With Central Texas facing a nursing shortage, new rules could help more nurses join the fight against the coronavirus

Data from the Texas Center for Nursing Workforce Studies shows that Central Texas will have a shortage of more than 7,000 registered nurses by 2030. (Graphic design by Shelby Savage/Community Impact Newspaper)
Data from the Texas Center for Nursing Workforce Studies shows that Central Texas will have a shortage of more than 7,000 registered nurses by 2030. (Graphic design by Shelby Savage/Community Impact Newspaper)

Data from the Texas Center for Nursing Workforce Studies shows that Central Texas will have a shortage of more than 7,000 registered nurses by 2030. (Graphic design by Shelby Savage/Community Impact Newspaper)

Marla Erbin-Roesemann said she remembers when she was growing up and deciding which profession she would choose as a career, her mother gave her advice that if she chose nursing, she would never have trouble finding a job.

It is a refrain that Erbin-Roesemann hears frequently now from her students and their families as the director of the St. David’s Texas State University School of Nursing program in Round Rock. And in Texas in recent years, the adage is still true.

According to data from the Texas Center for Nursing Workforce Studies, Central Texas is projected to face a shortage of 2,568 registered nurses by 2022, and in 2030 that deficit is projected to go up to 7,459 full-time equivalent positions. Statewide, according to the report, the gap between the number of registered nurses needed and the number working in 2030 is projected to be nearly 60,000.

This is not a new problem for Central Texas, where population growth has fueled a corresponding increase in medical needs. Adding to that demand is the short career span for the high-stress position of a registered nurse working at the beside of patients in the hospital. Erbin-Roesemann said nursing managers have told her they are lucky to keep a nurse for two years before that employee moves on to another role.

And Central Texas is aging, not just in its population—10.2% of the metro area is age 65 or older—but among nurses as well.

“The majority of our workforce now is baby boomers. They are of retirement age; that’s what’s causing us to see this shortage increase again,” said Serena Bumpus, the practice director of the Texas Nurses Association.

As cases of the coronavirus continue to rise locally, the consequences of that longstanding shortage could be significant for the community.

Not enough beds, not enough nurses

As of March 30, there have been 206 confirmed cases of the coronavirus in Travis County and 50 in Williamson County, including three total deaths. Local hospital resources have not yet been strained, but Dr. Mark Escott, the interim health authority for Austin Public Health, said March 26 that if local residents do not cut down ten-fold on their normal daily interactions through social distancing, the area could face a shortage of 20,000 hospital beds by June.

Anne Blumofe is a nurse who cares for patients on a medical-surgical floor at a local hospital. She said her team has been preparing for what may be coming and getting briefed daily on the evolving recommendations for best practices.

“I think there’s a lot of sadness and suspense; I think that I speak for most of the people that I work with when I say that we want to take care of people. We want to do our part,” Blumofe said. “The good thing is that each day that goes by before we have a massive influx gives us a chance to hopefully be better prepared to protect ourselves and our families.”

University of Texas models show that even with a 75% reduction in daily contacts among residents, hospitalizations may exceed the capacity of local facilities this summer.

“I think Travis County, Williamson County, we’re all preparing for what happens when we run out of beds, and we’re all praying that we don’t,” Erbin-Roesemann said.

Bumpus said normally nurses would have a 1-2 ratio with patients in critical care, meaning one nurse could care for two patients. However, if patients are intubated—or breathing through a plastic tube to receive adequate oxygen—that ratio drops to 1-1.

“We haven’t looked far enough ahead to see, ‘How many nurses does this mean we need to take care of these patients?’ Our local hospitals have, but in workforce planning at the state level, I don’t know if we know what that looks like,” Bumpus said.

Educational resources

On March 21, Gov. Greg Abbott waived certain Texas Board of Nursing regulations that could allow more nurses to to assist in the state’s coronavirus recovery efforts.

One of those waivers allowed graduates from a nursing program to extend their temporary permits to practice for up to six months, rather than the original 75-day length of the permit, before taking their licensure exams.

That means the 101 seniors in Erbin-Roesemann’s program can apply for their license in May after graduation and devote all of their immediate focus on their work with patients.

“They’re ready to graduate. Maybe more so this year, they see the need and want to be out there,” Erbin-Roesemann said.

Previously, those soon-to-be nursing graduates could only complete half their clinical coursework in a simulated environment, but with many universities closing their campuses, the requirements were waived to allow students to finish their studies under safe conditions and graduate on time.

In August, Austin Community College graduated its first class in its program that allows licensed registered nurses to receive a Bachelor of Science in Nursing, also known as RN to BSN. It helps health care organizations that want a more educated workforce, and it helps the students by opening up more career opportunities. Blumofe was a member of that first class over the summer, and while she was not working during the program, many of her peers were.

On April 2, ACC faculty member John Nation will begin his first class of the spring semester with his RN-to-BSN students, many of whom are studying to receive their bachelor’s degrees even as they are at the forefront of the community’s effort to overcome the coronavirus.

“They’re already registered nurses and are fulfilling critical roles in our community. It’s a unique time; I don’t think it’s anything like any nurse educator has ever seen before,” Nation said. “We’re focusing on supporting our students and doing the best job we can.”

