How Is the Shortage Affecting Patient Care?

The unfortunate reality of the nursing shortage is that it is a growing problem. The most difficult fact about the shortage is that because nursing programs can’t accept the number of students to meet the demand for more nurses, the nursing shortage is increasing dramatically each year. Because of the nursing staff shortage in hospitals, many seasoned nurses are working longer hours and becoming weary of their jobs. They are caring for more patients than they would if the hospital had an adequate supply of nurses, and patient healthcare is beginning to suffer.

Statistics for Nursing Shortages and Patient Care

Statistics show that just with surgical patients, hospitals with higher percentages of qualified nurses have higher surgical survival rates. In fact, these statistics reveal that a 10 percent increase in the level of qualified registered nurses, or RNs, reduced the risk of patient death by as much as five percent. This is just one example of the impact nurses have on patient healthcare.

It is also believed that the majority of medical errors made in hospitals and clinics are a result of the nursing shortage. One startling statistic says that each additional surgical patient in a nurse’s common workload increased that patient’s risk of death by approximately seven percent. This frightening figure demonstrates the negative effect that the nursing shortage is having on patient healthcare. The nursing shortage is resulting in an increased risk of patient deaths because there are simply not enough nurses present to safely care for all the patients. Many complications or medical errors could be prevented by an increased staff of nurses.

One estimate shows that in 24 percent of death and injury resulting to hospital patients, a low nursing staff in the particular hospital played a role. These are eye-opening statistics that should be examined to determine the overall impact on patient care. The impact is obvious: a shortage of nurses means a shortage of quality health care. These facts and figures should be taken into consideration in order to provide a basis for combating the problem of a nursing shortage, such as increasing funds to nursing programs or encouraging better working hours.

A View into the World of Nursing

It is easy to look at the numbers and see the reasoning behind the nursing shortage. A lack of funding of nursing programs is resulting in thousands of qualified applicants being rejected from nursing programs each year. However, another reason for the nursing shortage is one not as commonly reported through statistics: job burn out. While nursing has its rewards and benefits, it is of course a stressful career which many people find themselves to be burned out on before many years have passed.

Burn Out in the Nursing Profession

Part of the reason why nurses experience job burn out is the shortage itself. With fewer nurses entering the work force, hospitals and clinics are forced to keep their existing nurses on the floor for longer than they normally would work. These nurses become frustrated and exhausted when having to care for a larger group of patients because of the lack of nurses available. This frustration and exhaustion can lead to job dissatisfaction which can greatly influence a nurse’s work environment. Nursing shortages and turnover rates have been reported to be the highest in critical care facilities, in which nurses are worked for long hours and have to care for more patients then they feel they can safely care for.

Demands and Rewards for Nurses

It is not unusual for nurses to work 12-hour plus shifts for upwards of three days in a row. Although they receive some time off during the week, those long shifts can take their toll on the mental and emotional health of the nurse. They may find it difficult to complete other activities and to meet responsibilities outside of work because of the burn out they experience because of their highly stressful jobs. One study reported that approximately one out of every three hospital nurses under the age of 30 said they plan to leave their position within the current year. This is a dramatic number when the impact of the nursing shortage is taken into consideration.

The world of nursing does have its rewards. Nurses often make the biggest impact on patients and provide the majority of the patient care. However, a stressful work environment caused by the nursing shortage is only making the shortage itself worse.

An Overview of the Nursing Shortage

A nurse—whether working in a family clinic or large hospital—is responsible for a majority of patient care. Nurses perform some of the most important duties during a patient’s stay at the hospital, from monitoring vital signs to administering necessary medications. Nurses also provide a human face to what can sometimes be a cold, sterile environment. However, in recent years there has been a vast shortage of nurses in the healthcare industry. In fact, this shortage is expected to increase dramatically over the next few years.

Shortage of Nursing Education

Some statistics also show that the number of nursing school graduates has decreased quite significantly. Since nurses play such a large and important part in today’s medical care system, it is a worthy endeavor to investigate the causes behind these shortages. Although it can be difficult to pinpoint exactly why there is such a dramatic nursing shortage, examining the trends and statistics can provide clues. Investigating these clues is key to understanding how to combat the nursing shortage. Further, as hospitals and clinics struggle to recruit nurses, some nurses are seeking other avenues of employment or ways to perform their duties.

