Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 1

The Current Nursing Shortage is Causing Detrimental Effects: We Need to Take Action

Nina Lowe BSN, RN

Department of Nursing, Youngstown State University

NURS 6900 Healthcare Issues and Trends

Dr. Sheila Blank

July 30, 2022

Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 2

Abstract

The nursing shortage can become even more detrimental if not resolved. Many factors

including accessibility to nursing education, nurses’ dissatisfaction with their work environment

and pay, and the COVID-19 pandemic leading to an exponential increase in nurse burnout rates

have contributed to this healthcare issue. History of nursing shortages prove to follow a pattern

and can be studied to help resolve the current shortage and to help prevent future shortage

issues. Increase funding for nursing programs, increase awareness of resources for mental

health specific to nurses, increasing efforts to improve work environments and nursing pay

rates by employers, and the increase in nurses in political decision making can help resolve the

shortage of nurses that is currently affecting the nursing profession.

Keywords: nurse, shortage, issue

Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 3

The Current Nursing Shortage is Causing Detrimental Effects: We Need to Take Action

The current nursing shortage is a healthcare issue that needs to be addressed

immediately. Without action, the nursing profession will only continue to decline until there is

no chance for recovery. The most recent nursing shortage is not the first encounter with this

healthcare issue. The first known shortage in nursing began in the early 1900s and lasted

decades. There are many factors that contribute to this current nursing shortage, including the

effects from the COVID-19 pandemic. This long-standing nursing issue does not just cause

increase stress and burnout to the individual nurse, but it affects the nursing profession in its

entirety by causing nurses to leave the profession all together. There are answers to the nursing

shortage. Individuals from all levels of the healthcare system need to collaborate to successfully

stop the slow hemorrhage that the nursing shortage is creating in the nursing profession.

Why the Nursing Shortage is of Concern to Nursing

The nursing shortage is exacerbated by many factors. The number of registered nurses

(RNs) leaving the profession through retirement and burnout are much higher than the number

of RNs being retained as well as the number of new RNs entering the profession. The demand

for nurses is increasing exponentially and will continue to increase over the next several years

as well. Huston (2020) refers to the United States (U.S.) Bureau of Labor projections:

Employment of RNs is expected to grow much faster than the average for all

occupations through 2024. Indeed, the U.S. Bureau of Labor (2018b) projects that the

RN workforce will grow 15% from 2016 to 2026. The Bureau also projects the need for

649,100 replacement nurses in the workforce, bringing the total number of job openings
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 4

for nurses because of growth and replacement to 1.09 million by 2024 (AACN, 2017a).

(Huston, 2020, p. 83).

If nothing is done to correct these projections than the nursing burnout rates will increase this

issue even more substantially.

Nursing education accessibility is hindering the ability to grow the nursing profession.

Even though there are many interested applicants, many are turned away. The denials of

nursing program applicants are occurring due to the inadequate resources of these programs.

Many nursing schools have an insufficient amount of faculty and preceptors as well as

inadequate classroom space and clinical sites restricting the number of candidates they can

accept into their programs. This limits the number of new graduate RNs each year which

negatively affects the growth of our profession.

The current COVID-19 pandemic has affected the nursing profession in so many ways.

The novel coronavirus brought so much fear and uncertainty to healthcare. It led to numerous

deaths as well as chronic lasting health problems for many individuals, including the frontline

workers. It also led to an equipment shortage causing nurses to feel unsafe in the workplace. All

nurses went to work each day hoping not to become infected with the virus because they didn’t

have the appropriate supplies to do their jobs. They also feared that they would bring it home

to their families and loved ones. All these factors in conjunction with working with a short

nursing team has led to an increase in nursing burnout worldwide.

Many nurses felt undervalued and uncared for by their employers throughout the

pandemic, which caused dissatisfaction in the workplace. Nurses already work long shifts, are

forced to work weekends and holidays, and some nurses have experienced mandatory
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 5

overtimes due to this shortage. In addition, hospitals opted to hire travel nurses to fill the gaps

in their staffing, which is a short-term fix. This however increased the shortage of permanent

staff nurses even more because employers have not increased pay rates for their own staff

nurses in any attempt to retain them. Instead, employers chose to hire travel nurses at almost

double if not more than double the pay to do the same job as their permanent staff. This led to

many staff nurses leaving their current hospital positions to become travel nurses, causing

more problems with hospital staffing.

