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The Nursing Shortage in the United States: Why It’s Happening and Solutions

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We call them “angels of mercy.” We call them the “glue that holds the medical system together.” We call them “front lines” of American healthcare; “unsung heroes” of the medical profession.

Yet, our so-called angels of mercy are in a bad situation: they’re facing a dire nursing shortage that shows no sign of improving. If we have such glorified opinions of nurses, why are they dropping like flies? If nursing is one of the most secure and well-paid job markets in the country, why are we struggling to fill and keep nursing positions?

To start digging our way out of the shortage, we’ve got to first understand what’s currently causing the American nursing shortage—and what’s at stake.

Types of Nursing Shortages

  1. “Physical Nurse” shortage. There simply aren’t enough trained nurses.
  2. “Willing Nurse” shortage. Whether from burnout, low pay, or an overtaxed schedule, 20% of trained, able-bodied nurses no longer work in nursing.
  3. Educator/Education shortage. There aren’t enough educators or space for all nursing applicants, causing schools to turn away willing students.
  4. Financial Shortage. Even if hospital staffing personnel understand that a floor may need six nurses, they may only have the money for four.
  5. Young Nurse Shortage. The median age of nurses is 42.5, meaning more are closer to retirement than at the beginning of their career.
  6. A Shortage of Understanding. Not all hospitals understand the importance of having nurses, preferring to delegate caregiving to less-trained personnel.

Effects of Understaffing in Nursing

When hospitals are understaffed and do not have enough nurses, there can be major public health implications. A study conducted in 2017 found that higher rates of understaffing in a hospital is associated with more missed treatments among patients.

Another study looked at specifically the adverse events that can occur postanaesthesia. The study concluded, “The incidence of hypoxemia was significantly higher in the high understaffing group patients.” While this is a very specific instance, it demonstrates the severity of the issue.

Causes of Nursing Shortage

Several colliding factors snowballed to contribute to the current shortage. Here are some of the biggest causes to blame:

1. Nurse Burnout

It is not uncommon for nurses to start a career in nursing and quickly realize they are not as engaged in their new career as they thought they would be. The nurses that do stick around can experience nursing burnout from being overworked, another symptom of the shortage. According to a nursing shortage study in 2020, the turnover rate for nursing is 8.8 % to 37.0%, depending on geographic location and nursing specialty. This rather high.

2. A Swelling Healthcare System

A growing population needs a growing healthcare system, especially as the population ages and baby boomers clog the overworked system. Increasing medical technology also creates a higher demand for trained nurses. The same nursing shortage study from 2020 states: 

“Currently, the United States has the highest number of Americans over the age of 65 than any other time in history. In 2029, the last of the baby boomer generation will reach retirement age, resulting in a 73% increase in Americans 65 years of age and older, 41 million in 2011 compared to 71 million in 2019.”

3.Shifting Gender Roles

Nursing is still largely considered a women’s career. Modern women have more career choices available than the women of 40 years ago, so fewer women are entering the nursing profession–and men still shy away from the field. Roughly 9% of nurses are male and that number doesn’t show signs of growing.

Nursing Shortage Solutions

A problem as massive as this one isn’t going to be solved with one hard-and-fast solution. Here’s what the U.S. needs to start doing to start getting more nurses into our overworked hospitals.

  1. Restructure Nursing Education. We need nursing schools, teachers, and student space.
  2. Implement Nursing Residencies or Similar Transitional Programs. Doctors enjoy a 3-4 year structured residency after graduation to help transition into physicians. Nursing grads are thrown into the fray with little or no training. As a result, 20% of new nurses quit within the first year. Several hospitals have nursing residencies, such as the Versant RN Residency program, used in 70 hospitals across the US. One hospital reported lowering their turnover rate from 22% to 10% after 18 months.
  3. Encourage kids and males to become nurses.
  4. Groups such as Nurses for a Healthier Tomorrow raise interest in nursing groups for high school and middle school students—targeting male students would also help.

The Future of the American Nurse

American healthcare can’t survive without nurses…and the medical system is already operating over max-capacity. We need skilled nurses and we need them now. If the shortage continues on its projected spiral, the healthcare system will collapse entirely–and that’s a risk our nation can’t afford to take.

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Contributor Tera Rowland

Tera Rowland is the vice president of Soliant and has worked in the healthcare staffing industry for almost 20 years in public relations, social media, marketing and operations. In addition to Soliant, Tera worked at the Mayo Clinic as an internal communication manager and for the Children’s Miracle Network. She is a member of the American Marketing Association and the American Staffing Association. Also, Tera has served on the board of directors for the Jacksonville Women’s Leadership Forum as part of the communication committee. She has a Bachelor of Science degree in Public Relations as well as a Master of Business Administration in Marketing from the University of North Florida and has been published in the Huffington Post, Healthcare Finance News, Healthcare Traveler Magazine, and Scrubs Magazine. Make sure to read the rest of Tera's blogs!