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by Emma Large
We live in a world where little kids fall off bicycles and need to go to ER for stitches, Grandma and Grandpa get dementia and need to stay in a nursing home, and almost everybody needs to go to the doctor’s office for check-ups. Do you know what all these places cannot function without? Nurses. Unfortunately, the U.S. is experiencing a severe shortage of these talented, necessary caregivers. A study done by the American Hospital Association found that 35.8% of hospitals are experiencing at least a 10% vacancy in nursing positions.
But what has brought about this shortage of nurses? To start with, many regions of the U.S. are seeing an increasingly older population. These areas require more care, and naturally more nurses, than areas populated by younger generations. An article by Kristen Hamlin from NurseJournal.org tells us that the average age of a registered nurse is 52. So while we are beginning to need more nurses, at the same time, nurses are getting older and retiring.
At the same time, the colleges that train younger nurses, who would be taking the place of their retiring colleagues, are experiencing a shortage of nursing instructors. This has led to approximately 91,000 “qualified applicants” being turned away in 2021 alone. The shortage of nursing faculty is largely due to a mass retirement of these instructors.
Another cause for the nursing shortage is, at least in part, the Covid-19 pandemic. Many nurses were already feeling burnt out, and the extra responsibility accompanying the pandemic led them to quit, change careers or retire. Writing for StatPearls, Lisa M. Haddad, Pavan Annamaraju and Tammy J. Toney-Butler report that violence is another reason for the exodus of healthcare workers, as anywhere from 8% to 38% of healthcare professionals suffer violence at some point in their careers.
Some studies, such as those cited by Victor F. Caron of the University of Rhode Island, have also explained how the shortage relates to poorly trained nurses. In nursing school, students are shown ideals and perfect scenarios, but that does little to prepare them for the real world of nursing. Since this crisis has multiple causes, solving the nursing shortage in the U.S. will require multiple solutions.
Flexible Scheduling
Nurses need greater scheduling flexibility in their jobs. Kathleen Gaines, writing for Nurse.org, found that 87% of nurses say that they feel burnt out, and one reason that nurses are leaving their field is because of “an inability to take breaks, sick days, or even turn down extra shifts.” According to Bill Sirois, senior vice president of Circadian Technologies, for a nurse to go 18 hours without sleep “impairs the cognitive ability of a nurse the same as a blood alcohol level (BAL) of 0.05.” Sirois also explains that if a nurse goes 22 hours without sleep, that nurse’s cognitive function is equal to that of someone with a BAL of 0.08. In the United States, Massachusetts excluded, a BAL of 0.08 while driving is considered illegal. The shorter the shift of a nurse, the better the care provided by that nurse will be.
It also should also be mentioned that hospitals should be providing flexible scheduling for young mothers. A young mother is more likely to quit her job if she feels she can’t take care of her children because of how consuming her job is and because she is on a very strict schedule.
Workplace Environment
Nurses also need a restructuring of their workplace and a response to the negative attitudes of their workplaces. Low morale is present in too many workplaces, and this can be solved – mainly through steps taken by management. Higher satisfaction can be achieved by employing one of the earlier strategies mentioned in this essay: giving nurses scheduling flexibility and reducing overtime. This way, nurses feel less drained and are able to give quality care and thus obtain higher patient satisfaction, improving the workplace atmosphere.
Caron suggests that facilities could have days with themed scrub tops and sponsor “nurse of the month” events. According to Caron, this will “build employee cohesiveness and develop common goals.” Events like this help nurses to see their workplace as a fun place, thus leading to an increased morale. Increased patient satisfaction will lead to higher morale among nurses, as well. When nurses are satisfied that they are being heard and their needs are being met, then the environment is much more likely to be one of high morale and positive attitudes.
Valuing Nurses
A recent study shows that 84% of nurses are frustrated with their managers, while 61% of nurses feel unappreciated. Management in facilities can do so much to help solve this issue. Brenda Nevidjon and Jeanette Ives Erikson, in an article published by The Online Journal of Issues in Nursing, propose that executives in the world of healthcare “must learn new skills for valuing employees.” J. Adderton, a columnist for allnurses.org, believes management needs to promote greater communication. According to Adderton, who has 30 years of experience in clinical leadership, staff development and education, it is important that nurse managers make their best efforts to “set a tone of cooperation and teamwork” and actively stay involved in the nurses’ work. She goes on to explain that nursing managers should be quicker to praise than to offer negative, critical remarks. Nurses need their voices to be heard by managers who will take the time to understand the troubles they face and put forth a good effort to effectively eliminate some of their struggles.
