Nurse Staffing Shortages National Healthcare Issue/ Stressor
Walden University NURS-6053 Module 1: Discussion Review of Current Healthcare Issues – Nurse Staffing Shortages National Healthcare Issue/ Stressor
National healthcare issue/stressor
There are many issues and stressors that impact healthcare, one is the lack of adequate healthcare providers. The healthcare industry is facing a shortage of multiple disciplines, impacting the number of patients receiving treatment. By the year 2033 there is an expected shortage of 124,000 physicians, and hospitals are having to replace 200,000 nurses each year to keep up with care demands (American Hospital Association, 2021). The population is increasing due to people living longer, however the number of providers to render treatment is diminishing. The population expectancy is 2 billion people by the year 2050 with most of the population having at least one chronic health condition (Amalberti et al., 2019). The number of healthcare providers needs to increase to meet the demands of the growing population.
Impact on work setting
The shortage of healthcare providers impacts on the work environment by not allowing patients to receive adequate treatment for illnesses. Patients are forced to go without treatment or receive less than treatment because there are not enough providers to render care. Patients are having to wait long periods of time to visit with providers and are having the least informed healthcare works decide on whether the patient should see a physician (Slonim, 2023). The number of patients a healthcare worker is having to care for is increasing, adding stress to providers and decreasing the quality-of-care patients are receiving. Healthcare providers are having to render treatment as tasks, such as needing to give medications and drawing labs, rather than being able to listen to patients, spend time with them, while still performing tasks. Physicians often spend very little time with patients due to their workload, leaving patients feeling unheard and uncared for (Slonim, 2023).
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Social determinants affected
Healthcare and quality are the social determinants that are affected by the lack of health care providers. People already do not seek healthcare treatment for many reasons, one being the lack proximity to provider, some people do not seek specialized screenings because the provider who do the screens are not nearby (Healthy People 2030, 2018). If people are currently finding it difficult to find providers in close proximity with a even greater shortage of providers expected, then the number of people not choosing to seek treatment could increase. This leaves people at a disadvantage and an increased risk for many illnesses.
Responded to the healthcare issue/stressor
The changes I have witnessed in healthcare facilities are hiring providers that are from outside of the country to help with the staffing shortages. For example, one facility I worked with employed nurses that were from the Philippines and Africa, to help with nursing shortages. This phenomenon is not new and help physicians and nurses alike from other countries receive an expedited Visa authorization process in order to have these healthcare workers help with staff shortages (American Hospital Association, 2021). While it may not be a new concept it seems that with healthcare provider shortages more facilities are using this method to help with increasing staff needs.
References
Amalberti, R., Vincent, C., Nicklin, W., & Braithwaite, J. (2019). Coping with more people with more illness. Part 1: The nature of the challenge and the implications for safety and quality. International Journal for Quality in Health Care, 31(2), 154–158. https://doi.org/10.1093/intqhc/mzy235Links to an external site.
American Hospital Association. (2021). Fact Sheet: Strengthening the Health Care Workforce | AHA. Www.aha.org; American Hospital Association. https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforceLinks to an external site.
Healthy People 2030. (2018). Health Care Access and Quality – Healthy People 2030 | health.gov. Health.gov. https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-qualityLinks to an external site.
Slonim, Anthony (2023). Top Challenges Facing Healthcare: Back to Basics. Physician Leadership Journal, 10(2), 12-14. https://www.proquest.com/scholarly-journals/top-challenges-facing-healthcare-back-basics/docview/2788462727/se-2Links to an external site.
Nurse Staffing Shortages National Healthcare Issue/ Stressor
National Healthcare Issue: Nurse Staffing Shortages
One of the most pressing healthcare stressors in the U.S. is nurse staffing shortages. The increasing demand for healthcare services, the aging nursing workforce, and high burnout rates contribute to this ongoing issue. The COVID-19 pandemic further exacerbated shortages, leading to increased workloads, stress, and job dissatisfaction among nurses.
Impact on My Work Setting
As a Charge Nurse in the PACU at Mary Washington Healthcare, staffing shortages directly impact patient care and nurse well-being by increasing workloads, leading to fatigue and burnout. Inadequate staffing also results in longer patient wait times, affecting post-anesthesia recovery and overall satisfaction, while higher turnover rates create a continuous need for training new staff. Additionally, limited nurse availability reduces the time for crucial patient education on post-operative care. For instance, when fewer nurses are available to manage the 20-bed PACU, patient assessments and discharges are delayed, placing added pressure on the team to maintain safe, high-quality care under stressful conditions.
