Report anticipates future shortage of registered nurses in California

California will likely experience a shortage of registered nurses over the next five years because of the COVID-19 pandemic, according to a report from UC San Francisco.

The August report’s preliminary research found that during the pandemic, younger nurses experienced high unemployment rates and many older nurses retired earlier than planned – both of which have contributed to a California nursing shortage that may last until 2026.

According to UCLA Health data, the system’s average nurse vacancy rate as of Sept. 30 was 5.6%, less than the national average nurse vacancy rate of 9.9% but higher than previous years, which varied from 3.5% to 3.9%, said Phil Hampton, a UCLA Health spokesperson.

More than 53% of nurses said they felt increased stress and nearly 42% responded that they felt more frequently depressed during the pandemic, according to a National Nurses United report published in September.

A lack of personal protective equipment and the increased workload during the pandemic caused several older nurses to voluntarily leave their positions, said Jack Needleman, chair of the department of health policy and management. The high mortality rate among COVID-19 patients also places an emotional toll on them, he added.

Hampton said UCLA Health has implemented multiple mask, testing and safety protocols in compliance with national and local public health guidelines. UCLA Health has also focused on providing nurses with wellness resources, he added.

Nurses close to retirement leaving their jobs sooner than expected is the biggest driving factor for the predicted shortfall, said Joanne Spetz, a co-author of the report and director of the UCSF Institute for Health Policy Studies.

While many nurses actively retired from their positions in response to increased stress, some nurses were forced to leave their jobs unexpectedly through layoffs.

Many older nurses in units without COVID-19 patients were laid off because fewer patients were coming in for care, Needleman said. A lower demand for nurses in certain areas also contributed to layoffs of less-experienced nurses, he added.

Moreover, hospitals can’t easily hire traveling nurses or nurses from other states to solve the issue because the nursing shortage may be a national problem, Spetz said.

The report also found that registered nurse education programs saw small drops in new student enrollment between 2019 and 2021.

Although current nursing school enrollment will help replace older nurses as they retire, university administrators should maintain their funding for nursing programs while hospitals should continue letting nursing students complete their clinical rotations and hire recent nursing school graduates, Spetz said.

Spetz added that studying nursing labor is important because nursing is the largest health care profession in the U.S., with there being three or four times as many nurses as there are physicians. Nurses also have a far-reaching impact because of their work in various health care settings, ranging from patients’ homes to primary care offices, she said.

Nurses implement treatment plans for patients while advocating for and educating them, Needleman said. They also have to critically think about how to adapt their care to their patients, whose needs are constantly changing, he added.

Older nurses are especially skilled at managing different patients and monitoring how patients respond to various treatments, Needleman said, adding that older nurses often informally train newer nurses in providing patient care.

“That’s a very complex managerial process to do, … not just for one patient but for four or five,” Needleman said.