Ref https://www.usa.

edu/blog/nursing-shortage/

the 2021 American Nursing Shortage: A Data Study

Female in blue scrubs looks at clipboard with male doctor standing next to her
The United States is in the midst of a critical nursing shortage that is expected to
continue through 2030.1 In this post, we examine how this complex issue came
about, what the statistics reveal, and what strategies nurses can use to move
through the challenges it brings.

The Growing Nursing Shortage

“Nursing is what I was called to at a very young age, and I cannot imagine doing
anything else— but I am very tired.”
—Heather Josey Thomas, MSN-Ed, RN, CCRN, DNP student at USAHS

The bravery and dedication of America’s nurses have been displayed in front-page
newspaper stories across the country throughout the COVID-19 pandemic.
However, the pandemic has also been a huge strain on nurses and the healthcare
system, due in part to limited staff and resources. The nursing shortage facing
America began long before the pandemic propelled it into the headlines once
again.

The United States has experienced nursing shortages periodically since the early
1900s. Multiple factors led to each shortage, from world wars to economic
recessions. But the magnitude of the current nursing shortage, announced in 2012,
is greater than ever before in this country.2

Given the growing demand for healthcare services across a multitude of

specialties, reports project that 1.2 million new registered nurses (RNs) will be
needed by 2030 to address the current shortage.3 Nursing schools and graduate
nursing programs are working to accommodate the rising demand for skilled
nurses and nurse leaders, but they also face challenges.

Nursing Shortage Statistics

To create a visualization of the American nursing shortage, we compared each
state’s population to the most recent statistics on the employment of RNs in that
state to calculate the number of working RNs currently available per 1,000
residents.

How does your state rank?

Registered nurses available by state

Click on a state to reveal the statistics or use the dropdown menu below.

RNs per 1000 population

Fewer than 10

10.1 - 12

12.1 - 14

14.1 - 16

16.1 or more

Select a state
Why Is There a Nursing Shortage?
High demand and low supply have created the current nursing shortage, and a
multitude of factors have led us to this point.
Registered Nurses Shortages by State graphic

Demand Is on the Rise

As of February 2021, registered nursing was the fifth-most in-demand job in the
American workforce, according to LinkedIn.4 Healthcare facilities are searching
for skilled RNs because they are facing increased patient demand for care.

The country has a larger population over the age of 65 than ever before in its
history, composed primarily of baby boomers (those born between 1946 and 1964).
This 65+ demographic has grown rapidly, jumping from 41 million people in 2011
to 71 million in 2019—a whopping 73% increase.5 And the U.S. Census Bureau
projected that number to continue to rise, estimating it will reach 73 million by
2030.6

With better and more accessible healthcare, the growing population of seniors
requires more health services due to age-related conditions. Lengthened lifespans
stretch out the timeframe when patients require services, thus adding pressure to an
already strained healthcare system.

The Retirement Drain

“When COVID hit, many people retired or were given an early retirement
package… Now they are so understaffed that they are paying bonuses for people
not to call out or use their vacation for the next three months.”
—Beverly Banez, BSN, RN, MSN student at USAHS

The population surge from the baby boomer generation has led not only to a
greater number of aging patients but also means that a large portion of the nursing
workforce is heading toward retirement. Between 2000 and 2018, the average age
of employed registered nurses increased from 42.7 to 47.9 years old. And nearly
half (47.5%) of all RNs are now over the age of 50.7

A 2015 study predicted that over one million RNs will retire from the workforce
between now and 2030.8 As they go, they take with them their invaluable amount
of accumulated knowledge and nursing experience.

It’s important to note that COVID-19 created a wave of artificial early retirements
due to the extended period of limited access for both patients and staff to medical
facilities. Because hospitals stopped doing elective surgeries and patients stayed
away from the hospital, hospitals had less income and needed to reduce staff to
stay afloat. In response, many hospitals forced furloughs on their employees,
leading some people to opt to retire who wouldn’t have planned to otherwise.9

The Location Factor

When reviewing nursing shortage data at the state and national level, the numbers
can be confusing. The Bureau of Health Workforce projects that California will
face the largest nursing shortage of any state, with a projected shortfall of 44,500
nurses by 2030. In contrast, the state of Florida will have a projected surplus of
more than 53,000 RNs by 2030. Looking only at states better off can lead one to
falsely assume that the problem has blown over or never even existed.10
Rural communities absorb greater impacts of the nursing shortage than do
metropolitan areas. Only 16 percent of RNs live in rural areas, where they serve
over 52 million Americans who reside there.11

The Educator Exodus

Nurses need to be taught by other nurses. As the average age of the RN population
has increased, so has the age of RNs who have stepped into the role of educator.
They, too, are looking toward retirement, leaving nursing schools without a strong
pipeline of teachers to take their place.