We have discussed many areas of concern in the nursing profession that has led to this

healthcare issue. We cannot forget that the nursing profession is vital to healthcare. It has

shown through patient outcomes over the years. Nurses are the face of healthcare. They are at

the bedside in direct contact with patients for twelve hours with the goal of providing excellent

care to all patients to achieve positive patient outcomes. Ultimately, many changes need to be

made to resuscitate the rapidly declining nursing profession from the current shortage.

Historical Aspects

The current nursing shortage is not the first shortage in history. The first schools of

nursing were established in 1873 in the hospital setting. This created the beginning of the

nursing profession. In the 1930s an institutional model of nursing led to hospitals being staffed

by RNs due to the Great Depression. The first nursing shortage began in the 1930s and was due

to an increase in the demand of nurses resulting from an increased use of the healthcare

system.

Word War II increased the effects of the nursing shortage further resulting in an issue in

the supply of nurses. This led to the development of the Cadet Nurse Corps and the passing of
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 6

the Bolton Act in 1943 by congress, which was “the first example of a government subsidy to

aid nursing education, authorized $160 million to fund the education and support of student

nurses enrolled in the Cadet Nurse program” (Egenes, 2012, p. 19). The use of LPNs and non-

licensed nursing aids dramatically increased at this time as well. This slowed the nursing

shortage for a while, but didn’t completely resolve it.

After the war, countless nurses who served did not stay in the nursing profession when

they returned home. There was also a decline in the number of enrollees in nursing programs

during this time. In addition to the decline in nurses, there was a significant increase in the

demand of nurses in hospitals and a rise in community-based nursing opportunities. This led to

the worsening of the nursing shortage again.

In a 1950 report, The American Hospital Association labeled the nursing shortage as

"critical," citing the increasing number of hospital units that needed to be closed or new

units that could not be opened because of the persistent shortage of nurses (Egenes,

2012, p. 19).

Nursing shortages in history always seem to relate to a supply and demand issue

meaning there is not enough supply of nurses to keep up with the demand of the healthcare

system. Nursing shortages in the United States is cyclic in nature. This history should be studied

including each presented resolution. This history can be helpful in developing solutions to the

current nursing shortage and preventing future issues with shortages of nurses.

Implications to Nursing

As stated before, nursing directly affects patient outcomes. Increase in change and

innovation in the nursing profession leads to better outcomes in patients. For instance, the
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 7

implementation of safe nursing patient ratios as well as newly developed technology for safe

medication administration has positively impacted patient care and helped to decrease medical

errors. Inversely, the nursing shortage leads to a negative effect on patient care and patient

outcomes due to unsafe staffing ratios with higher acuity of patients.

The current nursing shortage has taken a toll on the psychological and physical health of

nurses in the profession. Many nurses were affected psychologically due to fear for the safety

of their families. In addition, nurses experienced many emotions holding the hands of their

patients and watching their patients take their last breaths alone.

A recent literature review analysed studies reporting nurses suffering from post-

traumatic stress disorder (PTSD) because of their COVID-19 experiences. This review

called for urgent interventions to protect nurses and other health care workers from the

psychological impacts of the pandemic that lead to them having symptoms of PTSD

(Turale & Meechamnan, 2022, p. 372-373).

Other nurses became physically ill and even died while working short staffed on the frontlines

during the COVID-19 pandemic. The negative physical and mental health that nurses are

experiencing can cause additional nurses to leave the profession as well as more pressing issues

of substance abuse and suicide among nurses.

Not only does this shortage directly affect bedside nurses, but it also has implications on

nursing leadership. Nurse managers continue to struggle to staff their departments, which

leads to increase stress and concern for their nursing team. Nurse managers may also resume

the role as a bedside nurse on days that staffing is extremely short causing a delay in

interviewing and hiring potential nurses for their department.

Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 8

Lastly, with fewer nurses in the profession, there are fewer nurses in the political

presence of nursing. Nurses should be directly involved in politics to help change the nursing

profession in positive ways. Only actively practicing nurses know what changes should be

implemented through their nursing experience that will lead to a beneficial impact on patient

outcomes. These same nurses can provide undeniable incite to the nursing shortage and to

other healthcare issues that can result in the development of appropriate and successful

resolutions to these issues.

Proposal of Resolutions

How do we as nurses resolve the current nursing shortage? Is there a long-term vision

to fix this issue, or are the short-term resolutions that are in place eventually going to crash and

flat line the nursing profession. To prevent this from happening, many changes can be

implemented to gradually decline the shortage and strengthen nursing all together.

