1

The Effects of COVID-19 on Staffing

Melanie Gomez

Santa Fe College

HSA4700: Healthcare Research Methods

Dr. Kezia D. Awadzi

November 30, 2023

 2

The Effects of COVID-19 on Staffing

COVID-19 remains a severe infection that has caused many deaths and disrupted

economies worldwide. In 2020, approximately 83 million individuals in the United States were

affected by the virus, and one million died in America alone (Al-Amin et al., 2022). The

increased infection rates placed enormous pressure on hospitals. Unprecedented hospital

circumstances and strain during the pandemic worsened with limited hospital capacity and

staffing. Clinical staff experienced increased workload because of limited staffing capacity,

which is correlated with patient outcomes (Al-Amin et al., 2022). The staffing requirements were

heavy and affected response to the projected high infection rates. Because of that, meeting the

required staffing resulted in the temporary redeploying of healthcare workers from surgical,

nonemergency, academic posts, allied health, and community (Abuown et al., 2020). The study's

importance arises from the increased reports of staffing shortages in mainstream media outlets

during COVID-19 and requires investigation to prevent such from reoccurring. The research

seeks to examine the impact of COVID-19 on staffing in healthcare facilities in the United

States.

Literature Search

The primary literature search was from the Academic Search Complete (SF library

Database). While the data covered several types of healthcare staff, the writer limited this paper

to healthcare professionals, primarily nursing staff (LPNs, RNs, and CNAs), since these staff

provide most direct care to patients and work in healthcare facilities. Their number may have

reduced during the COVID-19 outbreaks. The following search terms were used with specific

identifies: "COVID-19 and staffing," "COVID-19 impact on healthcare staff burnout," The

impact of COVID-19 and nurses' mental health," and "The impact of COVID-19 on health
 3

workers." The search terms produced over twenty articles, and the decision to use specific

articles was determined by considering how they answered the research question.

Literate Review

During COVID-19, nurses worked under enormous pressure because of increased

burdens, including professional strain, responsibilities, and workload (Hekel et al., 2021). Xu et

al. (2020) supported the assertion that COVID-19 saw healthcare workers, primarily nurses,

working under pressure in healthcare facilities. These facilities needed more staff and personal

protection equipment (PPE) access. Xu et al. (2020) examined the prevalence and factors

correlated with nursing homes (NHs) in the United States with NH staff shortages during

COVID-19. They found that NHs reported significant staff shortages caused by COVID-19

factors. Inadequate staff hindered the ability of NHS to fulfill the requirement of controlling

infection even when they could incur monetary penalties resulting from increased risk.

Similarly, Al-Amin et al. (2022) investigated the correlation between RNs and staffing

levels in hospital-based facilities and specialties with COVID-19 inpatient mortality rates. They

found that an adequate number of RNs lowered mortality rates caused by COVID-19 because

nurses and physicians provided emergency care. However, Hekel et al. (2021) supported the

assertion that the nursing workforce experienced increased stress and strain because of lower

staffing levels and increased workload during COVID-19. Hekel et al. (2021) found that Texas

Nurses, who accounted for 18.9%, considered quitting the profession. Nurses who also

reconsidered staying in their jobs were also considering leaving the profession.

Shen et al. (2022) examined staffing in nursing home facilities during COVID-19,

including when the pandemic was severe. They found that the severity of COVID-19 contributed

to reduced staffing levels due to absenteeism and departures. Healthcare facilities did not control
 4

the situation despite their efforts to bolster staffing using contract staff, pay overtime, and

increase hiring. Staffing declined since facilities offered these measures temporarily. Brazier et

al. (2022) reported similar findings, noting that staff shortages adversely impacted healthcare

facilities. Administrators used compensatory strategies to boost staffing, such as hiring additional

staff on contract, making overtime payments, and limiting admissions. They adopted these

measures to aid in maintaining operations and adhering to recruitment rules. Administrators in

nursing homes reported negative nurse experiences in their facilities that resulted in increased

stress and strain despite their efforts to address staffing shortages. The study's findings suggest

that nursing homes struggled with significant strain correlated with staffing shortages.

Research Statement

COVID-19 proved detrimental to all sectors, with the healthcare sector being relied upon

to prevent the virus and save lives. Equipment shortages during the beginning of COVID-19

were the main focus before it shifted to increased demand for human resources caused by

increased infection rates and staff shortages. Limited staffing threatened to provide patient-

centered care, especially in areas with high infection rates. Indeed, limited staffing levels in

healthcare facilities during COVID-19 or other pandemics could have adverse long-term effects

on the entire healthcare system, profession, and the health of a country (Abuown et al., 2020; Xu

et al., 2020). It has been established that burnout remains a significant problem affecting nurses,

physicians, and other healthcare workers. During COVID-19, healthcare workers, primarily

nurses, were needed to provide patient care, and the workload increased, resulting in fatigue

(Abuown et al., 2020; Brazier et al., 2023). Hence, an urgent need exists to investigate the impact

of COVID-19 on staffing in healthcare since the healthcare workforce, such as nurses, can help
 5

alleviate the healthcare burden and contribute to an equitable and stable healthcare delivery

system during the pandemic.

