NRS 93 Week 1 Discussion Nursing Shortage
Among all occupations nationwide, registered nurses (RNs) represent one of the three career paths that is expected to see the most significant amount of new job openings by 2026. More than 438,000 new RN jobs are projected to be added to the workforce within that time frame, surging from approximately 2.7 million jobs to 3.2 million, according to the Bureau of Labor Statistics (BLS).1
And there’s more to consider than just the net-new nursing jobs—every year, thousands of baby boomer nurses retire and new nurses are needed to replace them. These figures factor into one of the biggest stories in healthcare: a nationwide nursing shortage. So what does that mean for you?NRS 93 Week 1 Discussion Nursing Shortage
Join us as we analyze the facts surrounding each phase of the longstanding demand for additional qualified nurses in the U.S., and learn more about the role you could play as we begin taking steps to strengthen and replenish our nursing workforce.
The nursing shortage in the United States
Take a look at the following nursing shortage statistics to learn more about the causes and effects of this disparity in the largest subset of American healthcare workers.
Where demand for nurses hits hardest
As we mentioned, employment of registered nurses is projected to grow substantially—but this demand for nurses isn’t necessarily spread evenly across the country. Some American states, particularly in warmer climates, will be hit harder than others.
According to a report from Moody’s Investors Services, the southern and western U.S. will be impacted more heavily by the nursing shortage than the rest of the country, with the highest prevalence in Georgia, Florida, Texas and California. The latter three states alone are predicted to account for nearly 40 percent of the nursing shortfall nationwide.2
It’s also true that the nursing shortage will most adversely impact rural hospitals, since many urban hospitals benefit from their close proximity to nursing schools and sturdier local economies that boast more opportunities for the families of healthcare workers.
Causes of the nursing shortage
One large driver of the nursing shortage is the aging population in America. In 2014, the U.S. was home to 46 million people age 65 or older, and that number is projected to grow dramatically in the near term, according to the Population Reference Bureau. Between 2020 and 2030, this population of Americans is projected to increase by 18 million as the last of the baby boomer cohort reaches retirement age.3
These aging boomers present two related issues. First, among that group of aging Americans are hundreds of thousands of practicing RNs on the verge of retirement who will need replacing. Equally important is the fact that many diseases or conditions that were once terminal have since become survivable due to medical and technological advancements. As a result, Americans are living longer and are requiring more medical attention later into their lives.
Another factor straining the nursing labor force has been a lack of educational bandwidth to train new nurses. According to an American Association of Colleges of Nursing (AACN) report on 2016–17 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, schools in the U.S. turned away 64,067 qualified nursing applicants due to insufficient faculty, clinical sites, classroom space and funding.4 It takes a nurse to train a nurse, and this glut of retirements doesn’t spare the critical nurse educators who are bringing the next generation of nurses up to speed. NRS 93 Week 1 Discussion Nursing Shortage
Effects of the nursing shortage
An obvious impact of the nursing shortage is the heightened nurse-to-patient ratios that inevitably take place when a unit is short-staffed. This can have adverse effects on the quality of a nurse’s professional life, often leading to nursing burnout—a leading motivator for practicing nurses who choose to leave the profession.
Contrary to what you might think, even non-nurses can feel the residual effects of nurse burnout. The AACN reports that 75 percent of surveyed RNs believe the nursing shortage impacts both the quality of their work life and the quality of patient care—and the facts support this.4
Patients in environments in which nurses are stretched thin are more likely to be readmitted after 30 days of first being seen, and are even at a higher risk of hospital-acquired infection. Conversely, higher nurse staffing levels have been correlated with fewer patient deaths, fewer failure-to-rescue incidents, lower rates of infection and shorter hospital stays.
