Effects and Strategies to Address Nursing Shortage

Nurses are always considered the front liners in any healthcare setting. American Nurses Association (2011) has reported the total number of licensed registered nurses in the US to be at 3.1 million. This number represents the nursing profession to be the largest congregation of health care professionals in the USA. Despite this number, there is still a growing demand for nurses in the hospitals and community. The purpose of this article is to describe what the nursing shortage means and will provide useful information further understand issues affecting the nursing shortage.

What is a nursing shortage?

A nursing shortage is usually defined and measured in relation to a country’s historical staffing levels, resources and estimates of demand for healthcare services (Buchan & Aiken, 2010). In addition, Buchan and Aiken (2010) mentioned that the nursing shortage can be caused by “a shortage of nurses willing to work as nurses under the present conditions.” The shortage can further be defined in definition of absolute and relative terms. An absolute shortage is a situation where skilled people are not available for a specific vacancy. In contrast, a relative shortage is a situation where qualified people are available for the vacancy; however, they do not meet other employment criteria. Other examples of relative shortage may include; geographical location, equity considerations, recruitment and retention challenges and meeting the demand for replacements.

Factors Affecting Nursing Shortage

The United States, being a first world nation is not spared from this global crisis. One factor that is affecting the U.S. nursing shortage is nursing schools’ inability to increase enrollment due to a scarcity of nursing school faculty. Anderson and Carr (2011) have identified the following factors contributing to the nursing faculty. These are:

  • low salaries for educators compared to clinicians
  • the age-delayed trajectory of nurses obtaining higher levels of education
  • the late point in career development for entering educative roles
  • the ability to fill open faculty roles, and
  • the looming retirement of large numbers of currently employed nursing educators.
nursing shortage
Patients suffer is nurses are simply not there. (Image grabbed from Medrants.com)

Additional factors affecting the US shortage are: the average age of registered nurses (RN’s) increasing, changing patient demographics, insufficient staffing raising stress level, and high nurse turnover and vacancy rates (Buchan & Aiken, 2010).

Effects of Nursing Shortage

As mentioned in the introduction part of this paper, the lack of nurses in the healthcare industry can pose many negative effects in the community, the nation, and even in the global arena. A range of studies have demonstrated links between nurse staffing levels and a range of negative health outcomes. Buchan & Aiken (2010) have identified these factors:

  • increased mortality rates
  • adverse events after surgery
  • increased incidence of violence against staff
  • increased accident rates and patient injuries, and
  • increased cross infection rates.

Strategies to Address the Issue

                There are many ways to kill the cat, so to speak. Every country has encouraged their policymakers to plan and address this issue with great urgency. The following statements are recommendations gathered from several nurse experts that can help increase the supply of nurses in the country using all the possible resources available:

1.      Teach More Nurses Online

In a regulated profession like nursing, starting a new nursing school is not easy. But a dozen fully accredited, highly regarded nursing schools already offer their programs online. The academic portion of the program is completed online while the clinical portion is completed locally. A greater capacity to teach nurses today would significantly ease the nursing crisis facing us in the coming years. Opening more online nursing schools would help resolve the nursing crisis at its core.  Not only is the capacity for teaching nurses online higher than that of teaching them on-campus, nurse educators can leverage their time better, the programs are less expensive, and most of these programs have no waiting list.

2.      Teach More Nurse Educators.

The capacity for most nursing programs to expand is limited by the ability of qualified nurse educators. However, the number of programs teaching current nurses the skills to teach aspiring nurses is not enough. Through a combination of public and private incentives and partnerships, schools need to increase their capacity to teach more nurse educators.

3.      Educational Strategies

Presently, there are hospitals that utilize education strategies to address the shortage of nurses. These strategies included partnering with nursing schools, subsidizing salaries, reimbursing the nurses for advancing their education and providing flexibility to allow staff to attend classes that can further their career. Already the private sector is doing what it does best, squeezing the most productivity out of a situation that needs it. Best practices can be shared among the different organizations.

4.      Capital Grants to Schools

In an effort to increase the number of students and nursing faculty, many states are beginning to offer capital grants to hire and retain nursing staff, purchase new equipment, enhance audiovisual ability, and recruit students.

5.      Change Nursing Laws

It is important that the government must fund these programs and expand the Nurse Faculty Loan Program, Nurse Scholarship Program, and others. Increase the percentage and number of foreign-trained nurses to enter the United States.
The percentage of foreign-trained nurses in the US is far less than most of us think it is. The fact is that there are many very well trained nurses who wish to work in the United States. The process for screening well-qualified candidates is already in place. The biggest barrier is the limitations on the number of nurses allowed into the United States.

6.      Create Healthy Work Environments

The current working environment for many nurses is a stressful one. A nursing shortage only makes this worse. The mental and emotional state of individuals who have to work in a stressful environment causes a drop in the quality of medical care. Management needs the freedom to create dynamic working environments and come up with creative solutions so that the current nursing workforce can perform in a healthy environment.

7.      Develop More Public-Private Partnerships

The public may not know this, but they are deeply vested in solving the nursing shortage. As critical as the shortage is now, if it gets much worse, the quality of medical care will fall. Not only is the shortage a contributing factor in rising health care costs, the public at large will be the ones most severely affected if the shortage gets any worse. A heightened awareness about the rise health care costs along with a potential drop is a quality of medical care, the entrepreneur spirit that drives the private sector can be used to help find solutions to this crisis.

8.      Develop Strategic Partnerships

Nursing colleges and universities need to begin developing strategic partnerships to help expand student capacity and bulk up the nursing workforce.

9.      Improve Nursing Image

There is a negative stereotype that extends to nursing in some areas that may prevent potential applicants from enrolling in nursing programs. Campaigning to increase enrollment in nursing schools would want to include a presentation of a positive working environment, the benefits and current salary of a nurse, and the total value of what the nursing profession can contribute to the society.

10.  Co-operation at the Top

It is important that those at the top work together to ensure nurses have a safe environment to provide quality care to consumers. To do this, solutions need to be created that will keep a consistent supply of registered nurses in the pipeline to deliver the health care needs of tomorrow and to lessen the impact of the nursing crisis.


Most authors and researchers are still not assured that we have solved the problem in nursing shortage. The magnitude of the nursing shortage is negatively affecting the goals of improving health systems globally. Ultimately, the failure to deal with the nursing shortage whether it be local, regional, national, or global will lead to failed healthcare systems and poor healthcare outcomes.

When the nurses are “simply not there,” patients suffer, babies are born unattended, families are unsupported at critical periods, and people die alone. Burses are critical to the health of nations. “Simply not there” is simply not fair.



Anderson, B., & Camacho Carr, K. (2011). The global nursing shortage-an issue of social justice. In P. Cowen & S. Moorhead (Eds.), Current Issues in Nursing (8th ed.). Missouri: Mosby Elsevier.