Faculty Retention
Nursing instructors are in high demand. Part of the reason for this is because nursing instructors often spend some time in the field of nursing before they actually start teaching. Most are at an advanced age by the time they reach the status of instructor. This, combined with the fact that there have been some retirement age mandates, contributes significantly to the nursing shortage, according to Penelope A Cash, Donna Daines, Rose Marie Doyle and Linda von Tettenborn.
It would be profitable for colleges that want to retain nursing instructors to loosen or eliminate retirement age requirements for nursing instructors. In addition to that, colleges need to raise pay and salary for nursing educators. Marina Zhavoronkova et al. and Caron agree that nursing instructors often feel they are being paid less when compared to their instructing counterparts in other fields. Colleges will need to loosen retirement mandates and give higher pay and salaries to nursing educators.
Alternative Solution: Legislation
However, not everyone would fully agree with the solutions proposed here. Many alternative solutions have been proposed aside from those expounded on. One of the most common is that Congress should take the initiative to pass legislation that would help correct the nursing shortage. One such proposed piece of legislation would provide nurses with an associate degree resources like transportation and childcare as they attempt to get their bachelor’s, as well as seeking greater funding for programs approved under Title VIII of the Public Health Service Act. This would, at least in theory, provide greater funding for nursing scholarships and loan repayment.
Frankly, all these programs and legislations will simply take a lot of taxpayer money from a government that is over $31 trillion in debt. Besides the cost, a one-size-fits-all legislative approach to solving the nursing shortage will not fix the needs of individual facilities. In reality, it would also only be fair to mention that a lot of legislation regulating facilities in an attempt to make it easier for nurses could well be avoided by facilities finding loopholes in the system. However, when we apply adjustable strategies to different facilities, the facilities can tailor the strategies to fit their individual needs.
Conclusion
The nursing shortage is very real, but there are some solutions that can be very effective. It is important for facilities to grant greater scheduling flexibility to nurses, restructure the workplace and the attitudes embedded in it, value nurses and their contribution to our lives more, and employ practical strategies to retain nursing instructors. If medical facilities can apply all four of these solutions together, it will be possible to correct America’s nursing shortage.
References
Adderton, J. (2019, April 2). 5 ways managers can make nurses feel valued. Allnurses. https://allnurses.com/ways-managers-can-make-nurses-t697605/
American Hospital Association. (2022, March 1). AHA letter re: Challenges facing America’s health care workforce as the U.S. enters third year of COVID-19 pandemic. https://www.aha.org/lettercomment/2022-03-01-aha-provides-information-congress-re-challenges-facing-americas-health
Caron, V. F. (2004). The nursing shortage in the United States: What can be done to solve the crisis? (Paper 22) [Seminar Research Paper Series, Schmidt Labor Research Center, University of Rhode Island]. http://digitalcommons.uri.edu/lrc_paper_series/22
Cash, P. A., Daines, D., Doyle, R. M., & von Tettenborn, L. (2009, September/October). Quality workplace environments for nurse educators: Implications for recruitment and retention. Nursing Economic$, 27(5), 315–321. https://pubmed.ncbi.nlm.nih.gov/19927446/
Gaines, K. (2022, October 10). What’s really behind the nursing shortage? 1,500 nurses share their stories. Nurse. https://nurse.org/articles/nursing-shortage-study/
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing shortage. Department of Health and Human Services, National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Hamlin, K. (2023, March 21). Why is there a nursing shortage? NurseJournal. https://nursejournal.org/articles/why-is-there-a-nursing-shortage/
Nevidjon, B. & Erickson, J. (2001, January 31). The nursing shortage: Solutions for the short and long term. Online Journal of Issues in Nursing. 6(1), Manuscript 4. https://ojin.nursingworld.org/table-of-contents/volume-6-2001/number-1-january-2001/nursing-shortage-solutions/
Zhavoronkova, M., Custer, B. D., Neal, A., Al Sadi, A., Pandolfo, T., & Phan, H. (2022, May 23). How to ease the nursing shortage in America. Center for American Progress. https://www.americanprogress.org/article/how-to-ease-the-nursing-shortage-in-america/
Emma Large is a College Credit Plus student at Stark State College who is also entering her junior year of homeschooled high school. She is a member of Beta Gamma Epsilon who enjoys studying history and world civilization. For the last two years of her high school education, she plans to take all college classes. Emma would like to graduate with her high school diploma and an Associates of Arts degree from Stark State in two years.
In her spare time, Emma loves playing the piano and violin, having long chats with her friends on the phone, and crocheting baby girl clothing and other items. Reading books, mainly those about history, fills some of her spare time. Emma loves traveling, especially the Southeast. The Florida Keys, Savannah, Georgia, and Williamsburg, Virginia are some of her favorite places to visit. Making new friends at college is fun for Emma, too, and of course, she loves spending time with her cat.
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