Running head: NURSING STAFF SHORTAGE 1

A Look Into Nursing Staff Shortage

Stefany A. Ramirez

James Madison University

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Abstract

The nursing shortage has increased over the years. This shortage affects every healthcare facility

and also affects the care provided to the patients. The nursing shortage is an international issue

that cannot be resolved overnight. The factors affecting the nursing staff shortage are age,

education, pay, and opportunities. Creating nurse residency programs (NRP) help increase nurse

satisfaction and retention.

Keywords: AACN, RN, shortage, nursing, healthcare, NRP, nurse

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A Look Into Nursing Staff Shortage

Introduction

The healthcare world has been growing at a steady rate. Registered nursing (RN) is a

great occupation in the healthcare world. According to the American Association of Colleges of

Nursing (AACN), “registered nursing is listed among the top occupations in terms of growth

through 2026,” (Rosseter, 2019). The AACN has also seen the healthcare occupation to increase

a 15%. With the RN occupation growing, the AACN has projected a need of 203,700 nurses to

fill RN positions every year through 2026 (Rosseter, 2019). This would indicate that the nursing

profession is a great profession to be in. However, most healthcare facilities are experiencing

nursing shortages. It seems as though there aren’t enough nurses to fill the positions available.

This paper will dive into the world of nursing and the reason why the healthcare world is

experiencing a shortage of nurses.

Background

The AACN states that the “shortage of Registered Nurses (RNs) is expected to intensify

as Baby Boomers age and the need for health care grows,” (Rosseter, 2019). As the healthcare

facilities experience nursing shortages, it is obvious that there is something in the system that is

failing. There are many factors that are affecting the nursing shortages. Some of these factors are

pay, age, education, and opportunities. “A shortage of healthcare staff is recognized as a global

problem against ever increasing demands on health services,” (Combes, Elliott, & Skatun, 2018).

The nursing shortage would be fixed if some of these factors would be changed by the healthcare

facilities.

In an article posted by Applied Economics, it states, “where the competitiveness of pay

increases, shortage of nursing staff is reduced,” (Combes, Elliott, & Skatun, 2018). There are a
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lot of nurses that are not satisfied with their pay. Nursing is a very tough profession that requires

a lot of critical thinking, management skills, and stress managing skills. For some nurses, the pay

that some facilities offer does not equal the amount of stress and burnout they experience. This

causes the nurses to go out and look for other jobs that pay more for the same job position. This

option might be good for the facilities that have higher pay, but it effects the facilities that aren’t

competitive about their pay. “Our results confirm previous findings that the RNs pay

competitiveness drives down vacancies of RNs,” (Combes, Elliott, & Skatun, 2018).

Another factor of nursing shortage is the age of the nurses. The AACN states, “50.9% of

the RN workforce is age 50 or older,” (Rosseter, 2019). This indicates that “more than 1 million

registered nurses will reach retirement age within the next 10 to 15 years,” (Rosseter, 2019). The

nurses that will be retiring will be the nurses that have the most experience. Those nurses will be

taking all of their knowledge and hands-on experience with them. This will cause new nurses to

be taught by other nurses that do not have the same level of knowledge that an experienced nurse

would have.

Education and opportunities are huge factors that affect the nursing shortage. The AACN

states, “nursing schools turned away more than 75,000 qualified applicants from baccalaureate

and graduate nursing programs in 2018 due to insufficient number of faculty, clinical sites,

classroom space, and clinical preceptors, as well as budget constraints,” (Rosseter, 2019). Not

having enough nursing faculty affects the number of students the nursing programs can have.

This causes a lower number of nurses to graduate and the healthcare facilities are still being

understaffed. Another factor that plays into the nursing shortage is education. There are more

nurses that are wanting to get higher education. This causes the nurses to leave the bedside and

get their masters or doctorate degrees. Climbing the clinical ladder or going back to school to get
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a higher education is great. However, as those nurses leave their position, there isn’t another

nurse to take that position.

