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When it comes to the national nursing shortage, the prognosis is not good. Though some parts of the country may be experiencing temporary relief from the decade-long shortage of registered nurses (RNs), industry analysts caution observers from concluding that the crisis is indeed over.

In the November 26, 2008 issue of the Journal of the American Medical Association, Dr. Peter Buerhaus from Vanderbilt University reported that “a large and prolonged shortage of RNs is expected to develop in the later half of the next decade, threatening access and quality and increasing health care costs.”

Signposts pointing to an ongoing nursing shortage are everywhere:

  • Last year, the U.S. Bureau of Labor Statistics reported that more than one million new and replacement nurses will be needed by 2016.
  • The American Hospital Association found that more than 116,000 RNs are needed now to fill positions in hospitals nationwide. This translates into a national nurse vacancy rate of 8.1%.
  • Research compiled by the Agency for Healthcare Research and Quality shows that increases in RN staffing is associated with reductions in hospital-related mortality, failure to rescue rates and length of stays. In settings with too few nurses, patient safety is compromised.
  • The Council on Physician and Nurse Supply is calling for 30,000 additional nurses to be graduated annually to meet the nation’s healthcare needs, a 30% expansion.

Today’s nursing shortage is very real and more tenacious than shortages our healthcare system has weathered in the past. Simply stated, the need for nursing care is increasing, while the number of nurses available to provide that care is not keeping pace. The baby boomers are entering their senior adult years, and this demographic shift has triggered an increase in the demand for health care.

As the need for care increases, nursing schools are struggling to expand enrollment despite a growing shortage of faculty, resource constraints, and funding cuts in several states. The American Association of Colleges of Nursing (AACN) has just reported preliminary data from its fall 2008 survey and found that enrollment growth in professional nursing schools has hit an 8-year low with a minimal 2% increase this year even though thousands of qualified applicants continue to be turned away. This sobering news may signal that nursing schools have reached capacity and are unable to graduate more students needed to work as nursing clinicians, educators, and researchers.

AACN is taking the lead on several fronts to address one of the underlying causes for the shortage: an insufficient supply of nurse educators. The association is advocating for new federal legislation and increased funding for graduate level nursing education; launching scholarships and new faculty development programs; encouraging innovation in nursing programs including the development of fast track programs; and highlighting potential solutions to this issue.

Nursing schools are struggling to find creative ways to bridge the faculty gap, and many are making headway. Some schools are partnering with clinical agencies and hospitals to “share” graduate-prepared nurses who are also interested in teaching. Others are lobbying at the state level for additional funding and incentive programs to attract more nurses into teaching careers.

The nursing shortage has amplified the critical role nurses play in our nation’s healthcare system, and all stakeholders must take a larger role in alleviating this crisis. Policymakers should champion programs that remove financial barriers to graduate nursing education. Business and practice partners are needed to fund scholarships, support outreach programs, provide space for student training, and encourage ongoing nursing education. Together we can effectively mitigate the shortage while ensuring access to quality health care for all citizens.

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