(soft piano music) - It's heartbreaking to me what's been done to nursing.

- You lay your head down at night thinking, I just didn't have time to give my patient the best care, because the workload was too much.

- Not having safe ratios puts all patients at risk.

- [Narrator] Healthcare providers everywhere are facing a shortage of nurses.

- It's backbreaking labor, it's emotionally exhausting.

- [Narrator] Stress and burnout long have been depleting the ranks.

Then the Covid pandemic came along and made things worse.

- There were times that I would find myself crying outta nowhere.

- Today is a day for nurses.

- [Narrator] Now, nurses want their voices to be heard about staffing ratios and gaps in care that they say are putting patients at risk.

- They came into this to take care of patients, not to worry if someone's gonna die or something happen, because they couldn't get in there quick enough.

- [Narrator] Who is working for change and how can patients be better prepared?

- We need healthcare, so it's important to all of us.

- [Narrator] These college students aren't playing video games inside those virtual reality headsets, they are nursing students learning how to assess a patient.

- Do you have any other medical problems?

- Hmm, not really.

I've been seeing a doctor for my stress and been taking the medication she prescribed, but I'm not sure it's really helping me much though.

- It essentially puts you in the place of being the nurse in the emergency room, and you're asking the patient A, B, C, and D, in a specific order.

- [Narrator] The new technology is part of an effort by Indiana University of Pennsylvania to admit more students into its nursing program.

Across the state, nursing schools are struggling to provide enough instructors and classroom space.

- It's challenging to find faculty that are qualified, that have the experience in the areas that are needed, and also have the educational background.

So, there is really a faculty shortage.

- [Narrator] The nursing faculty shortage is one piece of a larger puzzle that reflects a troubling trend in healthcare.

Nurses are leaving the bedside, more than 100,000 nationally during the last two years of the pandemic, and Pennsylvania's problem is among the worst.

Hospital nurse staffing vacancy rates have risen from 20.5% in 2019 to more than 30% in 2022.

Pennsylvania's shortage is projected to be the worst in the US by 2026.

- Nice to meet you.

How far along are you?

- Oh, I'm ready to deliver this baby.

- [Narrator] Nursing is still a popular career choice and schools are working to bolster the ranks in spite of their own challenges.

The virtual reality lessons require no special clinical classroom space, something that's expensive and at a premium on college campuses.

- That's why we decided to do this.

We received a grant for this technology with a hope that we were able to take more students in by using the virtual reality.

- Do you have any questions for me?

- Not at the moment.

I'd just like to know what's going on.

- I thought it was cool.

I've always enjoyed video games, so it kind of felt like I was gaming.

It made you think more like a nurse in a way that you kind of had to find what was wrong with the patient and then kind of think of what you're gonna do next.

- I started feeling a bit lightheaded.

- We did this as a psychiatric patient simulation and it turns out that George is bulimic.

- I'm not really eating very well at the moment.

- [Narrator] While schools use innovation to clear the way for more students to begin careers, established nurses want to be heard.

- I was expecting a stressful job, I was not expecting traumatic conditions.

- [Narrator] Michelle Boyle is a registered nurse at Allegheny General Hospital in Pittsburgh.

She is among nurses who rallied at the State Capitol in Harrisburg to fight for better staffing.

- Are you gonna protect our patients or not?

- [Narrator] Healthcare worker unions are calling for passage of the Patient Safety Act.

It would mandate tighter nurse patient ratios in hospitals, reducing the number of patients for each nurse.

The measure passed the State House in June 2023, and while it was awaiting senate approval, the governor signed a separate executive order aimed at bringing more nurses to the bedside.

The measure will clear the way for nurses from 40 other states to be licensed to work in Pennsylvania.

Michelle joined two other nurses to talk about what they say is the need for the mandated ratios.

This is the story she recounted when testifying in Harrisburg.

She did not name the hospital.

- There were two nurses on the floor that night.

I think they had five to six patients apiece.

There was a woman who was my age and the one nurse had to go to the bathroom.