First, government funding needs to be allocated to nursing programs to allow for growth

within their programs and an increase in the number of faculty available to educate new

nursing students. This will allow for nursing schools to accept more applicants. Nurses also need

to change the image of nursing through communication. We need to encourage those who are

interested in applying to nursing school, instead of trying to persuade a different career choice.

Additionally, the covid-19 pandemic had detrimental effects on nurses psychologically.

Let’s talk about it. Nurses should not be expected to just deal with the mental health

implications that come with a pandemic. President Biden signed the Dr. Lorna Breen Health

Care Provider Protection Act on March 18, 2022 to help combat the effects of the pandemic on

nurses, which is an excellent step forward. Do all nurses know about this new protection act?
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 9

Awareness of this new legislation needs to be emphasized by employers. Hospitals’

administrations should have a process in place to protect the mental health of all employees, so

no healthcare professionals are left struggling alone. If nurses get the help they need with

mental health from working long short staffed hours in difficult working conditions through the

pandemic, nurses can find the love and passion they once had for the nursing profession. This

can decrease burnout and positively impact patient care.

Employers need to invest in their nurses. Many sources have made it clear that nurses

are vital to the healthcare system. Employers need to improve workplace satisfaction and

increase pay for all staff nurses. Nurses want a safe and healthy work environment and to be

paid fairly. The base salaries for staff nurses should not be equivalent to travel nurses’ salaries,

but with the evolving healthcare system, the increase demand for nurses, and the climbing cost

of living everywhere, the salaries of staff nurses should increase based on these adjustments. If

hospitals invest in their nursing employees, the high turnover rates will decline, and retention

of nurses will be the outcome.

Lastly, the voices of nurses need to be heard. Nurses need to become more involved in

politics related to nursing. If nurses increase their presence in the political aspect of nursing,

they will be involved in important decisions that will directly affect the nursing profession. This

involvement allows nurses to provide their much needed incite to guide new legislature that

will benefit the nursing profession in relation to all healthcare issues.

Conclusion

There are many factors that have contributed to the nursing shortage. Some of these

factors include nursing burnout, decrease access to nursing education, the COVID-19 pandemic,
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 10

dissatisfaction in the workforce, and low salaries of staff nurses. Historically this current

shortage was inevitable as nursing shortages have a cyclic nature. The implications of the

nursing shortage prove to be detrimental to nurses, leadership, and patients if not resolved.

Government funding for nursing programs, mental health awareness and public awareness of

available resource for nurses, employers investing in nurses by improving workplace

satisfaction and pay, and nurses voices being heard in political decision making can help

positively impact the shortage issue in the nursing profession.

Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 11

References

American Association of College of Nursing. (2017a). Fact Sheets: Nursing Shortage.

http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

American College of Cardiology. (2022, March 23). Biden Signs Dr. Lorna Breen Health Care

Provider Protection Act. https://www.acc.org/Latest-in-

Cardiology/Articles/2022/02/25/22/00/Dr-Lorna-Breen-Health-Care-Provider-

Protection-Act-Passes-Senate

Bureau of Health Statistics, U.S. Department of Labor. (2018b). Occupational outlook handbook

– Registered nurses (2016-2017 ed.). https://www.bls.gov/ooh/healthcare/registered-

nurses.htm#tab-6

COVID-19 INTENSIFIES THE NATIONAL NURSING SHORTAGE: For years, national nursing leaders

and health care experts warned of a looming nursing shortage... Add a global pandemic,

and that shortage is here. (2021). Washington Nurse, 51(3), 22–23.

Egenes, K. J. (2012). The Nursing Shortage in the U.S.: A Historical Perspective. Chart, 110(4),

18–22.

Ferguson, S. L., & Williams, M. A. (2020). The Lamp Still Burns: Nurses on the Forefront of

COVID-19, Health Disparities, and Gender Inequities. Nursing Economic$, 38(5), 252–

243.

Huston, C. J. (2020). Professional Issues in Nursing: Challenges and Opportunities. (5th ed.).

Wolters Kluwer.

Sharplin, G. (2021). Burnout as a systemic challenge: job demands, loss cycles and the need for
Running head: THE CURRENT NURSING SHORTAGE IS CAUSING DETRIMENTAL EFFECTS 12

a workforce strategy. Australian Journal of Advanced Nursing, 38(4), 1–3. https://doi-

org.eps.cc.ysu.edu/10.37464/2020.384.721

Turale, S., & Meechamnan, C. (2022). Investment in Nursing is Critical for the Health of the

World: We Need 6 Million Additional Nurses. Pacific Rim International Journal of

Nursing Research, 26(3), 371–375.