According to a new survey from the University of Michigan, 40% of registered nurses in the state plan to leave their jobs within the next year, which would have a devastating effect on the local healthcare system. What’s worse is that nearly 59% of newly trained nurses ages 25 and under said they plan to quit within the next 12 months as well. The announcement set off alarm bells throughout the state with experts working to quell what could be a mass exodus.
The study was published in the journal Medical Care. It surveyed 9,150 licensed nurses in Michigan. The researchers also interviewed 1,224 nurses who left their jobs within the last two years. So, what does this tell us about the state of nursing in Michigan? Are these providers hanging up their scrubs for good or are they planning on looking for work in another state/facility?
“That really says to me that we have a problem with our workplace,” said Christopher Friese, lead author of the study. “There’s a lot of calls to increase the supply of nurses, add more students, add more slots at nursing schools and things like that.”
“And that’s all important, but if we don’t improve their working conditions, they’re going to leave in droves. So just as we bring the nurses in, they’re going to be very likely to leave,” added Friese, who is a professor of nursing, health management and policy at the University of Michigan and director of the Center for Improving Patient and Population Health.
“My colleagues have told me that they’re seeing nurses join a unit, go through the orientation process, and realize that it’s not for them and that they don’t like the working conditions and they leave soon thereafter. That’s new. I haven’t really seen that in 25 years.”
Records show the state has lost 1,700 hospital beds since 2020 due to staff shortages. This has led to longer ER wait times, a practice known as ER boarding, and unsafe working conditions for nurses, which is only making the crisis worse.
As of March 2023, there were approximately 27,000 job openings at hospitals across the state.
“Michiganders deserve local access to care from their hospitals, but that access has been threatened by a generational workforce shortage,” said Brian Peters, chief executive officer of the Michigan Health and Hospital Association. “While our members continue to work closely with the education community to expand opportunities in the talent pipeline, this funding plays a crucial role in ensuring the viability of hospital service lines and capacity.”
The state legislature is working to address the crisis by freeing up additional resources. It recently approved a spending package that includes $75 million in hospital staffing grants and $67 million in nursing home workforce grants.
With so many job openings, state facilities often find themselves competing over the same pool of talent, and there just aren’t qualified nurses to go around.
Friese called the current situation “a hiring spree and a hiring frenzy” due to the number of job applications.
“They’re working really hard to bring these folks in,” he said of the hospitals. “They spend a lot of time and money getting them trained, and then these folks are not there very long and say, ‘I’m doing something else’ and we start all over again.”
Friese said the 39% departure rate is an all-time high for the state and that chronic understaffing is largely to blame.
“Care nurses have responsibility for too many complex patients, and it’s simply been too much for them to handle,” he said. “They’ve handled it in silence for a long time, but when you survey them, that’s consistently for the last decade, been the No. 1 issue for them.”
The study also found that 60% of nurses said understanding and a lack of resources limits their ability to deliver adequate care. Another 43% reported experiencing emotional abuse on the job, 22% reported physical abuse, 10% reported sexual abuse, and 26% reported workplace bullying and harassment.
Safety continues to be a major concern for providers across the state. Eighty-four percent also said they are emotionally exhausted because of the job.
“They’re not listening to the front line, who has the best lens as to what the problems are, and they’re not acting on those concerns directly,” Friese said. “So, if I had one suggestion for health care executives, it’s this: Listen very carefully to your front line. They’re going to tell you where the problems are in your organization, and work really hard to tackle the issues that they bring to you.”
Friese said many of the problems could be solved if hospitals were forced to adopt minimum nurse-patient ratios and enact anti violence legislation.
He would also like to see hospitals build more slack into the system in case someone doesn’t show up for work.
“Instead of running at the bare minimum, what if we actually built some slack into the system and were able to have enough personnel so that nurses weren’t running from patient to patient and actually had the time and space they needed to care for these really complicated patients?” Friese asked.
“That’s going to take two things: It’s going to take health care executives acknowledging the problem and redirecting financial resources to that goal, and they’ve been reluctant to do that … because that’s expensive,” he added. “The second piece is we need to make sure that nurses and other health care workers are safe and supported in their workplaces.”
Despite all these challenges, Friese said he is still optimistic about the future of nursing in Michigan.
“The state of Michigan is not a nurse-friendly state from a policy perspective,” he said. “We’ve got outdated nurse practitioner legislation. We don’t allow RNs (registered nurses) to practice across state borders like other states. We can improve the situation if we focus our efforts. I’m optimistic that things will get better, but it’s going to take effort and it’s going to take help.”