Shortage of Nursing Incentives

Hospitals and clinics have begun to investigate other methods for attracting nurses to their environments. Exactly how these facilities are addressing the shortage can provide insight into the larger problem of the nursing shortage, and it can provide clues to the trends of the nursing shortage in the future. If the statistics show the shortage growing worse, what can be done to stop it? Or will the nursing shortage continue to grow until the trends reverse themselves? A thorough examination into the shortage itself can provide some hints.

Reasons Behind the Nursing Shortage

It would be difficult to pinpoint each individual contributing factor that has impacted the nursing shortage over the years. However, there are a few main factors that should be examined in order to better understand the reasons behind this dramatic nursing shortage.

Enrollment in Nursing Programs

Although some enrollment numbers for nursing programs in schools have increased slightly, experts say the small increase is not enough to fill the projected demand for nurses over the new few years. In fact, some experts estimate that the enrollment numbers for younger people entering nursing programs would have to increase exponentially—by 40 percent annually—to meet the demand for nurses as older registered nurses, or RNs, retire from the work force.

However, enrollment cannot increase in these numbers because of constraining factors placed on nursing programs. Thousands of well qualified nursing applicants are being turned away each year because nursing programs are not well funded and cannot afford the staff, laboratories, and clinical facilities required to fulfill the needs of more nursing students. It has been estimated that about two-thirds of nursing schools turned these qualified applicants away because of lack of staff and facilities to teach them.

Average Age of Today’s Nurse

These two issues—a catch-22 in themselves—only compound the nursing shortage because as fewer nurses are able to enter programs and to graduate, the average age of RNs is increasing. These seasoned RNs have to keep working at their hospitals and clinics longer because there are not enough up and coming nurses to fill their positions. When these RNs retire, their hospitals or clinics will be faced with another nursing shortage.

As the American baby boomers age, the need for more nurses to care for them increases. However, because of the shortage of facilities and lack of funding to train new nurses, medical facilities are experiencing a shortage. This shortage is compounded by the lack of new nurses entering the work force as older RNs choose to retire. Although many different reasons can point to the forces behind the nursing shortage, these are a few of the most important ones.

The Big Things Ruining Your Job Satisfaction as a Nurse—and What to Do About Them

More than just helping nurses find a job, we want to help nurses find better jobs and higher job satisfaction. This involves a deeper understanding of what your work priorities are and whether they’re being fulfilled in your current position. Many nurses will burnout of the industry much faster than they otherwise would because they waited too long to recognize that it was time to switch positions and find a nursing job that better meshes with their personality. Here’s what our experience in the nursing industry has taught us about specific situations and concerns that can help you find the right job fit.


1. On-Call and Time Schedule Demands

One of the biggest long-term hassles—and one that’s consistently underrated by new nurses—is being on-call. This is a standard job requirement for many hospital jobs, especially those involving direct patient care. It’s easy to justify this job demand when you think about how you’re at least getting paid something when you don’t get called in and a slightly higher rate when you do get called in. Nurses looking to increase their paychecks may actually prefer to get called-in during their on-call shifts. Over the long run, however, the logistical cost of trying to plan things with friends and family as well as the psychological cost of not being able to enjoy your free time tends to add up.

Solution: Take an Industry Job

Unless you have advanced training in specialized nursing skills, an “industry job” is your best bet to find a position with no on-call shifts. Many RNs prefer a job that demands more direct care and skilled nursing, but an occupational health nurse who works for a company, school, or other organization can typically maintain a normal workweek schedule.


2. Gaining Experience and Building Your Resume

There’s a difference between job security and employment security. As a licensed nurse, you’ll probably never have to go long without gainful employment, but this doesn’t mean you’re guaranteed to find a job that won’t make you miserable. You may even want to take a job that you know you’re not going to love because it will help you land that dream job down the road.

Are the rewards worth the hassle? What if you’re not really sure what you may or may not want to be doing in the nursing field ten years from now? Even when there’s no perfect answer, early-career nurses would do well to consider how their resume will look in a few years even if they don’t take steps to develop their professional nursing skills.

Solution: Med-Surg Nursing

One of the most popular positions to build your skillset and demonstrate your value as a high-performing nursing professional, the med-surg nurse has evolved over the years into the person who’s responsible for coordinating patient care for acute care services. There may be a stepping stone position you need to take for direct patient care, surgery, emergency department, etc. to build your resume for this position. It’s also a fairly demanding job that frequently serves as a stepping-stone to an even higher position. For these reasons, once you build up your resume a little bit, it’s typically not too difficult to find Med-Surg job postings.