- [Narrator] Michelle said the patient coded and the remaining nurse needed help.

- There's no aid to call out to and they're just pounding on their chest until the other nurse gets out of the bathroom and they're screaming out into the hallway.

Well, she didn't make it.

- [Narrator] That may have been an extreme case, but the nurses say inadequate staffing ratios put all patients at risk.

- So, it isn't always a matter of life and death, a lot of times it's a matter of being able to make a connection with the person who's sick and doesn't have anyone else, or being able to give the education that that person needs at discharge, so that they don't come back into the hospital two weeks later.

- [Narrator] Healthcare systems and hospital managers agree there aren't enough bedside nurses, and they say they are doing all they can to close the gap.

Still, many oppose the Patient Safety Act, saying the mandated staffing ratios would lead to fewer available beds and longer waits for care.

UPMC pointed to its own efforts to increase staffing with programs to make nursing education more affordable and accessible through tuition assistance and discounts, as well as academic partnerships, investments in allied healthcare education programs, and pay incentives for the most in-demand nursing positions.

Allegheny Health Network said it is doing everything in its power to attract talented, dedicated professionals, to their programs and facilities.

But said that mandated staffing ratios enforce a one-size-fits-all approach to patient care and are an ineffective and static tool that cannot guarantee a safe environment or quality of care.

- And what patients need is they need more nurses.

They don't need more people in suits saying we're not successful.

Money needs to be directed towards patient care and direct patient care.

That's where money needs to be going.

- [Narrator] With more than six decades of experience between them, these nurses say they know the factors at play.

Patients need more help now because healthy patients are being discharged more quickly, leaving beds occupied by the most seriously ill. - Compared to when I first became a nurse, the patients are so much sicker and we have sicker people now with less nurses to take care of them, and we can't give the patients the tools they need to be successful in their care.

- [Narrator] The nursing workforce is getting older with the average age now at 52.

As those nurses retire, years of experience leave with them.

- A one year nurse came up to me and she's like after six months, they put me in charge because I was the one who had the most experience on that floor.

- [Narrator] And the main reason for the shortage; burnout.

In a recent survey of Pittsburgh hospital workers, 87% said they were burnt out.

73% blamed insufficient staffing, and more than half said, they were not able to deliver quality care.

And the stresses are hitting even those who are just starting out.

As many as half of nurses, leave bedside care in the first three years.

- But they leave for jobs not at the bedside, with better benefits, better pay, and better life-work-life balance.

- [Narrator] And it's not just registered nurses who are leaving, hospitals and medical facilities everywhere are struggling to maintain staffing across all departments.

- If work is too stressful and you're burnt out, how long would you work at a job?

If they all of a sudden told you tomorrow, you know what, I'm gonna let all your ancillary staff and you're gonna do their jobs.

How long would you stay at that job?

- [Narrator] With nurses leaving, what can patients and their families do to protect themselves?

Patients can't do the work of nurses, but patient advocates suggest some commonsense steps.

Tell your doctor about the medicines you take.

Have a family member go with you to the doctor's office and to visit often in the hospital.

Fill out patient satisfaction surveys, hospitals value them.

And it's always okay to ask your doctor or nurse if they've washed their hands.

There are no easy answers to this problem, but hope lies in current and new nurses' dedication to their patients, and their determination to make a difference despite the challenges.

- I always tell the students, put your patient first, and then the nurse second, the institution third.

And if you do that, you'll have a great outcome for the patient.

- Really, I think of wanting to take care of people, you also get to see patients recover, which I think is the coolest part of that.

- [Narrator] And those already at the bedside, say the best thing patients can do is to demand that hospitals give nurses more help.

- Take a pause on building a new hospital, a new wing, let's invest on getting the nurses to the bedside.

- Patients deserve better, nurses deserve better.

Everybody deserves better than what is currently being done.

- You might not need a nurse today, you might not need a nurse tomorrow, but everyone will need a nurse and I will do everything I can to take care of you, but I'm gonna burn out.

(soft piano music)