Social Determinants Affecting Nurse Staffing Shortages
Nurse staffing shortages are influenced by several social determinants, including economic stability, working conditions, and education access. Budget constraints in hospitals limit the ability to hire and retain nurses, while long hours, mandatory overtime, and high patient loads contribute to burnout. Additionally, a shortage of nursing faculty and training programs restricts the pipeline of new nurses entering the workforce, further exacerbating the issue. “Nursing shortages, especially in emergency medicine (EM), where nurses face significant burnout rates, are predicted to worsen.” (Hodgson et al., 2024)
Response of My Health System
To address these challenges, Mary Washington Healthcare has implemented several strategies to improve staffing and support nurse retention. Competitive salaries, sign-on bonuses, and retention incentives encourage nurses to stay, while flexible scheduling options, including self-scheduling and PRN shifts, help maintain work-life balance. Cross-training PACU nurses in multiple areas ensures adequate coverage during staffing shortages. Additionally, the integration of electronic health records (EHRs) and remote monitoring tools streamlines documentation and reduces nurse workload. To support mental health and well-being, the hospital also offers wellness programs, counseling services, and resilience training to help staff manage stress and prevent burnout. Companies have also begun using social media to promote job openings and share valuable information to increase visibility. “Hospital and health system recruiters use social media to connect with top talent locally, regionally, and nationally.” (Hale, 2021)
Example of Change Implemented
One specific change is the float pool expansion, where nurses from different units are cross trained to work in PACU when needed. This has helped fill staffing gaps during peak hours and high-acuity cases. Additionally, leadership has worked on improving communication and collaboration by implementing daily staff huddles to assess needs and reallocate resources effectively.
Conclusion
While staffing shortages remain a challenge, proactive strategies such as retention incentives, cross-training, and mental health support help mitigate the impact on both nurses and patients. “National work to improve nurse staffing offers specific recommendations and actions for short-term and long-term change, including recommendations to build healthy work environments and test new approaches to care delivery.” (Delgado, 2024) Continued efforts in recruitment and workforce well-being will be crucial in sustaining quality patient care.
References:
Delgado, S. D. (2024). Evidence-Based Approach to Appropriate Staffing. Critical Care Nurse, 44(6), 69–72. https://doi.org/10.4037/ccn2024614
Hale, K. (2021). Benefits and challenges of social media in health careLinks to an external site.Links to an external site.. Critical Care Nursing Quarterly, 44(3), 309–315.
Hodgson, N. R., Kwun, R., Gorbatkin, C., Davies, J., & Fisher, J. (2024). Emergency department responses to nursing shortages. International Journal of Emergency Medicine, 17(1), 1–5. https://doi.org/10.1186/s12245-024-00628-y
Nurse Staffing Shortages National Healthcare Issue/ Stressor
The United States has been battling Nursing Staff Shortage for many decades. Being in the healthcare field for almost 10 years, I believe that it has gotten worse each year after the pandemic. This healthcare issue has significant implications for the quality, accessibility, and cost of healthcare services. The nursing shortage impacts not only inpatient services but outpatient as well. According to the World Health Organization (WHO) report, it was estimated that there will be a shortage of 7.2 million health workers to deliver healthcare services worldwide, and by 2035, the demand of nursing will reach 12.9 million.
The impact of nursing staff shortage in a work setting is nurses’ experiencing burnout. Burnout syndrome has been characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is typically observed to be the result of chronic workplace stress (Li et al,2024). Nurses can also experience significant physical, emotional, and mental stress due to the nature of their work. Nurses work long shifts with high patient to nurse ratios and physical demands that can contribute to burnout. I currently work in an outpatient service and the staff is overworked with the influx of patients. With the inadequate supply of nurses has notably created many negative impacts on the patient’s health-related outcome as well as challenges to fight diseases and improving health, which causes increased workload and stress levels on nurses and later results in decreasing the quality of nursing care (Tamata and Mohammed, 2022).
Social determinants that affect the nursing staff shortage is income and financial stability, often nurses are underpaid in comparison to the level of responsibility they bear. Another social determinant is lack of cultural competence and support in a healthcare environment can lead to discrimination or unequal treatment of nurses from diverse backgrounds. Work- life balance has become big in healthcare. Nurses, especially women may face pressure to balance professional demands with family responsibilities. The lack of flexible working hours, paid family leave, and affordable childcare can discourage nurses. Multiple national medical professional associations recommend social risk screening and documentation in healthcare settings because of the compelling evidence that social risks are associated with poorer adherence to treatment plans, worse health outcomes, and increased costs of care (Tiase et al, 2022).
The healthcare system that I work for has implemented mental health days and recruitment programs. I work in Outpatient so there is some flexibility for nurses that are mothers and have children to work 5×8 hour days or 4–10-hour days. The manager is very big on work life balance and takes the extra step by gifting us with treat, food, and celebratory parties to show her appreciation for our hard work.
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. https://bookshelf.vitalsource.com/books/9780826135056Links to an external site.
Li, L. Z., Yang, P., Singer, S.J., Mathur, M. B., & Shanafelt, T. (2024). Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systemic Review and Meta-Analysis. JAMA network open, 7 (11), e2443059. https://doi.org/10.1001/jamanetworkopen.2024.43059
Tiase, V., Crookston, C. D., Schoenbaum, A., & Valu, M. (2022). Nurses’ role in addressing social determinants of health. Nursing, 52(4), 32–37. https://doi.org/10.1097/01.nurse.0000823284.16666.96Links to an external site.