One recent report discovered that, in 2020, over 80,000 qualified nursing school
applicants were turned away from baccalaureate and graduate programs due to a
lack of qualified faculty, clinical study sites, classroom space, and budget
constraints.12 As a result of the ongoing decrease in faculty numbers, fewer
nursing graduates will be joining the workforce.

Stress of the Job

The heightened stress levels of today’s nurses are due to more than just the
pandemic, more than just the need to make urgent life-altering decisions, and more
than just working long hours. It is all of these things and more, combined, that
weigh on the shoulders of many RNs.

Ongoing budget tightening has led many healthcare facilities to cut staffing levels,
leaving a major imbalance in the workloads for remaining nursing staff. This has
been especially true during the pandemic. Many hospital employees were asked to
move from their usual departments and roles to assist with the intensive care of
COVID-19 patients.13 Most nurses are dedicated to helping patients however they
can; however, it’s stressful to be thrown into a new area of nursing on short notice
—especially an area as demanding as critical care.

The Impact of the Nursing Shortage

Heavy workload impact on nurses and patient safety graphic
Source: Pascale Carayon and Ayse Gurses, “Chapter 30: Nursing Workload and
Patient Safety—A Human Factors Engineering Perspective,” Patient Safety and
Quality: An Evidence-Based Handbook for Nurses:
https://www.ncbi.nlm.nih.gov/books/NBK2657/
The shortage of skilled nurses entering and staying in the workforce affects both
patient care and other healthcare workers on the team. Nurses are so important to
healthcare delivery that any challenge they face impacts us all.

Higher Risk of Nurse Burnout

“I have missed kids’ school events, I have been short-tempered when I shouldn’t
have been, and I have compromised my own health at times due to my inability to
say ‘no’ to the extra shifts even on days when I knew I should.”
—Heather Josey Thomas

Overwhelmed frontline-working RNs have been running a constant risk of

developing nurse burnout. The phrase struggles to encompass the depth of the
physical and emotional exhaustion nurses experience as the result of heavy
workloads, long hours, and the stress of treating critically ill patients.

Pandemic or not, having fewer nurses available to spread the workload is

guaranteed to add layers of stress onto other staff. The weight of life-altering
decisions needing to be made on a constant basis and the knowledge that there is
never enough time to provide your patients can undermine staff efficacy and
exacerbate personnel shortages.

Higher Risk of Medication Errors and Deaths

A 2019 study revealed that a patient’s risk of post-care-associated infection
increased by 15% in facilities with low hospital staffing levels.14 Another study
conducted in California correlated an 8.9% decrease in pneumonia infections
among surgical patients to an increase of one additional work hour per patient per
RN.15

Longer Wait Times and Shorter Visits

The fewer staff members available at a given facility due to the nursing shortage,
the longer patients must wait to be seen by the staff on site. And with more and
more patients coming for medical assessments and treatments due to the aging U.S.
population, extensive wait times and brief visits with the nurse and doctor become
more and more typical.

Solutions for the Nursing Shortage

For such a complex problem, there is no simple solution. But there are strategies
and practices that we can examine and put into play today. Advances in nursing
education, in the workplace, and at the policy level may spark the change we need.

Greater Access to Education

“I hope that more people choose nursing as a career and that I can continue to be
involved in teaching and growing them. After all, they will be the ones caring for
me and my family someday!”
—Heather Josey Thomas

Education is the bedrock for growing the population of skilled nurses. Creating
programs that incentivize students to enroll in nursing school, complete their
studies, and continue their education to up-level their skills and careers is one
strategy for increasing enrollments. Registered nurses with a Bachelor of Science
in Nursing (BSN) degree typically have stronger job prospects than nurses without
the degree.
Naturally, encouraging nurses to earn their graduate-level credentials, such as a
Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP)
degree, will add to the pool of highly skilled nurses and improve patient outcomes.
Nurses with graduate degrees can serve in leadership roles, in advanced levels of
patient care, or as educators themselves.

