Nursing is a valued profession and plays a significant role in ensuring adequate quality care, which is critical in healthcare system improvement. However, sufficient nurses work substantially to enhance health target achievements and coverage. With that comes the need for the availability of more nurses. Globally, the nursing profession’s role is crucial in delivering healthcare services. However, the healthcare sector’s main challenge is nurse workforce shortage, which results in severe nurse performance effects relative to quality healthcare service provision. With the need comes the difficulty of improving global population well-being. The impact of nursing shortage can result in severe burnout and stress and shapes the delivery of effective interventions to meet patient, family, and community needs.
Who is affected by the nursing shortage?
The challenge of the nursing shortage becomes a severe problem when its impact on patient care is considered. Rosenberg (2019) shows that in some health facilities in the United States, improving the issue can lead to the prevention of deaths through improved nurse-to-patient ratios. Regardless of their practice state, specialty, or age, nurses struggle, and all need help. In the U.S., a study by the U.S. Bureau of Labor Statistics (BLS) established that only 12 percent of nurses are happy with their work (Nursing Shortage or Exodus, 2022). The same study revealed that over 35 percent of the nurses would continue working at their current positions only if changes in the nurse-to-patient ratio were improved (Nursing Shortage or Exodus, 2022). According to nurses, the main challenges they face are safer patient ratio assignments, safe staffing, and improved pay to maintain their working positions.
The issue of nurse shortage has been linked to nurses and physician burnout symptoms. The leading cause for such symptoms, as shown by Vuong (2020), is a nurse-to-patient ratio. None of the existing approaches to minimize burnout among nurses has been attributed to addressing staff ratios. Three dimensions of nurse burnout exist; cynicism, emotional exhaustion, and low personal accomplishment sense, all of which can be controlled by managing the staffing ratio challenge (Vuong, 2020). Nurses need energy and time to effectively care for their patients, families, and the community. Moreover, rapport plays an equally important role in practical care realization, which, together with energy and time, translates to better care. Uninterrupted time, which results from the above, affords nurses more time with patients and their families (Tamata et al., 2021). However, due to nurse shortage, burnout makes it difficult for nurses to spend sufficient time with their patients.
Nursing and midwifery are fundamental to primary healthcare providers and are often the first and sometimes the only healthcare professions people need to experience quality in their initial evaluation. According to the World Health Organization (WHO) (2022), nurses and midwives are also responsible for initial care and treatment. They are part of the local community, meaning they have the mandate of sharing vulnerabilities, strengths, and culture. With this, nurses and midwives have a critical role in how effective interventions are shaped and delivered toward meeting patient, family, and community needs (WHO, 2022). For nurses and midwives to achieve the mentioned activities, they require adequate staffing, which becomes a challenge when the problem of nurse shortage comes into practice.
What statistical issues are related to the nursing shortage?
The challenge of the nursing shortage negatively impacts a profession continuously acknowledged for its suffering, resilience, strength, and compassion, a universal issue. Based on the BLS, registered nurses’ employment was projected to by 9 percent between 2020 and 2030 (Rosenberg, 2019). Every year, the U.S. approximates that over 194,000 openings are available for registered nurses, on average, over the anticipated ten years (American Hospital Association, 2022). Nonetheless, the expectation was pre-Covid-19 and before the bedside mass exodus of clinical nurses, leading to a substantially lower number than the actual demand for nurses. The American Nurses Association (ANA) showed that the U.S. would need an additional 3.4 million nurses, a more than 20 percent increase in the existing registered nurses (AHA, 2022). In 2022, the ANA had projected an additional 1.13 million nurses, which means there is an ever-growing need to increase healthcare needs that help promote job growth in the U.S. (AHA, 2022). Moreover, the additional number of nurses means the U.S. must find alternative or effective measures to counter the impact of quality care resulting from the nursing shortage.