Nursing shortage solutions
Many agree that addressing the imminent nursing shortage in the U.S. must begin with enabling the thousands of aspiring nurses to begin their careers—which will only be possible with more educators in nursing programs to cope with the demand. With this in mind, several statewide initiatives have been put into motion to offer incentives like fellowships and loan forgiveness for future nurse faculty who commit to teach within that state after obtaining their degrees. NRS 93 Week 1 Discussion Nursing Shortage
In addition to government programs that incentivize the training of new nurses, healthcare organizations can implement short-term solutions to help prevent burnout and turnover among the current nursing workforce. This can be done by reviewing internal policies for productivity, better utilizing medical assistants as appropriate and more effectively implementing technology to improve efficiency.NRS 93 Week 1 Discussion Nursing Shortage
Additional incentives from employers can also help with retention, such as offering paid training opportunities, student loan reimbursement, more comprehensive compensation packages and increased opportunities for internal advancement. Solutions like these are not only important for the well being of nurses, but also for the bottom line of the healthcare facilities—after all, it costs a lot of money to recruit and train new nurses.
In fact, the hospitals, and nursing in particular, are witnessing a combination of problems that range in salary structure, medical economics/cost containment, post-graduate education, and an aging workforce (pending retirements of baby-boomers). The public health industry is not sitting idly by to address the shortage. It is critically reviewing the needs for both existing professions.
Definition of Nursing Shortage
Nursing shortage is defined as the inadequate number of qualified nurses to meet the projected demand for nursing care within a healthcare setting, where the demand for nurses is greater than the supply.
History of Nursing Shortage
Historical knowledge is important to analyze the present and prepare for the future. As we can see from the current shortage in America today, we learn that it is not a new problem. However what makes this current nursing shortage situation unique is that the causes are related to a multifaceted range of issues. The current nursing shortage is connected to supply and demand factors, demographic changes, population growth, and fewer students enrolling in nursing schools, RNs who are retiring or leaving the workforce and a growth in the baby boom population who will demand more healthcare services in the near future. These factors are occurring while many nurses are retiring and more jobs are being created. In addition, the nursing shortage is actually a worldwide phenomenon with areas like Western Europe, Australia, Canada and the Philippines facing shortages as well.
Economic factors have also contributed to the nursing shortage in the United States. Mark Genovese, spokesperson for the New York State Nurses Association explains, “For many decades the shortage was cyclical but as the economy tightened and as the insurance industry moved to a managed care model, there was less money in the system and hospitals had less money to work with and tighter budgets.”
Budgetary limitations affected the nursing workforce as many nurses began leaving the profession altogether. “They were forcing RNs to do more with less, handle more patients and work more hours. RNs started to leave the workforce because of the working conditions and fewer RNs entered the system,” explains Mark.NRS 93 Week 1 Discussion Nursing Shortage
Americans are also demanding more quality healthcare services while many RNs are retiring, further exacerbating the problem. The HRSA has stated: “to meet the projected growth in demand for RN services, the U.S. must graduate approximately 90% more nurses from U.S. nursing programs.”
Decreased staffing means that there are fewer nurses to work with patients. This impacts job satisfaction and causes work related stress. In some cases it has led to many nurses leaving the profession altogether. A 2010 study published in Health Services Research found that over 75% of RNs feel that the nursing shortage is a huge problem that affects their quality of work as well as patient care and the amount of time that nurses can spend with individual patients.
Another important factor contributing to a lack of nurses is that there is a shortage of nursing school faculty to train a new generation of nurses in colleges and universities. The AACN’s 2008-2009 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing report found that nursing programs in the U.S. did not enroll 49,948 qualified students into their bachelor and graduate degree programs because they did not have an adequate number of faculty, clinical practice sites, teaching space, and were constrained by budgetary limitations. Two thirds of the nursing program respondents reported that a big reason for not accepting students was due to not having enough nurse faculty on hand.
The Southern Regional Board of Education conducted a study which found that the nursing faculty shortage in 16 states was caused by vacant faculty positions, retirements, resignations and a shortage of new candidates applying for faculty positions. Shortages like this pose a threat to the availability of nurse education. Defining the Problem
For those students interested in careers in healthcare, becoming a nurse right now could be the best decision for you. Currently, the United States is facing a severe nursing shortage. For several reasons, the number of nurses graduating and entering the workforce, and those already in the profession, is not enough to fill the growing demand. Currently, RNs are the largest group of healthcare workers in the US at roughly 2.6 million and that still isn’t enough to meet the need. According to experts, by 2012, there could be around 1.1 million unfilled nursing positions in the United States.