3. Higher Pay and Compensation

Nursing school isn’t free, and if you were already carrying some student loan debt from a bachelor’s degree before you decided to become a nurse, you may be starting your professional career in a hole financially. Then, there are growing household expenses and the stress that comes along with never seeming to get ahead.

Advanced practice nursing is one way to go after a higher pay rate, but this typically involves additional years of training that you may not be able to get through and/or afford to wait to start earning real paychecks. On-the-job training and accruing years of experience will also help, but what if you need to start earning more sooner rather than later?

Solution: Become a Nurse for Hire

It’s one thing to know that you’ll be on-call for a certain number of shifts each week and each month. Leaving this flexibility in your schedule doesn’t always lead to higher pay, however. There are other, more reliable ways to leverage schedule flexibility into a higher pay rate. Per diem nurses can earn more per hour, but with it, comes the stress of not knowing exactly when or where you’ll be working from one day to the next. A travel nurse is more of a happy medium in which you’re still guaranteed a certain number of shifts, you just don’t know where exactly you’ll be working until checking in.


4. Management, Institutional Credibility, and Team Morale

As much as nursing and hospital managers talk about the importance of building a good work culture and strong relationships with co-workers, this culture can change very quickly. A good hire—or a bad one—especially in one or two key positions within a department can signal a sea change to the rest of the team. This is why good work culture is so important but also why it’s so fragile. A more insidious kind of burnout may result from a lack of institutional credibility. Nonsensical budget rules and internal hospital policies that persist for years without explanation hurt job satisfaction.

Often, you may even like your direct supervisor who themselves are subject to these harmful institutional policies. Alternately, if your immediate boss is the problem and you’re tied to your current department and skillset, you may find it easier to transfer to a different job in the same hospital.


Solution: Communication, Participation, and Self-Preservation

As an employee, it’s on you to communicate these types of concerns and work toward reasonable solutions. In some situations, however, the best choice is to look for another position. Whether it’s the work and schedule demands or the problems associated with large bureaucracies, it might be time you consider one of a growing number of nursing jobs outside of the hospital.


Finding Your Dream Nursing Job isn’t as Easy as It Sounds

If you’re a nurse looking for a job, you probably won’t have any trouble finding job postings. While certain locations and certain positions can be more competitive than others, the overall nursing shortage isn’t going away. There are hundreds, if not thousands, of job postings for nurses in most major U.S. cities.

More than just finding work, most nurses are looking for the job that’s the right fit for their professional development as well as their personal life. But how do you go about doing this? At first, you may not have much more than a vague notion of what your dream job looks like.

Job satisfaction is elusive for many nurses, and this starts during the initial job search. How much money do you need to make? How much flexibility do you need in your weekly schedule? How much stress and how many headaches are you willing to endure? What nursing skills are you most interested in using and developing? Most people will solicit advice from friends and colleagues. They recall plans that were sidetracked coming out of nursing school.

Once you have a sense of the type of nursing position that will make for your dream job—or help build your resume for the dream job down the road—then, the real search begins.

  1. Ask Around and See What You Find Out.

More than just doing this in a general sense with friends and colleagues, look at specific locations and their nursing staff to see if you can make a connection of some kind. Does that location and department have a good reputation with the nursing community? Is it known, in contrast, for ruining good nurses? If you’re currently working in a larger hospital setting, you might look about switching jobs in a different department.

  1. Be Prepared to Experience Setbacks and Frustrations.

By the time you filter out the job postings for which you’re either not qualified or not interested, there may be surprisingly few promising options. Unless you have considerable savings and need some time off anyway, then we’d be wary about quitting your current job before you have a new one. At the same time, if you hate the job you have now, you may think about settling for a new position that’s available now rather than wait for a dream job that may never come.

  1. Practice for the Job Interview.

This includes all the standard interview tips—know where to go, read about the company beforehand, dress professionally but comfortable. Basic preparation is essential for managing how nervous you’re going to be. Our big tip is to be prepared for the pivot from personal rapport to professional conduct. For a lot of nursing applicants, the resume speaks for itself and the interview is primarily about seeing how you’d fit with the existing nursing staff. In other words, prepare for the job interview, but don’t feel beholden to that preparation. Wait for the interview to come to you and then respond naturally. You’ll be nervous, but you’ll be fine.