Addressing the Nursing Shortage

Submitted by Maureen Kroning, RN EdD

Tags: nurse Nurse and Burnout nurse shortage nurse workload Nurse-to-Patient Ratios nursing shortage profession students

Research underscores a critical and complex nursing shortage both in the U.S. and globally, with projections indicating that this challenge will persist for years to come. This shortage is fueled by several interconnected factors, including increased demand due to an aging population, high levels of burnout and poor working conditions prompting nurses to leave the profession, and limited capacity within nursing schools caused by a lack of faculty, clinical training sites and clinical preceptors, and budget constraints. Additionally, declining nursing student enrollment and inadequate nurse faculty salaries further shrink the pipeline of nurses pursuing advanced education, exacerbating the shortage of qualified educators needed to train the next generation of nurses. Addressing these systemic issues is vital to sustaining the nursing workforce and ensuring the future of healthcare. Innovative approaches are needed to address this crisis, including increasing nursing school enrollment, reducing time-to-graduation, creating new clinical opportunities, and supporting nurse faculty.

The Severity of the Nursing Shortage

The nursing shortage is not just a US problem, it's a global one. The shortage is projected to worsen through 2030 and 2031, due to the aging population, nurse retirements and nurses leaving the field. The Bureau of Labor Statistics projects 203,200 openings for Registered Nurses each year through 2031 (ANA, 2022). The COVID-19 pandemic exacerbated the shortage by increasing burnout among nurses and contributing to a decline in the number of students entering nursing programs. Furthermore, nursing schools are not producing enough graduates to meet the growing demand.

Causes of the Nursing Shortage:

Nurses are facing significant burnout due to chronic staffing shortages and the demanding physical and emotional nature of their work. With 15 years of experience as a nursing supervisor, I’ve seen firsthand how many nurses arrive at their shifts knowing they will likely be working understaffed, which intensifies their feelings of burnout. Many express frustration and sadness, feeling unable to provide the level of care their patients deserve due to time constraints and overwhelming workloads.

A major challenge in addressing the nursing shortage is the lack of qualified nurse educators. The shortage of nurse faculty is directly impacting the ability of schools to produce enough nursing graduates. Many schools are forced to cap enrollment to meet faculty-to-student ratio requirements. Compounding the issue, nurse educators often earn less than newly licensed RNs in their first year, discouraging many nurses from pursuing teaching roles. According to the AACN, 1,977 full-time nurse faculty positions are currently vacant.

In addition to insufficient number of nurse faculty, nursing programs also report limited clinical sites, clinical preceptors, and budget constraints which all lead to limiting the number of students nursing programs can accept. According to AACN data, schools denied almost 92,000 qualified applications in the 2021-2022 academic year. Nursing programs are turning away qualified applicants due to lack of resources, infrastructure, and capacity, and thus, not fully addressing the demand.

Strategies to Increase the Nursing Pipeline:

There are effective strategies that can be effective in increasing the nursing pipeline. These strategies include:

Support nurses currently in the profession and implementing strategies to address burnout, incivility, and workplace challenges will not only improve retention but also strengthen and expand the nursing pipeline, helping to mitigate the ongoing nursing shortage.
Promote a positive image of nursing by highlighting positive, inspirational stories from nurses currently working in the field.
Expose students to the profession of nursing as they begin career exploration while in high school which provides nursing programs with a good way to recruit, address any misconceptions and provides students with valuable insights into the profession which is essential in fostering interest and building foundational skills that can streamline students path toward a successful nursing career.
Provide accelerated nursing programs which are effective in reducing the time to licensure and graduation and can make nursing programs more appealing to adult learners who will thus be able to lower tuition cost and join the workforce more quickly.
Offer dual admission and partnerships between community colleges, healthcare facilities and universities can create accelerated BSN and graduate educational pathways.
Offer courses and programs online which offer students flexibility and expands access to nursing education.
Offer rolling admissions can attract more students who might not fit the typical academic calendar.
Increase student financial aid, scholarships, and financial incentives can attract qualified candidates.
Expand clinical opportunities by providing internships and innovative clinical partnerships with public health settings can offer students a more diverse experiences and more opportunities for hospitals to connect with students for later employment.
Support for nursing faculty which can include increased salaries that consider experience, degree and service to the profession of nursing, providing loan repayment programs, tax incentives, and grants.

Conclusion:

The nursing shortage is a complex problem requiring multi-pronged solutions. Innovations in educational programs, expanded partnerships, and addressing the systemic issues nurses are facing are all necessary for building a sustainable nursing workforce. Highlighting the appeal of nursing, and improving perceptions around the job, is also important, especially when engaging with high school students who have not yet decided on a career path. It is crucial to inspire and encourage students to enter the nursing profession, as they may one day be the skilled caregivers we rely on in our time of need.

References:

AACN. Nursing Shortage Fact Sheet Nursing Shortage Fact Sheet
ANA Fact Sheet (2022) Nursing Shortage Fact Sheet