A systemic nursing shortage existed in many parts of the United States long before the COVID-19 pandemic upended our lives. When the health crisis spread across the country in the spring of 2020,  concerns of inadequate hospital capacity, supplies, and staff became a grim daily reality.

Exploding into a full-blown crisis, these simmering issues suddenly compelled a broad, coordinated response from all sectors of society. Fundamental to any strategy is getting key staff to where they needed to be, particularly front-line nurses.

Nursing, Supply, and Demand

A 2017 article in Host Healthcare shows that Texas, Florida, and California were among the top states experiencing a chronic shortage of nurses.

Further illustrating the point, Richard Fowler writes in The Grio:“With tens of thousands of nursing positions going unfilled each year, the United States, by all measures, seems to be caught in the middle of a prolonged nursing shortage that has been brought to the forefront by COVID-19.”

Of the 3.3 million working registered nurses in the United States, 60 percent work in hospitals. Of those, only 15 percent work in ICU or emergency care, not nearly enough to handle the sudden influx of infected patients. One of the main market responses is tapping into the pool of nurses willing and able to travel.

Into the War Zone: Traveling Nurses Answer the Call

As COVID-19 cases rose exponentially in March and April, federal and state regulators worked together to amend multi-state licensing requirements, expediting the ability of nursing staff to travel where they were needed most. TravelNursing.com reports that “every state, territory, and the District of Columbia have now declared a state of emergency, allowing nurses licensed in other states to be fast-tracked for practice.”

In response, many nurses stepped up to the challenge. Despite the risks of what many characterize as a “war zone,” nurses from across the country traveled to early hot spots like New York City and Seattle as well as many undeserved rural areas.

Dovetailing with changes in government regulations nonprofit organizations like Samaritan’s Purse deployed field hospitals and staff around the world, including one in New York’s Central Park. The story of Terri Kimble, an emergency care nurse from Houston who volunteered with Samaritan’s Purse, demonstrates the unflagging commitment of so many other nurses like her.

But the virus is everywhere, and its hot spots are a moving target. As the crisis eased in the Northeast, surging numbers of infected patients now have Texas, Florida, and California experiencing acute shortages of staff, supplies, and capacity. The Texas Tribune reports that resources for dealing with the surging number of COVID-19 hospitalizations are strained to the limit: “Many Texas hospitals are no longer accepting transfer patients in order to maintain space for a surge that’s expected to come. In some parts of the state, it’s already here.”

As the surge moves, so do nurses. Like they did in New York, traveling nurses go where they are needed. As of this writing in July 2020, travel nursing jobs posted on Nursefly top nearly 42,000 openings for nurses. Of those, 13,772 are for ICU and urgent care nurses. The states currently with the highest need for nurses include:

  • Texas: 4,975 jobs posted,
  • California 8,034 openings,
  • Florida: 2,616 open positions,
  • Arizona: 1,888 listed jobs.

There is a premium for traveling nurses in high-demand areas. Listed jobs from Nursefly report compensation packages ranging from approximately $1,400 all the way to $6,287 per week (as of July 2020).

Military Response

The July surge of COVID-19 cases across the west and south has also brought calls for assistance from the military. At the request of the state officials and the Federal Emergency Management Agency, “approximately 740 Department of Defense medical and support professionals from the Army, Navy and Air Force deployed to support COVID-19 operations in Texas and California,” according to the Military Health System website.

An article in the Los Angeles Times reports that “teams of military doctors, nurses and other healthcare specialists are being deployed to eight California hospitals facing staffing shortages amid the state’s record-breaking surge of coronavirus.”

Leveraging the Margins

Leveraging nurses before and after their careers is yet another key strategy to meet the demand. An article in Health Affairs speaks to several policy and staffing options to leverage a pool of skilled talent beyond the reach of business-as-usual. These include reactivating licensing, calling nurses out of retirement, and easing state scope-of-practice and oversight laws to streamline the flow of staff to where they are most needed.

Caring for the Caregivers

In the battle to recruit nurses we must not forget about the nurses themselves and the impact of caring for others during a pandemic. The emotional, mental, and physical toll of the health crisis will linger well beyond the worst of the health crises is abated.

Financial incentives are important, but more significant are protection and caring for the caregivers. Many already suffer from PTSD, anxiety disorders, and burnout. Mental and emotional support for nurses is vital at all times, but most especially during this unprecedented public health crisis.

Nothing Short of Heroic

In the best of times, being a nurse is tough. If the term “heroic” is sometimes bandied superficially, it is not the case here. Nurses face long hours, grueling work conditions, and pay often not commensurate with the requirements of their job. But they do it anyway. On the front lines of healthcare, they rush into the fire of a pandemic when everyone else is – or should be – running from danger.

For the more dire cases of COVID-19, there was little anyone could do but make patients as comfortable as possible. A job that fell almost exclusively on nurses. Nurse Terri Kimble recounts her experience comforting a frightened patient struggling with her C-PAP. “I could see she was scared,” she says. Kimble stayed with her, held her hand, and stroked her arm, comforting the woman until she fell asleep. “It was times like these that I felt I was really making a difference and it felt good,” Kimble says.

There are many lessons we must learn from the COVID-19 pandemic. Among the most important of those lessons is the need for more skilled, dedicated nurses. Nurses are among the quiet, unseen heroes we too often take for granted.