Student Perspective

After working at a hospital for five years, I have learned a lot. I worked as a Certified

Nursing Assistant (CNA) for four years and as a RN for one. I have definitely learned a lot from

the nurses that have left their RN position. I have seen a lot of nurses leave because they believe

their nursing pay is not enough. They have left for other positions that offer higher pay for the

same job. Often times the other job position offers more money and is a longer commute but it

seems as though some nurses do not care about that. I believe that some healthcare facilities do

not take into consideration increasing pay because they would rather be short staffed.

It is clear that not having enough nurses affects the quality of care the patient receives. A

research article from Wiley states, “… the shortage of nursing negatively impacts on the

outcomes of care,” (Jarrar, Rahman, Minai, Abumadini, & Larbi, 2018). When there aren’t

enough nurses, patient centered care is ignored, and this causes mistakes and errors. This also

negatively impacts the nurses that remain working. Insufficient staffing increases the stress level

of the nurses. This will cause the nurses to leave the job completely. According to AACN, “…

surveyed nurses see the shortage in the future as a catalyst for increasing stress on nurses (98%),

lowering patient care quality (93%) and causing nurses to leave the profession (93%),”

(Rosseter, 2019). When a unit is short staffed of RNs, it affects the whole shift for the other RNs.

It causes the nurse to patient ratio increase. This causes the nurse to feel overwhelmed and the

nurse will not perform to the best of her/his capabilities.

The nursing profession is a great profession that helps nurses grow into their career. I

have worked with a lot of nurses that want to get a higher education and get their master’s degree
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in nursing. I know a lot of nurses that dream of being nurse practitioners and some want to

become teachers. I have also seen nurses climb the clinical ladder and become RN V and I have

seen some nurses become managers and work with administration. The great thing about nursing

is that you can grow and work in whatever area you would like.

Conclusion

In conclusion there are a lot of different factors that affect the nursing shortage. Most of

these factors can be fixed with the help of the healthcare facilities. One way the healthcare

facilities can help nurses stay in the current positions they are in is by having a nurse residency

program (NRP). These types of programs are mostly for newly graduated nurses, but I believe

they can also help any nurse. Being a new nurse or moving to a new healthcare facility can be

very difficult. “These stressful work conditions have contributed to decreased retention and

satisfaction amongst new nurse hires,” (Eckerson, 2018). Having an NRP for new hire nurses can

help the nurses feel supported as well. “Research studying the impact of hospital work

environments on retention of new nurse hires found that new nurses experience less anxiety and

stress in environments that foster a safe learning environment and effective communication and

support,” (Eckerson, 2018). Having a support system in the workplace will also make nurses

stay. This will help the hospital spend less money on hiring new nurses and fill all of the open

RN positions. “Increased retention and satisfaction of new nurse hires have been proven

outcomes of NRPs, positively impacting nurse turnover rates and finances in healthcare

institutions,” (Eckerson, 2018). Increasing pay and making nurses feel supported will increase

nurse satisfaction and will also help with nurse retention. Although there are many factors

affecting nursing staff shortages, I believe that as the years go on, healthcare facilities will

improve in each of the areas and there will be great nursing satisfaction outcomes.
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References

Combes, J.-B., Elliott, R. F., & Skatun, D. (2018). Hospital staff shortage: the role of the

competitiveness of pay of different groups of nursing staff on staff shortage. Applied

Economics, 50(60), 6547–6552. doi: 10.1080/00036846.2018.1490000

Eckerson, C. M. (2018). The impact of nurse residency programs in the United States on improving

retention and satisfaction of new nurse hires: An evidence-based literature review. Nurse

Education Today, 71, 84–90. doi: 10.1016/j.nedt.2018.09.003

Jarrar, M., Rahman, H. A., Minai, M. S., Abumadini, M. S., & Larbi, M. (2018). The function of

patient‐centered care in mitigating the effect of nursing shortage on the outcomes of care. The

International Journal of Health Planning and Management, 33(2). doi: 10.1002/hpm.2491

Rosseter, R. (2019, April 1). Nursing Shortage. Retrieved November 23, 2019, from

https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage.