During the COVID-19 pandemic, the National Council of State Boards of Nursing (NCSBN) (2022) estimated over 100,000 registered nurses left the profession and predicted that another 800,000 nurses would follow them by 2027. The top reasons reported for leaving were burnout, feeling undervalued, and a high patient-to-nurse ratio. However, hospital layoffs are another culprit driving experienced nurses from their profession. In a short-sighted attempt to recoup costs, healthcare organizations cut more experienced nurses.alarming-trend-of-seasoned-nurses-being-laid-off-profits-over-patient-care

According to the Joint Commission (2022), 1,441 sentinel events were reported in 2022, a 19% increase from 2021. Getting rid of seasoned nurses will not solve the hospital’s financial problem. Instead, it will increase their financial losses due to increased sentinel events and a decrease in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores due to poor patient outcomes. This article plunges into this issue, exploring the possible reasons behind these layoffs and the potential impact on patients’ outcomes.

The Profit-Driven Healthcare Environment

One of the key factors contributing to the layoff of seasoned nurses is the profit-driven nature of the healthcare industry. Healthcare organizations, both public and private, are under constant financial pressure to maximize revenue and minimize costs. In this pursuit of profit, hospitals and healthcare facilities may resort to reducing labor costs, including laying off experienced nurses. “It’s just business, nothing personal,” one Human Resource Partner told a nurse of twenty-three years when her organization was eliminating her position.

Financial Constraints and Budgetary Cuts

Healthcare institutions often face financial constraints, with shrinking budgets and reduced reimbursements from insurance companies and government programs. As a result, they may resort to downsizing their workforce as a cost-cutting measure. Unfortunately, this approach fails to consider the long-term impact on patient care and the loss of invaluable experience and expertise that seasoned nurses possess, which is critical to the success of novice nurses.

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The Nurse Journal reports that novice nurses’ most common errors are medication errors, infection issues, documentation errors, and not reporting the correct information to healthcare providers when their patients’ condition is deteriorating. These errors can cause serious harm or adverse outcomes to patients. The pandemic affected the novice nurses’ orientation tremendously due to the need to have nurses on the frontline quickly, possibly prohibiting them from getting the proper orientation they were due. According to the National League of Nursing (2022), many nurses graduating from nursing school between 2021-2022 never interacted with patients until they were on the floor with their preceptor. Therefore, novice nurses are ill-prepared to practice safely as registered nurses.

New Graduates and Lower Salaries

Another factor contributing to the layoff of experienced nurses is the availability of a steady supply of new nursing graduates. Hospitals and healthcare facilities may opt to hire freshly graduated nurses willing to accept lower salaries as they appear more cost-effective. This preference for hiring entry-level nurses over seasoned nurses can lead to more sentinel events due to lack of experience.

Impact on Patient Care 

The consequences of laying off seasoned nurses can have a negative impact on patient care. Experienced nurses bring knowledge, clinical judgment, and critical thinking skills acquired through years of practice. Their expertise in handling complex cases, recognizing subtle changes in patient conditions, and providing effective interventions must be replaced. The loss of seasoned nurses may result in a dramatic decline in the quality of patient care, therefore increasing medical errors and compromising patient safety.

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Continuity of Care and Nurse-Patient Relationships

Seasoned nurses often develop strong bonds and trust-based relationships with their patients over time. These relationships enable them better to understand patients’ needs, preferences, and circumstances, leading to more personalized and effective care. When experienced nurses are laid off, this disrupts continuity of care and established nurse-patient relationships, potentially affecting patient outcomes and satisfaction.

The Importance of Balancing Profit and Patient Care

While financial stability is crucial for healthcare institutions, it is critical to strike a balance between profitability and patient care. Healthcare organizations should recognize the value of experienced nurses and invest in retaining them rather than prioritizing short-term cost savings. Strategies such as mentorship programs, professional development opportunities, and identifying the contributions of seasoned nurses can help retain their expertise and ensure optimal patient care.

Conclusion

Laying off experienced nurses favoring cost-cutting measures reflects a troubling trend in the healthcare industry. Prioritizing profits over patient care compromises the quality and safety of healthcare services. Healthcare institutions and policymakers must address this issue, emphasizing the importance of retaining and valuing experienced nurses for the well-being of patients, the nursing profession, and the healthcare system as a whole.

References

American Nurses Association (ANA) (n.d, August 24). Why nurses quit and leave the professionhttps://www.nursingworld.org/practice-policy/nurse-staffing/why-nurses-quit/

Joint Commission (2023, August 24). The sentinel event data 2022 annual review. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/03162023_sentinel-event-_annual-review_final-(002).pdf

Mcfanhn, C (2023, August 24). Some workers at U.S. hospital giant HCA say it puts profits above patient care. https://www.nbcnews.com/health/health-news/workers-us-hospital-giant-hca-say-puts-profits-patient-care-rcna64122

Muoio, D (2023, August 24). Layoff are ramping up among hospitals and health systems. Here are 72 examples from 2023. https://www.fiercehealthcare.com/providers/layoffs-ramping-among-hospitals-and-health-systems-heres-34-examples-2023

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National Council of State Board of Nursing (2023, August 24). NCSBN research projects significant nursing workforce shortages and crisis. https://www.ncsbn.org/news/ncsbn-research-projects-significant-nursing-workforce-shortages-and-crisis

Andrea Doctor
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