Time to solve persistent, pernicious and widespread nursing workforce shortages

Abstract

This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID-19 pandemic might offer valuable impetus to address this tenacious challenge. Background: Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID-19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave. Sources of evidence: This discussion paper draws on international sources of evidence. Discussion/conclusion: This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID-19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages. Implications for policy: Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied.

The resilience of emergency and critical care nurses: a qualitative systematic review and meta-synthesis

“…There is a strong link between job burnout and the turnover intention, as evidenced by multiple studies ( Hämmig, 2018 ; Lee et al, 2021 ; Özkan, 2022 ). With an aging population, increasing demand for healthcare services, and the threat of infectious diseases, the global nurse shortage is becoming ever more severe ( Peters, 2023 ). According to existing studies, older age groups utilize emergency and critical care services more frequently and require additional care due to complex chronic diseases accompanied by atypical symptoms.…”

Travel nurse work experiences

“… 3 Burnout has been linked to patient safety, as well as job dissatisfaction and turnover, which have contributed to nursing shortages. 4 - 6 Healthcare leaders have employed travel nurses to fill gaps related to understaffing. 7 Although there are many published studies about nurses' experiences of working in hospital settings, few have been published specifically about travel nurses.…”

Incentivizing an exodus: The implications of recruiting nurses from low-middle income countries to high-income countries

“…Second, the true nursing shortage disproportionately affects South-East Asia, Eastern Mediterranean regions and Africa, and HICs are mostly recruiting from these regions [ 12 ]. Third, the recruitment of nurses from LMICs to HICs is leading to “brain drain” [ 1 ], defined as the depletion of health workers from LMICs, exacerbating existing health inequities. Fourth, nurses from LMICs are being recruited to work in identical conditions that pushed out existing nurses.…”

“…In recent months, to palliate against a shortage of nurses, several high-income countries (HICs) have turned to low and middle-income countries (LMICs) to recruit nurses to their healthcare systems, despite the global nursing shortage disproportionately affecting LMICs [ 1 ]. This approach is ill-conceived.…”