A new report on the status of nursing in Montana highlights the increased demand for nurses in the state, an industry that has become more strained than ever during the COVID-19 pandemic.

“Montana’s healthcare system relies on a highly-skilled nursing workforce. Increased retirements from an aging population combined with increased demand on the healthcare system from a global pandemic have made understanding the current and future nursing workforce essential,” the report says.

According to the report, Montana’s unemployment rate among registered nurses is just 1.2%, slightly below the national average of 1.9%, indicating tight labor markets.

At the same time, the median age of registered nurses in Montana has fallen from 48.5 to 47.6 years old, according to the report, suggesting older workers are retiring and being replaced by a younger generation. And nationally, 18 percent of nurses surveyed said they plan on retiring in the next five years, which amounts to around 570 workers per year.

But what the report does not account for is how many nurses are leaving the field altogether, said Vicky Byrd, a registered nurse of 33 years and CEO of the Montana Nurses Association.

“One nurse literally quit on Wednesday and said they wouldn’t come back. A lot of them won’t come to the profession because they are emotionally and spiritually damaged,” Byrd said, referring to the toll the pandemic has taken.

The report resulted from a survey by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers. The national-level survey is sent out to a random sample of individuals that hold either an active registered nurse license or an active licensed practical/vocational nurse license. In Montana, 2,161 registered nurses were mailed a survey, and 843 responded.

“The COVID-19 pandemic has highlighted the vital role nurses play in the state’s healthcare system and economy. Ensuring the state’s workforce is healthy and safe is critical to continued economic growth,” the report says. “For the better part of the last two decades, Montana has faced a workforce shortage with low unemployment rates, and businesses across the state reported difficulty hiring.”

To help combat the workforce shortage, Montana joined the Nurse Licensure Compact in 2015, allowing all nurses with a primary residence in the state to be eligible for a multistate license.  The report says multistate licensing can help overcome workforce shortages in nursing by allowing employers to hire from outside the state.

But Byrd disagreed.

“The Montana Nurses Association has always had a problem with the multistate licensure. Employers can already hire from out of state,” she said.  Because nursing shortages are a country-wide issue, Byrd said multistate licensures do not help bolster the workforce and instead shifts nurses among beleaguered states. 

According to the report, 78 percent of Montana’s registered nurses hold a multistate license.

“All states have nursing workforce issues. And even within our state, many of our nurses that have full-time jobs are leaving those jobs to take a travel nurse assignment with the state,” she said.

On Wednesday, Byrd said two nurses said they were leaving their full-time nursing positions to take travel nursing positions within the state, which pays more.

“Now our hospitals are paying exorbitant amounts for travel nurses whether it’s within or out of the state,” Byrd said.

On average, travel nurses earn an average salary of $76,380, according to nursingprocess.org, compared to the statewide average of $60,000 for registered nurses holding a bachelor’s or associate degree.

But nursing wages have grown in the last five years, according to the report, which says is “important for recruitment and retention of qualified faculty needed to train the future workforce.”

Most nurses in the state — 60 percent — hold a bachelor’s degree, and 35 percent have an associate’s degree. However, the report says there is a minimum wage difference in salary between nurses with bachelor’s degrees compared to associate degrees due to tight labor markets. But nurses with a master’s degree in the state earn on average $90,000 per year, according to the report.

The Southwest and South Central regions, which include Bozeman, Helena, and Billings, have above average bachelor’s degree RNs compared to the rest of the state, according to the report.

“Higher educational attainment in the Southwest likely results from the presence of Montana State University’s nursing programs within the region, the report says. “For the South Central region, the high level of bachelor’s educated nurses is likely attributable to the large hospital employment. Hospitals are more likely to employ bachelor’s degree trained RNs than are other types of medical employers.”

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