Health and Healthcare

How Many of America's 3.8 Million Nurses Will Keep Jobs?

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There are 3.8 million registered nurses in the United States. Those who work for hospitals and medical centers will have jobs for months, if not years. About 60% of nurses work in hospitals. Most of the rest work in private practices. As private practices fail for lack of patients, many of these jobs are at risk.

Registered nurses go through a long education period. Some have bachelor’s degrees in nursing. Virtually all have to pass the NCLEX-RN (National Council Licensure Examination-Registered Nurse) test.

The problem with private practices is the coronavirus has shuttered many offices. The doctors who run these have to pay rent, insurance, staff (which includes nurses) and the cost of medical supplies and instruments. The government may pay some laid-off physician staff for a period, but that period may end in a few months. The American Medical Association has a long list of guidelines for how doctors can stay in business. None addresses what doctors do when they run out of money. Government loans may support some, but nothing can replace patient fees that many doctors receive every day.

The doctors, and therefore many nurses, who face severe financial shortfalls in their business fall into two groups. Just over 100,000 doctors are primary care physicians. Some will shutter their offices out of concern for doctor, staff and patient safety as the coronavirus spreads. Doctors who work in certain specialties, of which there are about 40, may be unable to treat patients at all. There are almost 20,000 ophthalmologists, 13,000 neurologists, 57,000 pediatricians and 7,000 plastic surgeons. Among these and several other specialties, office visits will drop to near zero as the number of sick and dead people multiplies.

Telemedicine has been suggested as one potential way to treat patients. However, the means to bill for these “visits” are ill-defined. In some cases, the doctor needs to examine and see the patient physically. Areas under lockdown make this impossible for many physicians. Doctors using telemedicine still need to pay office rents and insurance and sometimes staff members. Furthermore, telemedicine visits do not need to operate with both a doctor and a nurse in the video consultation.

A nurse employment crisis based on financial issues is about to begin in America and will get worse as the pandemic persists. Some nurses who practiced before the spread of COVID-19 will never come back.


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