U.S. still headed for nurse shortage




The existing nursing deficit in the U.S. — largely caused by the aging population, increasing prevalence of chronic disease, an aging workforce and limited capacity in nursing education programs — might be creeping closer to a crisis.

In “The U.S. is running out of nurses,” which was published Feb. 3 in The Atlantic, freelance writer Rebecca Grant recalls the time her mother was hospitalized, and how the nurses helped her family get through the experience. “Nurses checked on my mother — and us — multiple times an hour,” she wrote. “They ran tests, updated charts and changed IVs; they made us laugh, allayed our concerns and thought about our comfort. The doctors came in every now and then, but the calm dedication of the nurses was what kept us together. Without them, we would have fallen apart.” This, Grant wrote, makes the impending shortage more troubling.

Despite being one of the fastest-growing occupations in the country, demand for nurses is outpacing the supply, she wrote. According to Bureau of Labor Statistics projections,  by 2022 there will be more than 1 million jobs for RNs. The article cites a 2009 report by Vanderbilt University researchers, which noted the shortage in 2025 will be twice the size of any nurse shortage “since the introduction of Medicare and Medicaid in the mid-1960s.”

Contributing factors

One factor is the increasing demand for healthcare linked to the aging of the baby boomers, and the accompanying need for more services. “Between 2010 and 2030, the population of senior citizens will increase by 75% to 69 million, meaning one in five Americans will be a senior citizen; in 2050, an estimated 88.5 million people in the U.S. will be ages 65 and older,” Grant wrote.

As the population ages, many will have more healthcare needs. About 80% have at least one chronic health condition, according to the National Council on Aging, and 68% have at least two. “People with chronic diseases clearly use more healthcare services, and people who are older have more chronic disease,” Julie Sochalski, an associate professor at the University of Pennsylvania School of Nursing, Philadelphia, said in the article. “The aging population and chronic disease are creating the perfect storm driving demand for nurses.”

Nurses are aging and beginning to retire from the field, Grant wrote, which contributes to the shortage. According to a report from the Health Resources and Services Administration at the U.S. Department of Health and Human Services, more than one-half million RNs are expected to retire or leave the workforce by 2022, Grant wrote.

Filling the open positions won’t be easy. Even though an increasing number of new RNs are entering the workforce, nursing education programs haven’t been able to keep pace, Grant wrote. Nurse educators are also aging, and it takes time to develop nurse faculty with doctoral degrees to build up programs, she wrote.

Even if RNs do gain their entry-level degrees, many facilities are reluctant to hire brand-new nurses because of the experience gap between them and retiring longtime RNs, Grant wrote. Depending on the geographic area, there also are a limited number of facilities for them to gain training and practical experience.

Is it so severe? And what can fix it?

According to the article, researchers have different opinions on the severity of the shortage and possible solutions.

Ed Salsberg, MPH, who studies nursing-workforce issues at the George Washington University School of Nursing, Washington, D.C., said the U.S. is facing a distribution problem, with some parts of the country having a more plentiful supply of nurses and others feeling the scarcity more acutely, according to the article.

Other nurse executives Grant spoke with think having national licensing standards for RNs would help address pockets with more severe shortages, because many RNs prefer to work where they can practice to the full scope of their licenses.

The article notes several possible solutions to the shortage such as improving access to nurse education, especially in rural or poorer communities, and public-private partnerships and incentives for RNs to become nurse educators. The American Nurses Association is lobbying Congress to increase federal grants to help fund nursing schools and organizations that work to improve access to education, increase diversity in the field and repay loans for students who go on to work in underserved areas.

To comment, email editor@nurse.com.


About the author
Sallie Jimenez

Sallie Jimenez 

Sallie Jimenez, who is Content Manager for Healthcare, develops and edits content for OnCourse Learning’s Nurse.com blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the OnCourse Learning/Nurse.com Digital Resource Guides. She has more than 22 years of healthcare journalism, content marketing and editing experience.

14 responses to “U.S. still headed for nurse shortage”

  1. The government needs to look out for the well being of it’s constituents. You may have known that there are Registered Nurses in the US working under the table as caregivers. I know a few who are US Registered Nurses but are not able to work because they are illegal aliens. These people are already registered nurses. Why not tap on these resources and give them a chance to work. Get them out of the dark, let them pay a fee and give them work certificates. Hiring nurses from abroad is quite a taxing ordeal and educating one would take some time. Imagine how much money these Nurses can contribute. Once they can work legally, they will be paying taxes, not just salary tax but also property tax. Most of them eventually will buy a house or condo. It is going to be a quick fix since these Nurses are already here and are already certified US Registered Nurses.

    • Why are they working under the table? If they have successfully passes the NCLEX which is a requirement to work in the US, then applying for a Work VISA is not a problem. Many qualified foreign-nationalist nurses (those who have passed the NCLEX and criminal background check) work here in the US. As a registered nurse, it makes me wonder about the qualifications and criminal background checks of these nurses working illegally under the table. I have worked with many nurses from around the world who had no problem obtaining Work VISAs to work in the US. In fact because of the nursing shortage if a nurse is qualified to work here in the US, most employers (hospitals)help fund the nurses to come here to work. So again my question is; are those nurses whom you claim are really certified to work as US Registered Nurses? Have they proven that they are qualified by passing the NCLEX and criminal background check? If so, tell them to seek out employment the legal way and apply and obtain Work VISAs. It is not difficult to do and employers usually will help fund the cost,if they are truly qualified to work as a RN in the US.

