As nurses’ critical role in health care rapidly evolves, they are becoming harder to find. A 2018 study published in the American Journal of Medical Quality estimated a shortage of 510,394 registered nurses by 2030. This shortage is driven by both supply and demand factors. On the supply side, the nursing workforce is aging out and colleges are not graduating replacements in sufficient numbers: half of all nurses are over 50 years of age. Meanwhile, in the 2019-2020 academic year, nursing schools turned away more than 80,000 qualified applicants citing an insufficient number of faculty, clinical sites, classroom space and budget constraints, according to the American Association of Colleges of Nursing.
On the demand side of the nursing labor equation, the job may be losing some appeal to would-be nurses. Wages for registered nurses have not kept pace with broad wage growth. The chart below shows the total compensation per hour for registered nurses and all occupations separately, and as a ratio. The ratio (blue line) shows that while registered nurses enjoy a premium to the average wages in the workforce, that premium has been eroding since the end of the global financial crisis.
Furthermore, nursing has always been a physically and mentally straining occupation, which the pandemic has exacerbated. According to a recent McKinsey survey 22% of nurses are looking for new jobs, with half of that number seeking roles outside of direct patient care. Sixty percent of those nurses looking to leave their current roles said they were more likely to seek new employment because of the pandemic. The top factors influencing their decisions to leave are, in order: insufficient staffing levels, the demanding nature of the job and the emotional toll of the job.
Ways to support
What can organizations do to prepare themselves for the growing scarcity of this critical resource? While the appropriate actions will vary by organization, health care leaders should broadly consider several options, including:
- Assess how your organization monitors and supports the wellbeing of your employees, particularly your nurses. Are there ways they can be supported at or outside of work that will reduce stress and increase engagement?
- Explore virtual and on-demand staffing models. Nurses want the same workplace flexibility as other clinicians and as their friends in other industries. While total remote or on-demand nursing may never be realistic, leaders should explore offering whatever virtual work arrangements are possible.
- Evaluate alternative ways to secure nursing talent, such as partnering with local schools or even upskilling existing employees. HCA made headlines when it effectively bought a large nursing school in 2019. Now such acquisitions and partnerships may become more common, even for smaller systems.
Nurses are already critical to health care. As their roles evolve, health care organizations will need to deploy creative strategies to develop, attract and retain new talent. Successful organizations will reap the benefits, like lower turnover, reduced costs, improved satisfaction of employees and patients, and improved patient care.