Articles

Tennessee's Healthcare Workforce Shortage

Dr. Lisa Piercey

Commissioner, Tennessee Department of Health

March 21st, 2022

Whether it is restaurant wait staff, grocery store cashiers, or bedside nurses, it is safe to say that every business has been limping through staffing shortages over the last 18+ months. Yet, nowhere are these challenges felt more acutely – or arguably, have a bigger impact – than in the healthcare workforce.

Like states across the nation, the unrelenting workload, combined with vicarious trauma and moral injury, of the COVID-19 pandemic have driven Tennessee’s healthcare workforce to exhaustion and burnout. Because of this, many have voluntarily left the industry altogether, and sadly, a not insignificant portion have involuntarily departed our ranks due to disease – or even death – from COVID. 

Further, for those still in the workforce, the promise of high pay rates and novel environments has lured many into the contract staffing agency realm, particularly the younger and more mobile bedside nurses, with no assurance of a speedy return to traditional employment models. This enhanced competition for staff, growing wage inflation, and an expanding gig economy collectively pose an ongoing strain for healthcare organizations now and well into the future.

While we have all longed for returning to “normal,” the reality is that the shift in pandemic-related behavior, of both employees and consumers, is likely permanent. Likewise, it is crystal clear that we will be dealing with the waxing and waning of COVID caseloads for months or years to come. Thus, staffing flexibility is the new imperative of healthcare providers, to which our steeped-in-tradition industry is not fully accustomed. 

We must transform stagnant, long-term staffing models into a stable yet malleable need-based structure to accommodate the unexpected, and often rapid, shifts in workforce supply and demand from infection surges and market forces. While we continue our work in the community to reduce unnecessary demand, we can stabilize our supply of employees through recruitment and retention strategies. We must innovate the old model and take steps to create flexible work schedules and settings, ensure competitive compensation, and pursue an enhanced focus on the policy and societal issues important to today’s workforce, such as health equity, organizational diversity, cultural connectivity, and social justice.

To augment these critical private sector advances, Governor Bill Lee’s administration and Tennessee’s General Assembly are ratcheting up efforts in the public sector to help address the healthcare workforce issue, both immediately and for years to come. Federal COVID relief funds continue to be used for staffing assistance grants for hospitals and long-term care facilities, and American Rescue Plan (ARP) dollars are actively being considered for practice transformation grants, which will foster technological efficiencies to offset staffing shortages. Likewise, a budgetary package for expansion of the dental workforce pipeline and board rules for relaxation of EMS scope of practice are moving through the legislative process.

In addition to the continuation of the Tennessee State Loan Repayment Program (TSLRP), which offers educational loan repayment for PCPs practicing for at least two years in a health professional shortage area (HPSA), the Tennessee Department of Health will play a lead role in a soon-to-be-announced, public-private collaborative effort to develop a comprehensive plan for addressing the healthcare workforce needs across the state, at all points along the delivery spectrum.

Tennessee’s healthcare staffing shortage has been brewing for years and has reached a boiling point. Overcoming this “burn” will require creativity, innovation, and cooperation amongst providers, payors, and policymakers to position us for a more sustainable future of delivering high quality and efficient care to our patients.