For a decade, the United States has faced a critical nursing shortage, which is expected to grow through 2030—and California is bearing the brunt of the crisis. The challenges caused by the shortage, though, continue to be exacerbated by the COVID-19 pandemic as it surpasses the two-year mark, according to local hospital officials.

“They lived through the first wave of the pandemic and are entering the third year,” Tony Garcia, Long Beach Medical Center chief nursing officer, said in an email. “With the rapid omicron spread in our communities, our staff is vulnerable to contracting the infection and if they become COVID positive, they must quarantine and isolate, which makes day-to-day staffing more challenging.”

Earlier this month, California health authorities announced hospital staff that test positive for the coronavirus could continue working if they have mild symptoms or none at all, the Associated Press reported. The decision was a direct result of the staffing shortage amid the omicron surge that has seen a record number of new cases.

MemorialCare, for its part, opted to not implement the “immediate return to work” recommendation, Garcia said, for the safety of patients, physicians and other staff. COVID-positive asymptomatic staff members at St. Mary Medical Center, however, are returning to work.

“We continue to stay in close contact with state and county health departments to determine the best way to care for this surge of patients and ease the staffing crisis,” a St. Mary spokesperson said in an email. “This is an extremely challenging situation, and we are doing everything we can to ensure our hospitals can continue to operate while also keeping our staff and our patients safe.”

The two hospitals are taking various steps to offset the staffing shortage amid the surge. St. Mary is limiting visitors to the hospital, pausing non-essential surgeries and temporarily closing non-essential services.

At MemorialCare, the hiring process has been expedited to secure more nurses and other staff more quickly and traveling nurses have been brought in to fill in the gaps, Garcia said. Additionally, the hospital has non-clinical staff assisting at testing and vaccine sites, it has limited visitation and is being more selective with inpatient admission based on urgency.

The nursing shortage presented itself across the U.S. in 2012, according to a medically reviewed 2021 Healthline report. More than one million new registered nurses will be needed by 2030 to meet healthcare demands, the report states.

“In addition to newly created roles, the roles of nurses expected to retire or leave the profession will also need to be filled,” the report said. “The U.S. Bureau of Labor Statistics projects this will create a total of 175,900 openings for RNs every year until 2029.”

California has the greatest need for nurses, according to the report, followed by Texas, New Jersey, South Carolina, Alaska, Georgia and South Dakota.

There are numerous reasons for the shortage, including the aging Baby Boomer generation, healthcare reform, retirement and burnout. Two years of dealing with the coronavirus only has intensified those issues, Garcia said.

Amid the pandemic, some healthcare workers have opted to retire early, change careers or move to other areas to be closer to family, Garcia explained. They work eight- to 12-hour shifts, with some picking up extra shifts to offset the shortage.

Those who remain on the job must juggle family needs and the pandemic continues, including those whose children may still require remote learning.

“And then there are health care workers who are frustrated,” Garcia said. “Health care workers are seen as heroes but they see a community that is not willing to do the one thing that can slow this pandemic down and bring balance back into their lives—and that is vaccination.”

“The frustration can wear nurses down physically and mentally,” Garcia added, “and certainly impairs joy at work.”

The effects of the pandemic are not isolated to work for staff, Garcia said. MemorialCare has created a number of initiatives and resources to help combat burnout, including Well-Being In Stressful Events (WISE) teams of psychiatrists, counselors and spiritual care leaders who meet with staff on their units.

To relieve some of the burden off hospital staff, people should wear masks and social distance in public, as well as receive the COVID-19 vaccine and booster, the two hospitals emphasized.

“It’s important for hospitals and urgent care centers to be able to care for patients with the most immediate need,” Garcia said. “All of the preventative measures we’ve been discussing since the pandemic began … are effective. Vaccines work.”