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America’s most critical shortage

Lessons from Everyday Life By Theodore Lewis

Portland, Maine — Almost every industry in the U.S. today is dealing with a shortage of workers. The delta and omicron variants are causing havoc, but something else is going on.

CNN business reporters Anneken Tappe and Allison Morrow noted that while childcare issues and the virus have played a role in the participation rate of workers, “recently it has become clear that there is another dynamic at work here: early retirement.”

Prior to the pandemic, a shortage of nurses at U.S. hospitals was already looming because the average age of nurses was close to retirement. Now in 2022, with hospitals challenged as never before, the most critical shortage in America is that of nurses.

In 2000, the average age of nurses in the U.S. was 42.7. In 2018, it went up to 47.9. It is now well over 50 and a wave of unprecedented retirements are on their way.

The 2020 National Nursing Workforce Survey showed that more than one in five nurses in the U.S. planned to retire within five years. This was before the pandemic.

In 2020, 33 percent of nurses in Maine were between the age of 55-74. In Michigan, 34 percent of the nurses were in this age category and in California, 30 percent were over 55. Thus, before the pandemic, impending retirements were a looming crisis hanging over the industry.

This year, there is another factor starting to influence nurse shortages: Covid-related burnout resulting in resignations and early retirements.

During the first part of the pandemic, our nurses (and other healthcare workers) risked their lives while taking care of Covid patients, in many instances without adequate PPE.

While many of us were locked down and working remotely, nurses showed up for work every day to take care of very sick patients at the hospital. In New York City, the brave tenacity of nurses was recognized by hunkered down New Yorkers applauding every day from their balconies.

At the start of the pandemic in 2020, drops in patient volume due to the postponement of non-emergent procedures temporarily mitigated the nurse shortage situation.

However, surges in Covid patients in 2021 required every hand on deck and put unimaginable strains, not previously experienced, on hospital nurse staffing.

Hospitals have used overtime, Covid differentials, staffing agencies and travelers to survive. Travel nurses come from for-profit agencies that pay nurses significantly higher rates than normal staff nurse rates. They are deployed to different locations on a temporary basis.

As the pandemic developed, many agencies have been charging exorbitant rates for supplying nurses into positions that hospitals have been unable to fill.

At Guam Memorial Hospital, many open positions in 2021 were filled by a stateside agency charging GMH $225 per hour.

While these short-term band-aids are expensive for hospitals, a greater cost could be to the morale of the long-term dedicated staff nurses working alongside these short-term "for hire" nurses who are making double or triple the hospital-employed nurse’s pay rate and having no commitment to the hospital and to the community.

These temporary staffing solutions are unsustainable for hospitals in the long run.

Although nurses faced challenges during the first year of the pandemic, they were generally looked up to and appreciated by the vast majority of their patients.


A physician in Ohio shared with me recently, "No longer do I see the outpouring of gratitude toward nurses that was commonplace a year ago. Instead, nurses are having to put up with daily abuse by people who think they must be dying of something else, and transfer all of their guilt and anger onto the nurses trying to save their lives."

This is increasing the nurse burnout and stress, pushing dedicated hospital nurses to their wits’ end. Being required to work overtime and witnessing deaths on a daily basis have taken a toll on the nursing staff.

"Our hospital nurses are exhausted, both physically and mentally,” said Ernest Grant, president of the American Nurses Association. He sounded the alarm on Dec. 22, 2021 during an interview with ABC’s “Good Morning America.”

How much will the pandemic speed up and bring on early retirements in hospital nursing? The number remains to be seen, but this is not a good situation for those responsible for nurse staffing.

Outside of healthcare, early retirements have become a problem. Restaurants can cut back their hours and manufacturers can get behind on order fulfillment. But in the hospital field, retirements can be a devastating punch ready to knock out an already fragile situation.


U.S. hospitals already began seeing a crushing wave of retirements even prior to the Covid pandemic. Now with the pandemic causing levels of stress and burnout previously unknown in the industry, we are experiencing an unprecedented level of openings for nurse positions.

It is inevitable that an already critical nurse shortage will get worse before it gets better.

The good news is that there is now more focus on long-run solutions. Some hospitals in Detroit, for example, are developing long-range International Recruitment programs that will attract and bring nurses from the Philippines and other countries. Many states and hospitals nationwide are increasing the monies allocated for nursing scholarships.

Although there are many rocky days ahead, good hospitals realize that they cannot function without skilled nurses and will do whatever it takes to develop the next crop of talented caregivers.

Theodore Lewis is the former CEO of Guam Memorial Hospital and has a health care consulting business based out of Portland, Maine. He is collecting stories about lessons learned in life and can be reached at

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