Session: How will we staff the economic engine of the hospital?

Editor's Note

Surgical services contribute a considerable portion—roughly 60%—of a facility’s revenue; healthcare facilities cannot afford to not staff surgical departments and ORs. James Stobinski, PhD, RN, CSSM(E), CNOR, CNAMB, CEO of the Competency & Credentialing Institute (CCI), offered this year’s conference attendees a more holistic outlook when discussing the staffing deficit issue, starting with the following:

• Surveys/reports show that it is increasingly difficult to staff ORs.
• CCI has seen record increases of nurses retiring their credentials since 2019.
• The demand for surgery will not go away; surgical volume is projected to have a steady increase, and projections for ambulatory surgical procedures are even higher.

“There is a continued shortage,” said Stobinski. “And yet, no one knows how many nurses in the US currently practice perioperative services.” He asked the room for guesses of how many perioperative nurses there are in the US. Guesses ranged from 40,000 to 190,000. “You’re short,” he said.

The 2020 National Nursing Workforce Survey reveals that the total number of RNs holding an active license in the US is 4,198,031 (note that these are pre-pandemic numbers). Of these, 6.7% of the respondents chose the Perioperative specialty, an increase from 5.8% in 2017. In addition, 4.5% of respondents listed Perioperative as a secondary specialty (these could be nurses in Labor and Delivery or an ambulatory setting).

When adding respondents who chose Perioperative as a primary (281,286) or secondary (188,911) specialty, the result is this: perioperative nursing is a significant part of the work duties of 470,197 RNs. And yet, there is a shortage.

“It is difficult to attract nurses to the OR,” Stobinski said. “And the title Perioperative Nurse is not a protected title.” He listed many other factors he believes contribute to the difficulty in attracting talent to the profession, including:

• How nurses come into perioperative nursing; most found their way to the OR via a supervisor.
• Training for the profession is archaic, takes place in the hospital setting, and has heavy emphasis on learning hands-on skills.
• There is no workforce planning; the employer determines who becomes a perioperative nurse.
• There is no core curriculum or standardized professional development path; the quality of training programs is highly variable.

It is hard to reconcile the above number of perioperative nurses with the staffing deficit the profession is currently facing. Staffing shortages have always plagued the profession, Stobinski said, but looking at it holistically, it becomes apparent that the issue is much more complex than people realize.

For a more detailed breakdown of CCI’s study results, analytics of perioperative competencies, and a deep dive into the considerations of workforce planning, look for CCI’s article in the June 2022 issue of OR Manager, titled "Results of competency assessment study of OR nurses in the US."