By Ilene MacDonald 

A new analysis finds that collectively, hospitals have been paying billions to recruit and retain nurses—offering higher salaries, signing bonuses and even repaying student loans—to address the nationwide nurse shortage.

The problem is only going to get worse. With many Baby Boomer nurses set to retire, and an aging population that will need healthcare services, the Bureau of Labor Statistics projects that there will be more than a million openings for registered nurses by 2024.

Although the industry has faced shortages before, the current shortfall is more difficult to address, according to the report.

“I’ve been a nurse 40 years, and the shortage is the worst I’ve ever seen it,” Ron Moore, who recently retired as vice president and chief nursing officer for West Virginia’s Charleston Area Medical Center, told the news service. To help attract nurses—and get them to stay—the organization will reimburse their tuition if they agree to work at the hospital for two years.

While some hospitals try to meet staffing needs by employing foreign nurses, the current political climate has caused delays in issuing visas. Healthcare advocates are pushing Congress to pass proposed legislation to open the door for 8,000 international nurses to get the necessary visas to help alleviate the nursing shortage.

In the meantime, it notes that some hospitals have turned to travel nurses to fill the gaps. Staffing Industry Analysts stated that so far healthcare organizations have paid $4.8 billion for travel nurses in 2017.

But the costs are hitting rural hospitals hard. J.W. Ruby Memorial Hospital in Morganstown, West Virginia, has paid more than $10 million this year to hire and retain nurses. That money is used in part to give $10,000 signing bonuses and free housing for nurses who live more than 60 miles away from the hospital.

And that’s just the beginning. To entice longtime nurses to continue to stay in West Virginia and work at the hospital, next year J.W. Ruby Memorial may begin to pay college tuition for their family members.

Healthcare experts say other hospitals may want to follow J.W. Ruby Memorial Hospital's lead and prepare in advance for potential shortages. Among their suggestions: develop a succession plan now, and see if experienced nurses will consider delaying retirement if they can take on new roles in patient navigation or education or decrease their hours.