THE PRESIDENT of the Massachusetts Nurses Association says there is no shortage of nurses in the state, just a shortage of nurses willing to work under existing staffing conditions.

Hospitals insist they are grappling with a shortage of nurses, forced to hire temporary replacements at enormous cost. A June survey of more than half the state’s acute care hospitals by the Massachusetts Hospital Association found the vacancy rate for nurses had risen from 6.4 percent in 2019 to 13.6 percent in 2022. 

Katie Murphy, president of the nurses association, said there are 25,000 more licensed nurses in the state today than there were in 2019. The problem, she says, is that many of them are unwilling to work under the current conditions, which require them to care for too many patients at a time.

Murphy said some nurses are quitting or retiring, while others are going to medical school or seeking out jobs in less demanding areas of health care. 

“The reason why nurses are walking away is because the conditions in hospitals are so dire,” she said on The Codcast with Paul Hattis of the Lown Institute and John McDonough of the T.H. Chan School of Public Health at Harvard University.

Murphy said nurses at some hospitals are struggling to keep up with their patient loads, often with inadequate resources. She said nurses at some hospitals are being told they cannot take vacations.

“It’s really hospitals taking advantage of the fact that we’re not going to abandon our patients,” said Murphy, who works in the intensive care unit at Brigham and Women’s Hospital.

Many hospitals are bolstering their nursing staff by bringing in traveling nurses, who typically come to work for temporary periods and then move on. Murphy said the traveling nurses are a symptom but not a solution to the staffing problems plaguing the health care system as a whole.

“If you bring in nurses from out of state to fill in for 12 weeks, you’re not fixing the underlying problem,” she said. “Unfortunately, patients will continue to fare poorly and hospitals will fare poorly.” 

The Massachusetts Nurses Association led the charge in 2018 for a ballot question that would have established minimum nurse-to-patient staffing ratios, but it went down to defeat. 

Murphy blamed the loss on a massive hospital effort to defeat the measure and a report from the Health Policy Commission that said the cost of the proposed law could reach nearly $1 billion. 

Hattis asked Murphy whether burnout was a problem for nurses and whether there was a way to address it. Murphy, however, objected to the term. 

“Isn’t that crazy about the word burnout because that kind of puts the onus on me and the bedside nurse when really the one term that people are using more is exploitation,” she said. 

Murphy said nurses are continuing to push for a stronger voice in the workplace. “Nurses seem to have found a greater voice,” she said. “They said, ‘No, we’re the experts, we know what we need, we know what our patients need, we know what hospitals need, now you need to listen to us.’”