Nursing homes lose nurses

MYRNA BROWN, HOST: It’s Thursday the 15th of June, 2023. Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Myrna Brown.

MARY REICHARD, HOST: And I’m Mary Reichard. First up: losing the nurse in “nursing home.”

REICHARD: During the COVID-19 pandemic, nurses bore the brunt of caring for millions of patients. Over time, the strain burned out many of those frontline workers, who then left the profession in droves, leaving the U.S. with a severe nursing shortage. Back in April, the organization that certifies nurses made a startling announcement. Here’s audio from Good Morning America.

LARA SPENCER: According to a new survey by the National Council of State Boards of Nursing, 100,000 nurses quit the profession during the pandemic. And then 600,000 more nurses with at least a decade of experience plan to quit or retire in the next five years.

BROWN: Hospitals and doctor’s offices are recovering from the shortage, but nursing homes have not. They took the biggest hit – between 2020 and 2022, these facilities lost 15 percent - one-five- of their nursing staff, that’s over 200,000 people no longer caring for residents. And that’s bad news for families who either have a loved one in a nursing home or are planning to place someone there. Fewer nurses mean residents get less direct contact at a life stage when human connection is so important. In May, the U.S. Surgeon General warned that an epidemic of loneliness and social isolation is overwhelming the U.S., especially the segment of the population over age 65.

REICHARD: So what, if anything, can lawmakers do to help nursing homes give residents the care they need? WORLD Reporter Juliana Chan Erikson explains how legislators in Connecticut have tried to alleviate the problem.

JULIANA CHAN ERICKSON: The families went to these legislators in Connecticut saying that my mother and father are not being cared for in the nursing home. And the legislators read that to say, well, they just need nurses to spend more time with each resident. And so they came up with legislation that said, while the state requirement is that a nurse should spend three hours with each resident per day, let's increase that to 4.1 hours. And according to Medicare standards, that is the minimum 4.1 hours to be able to provide adequate care and make sure that grandma and grandpa have the time to get to the bathroom and have someone to talk to give them medication. Give them an appropriate meal 4.1 hours is adequate to give them that kind of service.

Sounds simple enough. Nursing homes short on nurses hire more nurses. Those nurses spend more time with residents. But at least one Connecticut nursing home administrator says that solution overlooks a serious problem, there aren’t enough nurses to fill those hours.

JENNIFER MALON-SEIXAS: From my perspective having run facilities that we’ve had this level of staffing, I know very, very intimately how challenging it’s been because the people don’t exist. Okay, they don't exist, and the people that do exist that stayed in the field in nursing are very, very costly.

BROWN: Jennifer Malone-Seixas, is the chief operating officer for two nursing homes privately owned and operated by her family in Danbury, Connecticut. The homes have weathered many storms since they were founded in 1947, but the strain of fighting pandemic infections has taken a significant toll.

MALONE-SEIXAS: And for some reason looking in retrospect the period of time that we're we've been in now for 2023 was harder because people are tired, they're burnt out, there are so many people who have left the field. You see everybody, everybody aged in place, including the staff. And the aging has, has accelerated because of the stress and the singular focus on that community.

Many staff nurses decided to try new careers or retire early. And once they left, they never came back.

MALONE-SEIXAS: There was one day in particular, I'll never forget it because I probably still have some trauma from it. It was April 12th, 2020, and it was a Sunday and eight people. Eight people decided to leave because of the pandemic. I remember that, I remember where I was, where I was sitting, I remember I started crying. And I remember it because it's, it was like so devastating.

ERIKSON: What do you, what do you do after you lose that many people on the, on the same day you still need to provide the hours. The resident’s aren’t going to check out.

MALONE-SEIXAS: You're just working, working, working, working, working, asking people to pick up, asking people to work an extra shift.

REICHARD: The optimal ratio of certified nursing assistants to residents in Connecticut is 8 to 10 residents per nurse. Malone-Seixas says if the state increases the time required between nurses and residents, every facility will struggle to find enough nurses to fill those hours.

MALONE-SEIXAS: When I tell you, there is no one to hire, there is no one to hire. Our wages over the past three years have gone up at least 22 to 25 percent on the base rate of what people are making. And then you have to incentivize people to work on top of that, because you don't have enough workers in the field. So a bill like this is nothing less than a punishment.

BROWN: Malone-Seixas and other nursing home administrators told Connecticut legislators they opposed the bill. Not because they didn’t want to give more nursing care to their residents, but because they simply couldn’t. Ultimately, lawmakers tabled the bill after failing to get enough votes to pass it.

REICHARD: But Connecticut lawmakers haven’t given up on fixing the problems faced by nursing home residents. At the end of May, they unanimously passed a bill that would require nursing homes to be more open about their finances. It would also add protections for residents who are discharged from nursing facilities. There’s more lawmakers can do to help residents and nurses, but getting more clarity on the problem is a good place to start.

BROWN: Juliana Chan Erikson is WORLD’s marriage and family beat reporter. If you’d like to learn more about this story, we’ve included a link in today’s transcript.

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