There has been a shortage of nurses since the 1930s. While this situation sometimes get more or less bad, it’s a professional anomaly that’s never gone away. An example of how bad this has been in the past was that in 1945, there was fierce debate in the US Congress about drafting nurses for military service. This was controversial at the time because there was no draft for women, and virtually all nurses at that time were women. Now, that shortage is being talked about in the context of the Covid situation.

Defining what we mean is important. Technically speaking, there’s no shortage of nurses in the US. Approximately one out of every forty women in this country is a nurse – not to mention the men in my field. (I graduated from nursing school in 1980, and have been practicing professionally for over forty years). So, a “shortage of nurses” means there’s a shortage of nurses who will come back to work for the pay offered, and in the workplace conditions available.

America’s nursing shortage is complicated, and there are several possible reasons for the shortage. Let’s look at this in the Covid context.

1. Nursing salaries have not responded upwardly as quickly as would be expected, given a general tight labor market. $15 an hour pay has become a de facto minimum wage. Throughout history, nursing pay has tended to be around 3x the general pay scale, but many nursing jobs are still paying in the range of $30-40 an hour. Many nurses play the employment field by working as contract nurses and are able to demand $40-50 an hour salaries, but those who are normal hospital (or other facility) employees can’t usually demand that amount.
2. Most people are neither idiots nor saints. They will not work for an amount they deem too low. If a salary will not rise in response to market demand, the employee will often find another, less stressful job even if the salary is lower, if the employee views the stress or hours not worth the difference. (Most hospital and facility jobs involve sometimes working odd hours – nights, weekends, and holidays. And while some nursing jobs are not stressful, many are. Intensive care nursing, for example, is an extremely complicated position that involves juggling a huge number of factors. It’s easy to miss just one of those factors, and the outcome can be very bad for the patient involved).
3. Many medical companies are demanding a Covid vaccination for all employees. Whether that’s wise or not is another discussion, but medical professionals have proven to be some of the more skeptical about these vaccinations. Those who feel very strongly are beginning to leave nursing jobs. This in turn aggravates the shortage and remaining staff members are having to take up the slack. Then we have a possible snowball effect, increasing stress in the nurses who remain in those facilities. This in turn leads them to consider leaving their positions.

Medical facilities are by nature employee intensive. While there have been some efforts toward using robots in a few limited care situations, it’s unlikely to be much of a factor. Facilities cannot alienate nursing staff without some dire consequences. Those who ignore these factors do so at their own peril.