The report, “On the Mend: Progress and Pain Points for Massachusetts’ Healthcare Workforce,” attributes the improvement partly to concerted efforts by hospitals and health systems to recruit, hire, and retain employees.
“Even through enormous operational challenges, our hospitals and health systems have devoted a record amount of resources to workforce in recent years,” said Valerie Fleishman, executive vice president and chief innovation officer at the association. “These investments have made a clear difference.”
The new head of the 26,000-member Massachusetts Nurses Association, the largest union of registered nurses in the state, took a decidedly dimmer view of the state of hospital staffing.
Joe-Ann Fergus, executive director of the association, said her members routinely file reports alleging unsafe nursing staffing at hospitals. Although she commended the hospital association for recognizing that nursing shortages have been a problem, she said a 10 percent vacancy rate is “not a passing grade.”
“To applaud yourself for doing less poorly? I’m not sure that would be the standard I would set, especially for hospitals in Massachusetts,” said Fergus, a registered nurse.
The hospital association released the report three years after it issued a survey that found the Massachusetts health care system in crisis. Hospitals in the state, like many across the country, struggled to handle repeated surges of COVID-19.
Although many would prefer to forget that time, it was common to see hundreds of patients crowding emergency rooms and other parts of hospitals. When patients who had been seriously ill were ready to be discharged, hospitals faced unprecedented backups in transferring them to post-acute care settings.
Overwhelming workloads spurred nurses to take leave or retire. Hospitals spent millions of dollars on more expensive traveling nurses to fill vacancies, often breaking their budgets.
Three years later, the hospital association said, the situation has improved significantly. Hospitals have increased salaries and benefits, given employees greater opportunities to advance in their careers, and sought to improve working conditions, including by preventing workplace violence, according to the report.
At the same time, the association said, Governor Maura Healey and the Legislature have taken steps to expand the pool of people who might go into health care through programs such as free tuition at community colleges.
Although the report examines the vacancy rates of a wide range of workers, from anesthesia technologists to food services aides, much of the focus is on nurses.
“It’s no coincidence that the voices of nurses and caregivers have been at the heart of our recent strides,” said Nancy Gaden, senior vice president and chief nursing officer at Boston Medical Center and cochair of the hospital association’s Workforce Leadership Task Force.
Among the jobs that have experienced the sharpest declines in vacancy rates since 2023 are nurses who work in surgery, emergency departments, psychiatric units, and intensive care, according to the report. At the same time, hospitals report a steep reduction in the use of expensive travel nurses, although temporary labor remains higher than prepandemic levels.
Several jobs continue to have high vacancy rates, according to the report. They include “sitters” who watch patients to make sure they don’t harm themselves or others; mental health workers; cardiac catheter technicians; certified nurse-midwives; endoscopy technicians; and paramedics. All have vacancy rates of at least 20 percent.
Fergus, the head of the Massachusetts Nurses Association, was underwhelmed by the progress cited by the hospital association. Indeed, she questioned whether the closing last year of Nashoba Valley Medical Center in Ayer and Carney Hospital in Dorchester, whose for-profit owner Steward Healthcare went bankrupt, and cutbacks in services at other financially strapped hospitals help explain why the percentage of vacant nursing jobs has declined from 15 to 10 statewide.
“Is that 5 percent a result of bed closures or hospital closures?” Fergus said. “Was that factored into the calculation? We don’t know.”
Fleishman, of the hospital association, said there was no relationship between the closing of the two hospitals or cutbacks in services and the decline in job vacancy rates.
Jonathan Saltzman can be reached at jonathan.saltzman@globe.com.
