Florida will be short nearly 60,000 nurses by 2035, report says

TALLAHASSEE — Florida didn’t have enough nurses before the COVID-19 pandemic. It doesn’t have enough nurses today. In a decade and a half, the shortage could be catastrophic.

That’s the main takeaway from a report commissioned by the Florida Hospital Association and the Safety Net Hospital Alliance of Florida on the nursing shortage in the Sunshine State. With too few nurses entering the profession and so many leaving in droves, the state is projected to be short 59,100 nurses by 2035, the report says.

The organizations plan to release their findings Thursday morning. The Times/Herald obtained a copy in advance of its public release.

In some ways, the shortage has been decades in the making. Nursing is a demanding job that requires a blend of patience, diligence and emotional stability, observers of the health care industry say. It also requires a robust educational pipeline. Colleges and universities have to be able to hire enough faculty members to train thousands of new nurses every year.

The coronavirus pandemic, which has killed more than 56,000 Floridians, disrupted all of that. Many nurses fled the trauma of the emergency department or took better paying travel nurse jobs in other cities or other states. Multiple school years disrupted by outbreaks and state funding uncertainty made it more difficult for caregivers to send newly minted nurses onto the front lines.

“The pandemic was a gasoline can over the fire,” Florida Hospital Association President and CEO Mary Mayhew said in an interview.

The shortage is not unique to Florida, Mayhew noted. But as the state — particularly its senior population — continues to grow rapidly, its nursing workforce must grow with it. That’s not happening. According to the report, Florida would need to add 4,000 more nurses to the workforce per year for the next decade and a half in order to achieve adequate staffing levels by 2035.

Willa Fuller, executive director of the Florida Nurses Association, said nurses are not primarily motivated by money. It’s a mission-driven profession.

During the pandemic, many nurses suffered because their jobs became less fulfilling. Instead of close interactions with patients, nurses were forced to keep their distance while extremely ill people flooded their hospitals. Keeping isolated COVID-19 patients alive was, at its worst, as monotonous as it was traumatic, Fuller said.

Even during non-pandemic times, if Florida wants to keep nurses on board, it has to make the profession less monotonous, Fuller said. Nurses face too much red tape, and too many minor bureaucratic tasks that prevent them from caring for patients, she said.

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“We have to make nursing a profession where, when you leave, you might be tired, but you leave feeling satisfied and accomplished,” Fuller said.

Marissa Lee, a registered nurse at Osceola Regional Medical Center in Kissimmee, said unsafe conditions in hospitals have forced nurses from the workforce during the pandemic. She attributed this problem to the “greed” of hospitals, which she said are more interested in protecting their bottom line than keeping their workers safe.

During a phone interview Wednesday, Lee, a member of the union National Nurses United, said she got a call from her boss asking her to work on her day off. She declined, then continued the interview.

Mayhew disputed the characterization that hospitals are motivated primarily by greed. She noted that hospitals “jumped through hoops” to get personal protective equipment for staff during the early days of the pandemic, and contended that infection controls largely kept staff from contracting the disease.

Although staffing is a challenge today, the solution to the nursing shortage must come from long-term thinking, said Justin Senior, CEO of the Safety Net Hospital Alliance of Florida. Hospitals must consider how to improve retention rates. Lawmakers, meanwhile, have to mull policy options that will encourage educational institutions to train the nurses of the future. As the report notes, the nurses of 2035 just started kindergarten.

“You can’t snap your fingers and bring people into the profession right away,” Senior said.

The new report comes with nine recommendations for Florida and its health care industry. Some urge officials to get a better handle on the problem: The report recommends surveying nurses every time they renew their licenses. Another recommended study would shed light on the state’s low nursing examination pass rates.

The report does not come with a specific ask to the Florida Legislature, said Lindy Kennedy, the Safety Net Hospital Alliance’s president and chief operating officer. But with all health care issues, funding is likely to play a big role. Colleges and universities could use more money to hire nursing school professors, for example, Senior said.

The issue is also intertwined with myriad other larger Florida challenges. Maintaining the supply of affordable housing is a must if the state wants a robust nursing workforce. Providing Floridians with better access to care could exacerbate the need for nurses, the study notes. If Florida wants to keep growing, it’s going to need nurses, Mayhew said.

“When companies relocate, one of the first things they look for is the availability of health care for their employees,” she said.

The report, which was conducted by the consulting firm IHS Markit, is based on data that was collected before the COVID-19 pandemic. The firm used state numbers to model projected supply and demand for registered nurses and licensed practical nurses into the future, and mapped shortages across Florida.

Generally, the firm projects that rural areas are likely to be woefully short of registered nurses — a classification of nurses who generally are paid more and are more likely to work in hospitals. Urban areas, meanwhile, will have a more pronounced shortage of licensed practical nurses, who generally work in office or long-term care settings, and are often supervised by registered nurses.