High staff turnover rates, nurse burnout, and an aging population are just some of the many factors leading to a nurse staffing shortage.
Unfortunately, nursing shortages are not limited to the United States; they are a global concern that jeopardizes patient safety.
In states such as Washington, Georgia, and Michigan, the nursing workforce is expected to decline while the demand for skilled healthcare practitioners will continue to grow. California will witness the largest shortage of nurses, with a projected deficit of 65,000 nurses by 2037.
The impact? Already worn-out caregivers will be even more susceptible to burnout, a.k.a. compassion fatigue, which will drastically reduce the quality of patient care.
The solution? Several promising solutions exist, such as offering nurses more flexibility and better working conditions or adopting flexible staffing models, could remedy—and are already alleviating—the nursing shortage.
In the end, “solving” the nursing shortage will take a multifaceted approach to ensure that a nurse is at the bedside of every patient in need. Read on for a look at how that could happen.
What is the nurse staffing shortage?
A nursing shortage occurs when more nurses are required to meet the demand for healthcare services. There is an ongoing shortage of nursing professionals both throughout the United States and internationally, caused in part by aging nurse workforces, aging populations, and limited enrollment in nursing programs.
According to the American Association of Colleges of Nursing (AACN), one million registered nurses in the United States alone will retire by 2030. Additionally, a recent study published in Wiley Online Library found that the global prevalence of nursing burnout was 30 percent.
Given these concerning statistics, facilities need to confront the growing shortage head on, but how?
Since the nurse staffing crisis did not occur overnight (shortages date back to the early twentieth century), it will not be resolved overnight either. Nonetheless, there are steps that facilities can take to start tackling the nursing crisis today.
First, let’s put the nursing shortage into perspective:
Nursing shortage statistics and facts
Here are some facts that can help illustrate the scope and severity of the nurse staffing crisis:
- Nursing shortages can be traced back to the time of Florence Nightingale in the 1850s.
- Recent reports predict that 1.2 million new registered nurses will be needed by 2030 to address the nurse shortage.
- According to research by the National Council of State Boards of Nursing (NCSBN), about 100,000 registered nurses left the nursing workforce during the COVID-19 pandemic due to stress, burnout, or retirement.
- Some researchers assert that there isn't a nursing shortage, but systematic reviews have emphasized that nursing shortages exist globally and negatively impact patient health-related outcomes.
- Numerous variables affect nursing shortages, such as educational, managerial, and policy-making factors.
- The median age of RNs is 46. More than a quarter of registered nurses say they intend to leave nursing or retire within the next five years.
- Those born between 1946 and 1964, known as baby boomers, make up the majority of the nation's population over 65. The percentage of the population over 65 is higher than it has ever been. This generation increasingly requires medical services for age-related conditions, and this high demand for medical services is one of the main drivers of the nursing shortage in the United States.
Let’s dig further into what is causing the nursing shortage to worsen.
What is causing the nursing shortage?
There is no single main factor that causes nursing shortages. Nonetheless, research shows that the following issues are major contributing factors to chronic understaffing throughout the healthcare industry:
1. Turnover and staffing shortages in nursing
Some experts agree that the number one reason nurses want to leave hospitals is that patient-to-staff ratios need to be lower. Not having adequate staffing levels on a facility floor can lead to nurse managers repeatedly asking nurses to fill in and work more hours.
Consequently, long hours compounded by a lack of sleep and general strain from working in high-stress environments can increase turnover and exacerbate the already grave nursing shortage.
2. An aging population and nurse workforce
Another major factor is the aging nurse workforce, which is compounded by an aging population of patients who require more healthcare services. As a result, an aging baby boomer population and increased demand for long-term care strain the healthcare staffing crisis in medical settings.
In addition, aging workforces (one-quarter of registered nurses report that they intend to leave nursing or retire within the next five years) and a lack of qualified nurses are all factors that currently contribute to the nursing shortage.
3. Financial constraints
Budgets for healthcare at facilities may be exhausted due to rising costs related to the following:
- High nurse turnover
- Increasing salary demands
- High overtime pay rates
- Emergency care and unexpected events
These financial constraints may make it impossible for facilities to hire and retain enough nurses to meet the growing healthcare demand for patient services.
4. Challenges in higher education among nursing
A lack of nurse educators, high educational costs, and school-imposed student capacity limits aggravate the nursing shortage.
Limited enrollment in nursing programs is also a growing issue, and various barriers make it difficult to inspire nurses to earn a degree and clinical experience. Some of these obstacles include the following:
- Insufficient clinical placements for students
- Long program durations
- High tuition costs (a Bachelor of Science in Nursing (BSN) degree can cost between $25,000 to $120,000 or more)
5. Nurse burnout and compassion fatigue
Another component contributing to the severity of nursing shortages is nurse burnout. According to the American Nurses Association, nearly two-thirds of nurses experience burnout. One significant factor contributing to nurse burnout is ongoing workplace stress.
Ongoing workplace stress can be influenced by the following components:
- Heavy workloads
- Low staffing levels
- Insufficient resources
- Lack of support from workforce management
- General stress from the emotional demands of nursing
All these factors are leading to nurse turnover at an alarming frequency.
