Nurse employment data during the first 15 months of the COVID-19 pandemic shows that the health care labor market tightened overall, but certain workers and settings were affected more than others.
That’s according to a new analysis published by Health Affairs on Tuesday that analyzed aggregate data from the U.S. Bureau of Labor Statistics from February 2020 to June 2021 for registered nurses (RNs), licensed practical nurses (LPNs) and nursing assistants (NAs).
The decline in health care employment during the pandemic was unprecedented. Dating back to 1990, overall health care employment had never decreased, yet it did during that 15-month period.
While the amount of home health nurses decreased by about 7% in the early months of the pandemic, that number eventually rebounded, though not entirely. The analysis shows that by June 2021, there were still about 4% less home health care nurses than there were in February 2020.
In fact, home health was one of the three sectors hit worst by the initial effects of COVID-19, along with physician offices and outpatient care centers, which saw 11% and 8% dips in employment, respectively.
But all three of those sectors recovered, at least in part. As of last June, outpatient care centers had a stronger labor market than they did before the pandemic; physician offices had made a near-complete recovery; and home health had improved, but not fully.
Conversely, nursing homes were not hit as hard by April 2020, as the setting experienced only a 3% dip. But their decline continued, unlike in home health. Nursing home employment has steadily lost workers, reaching an over 13% decrease by June.
Non-hospital settings were the hardest hit by the labor squeeze, which was marked by “falling employment and rising wages through June 2021,” the Health Affairs analysis shows.
Since 2011, the amount of full-time LPNs and NAs remained steady, with only the RN population slightly increasing from 2.4 million to just under 3 million. That is until the pandemic, when the RN increases leveled off, and the amount of LPNs and NAs began to decrease.
Unemployment in non-hospital settings – including home health – peaked for RNs in the second quarter of 2020. For LPNs, that peak came in the third quarter of 2020, and NAs have seen a high rate of unemployment in non-hospital settings for almost that entire 15-month period.
Despite the need for nurses being higher than ever, there were less of them in home health care by June.
But there are likely many reasons why the data shows what it does: layoffs at the beginning of the pandemic that ultimately ended in exits from the industry; employee burnout; vaccine hesitancy; unemployment benefits; or even an inability to work due to family caregiving responsibilities during this time period.
Either way, home health agencies are scrambling to maintain all the employees they do have.
“We don’t want any clinician to leave,” Jennifer Sheets, president and CEO of Caring Brands International and Interim HealthCare, said during Home Health Care News Home Care Conference in December. “For instance, we make sure that [for] those that fall under a vaccine mandate, we’re redeploying workers that are vaccinated. And the ones that aren’t, they’re providing service somewhere else where we can use them.”
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