The US Nursing Shortage: Examining Its Origins and Mediations

As the backbone of the US healthcare system, nurses play an indispensable role in providing quality patient care. Yet, one of the foremost concerns in the US healthcare system is the persistent nursing shortage. Dissatisfied nurses have been in the headlines frequently over the past few years for strikes and walkouts primarily driven by unmet demands for additional staff. The stressors on nurses during the height of the pandemic have driven some to resign. Locum tenens staffing has been invaluable in plugging immediate to near-term staff needs, which can also lead to longer-term placements. In addition, healthcare institutions and government entities have recognized the causes and longer-term implications of this crisis and are starting to lay the groundwork for change.

What Is Driving the Current Nursing Shortage?

The nursing shortage in the United States has been a persistent and concerning issue for the healthcare industry for several years. The American Nurses Association (ANA) estimates that the demand for nurses will continue to outpace supply through the next decade as employment growth for nurse practitioners is expected to increase by 40%. There are several ongoing challenges feeding this staffing gap.

1. Demographic Factors

• General Population

The aging of the baby boomer generation is increasing the demand for healthcare services, leading to a higher need for nurses to care for elderly patients with complex medical conditions.

• Nursing Workforce

The Bureau of Labor Statistics reports that approximately 500,000 of nurses over 50 will retire within the next few years. A 2021 study by the National Academy of Science projects that the RN workforce will grow from 3.4 million in 2018 to 4.5 million in 2030. This is potentially enough to replace the retiring RNs, but not all of the expected growing demand, and is not likely to occur uniformly across the nation, leaving ongoing shortages.

2. Work Environment Issues

The demanding nature of nursing, including long shifts, high patient-to-nurse ratios, and exposure to emotionally challenging situations, can lead to burnout and attrition.

3. Educational Challenges

A shortage of nursing faculty and lack of spaces in training courses are hindering the education and training of new nurses to add to the workforce.

What Solutions Are Being Explored to Support Nurses and Patient Satisfaction?

In a May 2022 report, How To Ease the Nursing Shortage in America, the Center for American Progress calls for bold policies toward solving the nursing shortage to ensure that more patients have access to safe, high-quality nursing services. To address the challenges of nurse retention and its implications for patient care, healthcare institutions and policymakers have been proposing and implementing various strategies, technologies and incentives.

1. Institutional Initiatives

-Last June, the National Conference of State Legislatures offered guidance for state and federal initiatives that profiled different legislative approaches states are using to address the nursing shortage, including adapting scope of practice laws and offering financial incentives. Since the beginning of this year, at least 18 states have initiated nurse staffing bills.

-Nursing schools are forming strategic partnerships and seeking private support to help expand student capacity. Minnesota State and the University of Minnesota established the Center for Nursing Equity and Excellence, a collaboration of state nursing schools, healthcare providers and others with the goal to “increase enrollment in nurse education programs at all degree levels, expand equity in the nursing workforce, and increase the success of nursing students.” Similar initiatives are also underway in Florida and Louisiana, among other states.

2. Continuing Education and Professional Development

In response to the evolving healthcare landscape, there is an increased emphasis on continuing education and professional development for nursing staff. Healthcare organizations are investing in educational opportunities to keep their nursing staff up-to-date with the latest advancements and best practices, which contributes to job satisfaction and retention.

3. Advancements in Telehealth and Digital Health

The COVID-19 pandemic accelerated the adoption of telehealth and digital health solutions in the US healthcare system. The American Hospital Association (AHA) reported that around 76% of US hospitals were using telehealth services in 2021, compared to just 43% in 2019. Telehealth expands access to care for immobile patients and those in rural or underserved areas and helps ease the load on nurses.

4. Nurse Leadership and Advancement Opportunities

There has been a gradual shift in recent years, with an increasing number of nurse leaders emerging in various healthcare settings. The Robert Wood Johnson Foundation (RWJF) has been actively promoting nurse leadership initiatives to address this imbalance and empower nurses to take on influential roles in healthcare administration, policymaking, and research.

5. Focus on Mental Health Support for Nursing Staff

Nursing organizations are advocating for better work-life balance. These efforts not only benefit nurses’ mental health but also contribute to improved patient care by reducing the risk of burnout-related errors. In addition to easing workloads and driving better patient outcomes through locum tenens staffing, many healthcare organizations are now prioritizing mental health support initiatives for their nursing staff, including counseling services, peer support programs, and stress management workshops.

Prescription for Progress: A Multifaceted Approach

The nursing shortage in the United States is a complex issue influenced by various demographic, educational, and work environment factors. While locum tenens staffing is a valuable option for healthcare institutions, addressing this long-term challenge requires a multifaceted approach, including efforts to increase the capacity of nursing schools, promote continuing education and professional development for nursing staff, and create supportive work environments. Policymakers, healthcare institutions, and nursing organizations are collaborating to develop and implement strategies to attract and retain a strong nursing workforce. By investing in the nursing profession, the US can ensure the delivery of high-quality patient care and maintain a robust healthcare system capable of meeting the evolving needs of its population.