When the COVID-19 pandemic hit and images of overworked nurses began flooding the news, Rylie Gill had moments of asking herself, “Why am I even doing this?”
Gill, a nursing major at the Milwaukee School of Engineering who is now just weeks away from graduation, says the state of the profession has given her pause over the past two years.
“I don’t know that I can do this,” Gill recalls thinking during her junior year, after the first wave of the pandemic had receded and the second began to flare. “Nurses are stressed out, they’re burned out. They don’t feel that they’re being compensated appropriately. … Is that the kind of field I want to go into?”
Gill is among the current cohort of aspiring nurses preparing to enter an industry where employment opportunities are plentiful but burnout rates are high. While COVID has largely waned from its previous peaks, the nursing profession has taken a serious hit.
A workforce report released earlier this year by the Wisconsin Hospital Association revealed massive shifts in the industry during the course of the pandemic, with registered nurse vacancy rates reaching the double digits last year for the first time since 2005.
“The nursing shortage has arrived,” WHA said in its report, noting the confluence of the “Silver Tsunami,” “Great Resignation” and pandemic as driving health care vacancies.
Nurses are also changing jobs at high rates. Prior to 2021, about one in 10 RNs changed jobs annually; in 2021, that number was approaching one in five, according to WHA.
Those trends are consistent with what’s playing out nationally. A McKinsey study found one-third of surveyed RNs indicated a likelihood of leaving their current position providing direct patient care in November 2021, up from 22% in February of that year. The reasons cited included insufficient staffing levels, a desire for higher pay, not feeling listened to or supported, and the emotional toll of the job, according to the report.
Catherine Uttech initially thought she wanted to become a surgeon or an anesthesiologist. But when she took a job as a transporter at Children’s Wisconsin as a freshman at Alverno College, her aspirations changed.
She observed how much one-on-one time nurses at the Wauwatosa hospital spent with their patients and how that allowed them to develop relationships with children and their families.
“It was actually walking around the hospital and truly being in that hospital environment that made me realize that a career as a nurse was so much more interesting to me,” she said. “… A nurse is the one who truly knows their patient better than anyone else.”
Uttech came to the realization that she wanted to become a nurse during the industry upheaval of the early days of the pandemic. Just three days into her job as a transporter – before she had even completed her training – the hospital instituted a mask mandate and altered many of its policies to mitigate the spread of COVID-19.
“Since then, I have never stepped foot into the hospital without a mask on,” Uttech said. “Literally everything in the hospital changed (that day).”
Now a junior enrolled in Alverno’s nursing program, Uttech sees the advantages of working in health care and studying to become a nurse during a time of significant shifts. Compared to more tenured nurses for whom changes in hospital policy required adapting to new procedures, Uttech said she has less to unlearn.
“I would see coworkers who had been there for five, 10, 15 years: Their whole world was changing in a role that they knew very, very well,” she said. “I think I almost had the advantage of just starting at that time because I wasn’t so used to old policies.”
Current nursing students have experienced many disruptions to their studies over the past two years. Classes were held online for a period of time; group simulations in many cases have become solo experiences; clinicals – essential hands-on, practical experiences at the bedside – were canceled when COVID cases spiked.
Gill said she and her peers are in near daily conversation about their concerns related to entering the professional world.
“It’s hard to have that balance of giving students the truth of what’s out there right now but also giving them the confidence they don’t have right now,” Gill said. “Even without COVID and all these other things, anyone’s confidence when you get to your senior year is dwindling a little bit. You don’t know everything that you have to know. Compound that on top of all the talk of COVID and nursing shortages … and long hours and harsh environments.”
Several students said they are glad to have plentiful opportunities available to them when they graduate, but some worry about their readiness to step into the positions that they expect to be offered.
“Knowing that by the time I graduate I will have not just one but probably multiple options to where I want to go as a nurse, that’s a great feeling,” said Uttech. “But on the other side of that, it’s very scary knowing that I am being hired to this unit with very little to no experience coming out of school. Am I just going to be thrown in so quickly because of the shortage?”
Gill, who is interviewing for positions at a major area hospital in its emergency department and cardiovascular ICU, said she is concerned about reports of growing nurse-to-patient ratios, which research indicates can impact patient safety.
At 46, Crystal Churchill is on track to become a registered nurse next year, 30 years after receiving her certified nursing assistant license as a high school student.
She put her RN license aspirations on hold as she raised her children, and for the past 12 years has worked as a medical assistant with Ascension Wisconsin.
When her daughter was accepted into a new, two-year associate nursing degree program at Carroll University last year, she decided to apply as well.
“I’ve been waiting for a two-year (RN) program for forever,” she said.
Today, she and her daughter attend classes together. After graduation, she plans to work in an emergency room setting. She’s already been offered a paid externship and job after graduation working in a local neuro-ICU.
“You never get a job like that out of school, an ICU job. Usually, you have to get more experience,” Churchill said.
Health systems are going to greater lengths to attract and retain employees, including offering bonuses, recruitment incentives and overtime pay.
Employers have also relied on travel nursing and other staffing agencies to fill gaps. For those soon entering the field, travel nursing offers the potential for higher pay compared to more traditional roles.
Several nursing students said they would consider travel nursing, noting how social media shapes their perception of the job.
“You’re scrolling through Facebook or Instagram, and you see ads where there’s just this ridiculous amount of money you can make going to work for three weeks or three months somewhere,” Uttech said. “That’s obviously very appealing, especially when you’re a broke college student. … The money is so hard to pass up.”
After working toward her degree for the past four years, Gill said she plans to take a nursing job after graduation and stay in the field for five years. But she’s also prepared to change paths.
“I’d say I have a plan A, B, C and D,” Gill said. “If it doesn’t work out for me, it wouldn’t be wise not to have a backup.”