When the COVID-19 pandemic hit Oklahoma, it exposed several inefficiencies with the health care system. Most had already been known, but they were exacerbated by the virus outbreak.
One of the issues that has been amplified in the state is a nursing shortage. From Lawton to Tulsa, almost every hospital in the state is having to deal with a lack of Registered Nurses (RN) to fill shifts even as the COVID-19 numbers continue to rise.
“There are still hospital beds available,” said OU Chief COVID Officer Dale Bratzler. “One of the challenges has been staffing of hospital beds (given) Oklahoma’s nursing shortage state. So, having enough nurses to take care of and staff all of those hospital beds has been a bit of a challenge.”
With the shortage of nurses, Bratzler said that hospitals across Oklahoma are doing their best to recruit nurses to help staff “the additional beds that are necessary for COVID-19.”
As almost every county in Oklahoma is seeing a rise in cases, the demand for RNs far exceeds the supply.
According to Chris Ward, Chief Nursing Officer at Comanche County Hospital, this has been a problem that has been building for a few years for a variety of reasons. But one of the biggest factors is pay.
“We’re finding that registered nurses are getting siphoned off from Oklahoma to other states who are willing to pay more,” Ward said.
According to Nurse.org, the average pay for the 31,350 RNs in Oklahoma is $64,160. That ranks No. 41 out of all 50 states and the District of Columbia. California leads the way at $113,240. Hawaii is second at $104,060. Texas, which is one of the states who has been able to attract a high number of RNs from Oklahoma has an average salary of $74.540.
According to Ward, RN salaries in Oklahoma have stayed stagnant since the state declined Medicare Expansion in the Affordable Care Act.
“All that does is give you more money to spend on healthcare,” said Ward. “If you’re looking at wages, that’s one of the areas to spend money on [but] if the health insurance companies or the state doesn’t have it to spend, you can’t raise wages, you can’t really give more benefits to your registered nurses.”
When the pandemic hit and other parts of the country start searching for RNs, Oklahoma has found it difficult to retain their staff.
“We lost nurses to other places. I’ll tell you we lost 12 nurses just because they were able to find a temporary job elsewhere that has really a high COVID-19 pay. And I’m talking $5,000 a week high COVID-19 pay.”
Despite wanting to keep his staff intact, Ward said he can’t blame any nurse who makes the decision to leave. However, money is not the only issue that caused the nursing shortage. According to HealthStar International, a staffing agency for health care workers, retiring nurses are not being replaced quickly enough.
As of 2019, only 77% of Oklahoma’s licensed nurses are residing in the state and still employed in the nursing profession, according to HealthStar International. Of that 77%, 17% have reached the retirement age of 60 or older and 18% are between the ages of 50-59. That adds up to 35% of the licensed nurses in Oklahoma being at or near retirement age.
“As many people are retiring as the new graduates are coming in,” Ward said. “I would say we’ve been tight for the last five to 10 years. The curve that shows you got this huge number of Boomers that are aging to the point of retirement. A lot of those Boomers were nurses and there just isn’t a generation following them that is large enough to even replace them all.”
Ward said CCMH is one of the few hospitals trying to attack the problem at the foundation. They have partnered with local colleges by providing funding. Western Oklahoma State College in Altus was able to hire two more instructors, which Ward says gave them the ability to add up to 30 more students in their nursing program last year.
While that is a long-term solution, there aren’t too many immediate answers to the current nursing shortage. CCMH has been looking to replace the dozen nurses they lost for some time, but it has not gone well.
“The only way that we’ve been able to meet the need has been to offer the overtime to our current staff,” Ward said. “And ask them if they would like to pick up in the extra shifts. We’ve been able to maintain everything that we were doing pre-COVID-19 and do it safely so that we really can make sure that patients are being taken care of.”