In the most basic sense, the current global nursing shortage is simply a widespread and dangerous lack of skilled nurses who are needed to care for individual patients and the population as a whole. The work of the world’s estimated 12 million nurses is not well understood, even by educated members of society. But nursing is a distinct scientific field and autonomous profession whose skilled practitioners save lives and improve patient outcomes every day in a wide variety of settings.NRS 93 Week 1 Discussion Nursing Shortage
In the Truth’s view, the vast gap between what skilled nurses really do and what the public thinks they do is a fundamental factor underlying most of the more immediate apparent causes of the shortage. These causes include nurse short-staffing (due to inadequate pay and long work hours), poor work conditions, the aging nursing workforce, expanded career options for women, nursing’s predominantly female nature, the increasing complexity of health care and care technology, and the rapidly aging populations in developed nations, to name a few.
Other causes of the nursing shortage episode include: the aging baby boomer population and lack of employee incentives. There were seventy-six million Americans born between 1946 and 1964 and are now classified the Baby Boomer Generation. As this population reaches retirement age and beyond, they are requiring more medical treatments and nursing home and long term care facilities. This country is also seeing an increase in population in general, projected to grow 18% over the next two decades. With more patients flooding the healthcare system, there simply aren’t enough nurses to meet this growing need. However, those currently employed in the nursing field should be rewarded for being encouraged and motivated to stay in such a questionable field of employment.
In light of this nursing shortage, it should be relatively easy to find gainful employment after graduation should you choose to study nursing. According to the Bureau of Labor Statistics (BLS), more than 581,000 new Registered Nurse (RN) positions will be created through 2018, which will increase that workforce by an astounding 22%. The BLS also estimates that even as other sectors of our economy continue to suffer, the healthcare sector will only continue to grow. Since the recession began, more than 600,000 positions have been created in the healthcare industry. With so many Americans out of work in other fields, a career in healthcare, specifically in nursing, might be a viable career choice.
Literature Review
Today, the average age of nursing faculty in baccalaureate and graduate degree programs is 51.5 years and the rate of projected retirements will exceed the rate of re placements. Nurses enter the faculty role later in their careers and typically retire at an earlier age, around 62.5 years. More efforts need to be put into place to encourage those already teaching to remain in their positions even if it is in a limited capacity while future faculty are educated.
What factors are present that facilitate the desire for nursing faculty to retire? Kowalski, Dalley, and Weigand (2006) conducted a cross-sectional, randomized study of 129 nurse educators teaching in 61 schools of nursing to find out what personal decisions influenced their retirement plans. With a 37.6% response rate, results reflected that the mean age of planned retirement was 64.4 years. However, the mean age respondents would like to retire was 62.4. Factors influencing retirement included workplace issues, personal and family health, attitudes about retirement, and financial security.
One of the most important factors influencing retirement plans was financial security. Faculty members who were financially secure retired earlier. Job satisfaction was another important influencing factor resulting in early retirement. In lieu of the faculty shortage, the authors contend that studies such as this will offer insight into future retirement trends which may help bridge the gap between supply and the demand of nurse educators (Kowalski et al., 2006). From the results of this one study it may be important to consider the needs of the aging faculty by providing healthy, satisfying, and stimulating work environments, appropriate benefits packages, and relaxing mandatory retirement ages.NRS 93 Week 1 Discussion Nursing Shortage
One serious factor contributing to the faculty shortage is financial. Not only are academic salaries much lower than they are for clinical practice and administrative positions of advanced practice nurses, but the cost of securing advanced academic degrees is costly. In 2004, the average salary of a master’s-prepared nurse practitioner in a clinical setting was $80,697 compared to $60,831 for that of a master’s-prepared nursing faculty member (Nevada Nurses Association, 2004). By increasing academic salaries and providing tuition allowances in return for teaching will indeed make teaching a more attractive career choice (Yordy, 2006).
