A New Nursing Shortage Looms

By Keith Carlson via Multibriefs

A new study by Reuters reveals that a significant and troubling nursing shortage is currently impacting rural and community hospitals around the United States.

With the rising costs of healthcare delivery and operations coupled with an aging population and an increasing number of retiring nurses not being readily replaced by new graduates, certain hospitals are struggling to keep their heads above water when it comes to nursing labor.

The scenario

According to Reuters' research, the symptoms of this current nursing shortage crisis are common to a number of healthcare institutions and hospital systems.

With numerous unfilled nursing positions, rural hospitals in states like West Virginia are needing to spend significantly more money on travel nurses and staffing agencies to keep shifts covered. Healthcare labor costs increased 7.6 percent across the U.S. last year, and almost half of all rural hospitals were running in the red in 2015.

In order to compete with relatively wealthy metropolitan hospitals in popular cities where many nurses want to work, rural facilities and small community hospitals are needing to offer sign-on bonuses, relocation expenses, tuition reimbursement and even housing for far-flung staff. This is an expensive undertaking for hospitals that already run on tight financial margins, but the incentivizing of nursing staff is crucial to maintaining the delivery of needed services that bring in significant revenue.

Meanwhile, nursing schools face a sizeable shortage of nursing faculty while the Bureau of Labor Statistics expects more than 1 million nursing job openings by 2024. Can we educate and retain enough nurses to fill the gap?

This recipe points to the beginnings of a nursing shortage that may deepen before it finds relief.

Communities suffer the consequences

Nursing care is key to prevention, and common diseases that kill Americans every day require nurses as educators, coaches, patient advocates and providers of skilled care.

In acute care facilities, high nurse-patient ratios translate into nurses not having the time to provide the quality of care they were trained to deliver, with resulting increases in nosocomial infections, morbidity and mortality.

For those with stakes in affected communities, finding potentially radical means of shoring up these hospitals is called for, including courageous leadership from both inside and outside the healthcare sphere.

Creative solutions needed

An aging American population will continue to demand more nursing and healthcare services. And an aging and retiring nursing workforce will necessitate the education and retention of talented nurses.

Nurses must be given prudent reasons to seek employment in rural areas with smaller, less prestigious hospitals. Lower cost of living, more affordable real estate, lower crime rates and more open space could be selling points for some, but a likely majority of nurses will continue to be attracted to more affluent and well-known institutions in urban population centers.

Encouraging nurses' relocation to rural areas of states like Missouri and West Virginia may necessitate public/private partnerships that not only offer tuition reimbursement and sign-on bonuses, but also perhaps first-time home buyer programs, career advancement assistance and other innovative initiatives. Small community and rural hospitals competing with well-funded teaching hospitals associated with well-endowed universities may very well need significant support in doing so.

The federal government would be wise to step in at this early stage of a growing shortage in order to support nursing schools in attracting top nursing talent to serve as well-paid faculty. Filling the job pipeline with high-quality nursing school graduates is essential to creating a new generation of nurses ready for the challenge of a rapidly aging population and a complex healthcare ecosystem.

This problem will not go away easily, and it will take courage, creativity and innovative thinking to assuage the crisis. We can muster the resources if we wish to, but we need to summon enormous collective will to catch this particular monster by the tail.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway and a widely read freelance nurse writer. Keith is also the co-host of RNFM Radio, a popular Internet radio station devoted to the nursing profession. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.