Flexible options for schooling, such as online programs, are critical to recruiting
and retaining engaged students—especially working nurses who need to fit school
into their busy schedules.

Strategic Workplace Accommodations and Flexibility

“The hospital where I work part-time as a direct-care ICU nurse hired many
travelers and/or agency staff. They also offered a huge COVID differential,
essentially doubling everyone’s hourly salary, but eventually, even that couldn’t
entice people to come in to work extra shifts because we were just so tired.”
—Heather Josey Thomas

Nurse executives are responsible for creating a workplace culture that supports
nursing staff and entices experienced nurses to remain on staff. For example,
beyond simply improving compensation and benefits packages, executives can
empower nurses to create their own schedules and reward senior nursing staff for
mentoring new nurses; programs like this can have a major impact on employee
retention at a time when it’s needed most.

As modern technology continues to shape healthcare delivery, the flexibility of

telehealth and travel nursing creates new paths for some nurses to continue doing
their good work in creative ways. Increased opportunities for career development
and growth in nursing will help maintain nursing as an attractive, desirable job
opportunity.

Lobbying and Advocacy

Everyone who benefits from the skilled hands and minds of RNs across the country
should be encouraged to advocate during the policymaking process at both the
state and federal levels. For example, the American Nursing Association (ANA)
currently works with legislators on a variety of key topics, such as workplace
health and safety, appropriate staffing, and reducing gun violence. The ANA even
provides an RN Activist Toolkit to help get you started.16

Opportunities Created by the Nursing Shortage

“The nursing shortage gave me a chance to work in another department for better
hours and for a new experience.”
—Beverly Banez

Thankfully, the current nursing shortage has a positive side: opportunities for
career growth. The healthcare industry is considered to be recession-proof, which
translates to potential long-term job security.

According to U.S. News & World Report’s list of the 100 Best Jobs in America for
2021, nurse practitioner takes third place as an optimal career path. In fact, 13 of
the top 20 Best Jobs are in the healthcare field, including speech-language
pathologist (#7) and occupational therapist (#19).17
Opportunities for nurse educators abound. A report from the American Association
of Colleges of Nursing in 2018 found that 56% of the educational institutions they
surveyed had full-time vacant teaching positions open.18
No healthcare system can function without skilled nurses. Nursing shortages are
being documented around the globe, with a recent report from the World Health
Organization noting that the world may be short 5.7 million nurses by 2030.19
The United States’ experience with the pandemic has placed the reality of our
current nursing shortage into the spotlight. With a better understanding of what
challenges the shortage brings, how we can improve the situation, and how nurses
can take advantage of the opportunities it brings, we can hope to shift the tide.
The University of St. Augustine for Health Sciences (USAHS) offers a Master of
Science in Nursing (MSN) program, a Doctor of Nursing Practice (DNP) program,
and Post-Graduate Nursing Certificates designed for working nurses. Our degrees
are offered online, with optional on-campus immersions.* Role specialties include
Family Nurse Practitioner (FNP), Nurse Educator,** and Nurse Executive. The
MSN has several options to accelerate your time to degree completion. Earn your
advanced nursing degree while keeping your work and life in balance.
*The FNP role specialty includes two required hands-on clinical intensives as part
of the curriculum.
**The Nurse Educator role specialty is not available for the DNP program.

