During the COVID-19 pandemic, many women have had to put their careers on hold to look after children who are remote learning, to care for elderly or ill loved ones or to relocate to be closer to family. They've left their positions temporarily or permanently as they juggle priorities.
Since February 2020, more than 1 million fewer women are in the U.S. workforce, whereas men have regained all of the jobs they lost during the pandemic, according to a National Women's Law Center analysis of Bureau of Labor Statistics data. In healthcare, where the workforce is 75% women, the sector was down 2.8% of women's jobs in November 2021 from January 2020, compared to 0.32% of men's jobs, according to the Bureau of Labor Statistics. Yet, healthcare, like many other sectors, continues to have a high demand for workers.
"I think this does disproportionately impact women in that women are more likely to take time away to care for family," said Dr. Ruth Chang, chief people officer at Northwest Permanente, a physicians' group that works at Kaiser Permanente.
As COVID-19 restrictions change and schools and daycares reopen, women who left the workforce can't always jump back onto the job.
For nurses, how difficult it is to return to work depends on how long someone was away from the job, American Nurses Association President Ernest Grant said.
If they have kept their license active and stayed up-to-date on continuing education credits, it's "fairly easy for them to reenter the profession," Grant said. Others might need to take a refresher course and go through a residency-type program to make sure their skills are on par. But that varies by state.
In some states, physicians must sit for an exam if they are out of practice for more than two years, Chang said. But every medical board has different requirements.
"It would be incredible if every state had a similar, if not the same, license," she said.
Because their service area covers Oregon and Washington, physicians at Northwest Permanente are dual licensed, Chang said. That means more hurdles for doctors looking to return to work. Sometimes, if a physician moves to a new state for a spouse's job, they won't apply for a new license because of the time and cost involved, Chang said.
It can take two to three months and nearly $1,000 to acquire a medical license, she said.
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Over 16 years, Susan VanBeuge moved 10 times for her family. As a nurse, it was always easy for her to find a job wherever they settled.
In each state, she had to apply for a new license, an expensive and lengthy process, and make new connections.
"Every time you move, you kind of have to start over again," VanBeuge said. "Nursing is great that you can do that but it also hinders you from being able to grow your professional side and your professional life."
Now, through the Nurse Licensure Compact, licensed nurses can practice in nearly 40 U.S. states and territories, making it easier for nurses to relocate and, during the pandemic, respond to areas with the greatest need.
But moving or leaving the workforce can still impact nurses' careers.
"If you're anywhere in the workforce and you're not around, I think you miss out on opportunities for perhaps professional development, promotions, all of those types of things," VanBeuge said.
Chang said she frequently reminds leaders not to discount women who are going out on leave from discussions about promotions and future leadership roles.
"That's an unconscious bias I've seen over and over again," Chang said. "We need our upper-level leaders to speed up about not making decisions against women because of child rearing and childbearing."
She recommended employers offer benefits that help women, such as childcare assistance; flexible hours; or parental leave, allowing men to take time off to care for newborns.
"Employers have to be cognizant of that and create workplaces and environments that are friendly to women," VanBeuge said.
Craig Ahrens, chief strategy and partnerships officer at CareRev, which offers a cloud-based healthcare staffing platform, said workplaces can offer employees more choices about how they work, too.
"In the past, health systems had the money and the time to attract top-tier talent. There wasn't a cultural expectation of flexibility. Society has changed," Ahrens said.
Some could remain in the workforce if they could work per diem or part time, he said.
"These people exist. They're everywhere. It's not just nurses; it's CNAs," Ahrens said.