Research Question

What effects did COVID-19 have on staffing in healthcare facilities?

Methods

This study is a preliminary study on the impact of COVID-19 on staffing in healthcare

facilities. The researcher conducted the study using a structured interview group. It involved

collecting information from nurses in five hospitals in the United States. The rationale for

selecting these hospitals is because they received an increased number of COVID-19 patients

and describe the cases of nursing shortage in American government hospitals. The researcher

used a member check to clarify the information. The researcher provided the participants

sufficient time to share their experiences and the impact of staffing shortages in their hospitals.

The researcher organized and categorized the data to aid in identifying essential statements and

formulating meanings. Afterward, the investigator categorized the data into themes. All

participants were required to fill and sign a form that guaranteed confidentiality by not

mentioning their names and those of their hospitals.

Variables

The dependent study variable was the impact of healthcare staffing on COVID-19. The

independent variables were the subcategories of healthcare workforce staffing: nurses'

availability during COVID-19 and healthcare facility approaches to increased demand on

minimum staffing. That also included COVID-19's impact on staffing numbers in healthcare

facilities and COVID-19 patients placing increased demand for nurses and healthcare services.
 6

The Study's Limitations

The study has several limitations, including a sample size of 20 nurses working in

government hospitals in the United States. As a result, the sample size needed to be increased to

represent or generalize all hospitals and nurses in the United States, which requires more in-

depth research with more participants. The researcher conducted the interviews in 2023, which

could not capture nurses' perspectives into 2024. Besides, the interviews or focus group

discussions primarily targeted nurses. That may not characterize other medical workforce

insights that also responded to increased workload, patients' loss and colleagues, and increased

pressure on their health facility.

Data Collection Instruments

The researcher used a qualitative method and conducted a Focus group Discussion in

December 2023. The study provided self-administered questionnaires to 20 participants,

primarily nurses. Selecting nursing committee members helped comply with rules regarding

credentials, arrangements, and interviewing nurses based on their placements during COVID-19

and competence. Some of the questions asked included in the questionnaires included the

following:

1. Were you active during COVID-19?

2. What duties were you assigned in your healthcare facility during COVID-19?

3. Did you experience burnout, anxiety, and depression during COVID-19?

4. Did you plan to leave the profession during COVID-19?

5. What factors or reasons made you contemplate leaving the profession?

6. Do you know some nurses or colleagues who left the profession during COVID-19?

7. What was the impact of reduced staffing on your healthcare facility during COVID-19?
 7

Conclusion

This assignment was beneficial in gaining in-depth knowledge and skills in conducting

scientific research or study. The task involved in-depth reading and accessing the database to

find relevant materials to answer the research question and completing the literature review.

With that being said, the conclusion that has been determined is COVID-19 has played a huge

part in the staffing shortage.

 8

References

Abuown, A., Taube, C., & Koizia, L. J. (2020). Impact of COVID-19 second wave on healthcare

workers staffing levels. Infection Control and Hospital Epidemiology, 1–5.

https://doi.org/10.1017/ice.2020.353

Al-Amin, M., Islam, Md. N., Li, K., Shiels, N., & Buresh, J. (2022). Is there an association

between hospital staffing levels and inpatient-COVID-19 mortality rates? PLOS ONE,

17(10), e0275500. https://doi.org/10.1371/journal.pone.0275500

Brazier, J. F., Geng, F., Meehan, A., White, E. M., McGarry, B. E., Shield, R. R., & Gadbois, E.

A. (2023). Examination of staffing shortages at US nursing homes during the COVID-19

pandemic. JAMA Network Open, 6(7), e2325993-e2325993. https://doi:

10.1001/jamanetworkopen.2023.25993

Hekel, B., Branson, S., Eunjung Lim, Michel, A., & Fontenot, H. B. (2021). Factors associated

with Texas nurses’ consideration to leave the nursing workforce: Impact of the COVID-

19 Pandemic. Texas Public Health Journal, 73(4), 30–34.

Shen, K., McGarry, B. E., Grabowski, D. C., Gruber, J., & Gandhi, A. D. (2022). Staffing

patterns in US nursing homes during COVID-19 outbreaks. JAMA Health Forum, 3(7),

e222151. https://doi.org/10.1001/jamahealthforum.2022.2151

Xu, H., Intrator, O., & Bowblis, J. R. (2020). Shortages of staff in nursing homes during

COVID-19 pandemic: What are the driving factors? Journal of the American Medical

Directors Association, 21(10), 1371-1377. https://doi.org/10.1016/j.jamda.2020.08.002