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Work Begins Now on Long-Term Workforce Challenges

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“The healthcare workforce is burned-out following a nearly two-year face-off against COVID-19. This impact will be felt by all of us, regardless of where we live or our field of work.”

— John Derse, healthcare industry vertical leader at Mercer, a N.Y.-based asset management firm

None of you needs a national report to understand the depths of the workforce challenges for California’s hospitals. From a shortfall in the workforce pipeline to a wave of early retirements and departures, to a remaining force of women and men who are depressed and struggling to find meaning in their daily work, there is genuine concern that there will be increasing difficulty to meet the health care needs of all Californians. 

Some of the data in Mercer’s Sept. 30 report help paint the picture of just how dire the environment is: 

  • More than 6.5 million individuals will permanently leave certain jobs (medical assistants, home health aides, nursing assistants) within five years, and only 1.9 million will take their positions. 
  • New York and California are each projected to fall short by 500,000 health care workers as early as 2026, driven by workers who decide to permanently leave their career in health care, with 1.6 million leaving for good in the next five years. 
  • 12% of family medicine, pediatric, and obstetrics and gynecology physicians are age 65 or older; by 2026 that number will grow to 21%. 
  • Over 3 million individuals work as registered nurses in the U.S., and the demand for nurses is estimated to grow by at least 5% over the next five years. 
  • In the next five years, 900,000 nurses are projected to permanently leave the profession, and employers will need to hire 1.1 million nurses by 2026. 

The data are troubling at the state level as well. A report on California’s nursing shortage that UCSF released in late August states it will take until 2026 to close the nursing shortage gap. From the study: “The preliminary data from the 2020 Survey of Registered Nurses indicate that many older RNs have left nursing, and a large number intend to retire or quit within the next two years. At the same time, unemployment among younger RNs increased and there were (small) decreases in new enrollments in RN education programs during the 2019-20 and 2020-21 academic years.” 

All of this means it’s harder for California’s hospital leaders to create short- and long-term plans to ensure health care services will be available when they are needed. And the workforce shortage is exacerbated in some communities by both the COVID-19 pandemic and the vaccine mandate deadline, especially in communities with low vaccination rates.  

At our request, they have created a concrete process for hospitals to raise any impairments to patient care that have come up as a result of the mandate. We encourage you to use this process if needed. As a reminder, if your health care facility experiences significant patient care delivery issues, please reach out to the local California Department of Public Health (CDPH) Licensing and Certification district office and the CDPH duty (

The workforce challenges hospitals are facing today and into the future will be an issue that is front and center for CHA’s advocacy work in the coming months and years — at the state and federal levels. This will be a decade-long effort to resolve. As the UCSF report notes, “With a shortage of RNs likely underway now, employers need to redouble their efforts to retain RNs and develop career paths for newly-graduated RNs. They also need to rapidly develop and implement strategies to mitigate the potential harm of shortages over the next five years.” 

As we begin to conceive and advance solutions, it’s vital that this becomes an effort broadly shared among hospitals, labor organizations, public policy makers, and more. COVID-19 may have sparked this challenge, but it will have ramifications for years if we do not come together quickly on solutions that are both meaningful and sustainable.