Where Have All the Nurses Gone?
Prospective nurses will find plenty of needy hospitals in the coming years. The U.S. is experiencing a severe shortage of nurses that is projected to get worse as baby boomers get older. With consequences for both patients and staff, hospitals must consider who will fill the gap and how to get potential candidates on the nursing track.
The aging baby boomer generation is a double blow to hospitals. As people get older they require more medical care, which means higher hospital censuses. Additionally, many nurses are reaching retirement age, (approximately one million in the next ten to fifteen years, according to the Health Resources and Services Administration) which means a lower nurse-to-patient ratio. A 2013 survey by The National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers revealed that 55 percent of RNs are already 50 or older.
While nurses are retiring, no one is lined up to take their place. Schools are forced to turn away qualified candidates because they lack the clinical space, clinical preceptors, classroom space and faculty - especially teachers. It is not that young people are disinterested in nursing: the American Association of Colleges of Nursing reported a 3.6 percent increase in enrollment in undergraduate nursing programs. The rate of acceptance is simply not high enough to bridge the gap left by baby boomers.
If the shortage persists, nurses will have to take on more patients, which is bad news for both parties. Many studies have shown the importance of adequate nurse staffing. A 2011 study published in Medical Care revealed that more nurses results in fewer failure-to-rescue incidents, fewer infections, shorter stays, and fewer patient deaths. A 2011 study published in the New England Journal of Medicine revealed that fewer nurses results in an increased risk of patient death.
Moreover, the shortage takes a toll on nurses’ mental health. Taking on more patients raises their stress levels doing a job that is already stressful. It lowers their job satisfaction, and ultimately, it perpetuates the shortage by causing nurses to quit.
The U.S. could follow the lead of countries that are attempting to remedy their own shortage by placing refugees on fast-track programs toward job placement. But efforts are slow-going even in Sweden, who accepted the largest number of refugees relative to population size, and Germany, who accepted the greatest absolute number of refugees. Already-qualified candidates spend three years training before they can practice. And, importantly, a majority of the refugee workforce is composed of men. When more refugee women enter the workforce, there is a chance that the shortage will diminish in those countries.
The circumstances surrounding immigration policy would make it hard for the U.S. to follow suit; bureaucratic roadblocks are now making even legal immigration difficult. Recent Trump administration policies have made it so employment-based visas now require an interview, lengthening the process and allowing authorities to arbitrarily turn people away. Under future administrations, hospitals will include refugees in their hiring pool. For now, U.S. solutions to the shortage will likely take a different shape.
Luckily for prospective students, measures are already being implemented that may allow nursing programs to accept more students. Nursing programs are forming coalitions and seeking private support to supplement funding. States like Wisconsin provide loan forgiveness to nursing students who agree to work in-state after graduation. NursingCAS, the U.S.’s centralized application service, helps fill vacancies in schools and maximize capacity in both undergraduate and graduate nursing programs. The AACN has a wealth of resources for those hoping to get their foot in the door. Individuals can also call upon policymakers in states that aren’t addressing the shortage.
Like most female-centric jobs nursing is thankless, but it is one of the most important, helping hospitals run efficiently and positively impacting people’s lives. As hard as nurses work to take care of their patients, it is important that someone is looking out for them, too.