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State of the Healthcare Workforce in Texas

Texas entered the COVID-19 pandemic with a 10% shortage of nurses, per the Texas Hospital Association (THA), and four significant surges in COVID cases with little to no reprieve only exacerbated the problem. While the most recent surge appears to be subsiding, there’s always the threat of another wave around the corner. Travel nurses were in high demand in Texas throughout 2021, as they were across the country, to help fill the gaps. To help curb ongoing staffing shortages in the state, especially among major Dallas healthcare and Houston healthcare systems, healthcare hiring must focus on attracting permanent staff. Although there are numerous perks to taking permanent staff nursing jobs, many travel nurses aren’t ready to make the switch to become perm nurses in Texas or elsewhere.


Healthcare Hiring Climate in Texas

After battling COVID-19 for more than two years, nurses in Texas are exhausted, as they are across the nation. Many believe burnout is largely to blame for the serious nursing shortages seen across the state and these shortages are only expected to get worse. In 2021, the lack of available nurses drove up salaries and created a competitive job market with thousands of positions remaining open throughout Texas. According to a 2021 labor analysis by the Texas Workforce Commission (TWC), there were 23,000 more unfilled registered nursing jobs in Texas than there were nurses seeking to fill them.

The demand for healthcare professionals continues to grow, creating massive shortages or projected shortages across the entire healthcare industry. Although these shortages aren’t just in nursing, the nursing field has some of the largest immediate issues. A February 2022 TWC Labor Market Information group report states there’s been a significant demand for nurses to fill job postings for the past 10 years in Texas, but the COVID-19 pandemic highlighted the critical shortage of RNs in the state and across the nation. By 2032, it’s estimated that Texas will have a deficit of 57,012 RNs in its labor market.


Travel Nurse Opinions on Permanent Nursing

Unfortunately, opinions on taking permanent nursing roles aren’t as promising as they could be, potentially perpetuating the lack of Dallas perm nurses and Houston perm nurses for the foreseeable future. A recent survey conducted by Vivian Health asked a group of current travel, per diem, or unemployed nurses their opinion on taking permanent positions. Among respondents from Texas, nearly 17% said they were open to working a permanent role in the future. About 22% said they were even considering working in a full-time or part-time permanent staff position within a varied timeframe:

  • 21% said they were currently searching
  • 8% said they’d start searching within 6 months
  • 4% said they’d begin searching within 6 to 12 months
  • 11% said they’d start searching within 1 to 2 years
  • 13% said it’d be more than 2 years before they began their search

Another section of the survey asked respondents from Texas currently working as travel nurses to name the hourly rate that would make them accept a permanent staff nursing job. The average response was $75.97 per hour. The average included about 16% who said between $50 and $75 per hour, 3.5% who said between $75 and $100, 3.5% who said over $100, and nearly 12% who said no amount would entice them to make the switch.


Staff Nursing Shortages

In 2021, hospitals in Texas struggled with historically low staffing levels. However, in the same Vivian Health survey, about 19% of Texas respondents felt staffing shortages were worse in 2020 compared to 2021. Another 46.5% felt staffing shortages were about the same in 2021 as they were in 2020, while 36.5% felt staffing shortages were worse in 2021 compared to 2020. About 39% of Texas nurses surveyed felt their unit was short-staffed all the time, every day.



Nurses Leaving the Profession

Many perm nurses aren’t happy in their current jobs and are considering a change, potentially including a change in nursing roles or facilities. Of the Texas nurses surveyed, slightly more than 62% said they were considering changing jobs in 2022. The most cited reason for the change was compensation, with 75% of surveyed nurses stating it would factor into whether they stayed at their current job or found a new position. Other top factors impacting their decision to change jobs included:

  • 49% Mental Wellbeing
  • 46% Staff to Patient Ratios
  • 41% Respect
  • 36% Benefits
  • 35% Shift Flexibility

After the most traumatic two years of their career on the front lines battling the COVID-19 pandemic, some nurses in Texas aren’t just considering a job change but an entire career change. When asked whether they were considering leaving the healthcare profession, about 38% said no, however:

  • 10.5% responded yes, within the next 0 to 6 months
  • 8% said within the next 7 to 12 months
  • 18% said within the next 1 to 2 years
  • 26% said within the next 3 to 5 years

The desire to leave the nursing profession entirely may partially stem from stress and a work environment that doesn’t support their mental health. Nearly 68% of nurses in Texas who responded to the survey said that overall morale had gotten worse in their hospital since this time last year. A resounding 78% said they didn’t feel their employers were doing enough to support their mental health and well-being.



What’s on the Horizon for Texas Employers

Staffing issues are some of the top challenges healthcare employers in Texas face. Whether you’re a Houston healthcare employer or a Dallas healthcare employer, the most significant demand for RNs and LVNs will be in the inpatient hospital setting. According to the Texas Center for Nursing Workforce Studies, the statewide supply and demand for nurse FTEs through 2032 will face a shortage of most nurse types. By 2032, the supply of RN FTEs in Texas is expected to grow by 30.5%, while demand is expected to grow by 38.8%, leaving a deficit of 57,012 RN FTEs. The number of nurses they have versus the number they need may never align without change.

In February 2022, the Texas Workforce Commission announced a change it’s hoping will help healthcare employers across the state. It said an allocation of $15 million in funding would be going towards developing a statewide healthcare industry apprenticeship initiative to increase career pathway opportunities for RNs and other healthcare professionals. The Statewide Healthcare Registered Apprenticeship Initiative offers healthcare employers an innovative approach to hiring and training future nurses and other healthcare staff through expanded opportunities for students pursuing career pathways to RN certification. It will also expedite application processes and coordinate across multiple workforce areas.


Getting Radical With Recruiting

The Texas Hospital Association stated in a February 2022 Texas Hospitals Magazine article that hospitals struggled to attract and retain adequate staff throughout the COVID-19 pandemic. Through this struggle, healthcare facilities across the country learned the importance of using dependable staffing partners to help bridge their staffing gaps with access to expedited staffing. The author stated that qualified staffing partners not only provide short-term solutions for crisis staffing but can also assist with developing post-pandemic workforce plans to help alleviate the burden on hospital staff.

Vivian Health helps you connect with qualified healthcare candidates actively looking for work and places nurses in Houston, Dallas, and throughout Texas in jobs they’ll love. Schedule a demo with Vivian Health and let us help you meet your current and future hiring goals.


Get early access to this year's State of the Healthcare Workforce Survey. 

Moira K. McGhee

Moira K. McGhee

Moira K. McGhee is Vivian’s Senior Editor & All-Around Wordsmith. As part of the Vivian Health team, she strives to help support the empowerment of nurses and other medical professionals in their pursuits to find top-notch travel, staff, per diem and local contract jobs.

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