If 1 in 5 healthcare workers have quit, where have they gone?

A frequently cited statistic is that nearly 1 in 5 healthcare workers have quit their jobs during the COVID-19 pandemic, according to an October 2021 Morning Consult report

But that doesn't necessarily mean 1 in 5 healthcare workers left the healthcare industry altogether, according to Altarum Institute Senior Economist Ani Turner. When looking at the national numbers, based on Bureau of Labor Statistics data, the overall healthcare workforce is only down 2.7 percent from February 2020, she told Becker's.

That number is mostly in nursing homes, she added. When looking at just hospitals, the workforce is down 1.8 percent from February 2020. 

This means many people who quit their jobs are being hired in other healthcare jobs. Or as some leave, others are being hired, Ms. Turner said.

"The number of people leaving their jobs is only one half of the equation when you're looking at employment," Ms. Turner said. "The other half of that is who's being hired."

It begs the question, where in healthcare are these workers moving if they aren't leaving the industry altogether?

The data

Ms. Turner's numbers are consistent with Kaiser Family Foundation's, which also cites the Bureau of Labor Statistics, Vice President Cynthia Cox told Becker's. At the start of the pandemic, overall healthcare workforce levels severely dropped, but have mostly recovered to prepandemic levels since then.

Although the numbers have mostly bounced back, there's no denying there's been a severe shortage in the healthcare workforce. COVID-19 has put more of a demand on healthcare workers, and many workers have been infected by the virus, Ms. Cox said.

"I think the bigger problem more recently has been that people are also having to call out sick and isolate and quarantine," Ms. Cox said. "You start out with already lower levels of employment than you probably should have and then you have a bunch of people calling out sick or needing to stay home to take care of kids who can't go to school. That means there's an even bigger problem on your hands."

Additionally, while the national workforce is only down 2.7 percent, shortages could be greater on a regional level, Ms. Turner said. COVID-19 surges ebb and flow, so while one region may be dealing with skyrocketing COVID-19 cases at a certain point in time, other regions may be managing better.

"First of all, this is a national number," Ms. Turner said. "So there's always going to be a lot of variation where you are. Secondly, we are not yet back to a post-COVID steady state, so hospitals in particular have to deal with the surges and the ups and downs of COVID itself."

Before COVID-19, the workforce had been gradually increasing. Although employment has mostly recovered to prepandemic levels, it's still about 6 percent below expectations for 2022, and the hospital workforce is about 4 percent below expectations, Ms. Cox said.

Where are the workers going?

Anecdotally, multiple sources told Becker's they've seen a lot of workers — particularly nurses — move to travel agencies, which generally offer higher pay and flexibility. But as for hard national data on what jobs employees are taking after quitting a healthcare job, there doesn't appear to be any, experts say.

Shane Jackson, president of staffing agency Jackson Healthcare, told Becker's his company is receiving and fulfilling requests for staffing on a larger scale than it did before the pandemic. He said workers have increasingly become interested in temporary assignments to avoid burnout.

Although Jackson Healthcare does not disclose how many people it has added to its agency, it works with more than 10,000 clinician providers in all 50 states, he said.

"The demand for healthcare providers is high, and clinicians working with a staffing company have more flexibility to select when and where they want to work," Mr. Jackson said. "They can choose to go where they’re needed most and ensure that their assignments are in alignment with their other priorities, whether personal or professional." 

Therese Fitzpatrick, PhD, RN, senior vice president of Kaufman Hall, told Becker's she has also seen more nurses move into staffing agencies. But different from prepandemic times, more people are taking local assignments, she said.

"Prepandemic, we thought about travel nursing as 'I live in Chicago, and I take a travel assignment and go to [Los Angeles] sort of thing.' But the pandemic changed that travel dynamic, so we're seeing folks traveling in a closer vicinity," she said.

But this uptick in movement to staffing agencies is a bit different for CHG Healthcare, which mostly works with physicians. The company has grown, but not much differently than it was growing before the pandemic, Chief Sales Officer Leslie Snavely told Becker's.

Often, physicians who come to a staffing agency like CHG Healthcare are using it as a way to find another job in healthcare, not to stay at the agency permanently, she said.

"What staffing agencies do is get them replaced in healthcare," she said. "To leave to work for us longview, we aren't really seeing that on the physician side."

In addition to more employees seeking out staffing agencies, there have been more people retiring early, Ms. Fitzpatrick said. The American Nurses Association predicts about 500,000 nurses will retire in 2022, creating a shortage of about 1.1 million nurses.

There have also been people simply leaving their hospital job for another hospital job with better pay, Ms. Cox said.

"It sounds like people who work in hospitals are still moving to work in hospitals, they're just maybe leaving for a higher paying job because we are seeing that average salaries are increasing," Ms. Cox said.

 
'A separate issue'

While the healthcare workforce isn't down as much as that "1 in 5" statistic makes it seem, movement into other jobs presents other issues.

High turnover creates a disruption in care as healthcare organizations work to fill open positions.

"Turnover is in and of itself a separate issue," Ms. Turner said. "So if there's very high turnover, that can present its own challenges as well in bringing new people on and in the disruption that it causes in care." 

The average cost of turnover for a bedside RN is over $40,000, a 2021 NSI Nursing Solutions report found. In 2020, the turnover rate for staff RNs was at 18.7 percent, a 2.8 percentage point increase from 2019.

"What we're trying to do is simply look at the top-line national numbers as kind of a reality check to simply say that we haven't lost 20 percent of the workforce," Ms. Turner said. "Nonetheless, there are some significant challenges and issues."

 

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