Emergency department responses to nursing shortages

Area of Science:

• Healthcare Management
• Emergency Medicine
• Nursing Workforce

Background:

• The COVID-19 pandemic intensified existing nursing shortages.
• Significant nurse retirements are projected within five years, worsening the crisis.
• Limited information exists on interventions for emergency departments (EDs) experiencing sudden nursing deficits.

Purpose of the Study:

• To investigate the impact of nursing shortages on ED operations.
• To identify real-world interventions used by ED leaders to address nursing shortages.

Main Methods:

• Survey of emergency department leaders affiliated with the American College of Emergency Physicians.
• Data collection on the effects of nursing shortages and implemented mitigation strategies.

Main Results:

• Nearly all respondents (98.5%) reported nursing shortages, with 83.3% experiencing prolonged deficits (>12 months).
• Negative impacts included increased "missed/near-miss" events (93.9%) and higher "left without being seen" rates (90.9%).
• Interventions comprised operational flow adjustments, use of alternative staff, recruitment from atypical pipelines, pay increases, and improved work environments.

Conclusions:

• ED leaders employed a variety of strategies to combat nursing shortages.
• The efficacy of these interventions varies across different ED settings.
• Personalized approaches are crucial for effectively managing sudden nursing shortages in EDs.