    • Why are they working under the table? If they have successfully passed the NCLEX which is a requirement to work in the US, then applying for a Work VISA is not a problem. Many qualified foreign-nationalist nurses (those who have passed the NCLEX and criminal background check) work here in the US. As a registered nurse, it makes me wonder about the qualifications and criminal background checks of these nurses working illegally under the table. I have worked with many nurses from around the world who had no problem obtaining Work VISAs to work in the US. In fact because of the nursing shortage if a nurse is qualified to work here in the US, most employers (hospitals)help fund the nurses to come here to work. So again my question is; are those nurses whom you claim are really certified to work as US Registered Nurses? Have they proven that they are qualified by passing the NCLEX and criminal background check? If so, tell them to seek out employment the legal way and apply and obtain Work VISAs. It is not difficult to do and employers usually will help fund the cost,if they are truly qualified to work as a RN in the US.

      • I do not believe Immigration is still approving work visa for foreign nurses. Where did you get this information? Thanks

  2. […] Nurse.com says that by improving access to education, we might be able to recruit more individuals into nursing programs. Increasing diversity in the field and repaying students loans for students who go to work in under served areas, might also help resolve short staffing issues. Personally, I think we need to reach out to more people, especially younger individuals, and discuss why nursing is such a great career path. From traveling nurses, to research nurses, there are some many different types of nurses and specializations to choose from. Educating people on all the possibilities of work in nursing will help open their eyes, and maybe more will consider the career path. Another important thing that I believe that can be done is offer more tuition assistance to nurses who further their education, in a specialization that is particularly understaffed. […]

  3. I am a filipino nurse with license to work in the US. But going there to be working legally is difficult because retrogression is still in effect. There are a lot of qualified nurses here in the Philippines but are unable to get visas. I for one have a tourist visa and i can go there to look for a an employer who will sponsor me for a work visa. But that process is so toxic and the possiblity of being deported is very high. And i dont want to put my license at stake. Hence, we have nothing else to do but wait. As to how long is a million dollar question.

    • Good reply “Mark Anthony”. Thank you for waiting your turn. I, and most other Americans, appreciate people who come to the U.S. legally. I’m sure the wait is difficult. Good luck to you!

      Derek, RN (Atlanta)

  4. I’m not sure why some people think it’s unfair to expect an individual to enter a country legally with a valid working visa. There is no other country in the world where it is possible to slip through the border and then be given all the legal rights and liberties not to mention privileges of operating a motor vehicle and working full-time. I have lived as a family member in residence in other countries. I was not allowed to drive unless I went back to the states and applied for an international drivers license. If I had attempted to work and were found out.. I would have been deported. That’s the way it is. We need to support our community of US citizens to gain educations in order to solve the nursing shortage not import individuals from other countries. There are American citizens that need guidance. Beginning with our highschool population being programmed to believe they must attend a Four year University.. Regardless of the fact that they really don’t know what they want to be when they grow up. I know this because my youngest just dropped out of OSU after two years… She really didn’t have a clue… But now she has student loans…

  5. The reason why “mature,” experienced nurses are leaving the work force in droves isn’t even mentioned here. The increasingly insane workloads, lack of administrative support, poor financial incentives for nurses (I’ve watched my salary go backwards for over a decade) and scarcity of opportunities to cross-train or move up in organizations figure prominently with the nurses I know.

    Another huge factor for many nurses—myself included—is that despite decades as an RN, I don’t have a BSN and can’t afford to front the expense of going back to school. The move to the BSN requirement in order to stay employed at all at some organizations—or gain employment with many others—without any legal requirement to do so, is a brick wall to many a career. The current model of the nurse paying out of pocket for a degree program just to remain employed is pretty insulting, especially to nurses who have put in valued, exemplary service over the years. This is even if the employer offers reimbursement (and a lot of them don’t). I’d wager that if employers shouldered the cost of continuing education for valued RNs, or there were a government program to pay for RNs to get BSNs, this shortage would be much less of an issue, and many nurses who have run for the doors might be enticed into becoming active, productive employees again.

    The ongoing shortage should be addressed at the state and local government level immediately. We shouldn’t have to import nurses from anywhere; we have plenty of talent going unused right here in our back yards. Nurses haven’t united to be politically effective, and I think the time has come to do so. The ANA seems to be lapdog mouthpiece for us, not a persuasive, effective advocate in Washington, DC. Start writing your Congresspersons. We won’t win this game unless we move the ball on the field ourselves.

  6. It’s true that most of the workers in US are working on H-1B visa policy. It’s illogical to say that nurses are getting older and will retire. They will, but more people are in the phase of becoming a qualified nurse too. There is an increasing ratio of people choosing home care services than the nurses or caregivers available in the country. If a legal citizen wants to become a certified nurse then the government should allow it irrespective of his or her origin.

  7. Wages are horrible for the amount of responsibility RN’s shoulder. The BSN requirement is the final straw for many experienced nurses,most of the nurses I work with are planning on retirement. Work loads have incrased,forced mandations,the list goes on and on.many of the new grads.tell me they are planning on leaving the field.

  8. I don’t know if my situation is applicable but I would appreciate advice. I am BSN RN since 1991 but in 2012, I fell into an illness that wasn’t related to substance abuse but because I had long-taken a sleep aid (prescribed for “shift-work sleep disorder”), the board suspended me as “unable to practice”. In the interim, I have retrained myself as a night-sleeper, seen no physicians and am quite well. I have applied for reinstatement and have met every requirement except that I need the $3,000 med/psych exam which I cannot afford (it also takes me far out of town for 3 inpatient days). Anyone have this experience and/or advice on ways to remedy? I’m so eager to return to my passion!
    Thank you.
    Karen

  9. THERE IS NO NURSING SHORTAGE. The healthcare industry bribes Congress. Fifteen percent of nurses are foreign born. They are scabs.

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