For almost as long as nurses have been working in American hospitals, industry leaders have been worried that we didn’t have enough of them.
Reports of nursing shortages date back nearly a century: The 1930s saw a shortage driven by widespread hospital construction and increased healthcare utilization; the 1940s drained nurses from the U.S. workforce in favor of the war effort; the shortage got so bad in the 1960s that the federal government was compelled to pass the Nurse Training Act.
And on it went, decade after decade. One might then assume that the shortage we’re now experiencing isn’t much different than those that came before it.
But it is. America’s current nurse staffing challenge is unlike anything we’ve seen in our careers. COVID-19, of course, has been a complicating factor—the stress of working in an intensive-care unit or emergency department throughout this pandemic can’t be overstated, especially in places where COVID has spiked time and time again. We’re losing good nurses because of it.
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Some are retiring earlier than expected. Some are leaving the profession altogether. And some are forgoing hospital jobs in favor of staffing agency work, for much higher hourly rates, pressuring hospitals to fill these vacancies by arranging for ad hoc coverage at inflated prices.
As a result, our remaining hospital nurses—really, our entire healthcare infrastructure—are now being tested. And on Sept. 1, the American Nurses Association, which represents the interests of the nation’s 4.2 million nurses, sent a letter to the U.S. Department of Health and Human Services, urging the department to declare the nurse staffing shortage a national crisis.
It’s a call to arms that must be answered. And that effort must start in the C-suite.
During the pandemic, hospitals and healthcare leaders have proven their ability to adapt and pivot. Now it’s time to stretch that creativity to address the nursing shortage.
We can start by immediately inviting more caregivers back to the bedside:
Change care models to include the forgotten caregiver—the licensed practical nurse. Bringing LPNs back to acute care, working alongside registered nurses and paraprofessionals, makes for a strong team. For decades, hospitals—especially those seeking Magnet designation—focused primarily on the bachelor’s-prepared nurse, to the exclusion of LPNs. The truth is, there is a place for everyone at the bedside. Welcoming LPNs back into hospitals supports the practice of all nurses and supports the care of our most vulnerable patients.
Remove barriers for those who left nursing, allowing them to come back through accessible refresher courses and re-licensure. Nurses are needed every hour of every day; being nimble from a scheduling standpoint is logistically challenging, but ultimately doable. It’s up to hospital leaders to provide nurses with the flexible schedules that were nonexistent in prior years, because that inflexibility is one of the culprits behind the ongoing exodus.
Of course, these steps—while they can make a real, localized impact—can’t fully address a shortage of this magnitude. There’s no magic fix at hand. We need a holistic approach that takes a hard look at the profession, its current demands, and its long-term needs.
First, that means rewarding difficult work with the competitive pay and incentives that it deserves, in what’s now an incredibly tight labor market, in a way that’s fair to all parties.
Second, we must increase nursing school enrollment, investing in capacity as well as simulation labs and virtual training. This means directing more federal funds to assist students with tuition, investing in schools themselves, and paying nursing instructors appropriately, reflecting the critical role they play. No potential nursing student should be turned away because they can’t afford tuition, and no student should be waitlisted because there aren’t enough instructors.
Finally, we must elevate the voice of nursing, at the bedside and in the boardroom. Actively listen to nurses, and seek their input on clinical and operational decisions. When nurses have more skin in the game, they’ll be more likely to stay in the game.
While nurses have always understood their worth, perhaps others have taken them for granted. We hope that’s no longer true; during the pandemic, nurses have demonstrated their value as critical thinkers who bring innovative solutions to difficult situations.
They are the beating heart of our healthcare system. As health leaders, we owe it to nurses to heed their insights and hear their concerns. Working alongside them, we can make much-needed improvements to our health ecosystem, creating a workplace environment that is respectful to current bedside nurses and welcoming to future ones.