Tamata, A. T., & Mohammadnezhad, M. (2022). A systematic review study on the factors affecting the shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247–1257. https://doi.org/10.1002/nop2.1434Links to an external site.
Nurse Staffing Shortages: National Healthcare Issue/ Stressor
Nursing and Clinician Shortage: A National Healthcare Issue
Nursing is a highly demanding and stressful profession. Many nurses are experiencing burnout, fatigue, and dissatisfaction with their working conditions at the bedside. According to a study by Petterson et al. (2015), cited in Broome and Marshall (2020), by the year 2035, there is expected to be a shortage of 33,000 primary care physicians. Additionally, it is estimated that 20% of nurses leave their jobs within the first year of employment.
Impact on the Work Setting
Due to nursing shortages, hospitalized patients are at an increased risk of unsafe events, such as falls, reduced quality of care, poor health outcomes, and decreased patient satisfaction ratings (Quaranta, 2024). According to Lasater et al. (2021, cited in Quaranta, 2024), “The lack of nurses in hospital settings increases errors, morbidity, and mortality, and decreases patient satisfaction.” As healthcare evolves and patient demographics change, with patients living longer, there is a strong push to enhance the quality of care. Hospital reimbursement models are increasingly focusing on quality of care rather than volume of services. Furthermore, there is a growing demand for patient care outside of hospital settings, leading to a shift towards more home care and telemedicine. However, the shortage of nurses and clinicians can negatively impact the quality of care delivered through these alternatives as well.
Social Determinants Affecting Shortage
Some argue that the COVID-19 pandemic significantly contributed to the trend of nurses leaving the profession, while I contend that COVID may have merely been the last straw. Nurses are facing burnout, fatigue, and dissatisfaction with their working conditions at the bedside. Sixty percent of the 3.2 million nurses in the United States are employed in hospital settings (Quaranta, 2024). In 2021, over 100,000 nurses exited the profession (Auerbach et al., 2022, as cited in Quaranta, 2024). According to Quaranta (2024), nurses leave bedside positions due to unfavorable working conditions, including unsafe patient ratios, low pay, long shifts, and poor management Nurse Staffing Shortages National Healthcare Issue/ Stressor.
Furthermore, financial concerns contribute to the shortages of nursing staff. Hospitals spend substantial amounts of money on hiring, training, paying salaries, covering insurance, and providing benefits such as retirement plans. These expenses may hinder hospitals from hiring additional nurses. Hospital CEOs, policymakers, and legislators may not fully grasp the importance of adequate nurse staffing for ensuring the safety of both patients and nurses, improving patient outcomes, and reducing nurse burnout. Additionally, the personal experiences of those in positions of power can significantly influence these decisions, making them less empathetic to the actual needs of nurses and patients.
Healthcare System Response
There is a growing population of aging individuals with health problems. In brief, people are living longer due to advancements in medicine and technology. According to Amalberti et al. (2019), “By the 2050s, over 50% of the global population will be living with a chronic illness.”
In response to the shortage of clinicians, some states are granting Advanced Practice Registered Nurses (APRNs) greater autonomy and flexibility. While this may help alleviate the shortage of clinicians, it does not address the ongoing shortage of nurses or the trend of nurses leaving the bedside profession. Many states in the United States do not have mandated nurse-to-patient ratios. There are currently bills pending that aim to address nursing ratios, but they have not made progress or received approval.
Conclusion
The nursing and clinician shortage remains a pressing national healthcare issue with far-reaching consequences for patient care and safety. The challenges faced by nurses, including burnout, inadequate working conditions, and insufficient staffing ratios, contribute to high turnover rates and diminished quality of care. As the healthcare landscape evolves, it is crucial to address these underlying issues to cultivate a sustainable workforce. While initiatives to enhance the autonomy of Advanced Practice Registered Nurses (APRNs) may provide some relief, a comprehensive strategy that also focuses on improving the workplace environment for all nurses is necessary. This includes advocating for mandated nurse-to-patient ratios, addressing financial constraints for hospitals, and fostering supportive management practices. By prioritizing these changes, we can ensure a healthier future for both healthcare professionals and the patients they serve Nurse Staffing Shortages National Healthcare Issue/ Stressor.
References
Amalberti, R., Vincent, C., Nicklin, W., Braithwaite, J. (2019). Coping with more people with more illness part 1: The nature of the challenge and the implications for safety and quality. International Journal for Quality in Health Care, vol 31 (2), pages 154–158. https://doi.org/10.1093/intqhc/mzy235Links to an external site.
Broome, M., & Marshall, E. (2020). Transformational Leadership in Nursing (3rd ed.). Springer Publishing LLC. https://mbsdirect.vitalsource.com/books/9780826135056Links to an external site.
Quaranta, N. (2024). Team nursing: An innovative approach to address the nursing shortage. MEDSURG Nursing, 33(2), 79–84. https://doi.org/10.62116/MSJ.2024.33.2.79Links to an external site. Nurse Staffing Shortages National Healthcare Issue/ Stressor