Another important factor affecting the faculty shortage is that of job satisfaction, stress, and burnout. To maintain current faculty on the job, more research should be conducted on factors affecting job satisfaction and what works to provide a better environment. Gormley (2003) performed a meta-analysis study on nursing faculty job satisfaction and which factors had the greatest influence using a sample of six studies from 1976 and 1996. Nursing faculty are pressured not only to educate future nurses to provide safe and competent care, but also have many other professional responsibilities, such as publishing, conducting research, writing grants, performing community service, and maintaining their own competencies (Gormley, 2003). These responsibilities combined can become overwhelming and lead to job dissatisfaction especially as the faculty is aging.
In Gormley’s study (2003), factors that affected job satisfaction were perception/expectation of the leader’s role in curriculum and instruction, suggesting that the dean’s role has significant effects on faculty’s job satisfaction and role conflict/ambiguity. Shirey (2006) argues that prolonged stress can lead to burn-out in many faculty who then become “deadwood,” jeopardizing the quality and spirit of the institution. These faculty members can ward off potential new faculty who are even more vulnerable to the stresses of the teaching role.
It is imperative that academic institutions pay close attention to the needs of their faculty. Mentoring programs, self-renewal, and organizational engagement are key strategies to prevent burnout (Shirey, 2006). “A carefully structured and deliberate mentoring program can be an invaluable orientation as schools of nursing seek to provide an academic environment that is conducive to the professional and scholarly development of adjunct faculty members” (Peters & Boylston, 2006, p. 64).NRS 93 Week 1 Discussion Nursing Shortage
One serious factor contributing to the faculty shortage is financial. Not only are academic salaries much lower than they are for clinical practice and administrative positions of advanced practice nurses, but the cost of securing advanced academic degrees is costly. In 2004, the average salary of a master’s-prepared nurse practitioner in a clinical setting was $80,697 compared to $60,831 for that of a master’s-prepared nursing faculty member (Nevada Nurses Association, 2004). By increasing academic salaries and providing tuition allowances in return for teaching will indeed make teaching a more attractive career choice (Yordy, 2006).
Program Analysis
Possible Solutions
For sustained change and assurance of evading the forthcoming shortage, solutions must be developed in several areas: education, health care systems, policy and regulations, and image. This shortage is not exclusively a nursing issue, but will require a collaborative effort among nursing leaders, practitioners, health care executives, government, and the media.
Creating Cultures of Retention
The American Nurses Association Magnet hospital program has had a proven success in raising the standards of nursing practice and improving patient outcomes. Currently there are 85 organizations that are designated Magnet hospitals. Magnet facilities are characterized by strong administrative support, adequate nurse staffing, strong communication, nurse autonomy, better control, and a vital focus on the patient and their family.
A growing body of research indicates that this program is making a positive difference for nurses, patients, and the hospitals as a whole. Research is proving that through this program, nurses are having increased satisfaction as well as increased perceptions of productivity and the quality of care given. Studies also indicate that these facilities have lower incidence of needle stick injuries, lower burn out rates, and double the retention of non-Magnet facilities. By adopting the characteristics of Magnet hospitals, facilities will be able to create a culture of retention that empowers and is respectful of nursing staff.NRS 93 Week 1 Discussion Nursing Shortage
Strengthening the Infrastructure
In 2002 the Nursing Reinvestment Act was signed by President Bush to address the problem of our nation’s nursing shortage. This initiative was intended to promote people to enter and remain in nursing careers, thus reducing the growing shortage. The law establishes scholarships, loan repayments, public service announcements, retention grants, career ladders, and grants for nursing faculty. Many statewide initiatives are underway to address this issue as well.
In Pennsylvania, six new nursing education initiatives have been announced to address faculty shortage by encouraging current nurses to return to school, earn graduate degrees, and teach the next generation of nurses. Illinois is unveiling a plan to provide faculty scholarships and grants to nursing schools in order to expand student enrollment. California, whose nursing programs currently have wait lists over three years, is trying to expand nursing education through a $90 million initiative.NRS 93 Week 1 Discussion Nursing Shortage