress.
“They don’t even look at grades. It’s just random as to who gets in, and I’ve been denied twice,” patient care coordinator Maria Garcia said. “It’s not fair to those of us who tried hard and scored high on our tests. We deserve a chance.”
More than half of the 77 nursing programs surveyed (pdf) in 2019 by California Community Colleges reported they use multi-factor admissions criteria, including grade point averages, while up to 30 utilize other processes, including lottery enrollment.
In annual reports to the governor dating back more than five years, the community college group notes the progress made and the need for increased funding and support from the state to overcome nursing shortages.
Delaying educational progress for prospective nurses is a compounding problem, especially given the advanced age and retirement rate of nurses today, according to experts.
Bills introduced this year by California legislators at the federal level seek to address the need for more educator and nursing programs across the country.
Rep. Adam Schiff’s (D-Calif.) Support Access to Nursing School Act would fund nursing school instructors, and Rep. Jim Costa’s (D-Calif.) newly introduced National Nursing Shortage Task Force Act is aimed at assessing the situation and bolstering educational opportunities.
A nurse performs range of motion exercises on a COVID-19 patient in the Intensive Care Unit at Sharp Grossmont Hospital amidst the coronavirus pandemic in La Mesa, Calif., on May 5, 2020. (Mario Tama/Getty Images)

A nurse performs range of motion exercises on a COVID-19 patient in the Intensive Care Unit at Sharp Grossmont Hospital amidst the coronavirus pandemic in La Mesa, Calif., on May 5, 2020. (Mario Tama/Getty Images)

“We have a nursing shortage in our country, fueled by the pandemic and burnout. As a result, hospitals and clinics are in crisis and rationing care because there are simply not enough nurses,” Mr. Costa said in a June 26 press release announcing the proposal. “My legislation will help develop a roadmap to bolster the nursing workforce and improve access to care.”
Disparities in pay between educators and clinical nurses is also fueling the shortage of educators, and thus worsening the nursing problem, according to experts.
“Schools have been unable to meet all the demand because we cannot recruit faculty to teach the students—clinical nurses earn significantly more than the teachers who instruct them,” Gina Intinarelli-Shuler, associate dean at the UCSF School of Nursing, said in UCSF Magazine. “It’s challenging, but our senior nursing leaders are putting together a comprehensive workforce recruitment, retention, and training plan.”
Travel nurses are filling the void in many instances, with licensed professionals signing contracts of varying lengths with health care providers. Representing less than 2 percent of nurses in 2019, travel nurse hiring surged in 2020 and 2021.
With increased demand for health care workers, and a bottleneck in educating and licensing new nurses, a series of proposals in the state Legislature seeks to minimize the impact of the ongoing shortage.
One such measure, Assembly Bill 698—introduced by Assemblywoman Wendy Carrillo (D-Los Angeles)—would require community colleges to set aside 15 percent of enrollment opportunities for health care workers.
Another proposal, Assembly Bill 1695—authored by Assemblyman Mike Gipson (D-Carson)—would create a pathway to nursing for high school students.
Nurses sit in front of UCI Medical Center in Orange, Calif., on June 3, 2022. (John Fredricks/The Epoch Times)

Nurses sit in front of UCI Medical Center in Orange, Calif., on June 3, 2022. (John Fredricks/The Epoch Times)

One potential short-term solution employed by some systems is the use of retired nurses for non-bedside care, a tactic that UCSF is using successfully and plans to expand, according to veteran nurse Ms. Intinarelli-Shuler.
“We are doing that now and have found that many retired nurses are willing to help,” she said in the interview with UCSF.
Another health care insider described a change in company culture that arose with the nursing dilemma, allowing some employees to take advantage of relaxed rules and limited enforcement due to staffing shortages.
“There are people here that would have been fired four years ago for their poor performance and bad behavior,” a staff member at a large hospital group in the Los Angeles area, who asked for anonymity in fear of workplace retaliation, told The Epoch Times. “Coming in late, missing shifts, no excuses, and repeat tardies were all serious offenses before, and now it’s become normal.”
Travis Gillmore

Travis Gillmore

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Travis Gillmore is an avid reader and journalism connoisseur based in California covering finance, politics, the State Capitol, and breaking news for The Epoch Times.

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