Nurse Shortage in US Health Care

Nurse Shortage in US Health Care

Background information

There is a projection that the United States health care system is going to experience a great shortage of the registered nurses as the health care needs continue to intensify (Yang, Hung, & Chen, 2015). Quality and outcome measurement are valuable methods of determining the influence of nurse staffing and achieving the desired patient outcome goals. A number of effort have been made to improve the capacity of the nursing schools across the US so as to have more students enrolling so as to assist in meeting the increased demand of the elevating demand for health care system. The American Association of Colleges of Nursing has made various cooperation with institutions and policy makers have tried to make this health concern as a global problem. Following a report by the bureau of labor statistics, registered nurse employment was projected to be among the top occupations in terms of growth form 2014-2024(Robert,2017). This growth in the health workforce is expected to elevate form 2.6 million in 2014 to 3.1 million by 2024 which will be translated as a 16% increase (Robert, 2017).

Further research by the American journal of medical quality explains that nurse shortage is projected to rise around the United States between 2013 -2030 (Nantsupawat, Nantsupawat, Kulnaviktikul, & McHugh, 2014). A report by the institute of medicine on the focus on future of nursing highlighted that there was a need to significantly increase the number of baccalaureate nurses in the health work force to 80% as well as increasing the number of nurse by two (Yang, Hung, & Chen, 2015). There is only 55% of the baccalaureate registered nurses and thus creating a big deficit. In a systematic review performed in the hospital setting, it was identified that increased patient load to a single nurse due to shortage was highly associated with elevated rates of patient readmission. Inaddition, American journal of nursing highlights that increased patient to nurse ration was greatly linked with rising incidences of nurse burnouts and profound health acquired infections such as urinary tract infection.

Significance of the problem

With a well proportion number of health care providers within the health care system, there will be reduced number of nurse burn out, reduced job dissatisfaction and finally enhances the health well-being of both the patients and the nurses. As a result of the escalating global nurse shortage, cases of medical errors are regularly being reported. This problem has been contributed by many factors among them being the ageing of the baby boomer generation. Yang, Hung, and Chen (2015)indicated that majority of the health care providers in the United States are aged above 65yeasr and thus approaching retirement age hence creating the shortage. Despite nursing being explained as the fastest growing profession in the US, about 1.2 job vacancies of registered nurses are likely toemerge between 2014 -2022 (Robert, 2017). It is very significant to address this issue and acquire a lifelong intervention to the problem.Measure of addressing this health issue must however focus on preparing more baccalaureate-prepared nurses in order to ensure access to high quality, safe patient care. Increasing the capacity of nursing schools is also very essential as this would at long last increase the number of physicians joining the job marketand hence reduce the remedying the shortage. With increased and appropriate number of nurses within the health care systems, patient’s health outcomes will be improved as well as ensuring a positive well-being of the care providers. With nursing care being a primary factor in patient satisfaction and little relief from shortages, nursing leaders are compelled to establish methods of measuring staffing effectiveness.


Problem Statement

The United States has the highest number of registered nurses of over 3 million nurse though there still exist a great deficit (Yang, Hung, and Chen, 2015). The most significant cause of the is nurse shortage in this great nation is the elevating aging population that has led to more incidences of chronic diseases, there is also a large number of old nurse work force as well  as the nursing institutions lack the capacity to satisfy the entire health care center with care providers. With the increased nurse shortage, there have been raise cases of job dissatisfaction which results from stressful working condition brought about by workload. Moreover, the nurses are pressured to leaving the job and find alternative career. Patient safety is another issue of concern that come about by reduced nurse number. In a research conducted by the health service research, it was indicated that a reduced patient to nurse ratio on both medical and surgical units consequently led to low numbers of death (Robert, 2017).

According to a study carried out in Canada, it was explained that there were 4.9 fewer deaths per 1,000 patients on intensive care units staffed with a higher percentage of nurses with bachelor’s degrees (Van et al., 2013). In a meta-analysis performed by the agency for health research and quality, it was found that registered nurse reduction plus increased nurses workload posed a significant threat to patient’s quality and safety during acquisition of health services. The main purpose of this research proposal is to examine the association between registered nurse shortage to the patients’ health outcome and wellbeing to the nurses.




Research questions

  1. What are the main causes of increasing nurse shortage in the United States?
  2. Is there a relationship between nurse shortage and patients health outcome and nurse well-being?


H0: increased incidences of nurse shortage in the United States health care system is directly associated with poor patient outcome, job dissatisfactionand burnout among health career providers.

H1: There is no direct association in deteriorating the patient’s health outcome and job dissatisfaction, nurse burn out with the increasing nurse shortage in the United States health care system.


The independent variables will include the patient’s health outcomes, nurse job dissatisfactionand burnout. These variables will be determined by getting the total number of nurses in a hospital and the resultant rate of patient readmission and incidences of medical errors and this will signify the level of patient outcome. For the well-being of the nurses, intentions of the nurses to leave the career coupled with cases of burn out will highlight the level of satisfaction and dissatisfaction for the nurses and thus this will directly be related to patient outcome.

The dependent variables that will be examined in the research paper will be the level of nurse shortage. This variable will be examined by determining the total number of nurses that are in a health care center compared to the appropriate number that should be present. This will however give out the nurse deficit.

















Nantsupawat, A., Nantsupawat, R., Kulnaviktikul, W., & McHugh, M. D. (2014). Relationship between nurse staffing levels and nurse outcomes in community hospitals, Thailand.  International Journal of Nursing Practice17(1), 112-118. doi:10.1111/nhs.12140

Robert, R. (2017). American Association of Colleges of Nursing | Nursing Shortage. Retrieved from

Van, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., &Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies50(2), 185-194. doi:10.1016/j.ijnurstu.2011.12.001

Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643

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