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Tackling the Nursing Workforce Crisis

AJN, American Journal of Nursing: August 2022 - Volume 122 - Issue 8 - p 12
doi: 10.1097/01.NAJ.0000854924.04730.fd
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Abstract

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Figure:
Health care workers protest outside the White House, May 12, for fair and realistic wages for nurses, safe staffing environments, no violence against health care workers, and changing the culture of biases and discrimination in the nursing profession. Photo by Susan Walsh / Associated Press.

The COVID-19 pandemic has shone a spotlight on what nurses have known for years: that inadequate staffing and consequent moral distress in acute care work settings have undermined nurses' ability to provide optimum care and now are spurring an exodus from the profession. The American Nurses Association (ANA) has repeatedly raised these issues and, in September 2021, asked the U.S. Department of Health and Human Services to declare the nursing shortage a national crisis and to take action.

Evidence of the severity of the crisis has mounted since then. A survey of 2,516 nurses conducted at the end of 2021 by Nurse.com found significant professional dissatisfaction, with 29% reporting they were considering leaving the profession and 17% saying they were thinking about changing jobs. This contrasts with results from a similar survey in 2020, when only 11% of respondents said they were considering either option. Another survey last November by McKinsey & Company of 710 direct care nurses found that 32% indicated they might leave their positions. And on May 12, the last day of National Nurses Week, thousands of nurses marched in Washington, DC, to protest poor working conditions and demand improvements in wages, staffing, and protection against workplace violence.

Nurses' voices are finally being heard. Nurses clearly have had enough, but there are signs their voices are finally being heard. Building on work that began in 2018, Partners for Nurse Staffing, a collaboration of the American Association of Critical-Care Nurses, ANA, American Organization for Nursing Leadership, Healthcare Financial Management Association, and Institute for Healthcare Improvement, launched the Nurse Staffing Think Tank in January 2022 with the aim of identifying actionable recommendations to address the acute care staffing crisis.

The group has identified several priority areas for policymakers, health system leaders, and nursing organizations to address within the next 12 to 18 months, including the following:

  • Creating healthy work environments that elevate clinician safety—both physical and psychological—to the level accorded patient safety and informed by research on appropriate levels of staffing
  • Integrating diversity and inclusiveness principles at every level of health care organizations and in all aspects of health care delivery
  • Improving flexibility in nursing roles and in the scheduling of work shifts
  • Addressing burnout and moral distress as a system core value and as a key to nurse retention
  • Adopting holistic care models that incorporate on-site care delivery with integration of technology, such as remote patient monitoring and virtual care delivery
  • Developing innovative and market-informed nurse compensation and benefit packages

According to the Nurse Staffing Think Tank report, “This work provides an action plan for the necessary cultural shift in health care delivery that can drive improved nurse retention, healthier work environments, and better patient outcomes.” You can read the recommendations at www.nursingworld.org/~49940b/globalassets/practiceandpolicy/nurse-staffing/nurse-staffing-think-tank-recommendation.pdf.

The nursing shortage is not unique to the United States. In a May 12 press release accompanying the International Council of Nurses (ICN) report, Nurses: A Voice to Lead, Howard Catton, ICN's chief executive, noted that “the scale of the worldwide nursing shortage is one of the greatest threats to health globally, but governments are not giving it the attention it deserves. Access to healthcare is central to safe, secure, economically successful and equitable societies, but it cannot be achieved unless there are enough nurses to provide the care needed.”—Maureen Shawn Kennedy, MA, RN, FAAN

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