The nursing shortage is becoming a national crisis and is expected to increase 23% by
2020 from the current 6% shortage (Cohen 2006). The current recruitment into the nursing field
is helping relieve the staffing shortage, but healthcare organizations should also focus on the
current staff as to why they are choosing to leave the workforce. There are many interrelated
factors as to why there is a shortage in the nursing profession, but there are a few more
prominent factors that are producing the shortage. This paper will discuss the current nursing
shortage within healthcare organizations, and the factors that contribute to this shortage such as
the aging workforce, increased career opportunities and the workplace environment. Also within
this discussion there will be talk about some possible resolutions to help minimize the nursing
shortage within our society.
A study done by the Canadian Nursing Association (CNA, 2009) in 2002 states, "Canada
will experience a shortage of 78,000 RNs by 2011 and 113,000 RNs by 2016". These numbers
are expected to increase partly because the age of the current nursing workforce less than 35
years of age is only 22% (Cohen, 2006). This is partly because the high turnover rates with
younger nurses entering the workforce who are dissatisfied with the nursing work environment
and even those who are more satisfied than others still choose to leave. This is because of the
high burn out levels in the workplace causing other nurses to take on a greater workload because
of the decreasing nursing staff (Khowaja, Merchant & Hirani, 2005). The staff leaving the
nursing profession are choosing other areas of work that supply larger salaries, limited shift work
and have better working conditions (Heinze, 2004).
Today, there are a growing amount of career opportunities available for healthcare
workers to enter specialised areas. These areas are available through privatized businesses who
still work within the health care system such as, the Cause & Effect Early Intervention Services,
which focuses on specific aspects of problematic children. Businesses like this give opportunities
to healthcare workers who do not want to work in the hospital setting. This creates more choices
for other career opportunities for people currently enrolled in healthcare, as well as people who
are looking into enrolment. Also, today there are more options within the schooling system that
offer more specialized training in certain areas, which in turn are leading more away from the
traditional nursing profession.
Factors Contributing to the Nursing Shortage
Increased Career Opportunities
There are a vase number of career choices that have opened up for young people today,
especially women who have made up more than 90% of the nursing workforce over the last few
decades (Kelsey, 1999). Women today have more opportunities to pursue careers; this in turn is
taking away from a large number of possible candidates entering the nursing profession (Kelsey,
1999). People are leaving and not entering the nursing profession because they are looking for
more regular hours, more money and more opportunities for advancement (Cohen 2006).
Research shows that "35% fewer women would choose nursing as a career in the 1990s than they
would have in the 1970’s” (Kelsey, 1999) this in turn contributes to the increasing job
opportunities available.
Aging Work force
There are many reasons for the nursing shortage and they vary greatly. Since 1964 the
post-baby boomers generation is decreasing. As a result, there are smaller amounts of eighteen to
twenty-four year olds entering the profession, and the nurses working now are getting to the age
where retirement is closer to their reach (Kelsey, 1999). According to Cohen, (2006) the average
age of nurses is rising steadily since 2002 and will increase by 3.5 years, bringing the average
age of working nurses to 45.4 years by 2010. Many of these nurses are cutting back on the time
they are willing to work, as well as are retiring or planning on retiring around 50 years of age
(Coile Jr, 2001). Soon, more nurses will be retiring then entering the work force resulting in a
shortage of health care professionals.
Workplace environment
The resulting vast number of career choices available today is taking people away from
the nursing profession because it is seen as a less desirable choice as a line of work. Nurses deal
with stressful working conditions on a day to day basis, they work shift work and have no
guarantee of getting holidays or important events off (Kelsey, 1999). They are exposed to
contagious factor, which in turn could be dangerous or even life threatening to their health, as
well as their families (Cohen, 2006). Also, nurses are pushed by employer policies to do more
with less; having outdated equipment, not having the correct supplies and materials, and having a
larger patient workload and not having enough staff to maintain proper services. When resources
are limited, the problem for nurses becomes stressful because they are not able to carry out their
ethical duty to "assist persons to achieve their optimum level of health in situations of normal
health, illness, injury, or in the process of dying” (CNA, 2009). Cohen (2006) explains that the
top reason, other than retirement for nurses to explore new job opportunities is because of the
high amounts of stress and the demanding physical work they experience in their workplace due
to unrealistic workloads and lack of the nurses concerns from administrators.
