Nursing Shortage in the US
The nursing shortage is locked in a self-perpetuating cycle: as more people leave the profession, remaining nurses must work harder and, thus, experience more stress to make up for the lack of staff which, in turn, makes them more likely to leave their jobs [1]. It is no wonder, then, that with nursing shortages being reported for decades [2], the problem has grown worse over time. In just the last two years, 100,000 registered nurses have given up the profession, and an additional 610,388 intend to leave by 2027 [3]. Given the dire consequences that a lack of nurses has on the US healthcare system, it is crucial to understand the causes of this mass exit and the longstanding nursing shortage.
The causes of nursing shortages are manifold. Chronic short staffing by cost-cutting employers, low morale, and insufficient or overly exclusive educational programs have all contributed to the paucity of nurses currently in the workforce [1, 4]. Discrimination against nurses of color, whose patients may refuse their services or attack them, also contributes to the shortage [4, 5]. Additionally, older nurses have struggled with new technology to the point that many have left the field [5]. And strain related to COVID-19 has exacerbated the lack of nurses, with approximately one-third of nurses reporting a desire to leave their profession because of the pandemic per a 2023 survey [1].
If these problems are allowed to continue, patients throughout the US will suffer tremendously as the nursing shortage continues. Having fewer nurses means remaining nurses will be tasked with caring for more patients [4]. Despite their best intentions, overworked nurses are likelier to be less attentive in their care and commit more errors [4]. Considering the association between adequate staffing and “reduced mortality, shorter hospital stays, and reduced incidence of adverse patient events,” the benefits of avoiding overstaffing nurses could not be clearer [4]. Furthermore, a diversity of nurses may make it easier to communicate and build greater trust with patients from minority backgrounds [4]. With fewer nurses among their healthcare staff, the quality of care for patients from traditionally marginalized backgrounds may suffer [4].
With the causes and consequences of the US nursing shortage established, it is now helpful to consider solutions to this pervasive problem. One class of solutions focuses on improving education. Programs aimed at increasing state funds for nursing faculty could boost educational institutions’ enrollment capacity [6]. Similarly, allowing high school students to take college credit courses in anticipation of a nursing degree may jumpstart them on their educational path [6]. And issuing grants toward nursing training, as the Department of Labor is doing through its Nursing Expansion Grant Program, may also better prepare nursing students for the rigors of the hospital, which in turn could lower stress levels and minimize the risk of early retirement [6].
Beyond education-level initiatives, there are a variety of other strategies helpful in addressing the nursing shortage. One option involves providing nurses with the opportunity to exercise greater autonomy in their workplaces [5]. By allowing nurses to weigh in on decisions regarding staff shortages, healthcare administrators may reach solutions that convince nurses to remain in the profession [5]. Other strategies may also be helpful, including facilitating the visa process for foreign-trained nurses so they can work in the US or protecting nurses against intimidation and violence [3].
By implementing a variety of programs responsive to the challenges faced by nurses today, policymakers and other authorities in healthcare may more effectively address the nursing shortage in the US.
References
[1] J. Diaz, “Nearly a Third of Nurses Nationwide Say They Are Likely to Leave the Profession,” NPR, Updated May 2, 2023. [Online]. Available: https://www.npr.org/2023/05/02/1173107527/nursing-staffing-crisis.
[2] J. Whelan, “Where Did All the Nurses Go?,” Penn Nursing. [Online]. Available: https://www.nursing.upenn.edu/nhhc/workforce-issues/where-did-all-the-nurses-go/.
[3] “Study Projects Nursing Shortage Crisis Will Continue Without Concerted Action,” American Hospital Association, Updated Apr. 13, 2023. [Online]. Available: https://www.aha.org/news/headline/2023-04-13-study-projects-nursing-shortage-crisis-will-continue-without-concerted-action.
[4] M. Zhavoronkova et al., “How To Ease the Nursing Shortage in America,” CAP, Updated May 23, 2023. [Online]. Available: https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/.
[5] L. M. Haddad, P. Annamaraju, and T. J. Toney-Butler, “Nursing Shortage,” StatPearls, Updated Feb. 13, 2023. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK493175/.
[6] J. Haines, “The State of the Nation’s Nursing Shortage,” U.S. News, Updated Nov. 1, 2022. [Online]. Available: https://www.usnews.com/news/health-news/articles/2022-11-01/the-state-of-the-nations-nursing-shortage.