Estimated read time: 5-6 minutes
SALT LAKE CITY — Some call it the "perfect storm" in health care as registered nurses leave their careers at a time in history when they have never been more critical.
The problem started before the pandemic but is only getting worse after two years of burnout and fatigue. And for patient care, it could mean big problems.
"Two years ago, I went in for a hip replacement," said Roger, who preferred that KSL-TV didn't use his last name.
That surgery began a harrowing couple of weeks in the hospital for the Utah County man.
"It was just ridiculous," he said, and this was in early 2020, just before the onset of COVID-19. His time at the hospital was not conducive to healing.
"Oftentimes, I could hear other patients yelling, 'I need help, I need help, where are you?' and I was like, 'Holy crap, this is crazy,'" Roger recalled, still in disbelief over his experience there.
Over the last two years, nursing shortages have become more severe across the country, and in Utah.
"I have about 7,200 people that report to me," said Tracy Nixon, chief nursing officer at University of Utah Hospitals and Clinics. "The last two and a half years have been, hands down, the hardest of my career."
She's not alone. Nationwide, more nurses left their careers in health care during the pandemic than at any other time in history.
"If I could hire 120 nurses today, in about seven months, I'll be able to be fully staffed," Nixon said.
And that's just the nurses. She also needs the same number of support team members.
But hiring that fleet, on the heels of a global pandemic, is proving to be a huge challenge. And keeping nurses is not easier.
In recent weeks, thousands of nurses across the country, including many in Utah, have rallied and marched, protesting pay and hours.
A local Instagram account called "UniteUTRNs" is a forum where nurses openly and anonymously discuss things like pay, benefits and patient care.
"Without nurses, we can't have hospitals," an anonymous nurse told KSL-TV. He's one of the dozens of nurses that regularly contribute to the forum, and he is fed up.
"We shoulder so much responsibility for not very much money," he continues. "We're, you know, 20% below the national average."
Liz Close advocated for the Utah Nurses Association and its 38,000 professional members. She said the pandemic started to shine a bright light on previously existing problems for nurses but became amplified during COVID-19.
"There's a multitude of things and none of it's a quick fix," Close explained of the changes that need to be implemented.
"If you're an ICU nurse, you're used to saving people," she continues. "You're not used to everybody coming in getting sicker and sicker and dying and doing it over and over with no time."
This is exactly what many nurses described as their experience over the last two years.
As a result, many nurses quit their jobs, leaving a heavier workload for those left behind. The problem won't be easy to solve, or cheap.
"It's somewhere in the neighborhood of $7 billion to replace nurses that have left," Close said. And that's if you can replace them.
As more leave the profession, the workload is getting a reputation for not being worth the payoff.
On top of that, morale is suffering partly due to "travel nurses," temporary, contract nurses who bounce around where needed. Hospitals have turned to travel nurses to fill the gaps, paying these nurses up to four times more per hour than the nurses on staff.
"They're nurses just like myself, but they don't know where things are. They might not know our system," said a disgruntled staff nurse, who feels his efforts are undervalued and unappreciated.
Sarah Sherer is over human resources at University of Utah Hospital. She said her team is aware of the issues and working to fix them, promising the management team is unveiling new programs regularly, including a new compensation package that includes pay increases and other mental and emotional wellness initiatives.
"Compensation is extremely important and that has been one of our top priorities for the past 18 months," Sherer said.
One of the challenges is implementing big changes in a hurry.
"I don't know at this exact moment and time if change can occur fast enough," Nixon worries.
Nurses in Utah make less than every surrounding western state.
In Utah, nurses make an average of $34.99 an hour. Nevada nurses are paid 22% more. Arizona and Colorado also make significantly more. Even nurses in Idaho bring home more money per hour than nurses in Utah, even though the cost of living in Idaho is less than in urban Utah areas.
As nurses leave, many are replaced by younger, less-experienced nurses, or travel nurses. The nurses we spoke to say that this has a real impact on patient care.
Back in 2005, Intermountain Healthcare boosted its nursing programs at LDS, Cottonwood and Altaview hospitals and earned certification from the American Nurses Association as "magnet hospitals."
That status is considered the "gold standard" for hospitals hoping to attract and retain well-qualified nurses who promote quality care. Fast forward 17 years, only one Utah hospital now has that status: Timpanogos Regional Hospital in Orem.
So, what is the solution? Some Utah nurses say better pay is only the beginning.
"Simply put, pay should be commensurate with responsibility, and ours is not," one nurse said.
Those in charge, like Tracy Nixon, a long-time nurse, believe now is a gold time of opportunity.
"This is an amazing time for us as professionals to reshape and redesign our profession so we can continue to advance care and take care of our communities," Nixon said.
Those nurses with the complaints say that would make a huge difference since most of them agree that they still love nursing.
"I love nursing and I love medicine. I love my patients," one nurse.
As for Robert, who still needs another hip replacement, "I will not go back," he worries the nursing shortage would put him at too great a risk.
"I just don't feel I got the care I needed while in there."