Edward Mehdaova, “Strategies to Overcome the Nursing Shortage,” Walden

University, 2017: https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?
article=5933&context=dissertations [↩]
Linda Workman, “Confronting the Nursing Shortage,” Nurse Key:
https://nursekey.com/confronting-the-nursing-shortage/ [↩]
Terri Williams, “1.2 Million More Nurses Needed by 2030 to Meet U.S. Demand,”
Good Call: https://www.goodcall.com/news/1-2-million-more-nurses-needed-by-
2030-to-meet-u-s-demand-09308/ [↩]
Mike Irvine, LinkedIn Talent Blog, “The Most In-Demand Jobs Right Now,”
March 15, 2021: https://business.linkedin.com/talent-solutions/blog/trends-and-
research/2020/most-in-demand-jobs [↩]
Lisa Haddad et al., “Nursing Shortage,” StatPearls Publishing, Dec. 14, 2020:
https://www.ncbi.nlm.nih.gov/books/NBK493175/ [↩]
U.S. Census Bureau, Population Division, “Projected Age Groups and Sex
Composition of the Population: Projections for the United States, 2017–2060,”
U.S. Census Bureau, Population Division, Sept. 2018:
https://www2.census.gov/programs-surveys/popproj/tables/2017/2017-summary-
tables/np2017-t2.xlsx [↩]
U.S. Health and Human Services, Health Resources and Services Administration,
National Center for Health Workforce Analysis, “Brief Summary of Results from
the 2018 National Sample Survey of Registered Nurses,” 2019:
https://data.hrsa.gov/DataDownload/NSSRN/GeneralPUF18/nssrn-summary-
report.pdf [↩]
David Auerbach et al., “Will the RN Workforce Weather the Retirement of the
Baby Boomers?” Medical Care, Oct. 2015: https://journals.lww.com/lww-
medicalcare/Abstract/2015/10000/Will_the_RN_Workforce_Weather_the_Retirem
ent_of.3.aspx [↩]
Alia Paavola, “266 hospitals furloughing workers in response to COVID-19,”
Becker’s Hospital Review, Aug. 31, 2020:
https://www.beckershospitalreview.com/finance/49-hospitals-furloughing-
workers-in-response-to-covid-19.html [↩]
U.S. Health and Human Services, Health Resources and Services Administration,
National Center for Health Workforce Analysis, “Supply and Demand Projections
of the Nursing Workforce: 2014-2030,” 2017:
https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/
nchwa-hrsa-nursing-report.pdf [↩]
Health Resources and Services Administration, National Center for Health
Workforce Analysis, “The U.S. Nursing Workforce: Trends in Supply and
Education,” April 2013:
https://www.ruralhealthinfo.org/assets/1206-4974/nursing-workforce-nchwa-
report-april-2013.pdf [↩]
American Association of Colleges of Nursing, “Student Enrollment Surged in U.S.
Schools of Nursing in 2020 Despite Challenges Presented by the Pandemic,” April
1, 2021:
https://www.aacnnursing.org/News-Information/Press-Releases/View/ArticleId/
24802/2020-survey-data-student-enrollment [↩]
Nancy Cleeland, “Hospitals Face Staffing Shortages, Reduced Budgets in
Coronavirus Pandemic,” SHRM, April 7, 2020:
https://www.shrm.org/resourcesandtools/hr-topics/employee-relations/pages/
hospitals-face-staffing-shortages-reduced-budgets-in-coronavirus-pandemic.aspx
[↩]
Jingjing Shang et al., “Nurse Staffing and Healthcare-Associated Infection Unit-
Level Analysis,” The Journal of Nursing Administration, May 2019:
https://pubmed.ncbi.nlm.nih.gov/31008835/ [↩]
Pascale Carayon and Ayse Gurses, “Chapter 30: Nursing Workload and Patient
Safety—A Human Factors Engineering Perspective,” Patient Safety and Quality:
An Evidence-Based Handbook for Nurses:
https://www.ncbi.nlm.nih.gov/books/NBK2657/ [↩]
American Nursing Association, “Federal Issues”:
https://www.nursingworld.org/practice-policy/advocacy/federal/ [↩]
U.S. News & World Report, “100 Best Jobs,” 2021:
https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs [↩]
American Association of Colleges of Nursing, “Special Survey on Vacant Faculty
Positions for Academic Year 2018-2019,” 2018:
https://www.aacnnursing.org/Portals/42/News/Surveys-Data/Vacancy18.pdf [↩]
Mackenzie Bean, “World may be short 5.7M nurses by 2030: 4 report takeaways,”
Becker’s Hospital Review, April 9, 2020:
https://www.beckershospitalreview.com/nursing/world-may-be-short-5-7m-nurses-
by-2030-4-report-takeaways.html [↩]

CHECK PDF FORM

Ref https://www.air.org/resource/report/recommendations-address-nursing-
shortage

Recommendations to Address the Nursing Shortage

By Gauri (Gee) Rege and Christina Curnow

Similar to other countries, the U.S. has had a long running shortage of nurses.
There are many reasons for this—including the high cost of education and
licensure. While the nursing shortage existed long before the COVID-19
pandemic, this crisis highlights the critical need for nurses in a healthcare system
that is strained.