Several factors have been attributed to the nurse shortage issue, among them a declining number of student nurses enrolling in the nursing program alongside an increasing number of early retirement cases among practitioners. According to WHO (2022), the 27 million nurses and midwives around the globe account for approximately 50 percent of the workforce in the healthcare sector. However, despite the number, there is a universal health worker shortage, with the world requiring an additional nine million nurses and midwives by the end of 2030 (WHO, 2022). In addition to the critical role nurses play in health promotion, primary and community care provision, and disease prevention, they are responsible for emergency care settings, which is crucial for universal health coverage achievement (Tamata et al., 2021). However, the nurse shortage challenge impacts the realization of health for all. With the problem comes the need to ensure well-trained, educated, well-supported, and regulated nurses and midwives. Nurses and midwives receive remuneration and recognition through commensuration with the provided care quality and services.
Nurse shortage has been associated with leaving jobs, in addition to burnout. WHO (2022) anticipated a deficit of more than 7 million health workers globally starting 2020s, with the demand rising to more than 12.5 million by 2035. The shortage of nurses has resulted in the creation of negative impacts on both the nursing profession and patient health-related outcomes. The inadequacy in nurses’ supply is linked to the difficulty of improving health and fighting illnesses, which are causes of increased workload and a decline in nursing care quality (Rosenberg, 2019). The overwhelming nurse shortage has been linked to the intention to leave bedside clinical care due to unsafe staffing ratios. The outcome has been a never-ending nurse shortage cycle with the professionals facing unsafe staffing ratios.
In the U.S., the difficulty of dealing with nurse shortage is complicated by an increased workload in a limited resource environment. Source (2022) shows that in a pre-Covid-19 scenario, intensive care unit (ICU) nurses experienced either a 1:1 or 2:1; however, in a post-Covid-19 design, nurses experienced either a 3:1 or 4:1 patient-to-nurse ratio. The increased imbalance in the patient-to-nurse ratio has been attributed to exacerbated unsafe nursing practices and staff burnout. An increase in patient census, especially in post-Covid-19, is the reason patients are not benefiting from the delivered healthcare services. Furthermore, handling more than four patients at a time exposes nurses’ licenses. Nurses report the increased patient-to-nurse ratio as the main reason they no longer provide adequate care; instead, they are just running around carrying out tasks (AHA, 2022). The other reasons some nurses are leaving their practice constitute staffing ratio inadequacy, insufficient backup, inability to receive hazard pay during the pandemic, poor gain compared to experience, and failure to have breaks.
However, despite the nurse shortage challenge, there is still hope for the profession. In the U.S., almost 70 percent of the practicing nurses still consider their work a great career, while another 64 percent still consider recruiting new nurses as a solution (Vuong, 2020). With the appropriate recruitment, the healthcare organizations can still salvage the profession to provide adequate healthcare and improve nurses working conditions. However, the starting point for this must be to address the systemic failures by healthcare institutions to invest in nurse protection measures from safety and health hazards.
The paper addresses the issue of nurse shortage by asking two questions that help provide answers. Question one, under level one, addresses the impact of the nursing shortage on the nurses’ practice and patient outcomes. Question two, under level two, provides an understanding of the analytical impact of the deficit on the nursing profession, with nursing and midwifery supplied as examples. The findings of the paper have shown that due to nurse shortage, nurses experience burnout and are struggling with the patient-to-nurse ratio, which impacts their intention to leave. The challenge has been made worse with the pandemic demanding for healthcare institutions to invest in nurse protection.
American Hospital Association. (2022). AHA Letter Re: Challenges Facing America’s Health Care Workforce as the U.S. Enters the Third Year of COVID-19 Pandemic | AHA. American Hospital Association. Web.
Rosenberg, K. (2019). RN Shortages Negatively Impact Patient Safety. The American Journal of Nursing, 119, 3, 51.
Tamata, A. T., Mohammadnezhad, M., Tamani, L., & Rajiah, K. (2021). Registered nurses’ perceptions on the factors affecting nursing shortage in the Republic of Vanuatu Hospitals: A qualitative study. Plus One, 16, 5.
Vuong, L. (2020). Staffing Ratios and Burnout. The American Journal of Nursing, 120, 5, 13.
World Health Organization. (2022). Nursing and midwifery. Who.int. Web.