University of Iowa Hospitals and Clinics is hiring more temporary nurses to help fill gaps left by retention issues

As the nursing shortage in the U.S. continues, the University of Iowa Hospitals and Clinics is hiring temporary agency nurses to fill gaps in its staff.


Katie Goodale

A nurse uses the walkway from the WCTC to the hospital during football media day in Kinnick Stadium on Thursday, Oct. 8, 2020.

Eleanor Hildebrandt, News Reporter

As the need for nurses continues to increase, the University of Iowa Hospitals and Clinics is using outside help to fill the gaps.

The U.S. has faced a nursing shortage for several years, UI College of Nursing Dean Julie Zerwic said. The need stems from added demand as people live longer and require more care, and fewer individuals interested in the career, she said, but the shortage now is exacerbated because of pandemic-related needs.

“The shortage is interesting because it’s really more of an issue of increasing demand for nurses because we have an aging population and people need more care… as well as nurses being utilized more than ever in out-patient settings,” Zerwic said. “Because of that, there are not enough nurses being produced to fill the need. That increased demand is anticipated to continue until 2029 or longer.”

The Bureau of Labor Statistics’ Employment Projections 2019-2029, predicts registered nurses will be one of the top occupations for job growth through 2029. The RN workforce is expected to grow 7 percent in the next decade — from 3 million in 2019 to 3.3 million in 2029. In Iowa, the 2017-2018 class of nursing students saw a 7 percent dip in students since 2015, according to the Iowa Center for Nursing Workforce.

The dean added that the shortage of nurses has impacted UIHC, which has resulted in temporary nurses being hired in the past few years.

In an email to The Daily Iowan, UIHC Public Relations Manager Laura Shoemaker said these additional nurses are hired temporarily while staff nurses are hired and trained. She said 160 nurses joined the ranks of UIHC in the last few months and are currently in orientation, with more filling in for the meantime.

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“Agency nurses will help fill the gap for us until we get everyone fully onboard, which can take a few months,” Shoemaker said.

The research hospital underwent a 60-day hiring freeze in July because of financial strain from the pandemic, but essential workers such as staff nurses could be still be hired to maintain sufficient staffing levels for patient care, Shoemaker said.

Zerwic said while temporary nurses do provide an important service and help facilitate care at hospitals, they are also more expensive to hire and create less stability within care units.

Laramie Wall, a registered nurse at UIHC, said he has seen an uptick in staff nurses leaving and temporary nurses taking their places in the past six to eight months.

“The hiring of agency nurses comes in waves and we’re definitely seeing a pretty high watermark at the moment with recent financial changes across the university due to [COVID-19],” he said. “The increase has been fairly recent. It was my understanding that this was a response to a number of furloughs, but I think it’s been more based on what feels like an increased number of people just leaving the university alongside the furloughs.”

Wall has been at UIHC since 2007 and he said the increase in hiring agency nurses has concerned him in recent years.

“In my opinion, the university does do a very good job of getting people ready to fill those positions with the orientation process,” he said. “But when they hire someone from an agency, those nurses are given twelve hours of a quick, geographical orientation of the [hospital] and then are let loose. That’s troublesome. I’ve seen firsthand the problems with it and have seen some health-care concerns with people who didn’t know where the boundaries were, which led to mistakes being made.”

Wall said he has not seen the staffing at UIHC change in response to COVID-19. He said he wished the hospital would focus on what’s going wrong with retention rather than focusing on using more temporary nurses.

“We are at a peak right now where we can’t get people to stay,” he said. “That’s a big concern. This is a gap fill and the facility needs to address it. You can’t put a patch over it forever. Retention needs to be addressed rather than using three-week contracts to fill the holes.”