Rebecca Love is the Chief Clinical Officer at IntelyCare, the first nurse featured on Ted.com and a leader in nurse workforce innovation.
Hospitals across the U.S. are experiencing a nursing shortage, causing these institutions to close units, delay life-saving surgeries and ration care.
The problem is particularly acute in rural hospitals. Another report from the American Hospital Association shows that 2.2 million women of childbearing age in rural America don’t have access to a hospital offering obstetric care, a birth center or an obstetric provider. On top of this, the Center for Healthcare Quality and Payment Reform reports more than 30% of rural hospitals—an astounding 600—are at risk of closing, potentially exacerbating such issues.
Lack Of Healthcare Access And Its Lingering Effects
Where there are medical deserts, there are often economic deserts. Hospital closures can have ripple effects, destabilizing entire communities and negatively impacting their long-term financial outcome and population growth.
Studies have shown that people who live in areas with limited access to healthcare are more likely to be unemployed and have lower incomes. They are more likely to miss work due to illness, which can lead to job loss. The closure of a local hospital can place a further financial burden on residents, for they may have to travel further to get care and pay higher out-of-pocket costs.
There is also evidence that the lack of access to healthcare can lead to a decline in productivity. People who are sick or injured and not being adequately treated are less likely to be able to return to work quickly, which can lead to a decrease in economic output.
Why Business Leaders, Even Outside Healthcare, Should Care
Despite the economic slowdown, businesses face labor shortages—especially outside urban areas. If your company hopes to attract employees to work on-site at an office, yet residents and job candidates must travel long distances to reach healthcare clinics or hospitals, this can hinder your ability to hire top talent.
Without access to healthcare, young people are less likely to move to a community, and employees are more likely to leave. A hospital closure means residents have less access to preventative care. Especially in rural areas, hospitals are major employers, and their closure can lead to job losses and tax revenue decreases.
I am seeing nurses leaving the profession in droves due to stress and burnout, with one survey showing that the biggest reason nurses are leaving is because they feel emotionally drained (50.8%). The National Council of State Boards of Nursing reports that almost 900,000, or almost one-fifth of registered nurses, intend to leave the workforce by 2027.
I believe that the crux of the issue is that too many healthcare systems are putting nurses at risk with unsafe practices. For example, last year, Wilmington’s Novant Health New Hanover Regional Medical Center in North Carolina had 400 unfilled nursing positions; the state threatened to pull its Medicaid funding due to a lack of compliance and unsafe practices. People died in the emergency room waiting for treatment. The center has since hired more nurses to remain in compliance.
Earlier this year, a report by North Carolina’s treasurer showed that $1.75 billion over the past 10 years went to executive pay at the state’s nonprofit hospitals, with chief executives’ salaries doubling over the past five years. This is while nursing salaries only increased by 14% during the same period.
Novant Health is not an isolated event. In 2022, The New York Times reported that Ascension Hospital Systems, which has 139 hospitals in its system, repeatedly cut staff to increase profitability, causing unsafe nursing-to-patient ratios. The article cites numerous instances of hospitals laying off nursing staff as a cost-cutting move.
The movement to implement mandatory staffing levels to improve nurse-to-patient ratios and provide relief for overburdened nurses is gaining momentum in places like California and Maine, where government authorities are stepping in to ensure ratios are maintained. But we’ve still got a long way to go.
While hospitals need to make it a priority to ensure nurses are safe with adequate staffing, since this is an issue affecting even those outside the healthcare industry—there are actionable steps business leaders across sectors can take.
How Business Leaders, In General, Can Help Keep Local Hospitals Safe And Open
The following steps can work in conjunction with more direct efforts by hospitals to improve compensation and benefits packages, reward senior nursing staff and even offer additional financial incentives beyond competitive pay. Here are some of the ways that business leaders across sectors can help.
• Join hospital boards to help provide oversight and ensure equitable treatment of nurses and patient ratios are maintained. Hospital boards of directors are often sourced from local business leaders, lawyers, private sector leaders, doctors, nurses and government leaders. They are typically recruited, although a citizen can reach out on their own.
• When situations become untenable in the local community, such as what happened in North Carolina, business leaders can use their influence to reach out to local politicians and media to ensure the health system implements policies that keep nurses and patients safe.
• If the local hospital faces financial difficulty, work with its leadership team to implement protocols that save money—but not at the risk of nurses’ or patients’ safety.
• Executives can partner with local community groups such as the Chamber of Commerce to ensure affordable housing is available for nurses and also help to attract more nurses to the area hospital.
For businesses looking to relocate or expand, I believe that the availability of healthcare infrastructure is a critical factor. Access to good healthcare—which must include safe nurse-to-patient ratios—is essential for people to be able to work, earn a living and contribute to the economy. Access is critical to sustaining a community and enabling the potential for economic growth.
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