Only three years ago, it seemed that every other lawn in New Jersey had a sign thanking our healthcare heroes. Now, there are signs that those healthcare heroes may soon be in short supply.
According to a statewide report published by Health Professionals and Allied Employees in
March, the past three years have seen almost a third of nurses departing hospitals. The other two-thirds may not remain long, either, as 72% of them had recently considered leaving themselves.
Poor staffing and burnout were cited as the top two reasons for leaving. Nationwide, nurses are leaving hospitals in particular in worrying numbers. Yet the shortage is
especially acute in New Jersey and projected to get worse.
According to a December 2022 article on RegisterNursing.org, by 2030 New Jersey is projected to need 11,000 more nurses than it will be able to supply. This would be the third-worst gap in the nation, behind only California and Texas.
This staffing shortage is already affecting Warren County. According to the 2023 Nursing Data and Analysis report by the New Jersey Collaborating Center for Nursing, Warren County has the third-highest demand for Registered Nurses in the state and the fourth-highest demand for Licensed Practical Nurses.
What’s driving the shortage? Nurse Scientist Susan Weaver points to two factors. One is the country’s aging workforce, which is especially true in nursing. The average age in the nursing profession is 50 years old and continues to increase.
This leads to a retirement rate in the profession that’s higher than the number of new nurses who graduate ready to work.
According to Weaver, a lack of interest in nursing isn’t necessarily the problem. In fact, she
says, “One of the schools in New Jersey turned away a thousand applicants for its nursing
program.”
The reason for the avalanche of rejections: not enough faculty to teach potential students.
“It’s very demanding to be a nurse faculty,” Weaver says. Ironically, the faculty shortage
becomes its own self-exacerbating problem. Just as there aren’t enough faculty to train new nurses, there aren’t enough faculty to train new nurse educators.
A February article on RegisteredNursing.org points to a drastic financial disincentive, as well. According to the article, “nursing educators in academic positions earn significantly less ($77k) than clinical or private-sector nurses ($97k) with the same education.”
But there’s some room for optimisim. Weaver points to New Jersey Senate Bill 2825, sponsored by Senator Joseph Vitale of Middlesex and Senator Fred H. Madden, Jr. of Turnersville.
The bill proposes the allocation of $26.7 million to various initiatives for the nursing profession. “The bulk of that is for grants for universities and schools to come up with initiatives to attract more faculty,” Weaver says.
Expanding the capacity of nurse education programs is bound to be an expensive endeavor
beyond personnel costs. Even simulation programs for medical professionals come with a
heavy price tag.
If funding and space allow, though, several nursing education programs in the state offer an accelerated program to help students become qualified nurses faster.
Weaver notes another bill that attempts to address the nursing shortage from a different angle. “It would expand the role of advanced practice nurses (APNs), defined as “registered nurses who are certified to provide an advanced level of health care to patients that exceeds the standard scope of nursing practice.”
Nationwide, each individual state dictates the scope of what an APN can do on their own. In 28 states and in the District of Columbia, APNs have full practice authority, meaning that they are authorized to diagnose patients, order and interpret diagnostic tests, and direct treatment plans-the tasks that are often performed by a primary care physician, another medical care role in short supply.
In New Jersey, APNs must work with a collaborating physician. One of the requirements is that the physician must review the APN’s charts on a regular basis. During the Covid crisis,
Governor Murphy signed an executive order temporarily allowing APNs to operate without this restriction.
Now that pandemic measures have been rolled back and the requirement is back in place, nursing professionals worry that nurses will leave New Jeresey in favor of nearby states that grant full practice authority, including New York, Delaware, and Maryland.
Senate Bill 1522, sponsored by Senator Vitale and Senator Troy Singleton of Burlington, would eliminate these restrictions, making New Jersey the 29th state to grant full practice authority to APNs.
If passed, the bill would address another concern: the lack of access to primary care treatment, especially in rural communities. A 2022 report by the Rural Health Information Hub notes a shortage of primary care health professionals in parts of Warren County. The shortage of mental health professionals is even more severe, impacting all of Warren.
Expanding the authority of APNs would address this shortage while acknowledging the different roles of primary physicians and APNs, Weaver says. “APNs are not trying to be physicians… They’re going to help within your scope of practice and refer as needed.”
Both bills were approved by the Senate Health, Human Services and Senior Citizens Committee by seven votes with no votes against and await further action by the state legislature.
In the meantime, Weaver says, hospitals and nurses around the country are trying to give their patients the same level of care even with fewer hands on deck. “I can say, nationwide we’re trying to be innovative in addressing this shortage,” she says.
Chip O'Chang, Contributing Writer
Chip O'Chang is an educator, fiction writer, and lifelong resident of New Jersey. He has also written for My Life Publications and NJ Indy. He lives in the NJ Skylands with his partner, two cats, and and a bearded dragon.