An early study from 2016 showed that 43 percent of newly licensed nurses who worked in hospitals left their jobs within three years. A more recent study from 2023 shows that the average turnover rate of all registered nurses (RNs) in U.S. hospitals stood at 18.4 percent.
Turnover rates surpassing 10 percent are considered bad, so this latest data indicates a concerning trend in nursing. Nursing shortages and high turnover rates directly affect not only the health and wellbeing of nurses but also the safety and care of patients.
One example is using float or talent pools to provide additional support for internal staff nurses. Contracting per diem or PRN nurses is an excellent strategy to account for unexpected absences or increased patient demands.
How the nursing shortage affects the healthcare industry
Some of the more severe consequences of the nursing shortage include increased workloads for existing nurses, higher rates of burnout and job dissatisfaction, and lower-quality patient care.
The following is a more in-depth explanation of how the nursing shortage affects the healthcare industry.
Patient care
The impact on patient safety is one of the principal reasons facilities need to start taking nursing shortages seriously. Patient safety is compromised when healthcare organizations lack nurses with the proper knowledge, skills, and experience to deliver quality healthcare or when nurses are overworked.
When nurses are overworked, they make more mistakes and provide less attentive care. Thus, the consequences of staffing shortages in nursing are overworked nurses, delayed patient treatments, patient dissatisfaction, and significant medical errors.
Nursing staff
Nursing is already a challenging profession.
When you add staffing shortages to the equation, nurses may feel depleted physically and emotionally. In addition, an increased workload and lack of facility support (i.e., no access to counseling services) could lead to feelings of burnout.
Plus, nurses who have to make up for gaps in coverage have to work longer hours. Not only does working long hours take a toll on a nurse's physical health, but it can also significantly disrupt a nurse's work-life balance.
Physical and emotional exhaustion, combined with a lack of recreation outside of work, can cause many nurses to leave their profession for good.
Healthcare systems and public health
When there is a shortage of nurses, healthcare facilities may need to offer incentives to retain existing nurses. Retention efforts may involve offering higher wages, higher overtime pay, or sign-on and retention bonuses, leading to significantly higher staffing costs.
Moreover, when a facility needs more staff, its medical team may respond poorly to health emergencies and high patient census levels. Nursing shortages can also cause inadequate access to healthcare services, further exacerbating healthcare disparities in rural hospitals.
Over time, low staff retention and compromised patient care quality caused by nursing shortages can lead to the public losing trust in healthcare institutions.
"Improving nurse retention is not an insurmountable task but requires commitment, a willingness to listen, and an investment of time, energy, and finances."
- How to Improve Nurse Retention: 7 Tips to Get Started
Solutions and strategies to address the nursing crisis
Addressing nursing shortages through proper staffing is vital in ensuring a facility can provide safe and attentive patient care. Facilities must implement strategies that prevent the negative consequences of nursing shortages, such as increased workload, compromised patient care, and burnout.
Here's a look at short-term and long-term strategies that address the nursing crisis and can help move a facility in the right direction.
Short-term strategies to address the nursing shortage
Practical and short-term strategies for handling nursing shortages involve getting to the root of the problem—a lack of nurses. These strategies approach the problem from a few different angles, including proactive retention and reactive staffing strategies.
1. Float pools and contingent staffing options
Rather than relying strictly on overtime or long-term contracts, a proven way to relieve immediate staffing pressure is to leverage existing PRN talent pools from staffing platforms like Nursa or to build a bench of qualified nurses who can step in quickly when needs shift or call-outs occur.
This strategy gives nurses the flexibility to work when and where they prefer while helping facilities improve staffing efficiency and maintain safe staffing ratios. In practice, this means identifying high-demand units, pre-credentialing supplemental staff, and posting recurring shifts ahead of time. Facilities that do this often see quicker fill rates and improved morale among their full-time teams.
Pro-tip: A streamlined nurse credentialing and onboarding process ensures that both internal float nurses and external PRN staff can begin working quickly and confidently.
2. Implement flexible scheduling and self-scheduling options
Flexibility remains one of the most requested benefits among nurses today. Facilities offering adjustable scheduling models—such as self-scheduling, 4-, 6-, or 8-hour shifts, and split shifts—help nurses balance their home and work lives more effectively.
This approach not only supports an agile acuity-based staffing strategy, but also builds a more appealing and supportive environment, helping retain existing staff while attracting new talent.
3. Listen to and act on nurse feedback
Sustainable staffing strategies require listening to nurses and taking meaningful action based on their feedback. Facilities that promote transparent communication, conduct listening sessions or pulse surveys, and implement nurse-driven improvements are more likely to retain engaged and motivated teams.
Trust and collaboration improve when nurses feel heard and supported.
Learn how shared governance bridges the gap between administrators and clinicians.
4. Offer targeted incentives and recognition programs
Shift incentives—such as weekend differentials, short-notice bonuses, tuition assistance, and employee recognition programs—help ensure coverage during periods of high demand without significantly driving up baseline payroll costs.
