Nursing Shortage, USA: Why It's Happening, & How It Can Be Resolved

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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 Shortages Plaguing American Nurses

  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 the beginning of their career.
  6. A Shortage of Understanding. Not all hospitals understand the importance of having nurses, preferring to delegate care giving to less-trained personnel.

Dangers of Nurse Understaffing

  • A AHRQ study revealed that lower nurse staff levels caused significant spikes in:
      • UTIs
      • Upper gastrointestinal bleeding
      • Shock
      • Longer hospital stays
      • Pneumonia
  • The same study found that just an additional 30 minutes of R.N. staffing can reduce pneumonia occurrences by 4%.
  • A .25 nursing increase per day can reduce a 30-day mortality rate by 20%.
  • Peter Berhaus, a Vanderbilt University nursing work force expert, found that increased nursing levels could prevent 6700 patient deaths and save 4 million days of hospital care.
  • Statistics project a shortage of 1 million nursing jobs by 2020. The number of nurses is expected to grow by 6%…but the number of needed nurses is expected to grow by 40%.

What Caused the Modern Nursing Shortage?

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

Education Shortfalls

The modern nursing education system can’t keep up with the current staffing and applicant demands. In 2008, nursing schools turned away 50,000 qualified applicants–including 6,000 applicants looking for master’s or doctorate degrees.

Nursing education salaries are pretty dismal: nursing faculty make only 75% of what faculty in other disciplines make, and practicing nurses make nearly $15,000 more each year than nurses who teach.

Bad Working Conditions

Of nearly 13,500 nurses surveyed in Pennsylvania, 40% were dissatisfied with their career. To put that in perspective, the average job dissatisfaction rates for other professions range from 10 to 15%. Short-staffing, burnout and increased patient levels cause many nurses to leave the profession. New nurses don’t fare any better: the Associated Press reports that one in five new nurses quit within 12 months.

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.

Shifting Gender Roles

Nursing is still largely considered a women’s career. Modern women have more career choices available than the women of 30 years ago, so fewer women are entering the nursing profession–and men still shy away from the field. Only 6% of nurses are male and that number doesn’t show signs of growing.

Fixing the Nursing Shortage

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.
    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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