The COVID-19 pandemic has exacerbated the ongoing shortage of health workers, leaving many health care facilities short-staffed even as the number of nationwide coronavirus cases plummets, experts say.
"Nurse shortages are a long-standing issue, but because of COVID, it is anticipated to grow even more by next year," Dr. Ernest Grant, president of the American Nurses Association, told ABC News. "Nurses and other health workers are overworked and they are exhausted from the pandemic."
Although nursing wages have in many cases improved in recent years, many nurses and nursing assistants have struggled with low pay, long hours and inadequate staffing -- issues that were highlighted during the pandemic, but not addressed, Grant said. As a result, hospitals and long-term care facilities are continuing to see older nurses retire and others simply leave their jobs, said Grant.
"Some nurses had to consider a career change or had to retire during COVID-19 to not be directly involved with COVID-19 patients, and others just left in the middle of the pandemic because it was too much for them," Grant said.
In South Florida, hospitals have been struggling to keep nurses from leaving the workforce, said Jaime Caldwell, president of the South Florida Hospital and Healthcare Association.
"Staffing, especially nurse staffing, has been an issue for as many years as I can remember. But the pandemic made it worse," Caldwell said. "The pandemic caused a perfect storm in a sense -- we saw some nurses retire, others leave because of the risks the job involved, and others are leaving the field because of increasing work shifts."
COVID-19 burnout and fatigue are also playing a big role, said Caldwell.
"Employers need to start looking at personally tailored health care support for nurses, especially the ones that might be suffering from PTSD," Caldwell said. "What many health workers went through this past year was traumatic. They are stressed out and tired."
According to a recent Washington Post/Kaiser Family Foundation poll, 3 in 10 health care workers have considered leaving the profession, and 6 in 10 say the pandemic has burned them out.
Caldwell said that because many of the states that were hit the hardest by the coronavirus were offering high bonuses and hazard pay, many Florida nurses relocated to those areas, causing even more of a shortage at local hospitals.
"States like New York, California and Texas were promising wages up to $150 an hour to move to these locations. Not only were the wages much higher than what is paid locally but they were also having their housing and transportation costs covered," Caldwell said. "One could hardly fault them for taking advantage of those opportunities, but that definitely had an impact on local hospitals here."
Dr. Polly Pittman, director of the Mullan Institute for Health Workforce Equity at George Washington University, told ABC News that research she performed during the pandemic showed how poorly distributed health workforces are across the nation.
"It's not distributed by population need," said Pittman of staffing in health care settings. "It's distributed by where there happens to be hospitals that have a lot of resources. So there's an issue of hospitals with low resources struggling more when it comes to the availability of care during a pandemic and in normal times."
And staffing of nursing assistants, who make far less money, can be even more challenging. High turnover is especially common in long-term care facilities due to the low wages nursing assistants typically earn, experts told ABC News.
"Staff in nursing homes who have been on the front lines for months are not even making a livable wage," said Robyn Stone, co-director of the LeadingAge Long Term Services and Supports Center at the University of Massachusetts. "These are not low-wage workers; they are professionals being paid low wages. So there are incentives for them to leave and go to a place where they're going to get higher compensation."
According to the Bureau of Labor Statistics, certified nursing assistants who provide basic care to long-term care patients made an average hourly wage of $14.25 in 2019. In some states, some certified nursing assistants earn as little as $10 an hour.
"Nurses and nursing assistants are underpaid, undervalued, and do dangerous work every day," said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit that works to improve care for older adults. "Until we have career ladders and better pay, we will not make progress."
"The downstream effect of the nursing shortage on our ability to deliver safe care to our residents is real, with no end in sight," said Brian Cloch, CEO of Transitional Care Management, which manages large nursing home facilities. "We need a new approach for the workforce."