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Coping with a nursing shortage that will only get worse

Hospitals have a few long-term options to reverse the trend of too few nurses.

Jeff Lagasse, Associate Editor

Nurses: There aren't enough of them.

That reality means hospitals need to rethink hiring, scheduling, mentorship programs and the work environment they create to retain and develop high-quality nurses moving forward.

[Also: Short-term, contract nurses could ease impending nursing shortage]

Much has been made of the worsening shortage of physicians in healthcare, but an equally vexing problem is the nursing shortage, which is expected to get worse over the coming years. Depending on the geographic area, nurses are either in short supply or have educational deficiencies that impact their effectiveness in a clinical environment.

Some of the drivers of this nursing shortage echo those of their physician counterparts. Others are different.

[Also: More nurses earning bachelor's degrees, but numbers still short of national goals]

One commonality is that the present nursing workforce is aging. According to the American Nurses Association, the average age of employed registered nurses is close to 44 years old, and those who are less than 30 years old represent only about 10 percent of the total working nurse population. That mirrors a trend occurring on the physician side, where physicians are aging out of the industry at the same time the massive Baby Boom generation is retiring -- creating a demand that can't be fulfilled by the projected physician supply.

There are a few long-term strategies for reversing this trend. The American Nurses Association suggests moving nursing students through their graduate studies more quickly.

[Also: Pay gap between men, women nurses remains, survey says]

Hospitals can help by creating and sustaining staff development programs and lifelong learning initiatives.

In terms of work environment, the group suggests introducing more flexibility into the work environment structure and scheduling programs; rewarding experienced nurses for serving as mentors to new nurses; and implementing appropriate salary and benefit programs.

ExecuSearch Vice President Amanda Bleakney said properly addressing the shortage will take time. And it is more prevalent in rural geographical regions that urban locations -- and that means hospital will be forced to adapt hiring practices accordingly.

"In some areas where there is a huge population of nurses, they're being more strict with their requirements," she said. "In areas where they're desperate for nurses, they may have to be more flexible and take an RN who has six months of experience, a year of experience. They need to have more hands-on, day-to-day training."

As for new graduate nurses, Bleakney said that "if they have the capability, they should definitely get their Bachelor's in nursing, because that's more and more of a requirement. Being bilingual helps in some areas. And some of them should consider going outside of the urban population and going to a rural market."

It's difficult to quantify the actual size of the nursing shortage. Registered nurses currently comprise the single largest group of professionals in American healthcare, and statistics point to a steady increase in the number of people entering the nursing profession. In the mid-to late-90s, growth in actual job demand for nurses dropped to an annual average of 2.7 percent, down from 3.6 percent in the years prior, according to the U.S. Department of Labor.

The statistics can be deceptive, however. The ANA maintains that the usual supply-and-demand dynamics with regard to nursing have been tweaked by variations in health delivery systems, Medicare and Medicaid reimbursement and even by regional and local customs and culture. How and where care is delivered, and how it's paid for, directly impact the need for nursing services. Plus, an aging population coupled with an increased prevalence of chronic disease suggests that the overall nursing demand will only increase.

A look at the education pipeline raises further concerns. Countrywide, the number of nursing programs has actually increased, but enrollees in all programs are on the decline, save for doctoral programs, which have seen a slight uptick.

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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