Nurses answer the call

Data from Workforce Solutions of the Capital Area shows that between 2016-26, the number of available registered nurse positions in Central Texas is projected to grow to 3,225, along with 236 openings for nurse practitioners, 527 licensed vocational nurses and 904 certified nursing assistants.

Those gaps cannot be filled immediately with new graduates from nursing school or licensed nurses receiving additional education to further their careers, so hospitals are doing all they can to fill the gaps with the staff they have.

According to Bumpus, Abbott’s recent decision to postpone elective surgeries allowed nurses who have a critical care background to be redeployed in emergency rooms or intensive care units in order to meet the projected need of the community.

“It’s another set of hands and resource our hospitals are tapping into,” Bumpus said.

Nurses who are retired or let their licenses expire will also be able to re-enter the workforce more easily thanks to another waiver Abbott approved March 21 that exempts certain requirements and fees.

Bumpus said the nurses she has talked to who have asked about reactivating their licenses have expressed a desire to help their fellow nurses in the profession any way they can.

“There’s this innate need we have as nurses to step up. For a nurse who is retired who has put in more than their fair share of time, for them to come back in and help in some way, it’s admirable, it makes you proud to be a nurse,” she said.

Meanwhile, nurses, medical professionals and community members are breathing a small sigh of relief with every day that goes by without a significant spike in hospitalizations locally. Blumofe said when she went back to school and began working as a nurse, she could not have predicted this—but she is ready to be part of the solution.

“None of us know when it might be our own loved ones who need care. When you’re able to provide that to someone else, you feel a little less powerless in the face of something unknown,” she said.

Jack Flagler


COVID-19 hospitalizations also increased to 97 in the Austin metro. (Community Impact Newspaper staff)
88 new coronavirus cases in Travis County on June 1 set single-day high

COVID-19 hospitalizations also increased to 97 in the Austin metro.

Director of Elementary Schools Monica Gonzalez said June 1 that the district is looking into training teachers this summer to prepare for partial or full-time virtual learning. (Courtesy Austin ISD)
Austin ISD planning for blended teaching approach for school year beginning Aug. 18

A blended approach would allow the district to switch from in-person learning to virtual learning when needed.

Protesters and Texas Rangers stood face to face during demonstrations at the Texas Capitol on May 31. (Christopher Neely/Community Impact Newspaper)
National, state, local officials continue to blame outside agitators for turning protests violent over the weekend

As violence erupted in Austin and cities across the country over the weekend, leaders from all ranks said outside groups usurped the demonstrations and turned them chaotic.

Richard Rhodes, the president and CEO of Austin Community College, said June 1 that the district is prioritizing the hiring of a new chief equity, diversity and inclusion officer. (Courtesy Austin Community College)
Austin Community College prioritizing hiring equity officer despite ongoing hiring freeze

The district brought up the hiring during a discussion about protests and demonstrations that have taken place over the past weekend.

Businesses shuttering their doors due to coronavirus restrictions lowered the sales tax revenue collected by cities in May compared to May 2019. (Andy Li/Community Impact Newspaper)
Texas comptroller reports 13.2% year-over-year state sales tax revenue drop in May

Tax collection revenue fell significantly in several sectors from May 2019 to May 2020, according to the comptroller's office.

Bull Creek
Study finds municipal water runoff responsible for more than half of stream flow in parts of Bull Creek

A recent study found municipal water sources, such as irrigation runoff or wastewater leakage, account for at least half of Bull Creek’s stream flow in some urban areas.

Austin-based taco restaurant Veracruz All Natural added a downtown walk-up window location in late May. (Courtesy Veracruz All Natural)
Veracruz All Natural opens new walk-up window at The Line Hotel

The other locations of the local taco restaurant remain open.

Demonstrators gathered at the Texas Capitol on May 31 to protest police brutality. (Christopher Neely/Community Impact Newspaper)
Texas officials respond to demonstrations, unrest in wake of George Floyd killing

Gov. Greg Abbott issued a state of disaster in Texas on May 31, while various city officials and law enforcment responded to protests and violence over the weekend.

Austin City Hall was one of several downtown buildings to be vandalized during this past weekend's protests. (Christopher Neely/Community Impact Newspaper)
Austin leaders, representatives react to weekend protests

Local, state and federal representatives took to social media throughout the weekend to voice their opinions.

Wanderlust Wine Co. is now open in downtown Austin. (Courtesy Wanderlust Wine Co.)
Wanderlust Wine Co. now open in downtown Austin

The self-pour wine bar is open in a limited capacity. Owner Sammy Lam said he is planning a grand opening once coronavirus restrictions are lifted completely.

Protesters march toward the Texas Capitol. (Christopher Neely/Community Impact Newspaper)
PHOTOS: Demonstrators gathered in front of the Texas Capitol as protests against police brutality continued nationwide

Protests against the killings of Goerge Floyd and Michael Ramos took place throughout the weekend in Austin.

There have been 1,168 coronavirus recoveries in the county since mid-March, and active cases in Travis County are estimate at 2,011. (Community Impact Newspaper staff)
Weekend update: Austin metro coronavirus hospitalizations drop to lowest level since April 28

There have been 1,168 coronavirus recoveries in the county since mid-March, and active cases in Travis County are estimate at 2,011.