The storm on the health care horizon has come to Butler County providers, as hospitals and care centers across the region grapple with the ongoing national nursing shortage.

Many nurses who went through the ordeal of the coronavirus pandemic and its aftermath are stepping back or quitting, leaving hospitals with staffing gaps and increased workloads.

At UPMC Passavant's Cranberry and McCandless locations, the nursing shortage “absolutely feels like a crisis,” according to Lisa Bryan Morris, chief nursing officer and vice president of Patient Care Services at UPMC Passavant.

“I've been a nurse for about 24 years,” Bryan Morris said. “There has always been a nursing shortage. If you've been a nurse for a while, you have seen cycles where the shortage sort of peaks and ebbs, and the pandemic has thrown a wrench into an already difficult situation.

“It was something we had never seen before, and it forced us to take a look at what was happening to our nurses at the bedside.”

Bryan Morris said that older and more experienced nurses “said they needed to step back,” and many left after the stress of the pandemic. This puts a lot of pressure on providers as the seasoned nurses are the ones who train newer nurses.

“It's really forcing us to take a look at our staff, and what we can do to increase morale,” she said. “You really have to take care of the nurses who we have who have gone through this. We lost a lot of patients, and the nurses at the bedside really felt that.”

UPMC has removed a cap on earning additional paid time off, and is encouraging nurses to use their paid time off. They've also set up stress reduction exercises for nurses on their website.

“It's little things that put the nurse at ease, even though it might seem small,” said Bryan Morris.

Combat shortage

UPMC began offering a sign-on bonus for nurses who have more than a year of experience.

“We've seen sign-on bonuses come and go, but to be competitive in the market, we need to offer one,” said Bryan Morris.

At Butler Health Systems and Concordia Lutheran Ministries, initiatives to recruit new nurses are also cropping up as the providers face the shortage.

“Our staffing numbers have never come close to reaching critical levels, but like our peers and organizations in nearly every other industry, we are in need of great people, especially during the summer months,” said Frank Skrip, director of public relations at Concordia Lutheran Ministries. “As an organization, we offer a number of opportunities to further employees' education, significant sign-on bonuses for many positions, an outstanding retirement package and more. We have traditionally offered some of the highest wages in our industry, and have significantly increased those wages to attract the best staff.”

“Butler Memorial Hospital has a long history of recruiting and retaining nursing staff,” said Karen Allen, chief nursing officer at Butler Memorial Hospital, in an email. “The pandemic has, however, led to hospitals across the nation experiencing staffing issues. There are fewer applicants for almost all jobs, which in turn results in a longer time to fill positions.”

Allen said Butler Health System also instituted incentive pay in areas where it takes longer to fill vacant positions.

“This strategy has been successful in sufficiently staffing those areas,” she said. “Incentive pay has been used from time to time over the years to address staffing issues.”

Offering peer support

One group in particular has seen the stress that nurses are under firsthand, and was created to fill some of those needs. Nadia Moore and Anthony Berardi are two former Pittsburgh nurses who founded the national virtual nurse support group, Nurses Anonymous. The group has regular Zoom meetings during which nurses can seek peer support, resources or just someone to talk to.

“We get nursing students, brand new nurses, nurses with all different experience, and this year has definitely been a test of everybody's stress tolerance,” Moore said. “A lot of nurses who show up to our meeting are looking for new jobs, or just trying to find different nursing positions. They're feeling super burnt out. The stress of the pandemic has really exacerbated issues within health care that were there pre-pandemic, and it became unmanageable this past year.”

Berardi has found that the crisis is to some extent self-perpetuating. The lack of staff is making the burden heavier on nurses who are still there.

“We have anecdotes from members, and if you ask anyone professionally why work is so hard, I feel confident everyone would tell you it's related to staffing,” Berardi said.

Moore says that what nurses need most right now is support from their management teams.

“We need to know we're supported and that if we are having a tough day or tough week or tough month, we need resources,” she said. “If nurses are feeling better and better able to deal with our job and our stress, that will have a snowball effect on the patients.”

Many nurses are concerned that talking to management isn't worth it, and that their management won't listen to them, Berardi said.

“We try to illuminate that this is a problem throughout nursing,” he said. “People are dealing with this everywhere, and you're not alone. We die in isolation. We want to start a cultural change.

“There's a ton of administrative policies and attitudes that need to be altered to be more supportive of bedside staff.”

Bryan Morris said the pathway for new nurses to join the UPMC workforce has also been damaged. Nursing students who otherwise would have been going to in-person clinical situations in hospitals weren't able to do so because of COVID-19.

“Basically, our pipeline disappeared, and that will have a lasting effect,” she said.

However, Bryan Morris is already seeing nursing students returning to hospitals now that restrictions are lifted.

“The awesome thing about UPMC is we have a great relationship with our schools of nursing, and they did not miss a beat,” she said.

The next generation

At Butler County Community College, nursing students are coming back in larger numbers than before. While 2019 and 2020's nursing student populations were around 160 and 140, respectively, this year's nursing class is at 194, one of the college's largest classes ever for nursing.

“I don't think that COVID helped the whole wanting to get into nursing, to be honest,” said Patty Annear, dean of BC3's Shaffer School of Nursing and Allied Health. “Some folks became a little nervous about working in health care facilities. We're not done by any means. But students see the opportunities in health care, and with nursing particularly, there are so many avenues you can go with it.”

BC3 is expanding its nursing program and plans to break ground soon on the Victor K. Phillips Nursing and Allied Health Building, which will host the Shaffer School of Nursing and Allied Health in the future.

The college has also partnered with Concordia Lutheran Ministries, and Concordia offers tuition assistance to students who agree to work for the provider after they graduate. Students can receive one year's worth of tuition sponsorship from Concordia if they commit to working for them for two years, and two years' worth if they commit to three.

“The college is all-in for nursing,” Annear said. “They know that we have a lot of older people in Western PA, and so you have the need for increased health care providers. Butler County and its community have really embraced helping out with this nursing shortage.”

Eagle Staff Writer Alex Weidenhof contributed to this report.