The Nursing Shortage: Where Are We Now?

The Nursing Shortage: Where Are We Now?

This is part one of a four-part series examining various aspects of the nursing shortage. Are we facing a serious deficit of RNs? If so, what factors are contributing to the shortage and how can we best address them? Since industry forecasts tend to influence health policy decisions—as well as YOUR career choices—it’s important to understand the forces at play in today’s labor market. 

We’ve been hearing about either an existing or upcoming nursing shortage of crisis proportions for a long time now. In fact, a recent New Yorker article titled “Why Is the U.S. Perpetually Short of Nurses?” excerpted an editorial about the nursing deficit that appeared in print way back in 1965. Is it possible that a major labor-supply shortage has persisted for half a century—and will continue to persist? It seems that no one can quite agree on this.

It seems to be true that the perennially projected shortages don’t always materialize. According to the Robert Woods Johnson Foundation (RWJF), during the recession of 2008-09, many nurses either delayed retirement or returned to the workforce because of a spouse who was out of work. This increased supply of RNs inspired an editorial in the New England Journal of Medicine, in which the authors speculated that the industry was experiencing a “nursing bubble” rather than a shortage. And as recently as January, 2015, a report by the U.S. Health Resources Services Division forecasted a surplus of 340,000 nurses by the year 2025 (although it conceded certain geographic areas will likely see shortages). Yet at the very same time, researchers at Georgetown University concluded a national shortage was once again imminent—they predicted a deficit of 92,810 RNs by the year 2020. Who to believe? 

No statistical model is foolproof. Whether the future holds an actual surplus or a shortage depends on a number of fluctuating factors, including staffing policy, education capacity, wages, working conditions, and the general economy, to name a few. (These will be explored in more depth later in this series). Geography also plays a role, with rural hospitals facing greater staffing challenges than their urban counterparts. However, there are currently whispers in the industry about a “new nursing shortage” that is defined by a lack of sufficiently experienced professionals. When Health eCareers surveyed healthcare recruiters, hiring managers, and human resource professionals for its 2015 Healthcare Recruiting Trends Survey, 43 percent of respondents reported that they face the most difficulty finding qualified candidates

As the skilled RNs who delayed retirement during the recession begin leaving the workforce in droves, we’re likely to see a “knowledge gap” that newly graduated nurses cannot fill (more on this in part two of the series). So this new version of the nursing shortage means hospitals may find themselves with a high proportion of young, inexperienced nurses, even if their job vacancy rate is low. Clearly this will have an impact on patient care. 

The increasing emphasis on specialization in nursing may also contribute to specific types of shortages. Various industry trends, including those stemming from the Affordable Care Act, have increased demand for nurses with specialized skills in areas like case management, informatics, patient navigation, and infection prevention. As employers seek to fill these specialized roles, they will likely offer attractive wages and benefits, potentially luring seasoned nurses away from the bedside and into these emerging roles, adding to the shortages in direct patient care. 

The bottom line? It’s likely to be a job-seekers’ market for experienced and well educated nurses in the years ahead. 

Looking ahead: Some new nursing graduates wonder how there can be a nursing shortage if they can’t find a job. Part two of this series will explore that classic conundrum of how to get a job without experience, when you can’t gain experience without a job. 


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