When Lack of Childcare Drives Nurse Turnover

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

The Nursing Workforce in 2021 is not the same workforce we had in 2019 – especially demographically. Large numbers of Baby Boomer and Older Gen X nurses have or are in the process of retiring. 60% of the current nursing workforce are either Millennials or Generation Z. By 2025, these two generations will be closer to 75% of the workforce, AND they are in their prime childbearing years. Over the past three weeks, I have been doing virtual retention workshops for health systems nationwide. I am surprised at how many nurse managers have told me the same thing – their younger staff are leaving because they can’t find childcare.

Lack of childcare is now a crucial workforce issue in the United States. Many childcare centers shut down during COVID and have not reopened. Compared to the 1980s and 1990s, few health systems have childcare available or partnerships with local childcare agencies. The challenges are illustrated in this story from a critical-care director during a recent interview. She lives in a Midwest COVID hotspot in a medium-sized metropolitan area. The community hospital where she works is part of a larger health system. She manages two critical units, and due to COVID, they are expanding ICU beds. She painted the following picture about what is happening in her setting:

We saw some COVID in our community last spring and fall, but nothing close to what we see now. We are surging with COVID patients and expect to run out of ICU beds soon. We need critical nurses to staff them to expand the number of beds, and we don’t have them. Many of my experienced critical care nurses have opted to retire early or seek telehealth jobs. More than half of my current staff are Millennial nurses (born 1981-1996). Most now have kids; some are school-age, but many are much younger. Some are single parents. Others have spouses or partners who also work outside the home. We had a large, well-run childcare center about two blocks from the hospital but not any longer. I am getting multiple texts from frantic nurses about not having childcare for their next shift. There seem to be no good solutions. I now have young nurses at the breaking point – stressed at work and stressed at home. I had one single Mom put in her resignation after a weekend shift telling the house supervisor that she had reached her breaking point. I did not process that resignation – she had been with me for six years, and this was heartbreaking.

Even before this latest surge, there have been widespread reports about the childcare industry in the US being at the point of collapse. It is unclear what will happen in the Fall. Schools plan to reopen in person but whether they can stay open with the Delta variant is a key concern.

Now is the time for nurse leaders to get involved in this critical situation by doing a demographic profile of their current nursing staff to learn how many might be struggling with this issue. It might not be realistic to set up a childcare center in the midst of the fourth surge of COVID, but it might make sense to partner with and fund a childcare business. Some nurses are forced into making difficult decisions about family versus work. It all comes at a time when we need them more than ever. Supporting childcare could be a critical recruitment and retention differentiator.

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