Decreased Nursing School Enrolment and Shortage in Nursing Faculty
The National League of Nursing states there has been a decrease in all types of nursing
enrolment (Munoz, 2009). This in turn could be a resulting because of the shortage of nursing
faculty. The lack of faculty to educate has a factor on the growing demand of nurses that are
graduating from the nursing program and having a lack of graduates takes a major toll on the
availability of hiring nurses (Allan, 2008). Many hospitals have a bachelor degree preferred
policy for hiring new nurses, and in the province of Ontario starting January 1, 2005, first time
nurses require a minimum of bachelor degree to be considered for a nurse’s position (Munoz,
2009).
Possible Resolutions
Our society must acknowledge the critical role nurses play in our healthcare system, and
provide nurses with rewards that correspond with these roles. Some of these rewards are
financial, while others are intangible and tangible, but all are equally important.
Flexibility
Some recommended solutions to the shortage could include offering flexible scheduling.
People today are busier than ever, so sometimes nurses are too busy with advancing their
education, parenting and other responsibilities within their personal lives (Cohen, 2006). By
having more flexible hours they will be able to balance work and family commitments and be
able to split their shared roles to accommodate their lifestyle as well as the demands from of their
job (Cohen, 2006).
Benefits and Compensation
There are a number of benefits that are already being used to preserve and employ nurses
within our hospitals. However, these benefits must accommodate both younger and older nurses
such as packages geared towards a specific age group; older workers are looking more for
insurance and retirement planning as well as health programs and the possibility of reducing their
hours due to age and limitations; younger nurses want benefits that cover paid seminars and
scholarships that will allow them to continue with their education (Cohen, 2006). By offering
benefits of interests it can help not only recruit experienced nurses from outside varying
organization, but also can help hold on to capable nurses already working.
Compensating could also help deal with the issue of the nursing shortage. Many
institutions are already taking this into effect because of the increase in salaries over the years for
nurses (Kelsey, 1999). Nurses have a very important job and should be acknowledged by
increasing their wages because nurses too have the right to earn an expectable living for the
important job they do for society.
Reducing Stereotypes
Only a few decades ago, men were not seen as the 'typical nurse' because nursing was
seen as a female’s profession, therefore the role of a nurse was done solely by women. Because
of this view a stereotype was created and still exists today (Kelsey, 1999). There needs to be a
decrease and elimination of the barriers and stigmas facing men in the nursing profession. Even
though today’s society is becoming more able to except women and men in different careers,
there is still a small label towards men entering the nursing profession. The noticeable lack of
interest by men entering the nursing profession needs to be reduced and then ultimately removed.
If men were to enter nursing at the same pace as women, we could potentially eliminate future
shortages (Kelsey, 1999).
Recruiting and Retaining
Nurses going through training and those thinking about entering the profession are all
looking for a career that is exciting, satisfying and rewarding. These people want to work in an
environment where they are treated as trained professionals, are acknowledged for their
achievements and expertise and are included in decision making concerning their patients. These
new, up and coming nurses are looking for opportunities where they will learn and progress
within a career will reward their efforts along the way.
As for those nursing who are soon approaching retirement age, we need to try and retain
them by not only offering them more money, but by increasing their work place enjoyment and
giving them a sense they are still useful in the healthcare team (Cohen, 2006). We can do this by
enhancing and improving certain parts of their job satisfaction that will hopefully motivated the
aging nurses enough to continue in the workforce which could be done by changing some of the
working conditions to help alleviate any physical or mental stress. By having a lighter workload
stress levels can decrease greatly which is beneficial for creating strategies to help deal with the
health and safety of the staff as well as patients within the hospital (Cohen, 2006).
“Hospitals must look likewise for strategies to open up nursing to opportunities in
teaching, research, specialization, and management. A number of healthcare institutions
nationwide, notably academic medical centers, have in fact found success with such programs”
(Kelsey, 1999). Healthcare organizations need to use long-term strategies that will reflect the
career potential and image of nursing as a line of work (Coile Jr, 2001).
Conclusion
The nursing shortage has the possibility of becoming more of a national crisis unless we
analyse the factors that contribute to this shortage and look at possible resolutions.
The critical shortage for nurses cannot be resolved if the needs of the current and up and coming
nurses are not met. Our society must implement incentives to further pursue the nursing
educational program, having nursing staff continuing their employment and improving the work
environment to help attract and keep current nurses in hospitals working in the healthcare
system.
References
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