Nursing Shortage 2023: Challenges for Hospitals

hospital manager reviewing staffing numbers
June 27, 2023

Are We Currently Experiencing a Nursing Shortage?

The nationwide nursing shortage is not something new, and there is a need to take action to face this problem. Hospitals must make extreme efforts to make their nursing staff feel valued and supported in their daily responsibilities.

The main reasons for nurses to leave their jobs or even their careers are feeling undervalued, difficulties with work-life balance, heavy workloads, and insufficient payment, among others. Additionally, according to the National Council of State Boards of Nursing, around 100,000 registered nurses (RNs) stopped working in the last two years due to the pandemic, and one-fifth of the workforce intends to leave by 2027. Furthermore, 31% of nurses working in direct patient care and 40% of inpatient RNs intend to leave their jobs next year. According to the National Library of Medicine, the current turnover rate is 8.8% to 37%, depending on the nursing specialty and location.

Another factor that adds to the shortage is that one-third of the current nurse workforce is in their 50s and will be retiring in the next 10 to 15 years, including nursing faculty, affecting the possibility of training new nurses.

The nursing faculty shortage translates into limited enrollments and increases the gap between the need for new nurses and their availability. In 2021, 91,938 qualified applications were turned away from the baccalaureate and graduate nursing programs due to faculty shortages, classroom space, and budget constraints.

In 2029, the last baby boomer generation is expected to reach retirement age, increasing by 73% of the population aged 65 and older in the United States. The aging population will depend more on healthcare services, and the demand for nurses will continue to rise. 

The panorama doesn't look good, and everything indicates that the nursing shortage will worsen if hospitals and healthcare facilities don't find a way to reduce turnover rates and ensure the quality of their healthcare services.  

What Is a Staffing Crisis?

In healthcare, a staffing crisis happens when hospitals and healthcare centers can't fulfill their needs for nursing professionals. In other words, hospitals are having difficulties filling their nurse vacancies because the demand exceeds the offer.

The current staffing crisis has led to an increase in the patient-to-nurse ratio. A survey found that 84% of nurses from the emergency room and 96% of intensive care unit (ICU) nurses said the ratio was 4:1, double the recommended 2:1 ratio in those units. This fact affects patients' healthcare outcomes and can increase hospital mortality rates.

According to the Journal of Nursing Regulation, by 2025, in the US, there will be a gap of 200,000 to 450,000 nurses between the available amount and the required number of nurses, meaning that the nurse staffing crisis is still ongoing.

How Many Nurses Have the Intention of Leaving Their Job?

The Covid-19 pandemic only accelerated the wear process nurses face in healthcare services. High patient-to-nurse ratios, burnout, feeling undervalued, insufficient payment, an aging workforce, and heavy workloads already existed before the pandemic, which is why nurses are leaving their jobs in increasing numbers.

During the pandemic, nurses with a mean age of 36 with ten or fewer years of experience represented 41% of the nurse drop-off. Also, nurses with the same experience plan on leaving nursing within four to five years, representing 15.2% of the nurse workforce or 188,962 RNs (Weighted national estimate).

Nurses with ten years or more of expertise and a mean age of 57 that intend to retire in the next four to five years represent 44.8% of the workforce or 610,388 nurses. Regarding licensed practical nurses, 33,811 LPNs left the workforce during the pandemic, representing a 4.2% reduction in nursing support staff (Weighted national estimate). 

Finally, nurse workforce turnover is the result of many factors. 62% of nurses who participated in a 2022 survey said they were considering retiring due to increased workload, 50.8% felt emotionally drained, 56.4% felt fatigued, and 49.7% experienced burnout, among other factors.

How Can Hospitals Improve Nurse Retention?

Hospitals need to work on strategies through which nurses are valued, supported, compensated fairly, and provided with professional growth opportunities.

Nurse retention is critical nowadays since turnover rates continue to be high; working side by side with nurses is necessary to build better work conditions and create stronger work teams with excellent communication, support, and flexibility.

Compensation 

Salaries must be determined according to the nurse's responsibilities. Creating compensation bonuses and benefits for the nurse personnel is also essential. One main reason for turnover rates is feeling undervalued; developing financial compensation strategies makes the nurse's effort tangible. 

Nurse-to-Patient Ratio

Since hospitals are running with nursing shortage problems, the patient-to-nurse ratio increases, resulting in unmanageable workloads for nurses. With these conditions, nurses burn out. The malpractice risks become more significant, and the possibility of in-hospital mortality increases.

Hospitals must look for a way to maintain the recommended nurse-to-patient ratio in all units to maintain the quality of healthcare services and not drain nurses. Hospitals can work with nurses "on demand," which can help with the gaps in the schedule and not overwork their permanent nurses.

Well-being Programs

Nurses work in direct contact with patients, and many times they have to live with the difficulties that patients and their families are going through. These experiences can easily lead to feeling emotionally drained; support is necessary to process these emotions. 

Some healthcare centers have decided to create quiet places for nurses with good results. These places have hot beverages and aromatherapy, among other things, that help nurses to have stress-free moments.

Training

Programs to constantly improve nurses' skills are crucial to build a sense of belonging and creating a positive work environment. More experienced nurses can train new nurses, but experienced nurses need to have the opportunity to grow professionally as well.

Also, as mentioned previously, a faculty shortage affects the enrollment of students in nursing programs. Hospitals working side by side with schools is a great way to help reduce the nurse deficit and train new nurses with the hospital's know-how. 

Communication Channels

Communication is critical to understanding where the institution is and where it is going. This understanding gives nurses greater job security and a sense of belonging. Therefore, healthcare facilities must provide good feedback, have updated meetings, and have clear communication paths among different levels of the institution. 

Flexibility

Offering flexible schedules is one way to reduce burnout rates and improve work-life balance among nurses. According to McKinsey and Company, 63% of nurses surveyed chose flexible schedules as the most effective for their well-being.

Per Diem Nursing Is a Great Way to Maintain the Nurse-to-Patient Ratio

Hiring per diem nurses efficiently balances the work between permanent hospital employees and nurses hired as needed. The Latin term per diem means "by the day," so when hospitals hire a per diem nurse, they don't pay all the benefits associated with permanent staff. The payment is by the shift, and open professional nursing markets like Nursa make this possible. With Nursa, hospitals, and healthcare centers can hire nurses as needed, maintaining adequate nurse-to-patient ratios and avoiding overworking the hospital's permanent staff.

After completing Nursa's requirements, healthcare centers can post jobs and fill shifts with per diem nurses. Learn more about Nursa here!  

Guillermo Gainsborg, MA
Blog published on:
June 27, 2023

Meet Guillermo, a contributing copywriter for Nursa who specializes in writing nursing content about finances, licensing, technology, and staffing solutions.

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