Unless you’ve paid a visit to a healthcare facility lately, you may not know that the state of Georgia, and Augusta specifically, is afflicted by one of the worst nurse shortages in the country. And this shortage can be felt everywhere from hospitals, hospice wards and clinics, to elementary schools. All signs seem to indicate that the nursing shortage is only going to get worse in the state for a number of reasons, which could present both challenges and opportunities.
The Hard Data on Georgia’s Nursing Shortage
Georgia has been suffering from shortages for a while, though it may not seem that way since there are around eighty thousand nurses in the state. The worst affected areas are Atlanta and Augusta. Augusta has at least several hundred unfilled nursing positions currently. The state of Georgia is expected to have the sixth worst nursing shortfall in the country by 2030. Some sources project a shortfall in 2030 of up to fifty thousand nurses below the number needed for proper patient care.
The Projected Shortfall
Georgia is also expected to have the sixth highest gap between supply and demand by 2030. There are around eighty thousand nurses in the state. The supply of nurses is projected to be just under a hundred thousand by 2030. The problem with this is that the demand for registered nurses is going to be well over a hundred thousand nurses. The state will need around ten thousand more nurses than it will have to meet the needs of an older, growing population.
Factors Driving the Georgia Nursing Shortage
There are tons of demographic shifts in the profession that are affecting the demand for new nurses as well. About sixty percent of registered nurses in the state are over fifty years of age. Young nurses are needed to fill in the gap as these nurses retire. Nationwide, there will be around a hundred thousand job openings coming onto the market to replace the Baby Boomers who are retiring. Yet there are not enough young nurses in the pipeline.
An ironic contributing factor is the lack of nursing school faculty. The tragedy is that there are students interested in becoming nurses, but almost half are turned away due to a lack of instructors and attendant classroom slots.
Nursing instructors typically earn as much as registered nurses, but specialized nurses earn more. This has led many nurses to earn specializations instead of teach the next generation of nurses. Compounding the nursing instructor shortage is that their demographics mirror that of nurses overall; many nursing professors are retiring, and there are not enough nurses with masters and doctoral degrees to replace them.
The economic incentives for nurses moving into specializations are strong. Registered nurses earn around 65,000 dollars a year. Nurse practitioners can earn 100,000 dollars a year and sometimes more. Family nursing practitioners, or nurses working in primary care in lieu of physicians, are in high demand. As a result, more students in the state are deciding to pursue family NP programs online to address the shortage of nursing instructors. Online nursing courses allow them to get the same credentials as their nursing school counterparts, without having to go through the same grueling admission process.
Another major issue is that many nurses who earn master’s and doctoral degrees that could allow them to work as de facto primary care physicians or instructors often move out of state. If every nursing program kept up its current graduation rates and no one left the state, Georgia would still have a nursing shortage because of the growing demand from an expanding population. The state’s population grew about one percent a year since 2010.
Georgia has a relatively unhealthy population as well, which puts even more pressure on the system. It has the highest rate of pregnancy related deaths in the country. The state’s death rates for diabetes, HIV and heart diseases are much higher than average. This explains why Georgia ranked 41 out of the 50 states in terms of health. More nurses and nurse practitioners would bring down those rates, but they currently contribute to a higher caseload per capita.
The largest association of registered nurses suggests having four patients for every nurse. Many facilities report a caseload of five patients per nurse. This adds to the stress level of nurses, and it can adversely affect the quality of care patients receive. A side effect of the retirement wave as Baby Boomers leave the workforce is that hospitals lose their most experienced nurses, though they are gaining patients. This adds to the stress and odds of burnout of younger nurses.
Solutions in the Works to the Georgia Nursing Shortage
Some universities have announced new accelerated programs that will help nursing students earn a Bachelor of Science in nursing in just a year. These programs will allow those who have already earned a bachelor’s degree in another year to switch to nursing. Other schools are receiving grants to attract new students. There are several programs to introduce nursing to high school students. At the other end, healthcare systems are offering tuition reimbursement programs to improve the skill sets of their employees.
Several institutions are reviving their Candy Striper program to promote nursing to teens in the hope that more of them consider becoming nurses in a few years. Medical centers and nursing schools are collaborating to create a pipeline to move nurses from schools to medical providers.
The goal is to keep local nursing students in Georgia. Some facilities rely heavily on overtime, though this can contribute to burnout. Others try to rely on contract or traveling nurses to meet patients’ needs. This is more common in specialty areas within the hospital.
A few facilities have turned to international nurses, though this barely makes a dent in the vacancies. Another solution is improved scheduling and workforce management tools. These allow nurses from a broad area to cover open shifts. This can meet the needs of a facility without demanding overtime from existing staff or paying higher wages to travel and contract nurses.
State Laws are Also Contributing to the Issue
Other states allow nurse practitioners to run limited medical practices if they are within fifty miles of a supervising physician. There is discussion about adopting the same laws in Georgia, since the state currently requires nurses to work under the supervision of a physician.
However, they cannot order tests like MRIs, and they cannot write prescriptions for schedule two drugs. This puts hard limits on nurses who want more autonomy and may contribute to them working in surrounding states. It also means that nurse practitioners cannot work in under-served, rural areas to fill in the talent shortage there.
There are around ten thousand APRNs and nearly 200,000 nurse practitioners who could work in these areas if they were given more autonomy. It would also improve primary care for patients in a state that came in second to last in terms of primary care physicians per capita. By liberating nurses to provide primary care, this could also bring down the cost of care for many patients and help them get healthcare before their health has deteriorated.
There are other regulatory changes being discussed. For example, Georgia has some of the strictest nursing laws in the country. Some legislators are suggesting lowering the bar. If you have done the practicum for a semester and meet the minimum standards, you should be allowed to work instead of being told you are not good enough to be a nurse. This would allow more nursing students to actually become nurses.
Another problem is the burnout rate among new nurses. About one in five nurses leave their first job within twelve months. Some find a new job, but others leave the profession. Industry experts say that leaders in the field need to foster relationships with staff and remove barriers to their success.
Stress-management and providing more support for new and experienced nurses is a necessity. Facilities have to do what they can to manage the workload of nurses, though the lack of healthcare talent is taking a toll on healthcare providers. It feeds a downward spiral that many are working to correct.
Programs offering tuition reimbursement and listening to what nurses say they need would help to keep nurses by patients’ bedside. If more nurses earn advanced degrees, this could in turn alleviate the nursing instructor shortage. However, that is not going to significantly change until pay rates for nursing instructors go up.
If the state had more nurses offering primary and preventative care, then the overall health of the population would improve. This would reduce the demand for medical services, because people will be less likely to develop severe lifestyle diseases and would get treatment earlier rather than later. The greatest benefits would be seen in rural areas and among the uninsured population.
Georgia is in dire need of nurses now, and the shortage is only projected to get worse. There are solutions in the pipeline that temporarily fill in the gap, but major changes are needed to prevent things becoming untenable for nurses and patients alike.
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