Florida’s healthcare workforce faces significant challenges, and its shortage of nurses is a primary concern.
The state faces an overall shortage of nearly 60,000 nurses by 2035, according to the Florida Hospital Association (FHA). Stakeholders discussed workforce concerns and possible solutions at the 2024 Florida State of Reform Health Policy Conference in April.
FHA President and CEO Mary Mayhew said the level of trauma, stress, and fatigue healthcare staff and nurses felt during the COVID-19 pandemic led to some of the highest turnover and vacancy rates the state has ever seen.
“And this is over more than four decades of collecting that data,” Mayhew said. “There has been a call to action in (the) Live Healthy [legislation]. Prior to Live Healthy, the legislature mobilized around how (to) expand capacity in our educational system. One of the initiatives we continue to focus on is that pipeline. One of the challenges remains recruiting faculty. The pay simply is not commensurate with what a nurse can receive in so many other parts of healthcare. That is a national problem.”
Kelli Stannard—who moderated the panel—associate principal at Health Management Associates, noted that Florida’s 60-and-older population is estimated to increase by 11.5 percent by 2030, which could put more stress on the workforce.
“So a focus on the supply of talented professionals is going to be a key strategy for everybody in Florida,” Stannard said. “So what are you hearing from nursing students and prospective students that is giving insight into the shortages, and what do you see as being critical to get right in order to meet the growing demand?”
Florida Nurses Association (FNA) Executive Director Willa Fuller said she has heard of nurses telling young nursing students or potential students that they should not enter the field, which is unsettling. FNA represents over 300,000 nurses in the state, and new nurses only stay one to two years, which is a huge concern for FNA, she said.
“That’s disturbing because nursing is a wonderful job. We have to figure out how to make the environment a place where people want to work and stay. Nurses have to have critical skills. Nurses save lives every second of every day. And you need a basis in theory, skills, knowledge, and clinical judgment. And that takes time. Physicians get to be in a residency program and internships. They get to follow everybody around and learn things. Nurses finish nursing school—they might have a practicum—and then they are thrown into the water and expected to swim.”
— Fuller
FHA often convenes with nursing deans throughout the state, which is a good way to get insight into what students are thinking, Mayhew said.
“We need to learn about that environment of care and what new students or new graduates expect,” Mayhew said. “And how can we share feedback and information to the nursing schools that might inform either the classroom experience or the clinical training experience? That’s really important as we all work toward making sure high school students that might be thinking about a career in nursing are not told not to do it. We want to minimize that.”
Florida has seen a 38 percent reduction in nurse vacancy and turnover rates in the last year, however, Mayhew noted.
“We had the highest turnover rates we’d ever seen,” Mayhew said. “We were at a 32 percent turnover rate for a new nurse. Some hospitals were over 50 percent. But in a year, those turnover rates decreased by 38 percent. That is a reflection of a concerted, laser-beam focus on the workforce.”
Steven Bennett, director of workforce programs at the Florida Association of Community Health Centers (FACHC), said FACHC serves 54 community health centers in the state, which employ 13,000 workers. He noted that 50 million people quit their jobs in the U.S. labor market in 2022.
“Most went on to find other jobs. That churn, though, is eye opening for employers of any size, especially within healthcare. That’s forcing us to look beyond just credentials (and) years of experience, and beginning to understand what makes somebody tick. What makes somebody excited to get to work? Do we understand, at the point of hire, that person’s stress tolerance (or) their ability to function in a highly stressful environment?”
— Bennett
The Florida Reimbursement Assistance for Medical Education (FRAME) program provides a good opportunity to supplement the workforce, Bennett said. FRAME provides medical education loan debt relief to healthcare professionals who are practicing in less populated areas of the state.
“It is a built-in retention initiative that also has incredible recruitment strategies attached to it,” Bennett said. “We’re talking real dollars that will get people to stay in these positions. And it’s not a one-and-done initiative. FRAME is intended to be a four-year program, so you’re incentivized to stick around.”
FACHC is also beginning to launch a new program that will help workers develop six-month and two-year growth plans, Bennett said.
“Self-assessments are done that help individuals develop their language around their career, understanding what (they) value about (their) job, from work values to enablers, that will help you succeed,” he said. “It culminates in an agreement where an individual says, ‘Here’s what I want to do in the next six months and then the next two years.’ If you want to advance, a mentor (is) going to answer (your) questions.”