A Nurse Executive’s Strategy In Approaching Nursing Shortage And The Economic Crisis

A Nurse Executive’s Strategy In Approaching Nursing Shortage And The Economic Crisis

For the last 10 years, healthcare around the world has been plagued with a shortage of nurses that would provide quality care to patients (Auerbach et al., 2007).  Health systems analysts have estimated that this nursing shortage will continue to worsen until the year 2020.  It has been projected that despite the increase in the nurse hiring since 2001, there is no substantial evidence that points towards the end of the nursing shortage dilemma.  National surveys have shown that approximately 80% of the hospitals in the United States are not supported with enough nurses.  The average age of the current nursing population is at 47 years old and thus it can be projected that during the period 2011 to 2020, almost half of these nurses would have retired or preparing for retirement.  It is thus critical that the number of retiring nurses be replenished with a new batch of nurses.  However, there are not enough nurses that join the workforce and thus the quality of healthcare is most likely to suffer.

Another reason for the nursing shortage is that these healthcare professionals have gone to other fields of profession, or simply stopped practicing in their field of training (Doiron et al., 2008).  There are several reasons behind this choice.  It has been reported that there are quite a number of nurses who feel that they do not experience a sense of professional growth since they continue to perform the same tasks for several years and yet they do not foresee any form of professional growth in their future (Bradley and McAuliffe, 2009).  Other nurses express that they have reached the point of fatigue and that it is best for the patient, as well as for themselves, to stop working since such loss of enthusiasm may result in mistakes in their delivery of healthcare services (El-Jardali et al., 2009).

The economic crisis has further magnified the problem of nursing shortage.  The significant decrease in the budgets of hospitals and other healthcare institutions have resulted in both the non-renewal of nurses, as well as the freeze hiring of new ones.  The vacancy rates for nurses have thus significantly decreased, as influenced by the economic crisis that affects the entire globe.  It is thus important for a nurse executive to implement specific strategies that would address the current issues of nursing shortage and the global economic crisis in his own healthcare institution.  Another confounding issue that is strongly associated with the nursing shortage is that the number of patients will increase in the very near future, as the life expectancy of the average American has increased due to the developments in science and medicine.  It is safe to assume that the elderly population will double in the coming 10 to 15 years, which in turn will require a significant increase in the number of nurses that are working in healthcare institutions.

One important aspect to understand in this scenario of nursing shortage is that the rapid increase in the coming elderly population is not equivalent to the number of nurses that enter training.  Since it has been projected that there the number of elderly individuals will double in the next 15 years, it should be safe to see if the number of nurse trainees have also doubled in the latest enrolment registries.  Unfortunately, surveys of nursing school registries only show a 5% increase in the number of nursing students in the recent years.  This number is not enough to provide healthcare to the current adult population, more so when this generation reaches the elderly stages of their lives.

The economic crisis may also further affect the training of new nurses, as there may be some difficulty in maintaining the nursing faculty, as well as the sites and spaces for classroom and clinical instruction.  There will also be a limit in the hiring of clinical preceptors, as this will also entail additional budget for their payment.  It is thus possible that certain nursing faculty would resign to find another position that is much more beneficial to their career as the economic crisis not only affects the nursing student, but the faculty as well.

It is thus important that nurse executives are proactive and aware of the impending nursing shortage so that contingency plans could be designed to address this issue.  In addition, it is also important that the nurse executive could propose strategies that would also consider the current economic crisis that plagues almost every institution around the world.  One of the most effective strategies that could address the nursing shortage is to identify factors that would make a nurse appreciate his profession and thus prevent him from looking for another field of profession.  The nurse executive could thus implement a non-traditional schedule for work for the nurse, wherein each nurse can enter into a flexible schedule so that his personal matters can still be attended to (Molinari and Monserud, 2009).  It should be understood that there are some cases wherein a female nurse would quit her job as a nurse because she finds that she has no more time to spend with her young children.  Given the option of following a flexible work schedule, this feature will thus help the female nurse to attend to family matters and still provide help at the healthcare institution.

Another strategy that could be presented by a nurse executive is to invite nurses who have long been out of the practice to come back with an acceptable responsibility.  One example is to assign these nurses to on-site child care, which technically does not demand so much of the physical and emotional components of this professional.  When this scenario is presented to a nurse who has not practiced for several years, this professional will feel driven and excited to return to the healthcare force, as the nature of their work would not be too exhaustive.  At the same time, the healthcare institution would still receive additional personnel for the workforce and the other more able-bodied nurses can be assigned to more rigorous tasks.

Another strategy that could be considered is to update the salary scale of the nursing staff, in order for these healthcare professionals to feel that they are being compensated for their hard work.  If a nurse is well paid, then they would not feel that as bad as they work hard in providing healthcare to the patients.  In addition, they would also hesitate in giving up their position, which will most likely be given to another aspirant.  Overtime salaries should also be reviewed, despite the economic crisis, as long as the salaries are objectively disbursed to the proper healthcare personnel.

In terms of nursing schools, it is important that nurse trainees be provided with a comprehensive view of what the profession entails, as well as what career options are available for them.  The paths to each career level should also be presented, so that the nurse trainee can gauge how far he can go in his profession.  It is also important to present to both nurse trainees and active nurse professionals any continuing education programs that are available at the healthcare institution.  These programs may be provided at the site itself, or through distance learning programs, and appropriate time should be given to each nurse professional to prepare for their programs (Cunningham and Merwe, 2009).  If these options are provided, the nurse professional will definitely feel that he is still improving his professional career, as thus resigning from his job would be less likely to occur.

Another cost-effective method that could be adapted is the mentorship program, which involves the assignment of a junior nurse staff to a more senior nurse professional for training and education.  The mentor could assist the younger nurse on identifying career paths that would be a perfect match to his professional, as well as personal conditions.  It has also been proven that mentorship is a very effective method of teaching, in both healthcare and non-healthcare fields of profession.  These aforementioned strategies are thus important in addressing the current problems of nursing shortage, coupled with the global economic crisis that affects the entire world.



 Auerbach, D.I., Buerhaus, P.I. and Staiger, D.O. (2007).  Better late than never: Workforce supply implications of later entry into nursing.  Health Affairs, 26, 178–185.

Bradley, S. and McAuliffe, E.  (2009).  Mid-level providers in emergency obstetric and newborn health care: Factors affecting their performance and retention within the Malawian health system.  Human Resources for Health 2009, 7, 14-22.

Cunningham, B.J. and Merwe, R.V.  (2009).  Virtual grand rounds: A new educational approach in social work that benefits long-term care providers and patients in rural Idaho.  Rural and Remote Health, 9, 1073-1080.

Doiron, D., Hall, J. and Jones, G.  (2008).  Is there a crisis in nursing retention in New South Wales?  Australia and New Zealand Health Policy, 5, 19-31.

El-Jardali, F., Dimassi, H., Dumit, N., Jamal, D. and Mouro, G.  (2009).  A national cross-sectional study on nurses’ intent to leave and job satisfaction in Lebanon: Implications for policy and practice.  BMC Nursing, 8, 3-16.

Molinari, D.L. and Monserud, M.A.  (2009).  Rural nurse job satisfaction.  Rural and Remote Health, 8, 1055-1067.

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