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Nearly 39,000 Alabama nurses likely to leave profession in next five years

MONTGOMERY, Ala. – A total of 38,727 experienced nurses in Alabama indicated that they intend to leave the profession within the next five years, according to a new survey conducted by the Alabama Board of Nursing.

Shared during a recent meeting of the legislative Health Care Task Force, the survey also revealed that based on current trends, nurse vacancies in the state could grow to as high as 14,000 by 2027, nearly double the current nurse shortage of around 7,200.

“We can’t lose 38,000 experienced nurses and not be affected greatly in the state,” said Peggy Benson, executive director of the ABN, who shared the findings of the survey with the task force.

Broken down further, Alabama hospitals are currently short 5,422 registered nurses, 1,500 licensed practical nurses for long-term care, and 300 general licensed practical nurses. 

While the ABN did project about 25,000 new graduates will apply for nurse licenses in Alabama during that same five-year time frame, as well as an additional 8,500 from out of state, those numbers, Benson said, would not be sufficient to counter the projected losses. Furthermore, the ABN predicted that the number of nurses coming from out of state may decrease in the coming years due to the Nurse Licensure Compact, an interstate agreement that allows nurses to practice in multiple states.

As nurses in Alabama are paid the second-lowest median salary in the nation at $56,570, ahead of only South Dakota’s $55,660, many have taken on second jobs, further contributing to burnout and eventual retirement. Of the 84,779 Alabama nurses that participated in the survey, roughly 58,000 of them indicated that they hold a second job, 37,000 of which spend at least 32 hours a week at that second job.

“Losing 38,000 is a projection, but presumably some could be persuaded to stay if they got more pay?” asked task force member David White, senior policy advisor with Gov. Kay Ivey’s office.

“Pay has always been an issue, (but) the Board of Nursing tries not to get into pay,” Benson said.

“Alabama is on the lower side of the pay structure, (but) I don’t know that that would keep the nursing workforce. I think we’re going to have to look at many things; pay is one of them, but many things related to the schedules, related to how you’re legalizing the older nurses and those kinds of things.”

David White speaks at the Sept. 26 meeting of the Health Care Task Force.

Outside of advocating for pay increases, what Benson did advocate for as a way to prevent an impending nurse shortage crisis were four proposals.

The first were legislative revisions to the Nurse Practice Act, a longstanding law in Alabama that codifies definitions and practices related to nursing. 

Among the revisions to the Nurse Practice Act Benson proposed were to allow for the ABN to apply for and award grants to provide mental health and substance abuse counseling and testing for nurses to return to practice. Along with increased work burnout and stress, substance abuse among nurses has risen dramatically since the onset of the COVID-19 pandemic, and is a large factor in nurses leaving their profession.

Another proposal offered by Benson was for the Legislature to pass legislation that would fund a practical nursing dual enrollment program for high school students. Another was for the Legislature to provide supplemental funding in 2024 for the state’s Education Loan Repayment Program, which, with adequate funding, would allow nurses to have up to $60,000 of loans forgiven were they to work in underserved areas.

Lastly, Benson proposed the Legislature provide $2 million for the ABN for the continued development of its licensing management system, which she said was inadequate to meet existing demands.

“We still have ongoing issues with our license management system, I put it on the list again this year,” Benson said. “I can do this, the Board of Nursing can do this, but it’s going to take me years; I don’t have the money to get us to where we need to be.”

Unanimously, the task force voted to support all four of Benson’s recommendations, as well as a fifth recommendation to reauthorize the ReEngage Alabama Grant Program, which assists older adults with completing degree programs in high-demand sectors. The task force’s supported recommendations will be forwarded to the Legislature and considered during the next legislative session in 2024.

Sen. April Weaver, R-Briefield, the chair of the task force and the only registered nurse in the Legislature, told Alabama Daily News after the meeting that she would be working on drafting legislation to help alleviate the nursing shortage in the coming months.

“Obviously, based on the information that was presented today by the Board of Nursing, we are facing some really difficult challenges relating to the nursing workforce, and that is certainly something I’ll be working on in the months ahead,” Weaver told ADN.

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