A dire situation is unfolding in healthcare facilities around the world. In Nova Scotia, hospitals are holding onto hundreds of patients who can’t be released into long-term care facilities because of staff shortages. Multiple U.S. states have deployed the National Guard to help handle logistical and janitorial work at overstressed hospitals, and healthcare systems everywhere are cancelling elective procedures to free up space and ease burdens on burnt-out healthcare staff.
Since the worldwide outbreak of COVID-19 in the beginning of 2020 and the devastating multiple waves that have spread across the globe since, public health measures and workplace restrictions have left an indelible impact on the size and behavior of the labor force around the world. One of the most apparent consequences of the pandemic has been a worldwide labor shortage, a phenomenon that has been perhaps most noticeable in fields like healthcare and education, and has been spreading to industries such as trucking, aviation, and restaurants.
As the pandemic unfolds, its resultant labor shortages will continue to create new goals and challenges for regulators. In the area of licensing, labor shortages have incentivized regulators to relax licensure requirements to boost the workforce’s numbers. Labor shortages may also force regulators to consider whether information in complaints arose because of inadequate staffing and consider how they respond in kind.
Licensing: how can the process be simplified?
One of the most immediate steps regulators have taken to combat pandemic-related labor shortages has been easing licensure restrictions for new or out-of-state professionals. By making it easier for applicants to get their licenses, regulators can hope to add numbers to their workforces while also trying out a new approach to licensure. Only time will tell if the easing of these restrictions will compromise the integrity of any given profession.
Hospitals across North America, for example, have faced crippling nursing shortages since the start of the pandemic — shortages that have pushed regulators to consider new policies that would relax the licensing process for nurses. In Connecticut, for example, the state’s Department of Public Health (DPH) issued an order in December 2021 allowing out-of-state healthcare professionals to work in the state without any additional licensure, provided they are in good standing in their respective home jurisdictions.
In the field of commercial transportation, the U.S. Federal Motor Carrier Safety Administration (FMCSA) announced in January 2022 that states will now have the option to waive certain parts of their commercial driver’s license exams. The move is intended to mitigate the worst effects of school bus driver shortages, which in places like Massachusetts have been so bad at times that the state has had to call in the National Guard to pick up the slack.
Where regulators have not been able to cover labor shortages by relaxing the licensing process, they have sometimes been forced to consider more drastic measures. Some healthcare regulators in British Columbia, Quebec, and Ontario, for example, responded to the outbreak of the Omicron variant in late 2021 by moving to allow symptomatic healthcare workers to return to work. B.C.’s top doctor, Dr. Bonnie Henry, explains the move as a compromise made in the face of crippling staff shortages.
“Obviously if somebody is sick, whether it’s with COVID or any other illness, we don’t want them in a workplace setting because it is a risk to others,” Henry says. “But there are certain settings where we need to make sure that we have that balancing of continuity of care; health-care workers are one.”
Complaints: what to look for in public feedback
Any uptick in complaints arising from labor shortage issues may cause regulators to reconsider their approach to investigations. They will now have to look more closely for signs indicating an incident may have stemmed either directly or indirectly from a staff shortage. These signs can present themselves in many ways because there are many ways for the consequences of a labor shortage to cause harm to the public.
A hospital experiencing a staff shortage, for example, can have nurses working outside their areas of expertise to fill gaps in coverage. Over time, staff can become burnt out and more likely to make errors in patient care. And this is to say nothing of the immediate danger that patients can be mistreated or neglected when a hospital floor is understaffed. A nurse treating four or five patients at a time is more likely to make a mistake than a nurse with one or two.
Specifically, regulators will have to make sure they do not unfairly punish professionals under their jurisdiction for incidents caused or influenced by the labor shortage. Since hospitals are already short-staffed, regulators need to be sure that the complaints levied against professionals constitute actual misconduct before penalizing these practitioners. It can be a fine line to walk, and it will simply take time for regulators to amass complaint data and make themselves aware of patterns and trends indicating staff shortages.
The future of the labor shortage
With every new wave of COVID-19 that breaks out, hospitals, schools, and other institutions continue to find themselves short-staffed and facing new lines of complaint from an underserved public. According to Cara Moroney, a former regulator, regulators will be a key stakeholder, among many, to assist in determining the true extent of the staffing deficit, both currently and for years to come. This will inform governments’ resource planning, particularly in healthcare.
Regulators hold different data than employers do and will be a source of information as to how many people gave up their licenses, which may be more of a signal than a professional who simply leaves a job. Regulators will also be able to compare, year on year, new licensees and those retiring to determine whether there will continue to be a deficit in the workforce overall. Knowing this data can help regulators and governments formulate policy on how to repopulate a particular profession by attracting new talent and/or by enticing former practitioners back into the fold.
Regulators will also spend the next few years learning whether the restrictions eased during this labor shortage actually did anything to protect the integrity of their professions in the first place. If it turns out that certain rules did, in fact, hamstring potential licensees from doing good work, regulators will have at least one path forward in continuing to relax the rules and ease the administrative burden, helping to bring qualified practitioners into the profession faster.
By looking closely at the complaint and licensee data collected in the following years, with more attention paid to certain details, regulators can equip themselves to make the difficult decisions necessary to bring strength and vitality back to the workforce, while also ensuring the public is protected from potentially unsafe or unethical care.