Similarly, recognition programs, wellness initiatives, and financial support for continuing education also promote morale and retention. Nurses who feel valued and supported are more likely to stay, even in high-pressure work environments.
5. Emergency public policy and surge support
During large-scale public health emergencies or natural disasters, government-driven staffing support and emergency response policies play an essential bridging role.
These policies may include temporary licensure expansions, federal staffing assistance, emergency credentialing processes, and crisis workforce funding. While not a daily staffing tool, having protocols to activate state and federal support rapidly gives facilities an additional safety net during extraordinary circumstances.
6. Immediate wellbeing protections
Protecting nurses from fatigue is essential for preserving quality of care. By establishing limits on consecutive shifts and ensuring mandated rest periods, facilities reduce burnout and minimize fatigue-related errors.
Many organizations now embed these rules directly into scheduling systems to ensure compliance. The result is a healthier workforce, safer patient care, and a more sustainable staffing model.
Additionally, structured support systems—such as relief staff to ensure meal breaks, mental health check-ins after traumatic events, and protected time off—helps nurses feel respected and supported. Even small steps that safeguard rest and emotional recovery can drastically improve day-to-day morale, stabilizing the workforce and reinforcing retention efforts.
Long-term Sstrategies to strengthen nursing workforce stability
One of the goals of long-term strategies is to ensure short-term initiatives are sustainable and effective. Additionally, below are some examples of long-term strategies that facilities can implement to support the success of staff nurses, reinforce nurse retention, and employ creative recruiting strategies:
1. Build internal career-advancement pipelines
Long-term workforce stability depends on growing talent from within. Facilities that provide scholarships, paid certification pathways, and structured mentoring for CNAs, LPNs/LVNs, and early-career RNs can create predictable pipelines of loyal, highly skilled clinicians.
This "grow-your-own" model supports upward mobility and builds a stronger, more stable workforce over time.
2. Expand capacity through nursing school partnerships
Developing partnerships with nursing programs supports both clinical placements and future hiring opportunities. Offering residency programs, student shadowing, and mentorship experiences helps convert students into long-term team members.
Facilities also increasingly provide tuition reimbursement or loan-assistance programs, creating an incentive for nurses to choose and remain with their organization.
3. Recruit internationally educated nurses (EINs)
Internationally educated nurses can play a valuable role in addressing long-term staffing needs. When done ethically and with structured support, these professionals can help fill shifts, bring diversity in skills and perspectives, and accelerate staffing relief compared to domestic training pipelines which take years to mature.
IENs can shorten the time to be “shift-ready” talent compared to waiting for new domestic grad cohorts. However, an important consideration is that facilities must manage onboarding, cultural/language integration, and visa/immigration challenges.
4. Telehealth and virtual nursing expansion
Virtual nursing support and telehealth solutions can help alleviate staffing strain by offloading administrative tasks and expanding access to care without requiring physical presence.
For example, virtual nurses can support admission documentation, patient education, tele-triage, monitoring programs, and discharge coordination. These innovations maximize nurse efficiency and help facilities extend care capacity sustainably.
5. Invest in long-term support and resilience programs
Providing ongoing emotional, psychological, and professional support reduces burnout and improves job satisfaction.
Programs such as peer mentoring, mental health counseling, stress-management resources, and resilience training cultivate a work environment where nurses feel equipped to manage the emotional demands of care delivery. Supporting staff well-being is one of the most important long-term strategies for retaining talent.
What recent legislation and other efforts are under way?
There have been some efforts within lawmaking to address the nursing shortages, with particular efforts to tackle severe nurse burnout.
In 2022, a bill known as the Lorna Breen Act was signed by former President Biden to combat nurse burnout and suicide. This bill was inspired by the untimely demise of an emergency physician who committed suicide early in the COVID-19 pandemic. The act allocated $100 million for hospitals and health systems looking to prioritize mental health among healthcare providers.
Facilities are also stepping up in their efforts to crush the nursing shortage by offering better work conditions, such as allowing nurses to choose their own schedules.
What does the future of nursing hold?
For the time being, nurse staffing shortages are not going anywhere. In fact, between 2020 and 2030, the U.S. Bureau of Labor Statistics predicts that there will be an average of 194,500 openings annually for registered nurses.
“The focus on “right now” and “what’s next” distracts healthcare leaders from facing the hard facts: Nursing shortages are a complex phenomenon that began to take shape even before WWII and have continued to challenge hospitals and healthcare facilities for 90+ years. And unless leaders expand their perspective and go beyond solutions suggested in the 1930s—like incentivizing students to attend nursing school rather than incentivizing nurses to remain in the workforce—healthcare organizations will be hard-pressed to make a sustainable difference.”
- Curtis Anderson, CEO and Founder of Nursa
The first thing that facilities can do to recruit and retain nurses is enhance their work conditions and start taking care of their nursing workforce. From there, anything is possible.
Want to learn more? Find out how Nursa helps healthcare facilities and professionals address the nursing crisis with healthcare staffing solutions.
.png)
.png)