In this white paper we offer recommendations and considerations for when

COVID-related emergency responses subside and the nursing shortage continues to
be an issue. The recommendations cover education, financing, professional
supports, and licensure. We hope this paper will inform employers, educators,
licensing boards, and policymakers.

This white paper provides information that supports six major recommendations:

Promote nursing as a career choice in high school students;

Offer and promote alternative financing options;
Offer professional support and opportunities;
Enhance nursing education resources;
Consider maximizing licensure reciprocity; and
Consider leveraging assessments as an alternative to some licensing requirements.

REF https://www.dw.com/en/philippines-nurses-threaten-mass-resignation-amid-
covid-surge/a-59028522
Philippines: Nurses threaten mass resignation amid COVID surge
Saying they are overworked and underpaid, health care workers across the
Philippines are threatening to walk off the job unless they receive benefits
promised by the government

A nursing shortage in the Philippines has stretched many hospitals to the limit

The Philippines is currently experiencing record-high COVID caseloads driven by

the highly transmissible delta variant. As hospitals fill up, overworked nurses have
staged protests and are threatening mass resignations if government benefits are
not paid by September 1.
At the start of the pandemic last year, the Philippines' government set aside special
risk allowances for health care workers, which included hazard pay and money for
accommodation and transportation.

However, health care worker unions allege that the promised benefits and
compensation have not been paid out.

"Health care workers are tired and extremely demoralized. Many have already
resigned and many more want to," said Jao Clumia, union president of St. Luke's
Medical Center, one of the largest private hospitals in Manila.

The dispute over payouts stems from a stipulation that only health care workers
directly handling COVID patients are entitled to receive benefits. However, health
care workers claim that this provision is both unfair and unrealistic.

Could hospitals close in the Philippines?

"When you work in a hospital during a pandemic like COVID-19, you are exposed
to the virus. It's as if you have one foot in your grave already," Clumia told DW.
"Our hospitals will close if we don't address this issue," he added.

VIDEO….

The Philippines Department of Health has pleaded with health care worker unions
to reconsider plans for mass resignation.
"We understand their points, but we want to explain to them that there are policies
that we have to follow," Department of Health undersecretary Maria Rosario
Vergeire said in a press conference.

Takeshi Kasai, the World Health Association (WHO) Western Pacific Regional
Director, called on the government to ensure that health care workers receive
adequate support.

According to Department of Health data, over 22,000 COVID cases were reported
in the Philippines on August 30. The seven-day moving average of new cases is
currently more than 16,000. Hospital beds are also filling up around the country.

Surge comes amid hospital staff shortage

The Philippines is one of the world's top sources for nurses, however, many
hospitals and health care facilities in the country are consistently understaffed.

According to labor unions, low wages are a major deterrent. Many nurses say they
would prefer to work abroad or in alternative industries that offer more competitive
salaries.

"There has always been a chronic understaffing of nurses. This pandemic has just
made it worse. Nurses are severely overwhelmed," said Maristela Abenojar,
national president of Filipino Nurses United (FNU), a national labor association for
nurses.

She said the FNU has received reports of certain hospitals with a shortage of 100
or more nurses.

"Some nurses are working 12-hour shifts and caring for as many as 20 patients.
They forgo meals and bathroom breaks to save on PPEs. All of this is putting them
at increased risk of COVID infection and adding to their fears of catching the
disease. Their working conditions are no longer humane," Abenojar told DW.

"The government has the funds but health worker benefits and salaries are not
prioritized by the health department," Abenojar added.

Last week, the Philippine General Hospital, the country's largest public hospital,
announced that it would close its emergency room as it was unable to take in
additional patients.

Long-term nursing solutions needed

Cristy Donguines, a nurse at the Jose Rodriguez government hospital in Manila,
told DW that her hospital is bracing to take in a surge of patients that can no longer
be accommodated at other, overflowing hospitals.

Amid the crunch, workers like Donguines say that having to resort to protests and
mass resignations for government-promised benefits is both frustrating and
insulting.

"Does the government think we want to be out on the streets protesting? We would
rather be at our hospitals, caring for our patients," she said.

"We are needed more there, but if we don't do this, we will not be heard. The
government is playing deaf and blind to our pleas. The government should be
ashamed of itself," said Donguines, who also heads a local chapter of the Alliance
of Health Workers.

