Nurses are at the heart of healthcare, playing a pivotal role in all levels of patient care and making up the largest section of the healthcare professions. There is no other professional in the medical field with such an encompassing role in both a patient’s livelihood and personal care. Unfortunately, a critical nursing shortage in recent years jeopardizes these invaluable health-care workers.
The United States has faced nursing shortages since the 1900s; however, this shortage has turned dire in recent years. The COVID-19 pandemic has put a particular strain on all medical professionals, including nurses. A recent study found that 34.1% of 18,935 nurses surveyed experienced emotional exhaustion due to working understaffed during the pandemic. Younger age, decreased social support, and working in hospitals with inadequate materials and resources were all highlighted as risk factors associated with emotional exhaustion. As the demand for nurses grows higher, it is crucial to address the unsustainable working conditions in the nursing field to minimize the level of burnout witnessed today.
Discrepancies in the Nursing Shortage
The nursing shortage is defined by high demand and low supply, as experts worry about the trajectory of employed nurses heading into 2030.
However, significant discrepancies can be observed when comparing nursing demands from state to state. For instance, California is predicted to have the largest nursing shortage by 2030, missing 44,500 nurses, according to the Bureau of Health Workforce. Florida, by contrast, is projected to have a 53,000 nurse surplus by that time. There is also a discrepancy between rural and urban environments: rural communities will feel the impacts of the shortage more severely because just 16% of nurses work in those areas. The nursing shortage is more severe in rural areas, but the work is also harder. Rural communities tend to be poorer than urban areas, increasing the likelihood that rural patients will not have health insurance.
Furthermore, many rural areas are underpopulated; thus, patients must travel far distances to receive medical care, putting them at a disadvantage if there are no accessible modes of transportation. Rural areas have also been found to possess risks not observed in urban areas. For example, living in an underpopulated area can lead to high blood pressure and an increased risk of stroke. People in rural areas also have a higher risk of developing destructive habits at a younger age, such as smoking and alcohol abuse.
Nurses are even more vital in these rural areas, given the lack of overall access to medical professionals. This, consequently, comes with a higher burnout rate for nurses as their scope of responsibilities increases. However, rural nurses tend to stay within the same community for their entire career, developing an understanding and trust with individual patients and the community as a whole. Therefore, it is vital we support rural nurses and plan for the future to prevent widening the gap in healthcare outcomes between rural and urban communities.
Stress and Burnout within the Nursing Profession
Burnout is a permeating condition in the healthcare field, especially in nursing.
Many units in hospitals must hold a 1:5 ratio of staff to patients. Burnout is characterized by three key aspects: emotional exhaustion, depersonalization, and low personal accomplishment. A study that surveyed nurses who left their job in 2017 found that of 50,000 nurses, 31.5% cited burnout as the main reason they left. There are three leading causes attributed to nurse burnout caring for more than four patients at a time, shifts longer than 8-9 hours, and stressful specialties such as the emergency department.
Implications of the Nursing Shortage
Aside from personal burnout, the nursing shortage has far-reaching effects on the medical world. The performance of nurses is so vital to the healthcare system that a heavy workload causes a cascading effect (of what) that can reach individual patients. For example, nurses who experience exacerbated stress may have reduced job performance, which directly impacts patients- there could be a more significant risk of medical error, such as incorrect medication dosage. Furthermore, a study in 2019 showed a 15% increase in post-care infection correlated to low hospital staffing, and another study on patient outcomes found that the odds of 30-day mortality for each patient increased by 16% for each additional patient in the average nurse’s workload. Patient satisfaction, vital to the healthcare industry, is also heavily influenced by nursing performance. Nursing staffing patterns have a significant impact on patient satisfaction and outcomes. As healthcare is a service industry, patient satisfaction in the United States is extremely important to the success of the healthcare market and the delicate balance of supply and demand. Furthermore, concern continues to grow as the baby boomer generation ages and the rate of chronic illness increases. An expected one million nurses will retire between 2017 and 2030, leaving a great demand for nurses, especially experienced ones.
Combatting the Nursing Shortage
The nursing shortage is projected to increase its impact on healthcare practices in the future, so it must be combated as soon as possible. Greater access to education can serve as an effective solution to this shortage. Accommodating future nurses with online courses, scholarships, and overall accessibility will allow the nursing profession to be much more realistic for many more people. Currently, financial, educational, physical, and minority barriers exist in terms of becoming and working as a nurse. For example, the AACN reported in 2017 that the median debt for graduate nursing students was between $40,000 and $54,999. In addition, providing more accommodations and flexibility in the workplace may entice more people to pursue a nursing career and limit the exhaustion of existing nurses. For example, allowing shorter shifts will let nurses plan out their schedules to accommodate their personal lives and increase workplace satisfaction. Furthermore, increasing diversity and representation in nursing by recruiting more minority faculty, making education more accessible, reaching out to youth about careers in nursing, and providing more academic scholarships and grants to minority groups can also increase numbers in the nursing workforce.
The nursing shortage threatens both individual patients and health organizations. Therefore, it is crucial to address the working conditions and other concerns sooner to make nursing a more sustainable occupation and further grow the field.