The Impact of COVID-19 on the Nursing Workforce: A National Overview

Abstract

The COVID-19 pandemic has had a significant and negative impact on the nursing workforce. Immediate and long-term actions must be taken to mitigate the adverse effects of the pandemic. Understanding these effects in various contexts is essential to conduct research, implement innovative interventions, and create supportive policies. This article provides a comprehensive overview of the issues in the framework of six key areas of the HealthImpact Workforce Strategy Model, including K-12 and second-degree students, pre-requisite nursing education, and pre-licensure nursing education; upskilling the existing workforce; retention and well-being; and migration of nurses. We also discuss expanding advanced practice registered nursing scope of practice; crisis standards of care; and the impact of telehealth. Exemplars highlight the issues, and document action and innovation in the domains of workforce strategy, education, research, and policy in these challenging times.

New graduate registered nurses: Risk mitigation strategies to ensure safety and successful transition to practice

“…1 To date, challenges remain in nursing education with a reduction in clinical placement availability that result in higher utilization of virtual simulation and telehealth to bridge gaps and advance the development of clinical judgement. 2 NGRNs report they do not feel nursing school prepared them for a pandemic, 3 and they have concerns about personal safety and the safety of others. 4 These new graduates are entering practice with varied clinical experience, and most will have had less clinical education than graduates before them.…”

“…Virtual simulation is widely used to meet course objectives and advance the development of clinical judgment. 2 More research is needed to assess the overall quality of virtual didactic education vs. face-to-face instruction and the differentiation of the impact on various types of nursing classes. 2 A major indicator of the preparedness of new graduate nurses is the national council licensing exam for registered nurses (NCLEX).…”

“…2 More research is needed to assess the overall quality of virtual didactic education vs. face-to-face instruction and the differentiation of the impact on various types of nursing classes. 2 A major indicator of the preparedness of new graduate nurses is the national council licensing exam for registered nurses (NCLEX). The NCLEX® exam is developed to assess minimum knowledge, skills and abilities required to deliver safe, effective nursing care for entry level nurses.…”

“…These disruptions included limited time to learn the essential skills of prioritization, organization, clinical judgement, clinical reasoning, and interprofessional communication, with peer support 1 . To date, challenges remain in nursing education with a reduction in clinical placement availability that result in higher utilization of virtual simulation and telehealth to bridge gaps and advance the development of clinical judgement 2 …”

Relational leadership

“…To translate the monumental nature of these statistics, consider this: if there are approximately 4 million nurses in the US, and 22% of frontline nurses along with 20% of nurse leaders either plan to or are considering exiting their jobs, this equates to an astounding migration of 1,680,000 nurses 1,4,5. Leaders have valiantly tried to mitigate the exodus with a mix of innovative strategies, such as offering mental health support, flexible scheduling, and bonuses; increasing float pools; adding support staff; and partnering with nursing schools to increase output 2,4. The verdict is still out on the effectiveness of these operational strategies.…”