As the pandemic wears on, nurses are calling for long-term solutions that will
value health care workers as the backbone of the health care industry.
“We will not stop protesting until we see health care reforms that are badly needed.
That includes a just living wage for nurses and continued provision of hazard pay
during the pandemic. We're not asking for too much. This is what was promised to
us by law," said Donguines.

REF https://www.japantimes.co.jp/news/2021/09/18/asia-pacific/philippines-
health-care-workers/

'Burned out': Philippine nurses battle COVID-19 and resignations

MANILA – Exhausted nurses in the Philippines are struggling to care for patients
as colleagues contract COVID-19 or quit a profession that was dangerously
understaffed even before the pandemic.

The country is enduring a record rise in infections, fueled by the delta variant, with
the health department reporting a nursing shortfall of more than 100,000 — forcing
those left to work long hours for little pay on often precarious short-term contracts.

“They are tired and burned out,” nursing director Lourdes Banaga said.

“At the start of the pandemic we had almost 200 nurses,” said Banaga, director for
nursing services at the Lipa Medix Medical Center in Batangas province, south of
Manila.

“By September that will reduce to 63.”

Official figures show 75,000 nurses are working in public and private Philippine
hospitals but roughly 109,000 more are needed.
The pandemic has exacerbated a pre-existing lack of nurses, said Maristela
Abenojar, president of Filipino Nurses United — a situation she describes as
“ironic” in one of the world’s biggest exporters of health care workers.

The “chronic understaffing” is down to inadequate salaries, she said.

An entry-level nurse in a public hospital can earn 33,575 pesos ($670) per month,
official data show.

But Abenojar said most were on short-term contracts, earning 22,000 pesos with
no benefits such as hazard pay. Meanwhile, those in the private sector were making
as little as 8,000 pesos.

And many have had enough: About 40% of private hospital nurses have resigned
since the start of the pandemic, according to the Private Hospitals Association of
the Philippines.

More than 5,000 nurses have been given the green light to go abroad this year after
a COVID-19 ban was replaced with a cap to ensure enough nurses were available
in the Philippines.

It hasn’t worked.

“We can’t get additional nurses, we can’t compel them to apply,” said Jose Rene
de Grano of the private hospitals association.

‘We feel exhausted’

In recent weeks, health workers have protested over unpaid benefits, including a
coronavirus special risk allowance. Abenojar said many were still waiting.
President Rodrigo Duterte has asked for patience while the government tries to
come up with the money.

An entry-level nurse in a public hospital in the Philippines can earn 33,575 pesos
($670) per month, official data show. | AFP-JIJI
An entry-level nurse in a public hospital in the Philippines can earn 33,575 pesos
($670) per month, official data show. | AFP-JIJI
“We don’t feel cared for,” said Melbert Reyes of the Philippine Nurses
Association.

Many hospitals boosted their bed capacity after a virus surge earlier this year
threatened to overwhelm them.

Official data show coronavirus ward and ICU bed occupancy rates at more than
70% nationwide as daily cases often exceed 20,000, fueled by the highly
contagious delta variant.

A public hospital in Binan city, near Manila, turned a parking lot into a ward.

“Many of our nurses are sick and in quarantine,” medical director Melbril Alonte
said.

“We feel exhausted … but we always keep in mind that we have to help our people
because … no one else will.”

But due to the nursing shortfall, some facilities — like the Lipa Medix Medical
Center — have had to slash their bed capacity, and extend their nurses’ shifts.
Trixia Bautista said she works up to 15 hours per shift looking after mostly severe
COVID-19 patients at a public referral hospital in the capital.

At times, she has cared for as many as 30 patients on her own after nurses in her
ward quit or got sick.

“Physically it’s very tiring,” she said. “There’s not enough people to cater to all
these patients.”

‘Not worth being a nurse’

But there are plenty of qualified nurses in the Philippines, said Abenojar of
Filipino Nurses United.

She estimated 200,000 to 250,000 were not working in the sector.

Many health care workers enter the profession to try to secure better-paid jobs
abroad, but the shortage is not due to overseas migration.

“It’s because nurses have left the profession,” said Yasmin Ortiga, assistant
professor of sociology at Singapore Management University, pointing to the dearth
of stable jobs and dismal wages.

A proliferation of nursing programs led to an oversupply, with many unable to get

a permanent position in a local hospital — necessary to work abroad — and
subsequently a drop in enrolments.

“People realized that if I am unable to leave the country it’s really not worth being
a nurse at home,” Ortiga said.
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