Nurses make up one of the most in-demand workforces in the U.S. Registered nurse (RN) employment is expected to grow 6% between 2021 and 2031, while the U.S. Bureau of Labor Statistics (BLS) projects nurse practitioners (NPs) to be the fastest-growing occupation at 46% over the same period. But the country isn’t producing enough new RNs and NPs to keep up with demand. McKinsey estimates the country could face a shortage of between 200,000 to 450,000 nurses by 2025. To learn more, check out the infographic below, created by Hawai‘i Pacific University’s Master of Science in Nursing.
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What’s Driving the Nursing Shortage?
People typically become nurses because they want to help, and there’s always a need for their services. But nursing has long struggled to maintain adequate staffing levels. Various factors, including the pandemic, have supercharged the underlying issues.
Issues Underlying the Shortage
The U.S. population is getting older, and an older population typically requires more health care. There were 41 million Americans over the age of 65 in 2011; that number climbed to 71 million in 2019. At the same time, nearly half of nurses are approaching retirement. The average nurse is 50 years of age, and many will retire in the next 15 years.
Educators are struggling to fill the gap, largely because there aren’t enough nurse instructors to meet demand. Among the factors contributing to the instructor shortage: it pays more to be a nurse than it does to train one.
The pandemic has also made nursing more challenging. Patient care became more complex, and work-life balance harder to achieve. Turnover increased from 17% in 2017 to 26% in 2021. Nearly 1/3 of nurses said in 2022 they didn’t want to treat patients directly anymore. Others simply want a new career, leading McKinsey to estimate a 10-20% shortage of nurses by 2025.
Consequences of the Shortage
What happens when there aren’t enough nurses? There’ll be more burnout, longer patient wait times, and medication errors that could lead to deaths.
The shortage is reaching critical levels in pediatrics. While children made up almost 1/4 of the population, in 2022 just 2.4% of nurse practitioners were certified in pediatrics as their primary certification.
As a result, nurses are stretched thin when it comes to caring for children. They provide health and medical care, but they also have to find time to manage the processing of labs and take on ancillary tasks like delivering food trays.
Why Nurses Are Key to the Well-being of Children and Their Families
One in six American children live below the poverty line. Poverty can negatively impact children’s health for the rest of their lives. Keeping children healthy prevents their parents from missing work and more severe health issues requiring visits to the ER.
Creating safe environments for children to learn and grow requires attentive adults who provide consistent support and nutritious food. That’s where nurses come in. Nurses have been helping keep children healthy by working in schools since the early 1900s.
School nurses provide health care, monitoring for potential health issues, coordinating students’ care with their families and providers, and informing students and their families about health and safety issues.
They improve children’s health through education, prevention, and intervention. This is key, because nearly half of children have a chronic health condition, such as diabetes, asthma, a seizure disorder, allergies, or oral health issues.
Research suggests for every $1 that funds school nursing, society at large saves $2.20.
Children Need Nurses Like Never Before
The U.S. faces a shortage of pediatric health care providers. The number of new doctors choosing pediatrics is not enough to meet demand and the pandemic has strained the existing health care workforce.
Children are increasingly vulnerable to adverse social conditions, such as poverty, food insecurity, abuse and neglect, and access to education. Hundreds of thousands of children live at home with complex care needs. That number is on the rise and Medicaid coverage isn’t always adequate.
How Do We Fix the Shortages?
Fixing the nurse shortage requires stronger leadership and nurse advocacy, which can lead to reduced workloads, better pay, more time off—clear indications that nurses are valued. Prioritizing nursing education requires more grants and funding to those areas especially short of nurses. Other steps include creating organizations specifically designed to manage the issue of recruitment, training, and retention at the federal level.
The Need for a Comprehensive Strategy
In the face of a nursing shortage, the U.S. is in need of a comprehensive, long-term plan to train and place more nurses in direct patient care. Without such a strategy, children struggling to manage chronic conditions, complex health needs, or the ongoing impacts of the pandemic will likely continue to experience difficulties with potentially lifelong impacts.
Healthy nurses who are trained, valued, and rewarded are key to a healthy workforce and population.
American Association of Colleges of Nursing, “Nursing Shortage”
American Association of Nurse Practitioners, “Fact Sheet”
American Academy of Pediatrics, “Poverty and Child Health”
American Progress, “How To Ease the Nursing Shortage in America”
CDC, “School Nurses Help Keep Students Healthy”
Children’s Hospital Association, “Children’s Hospitals Work to Address Nursing Staffing Challenges”
Elsevier, “Nurses are vital in safeguarding children against COVID fallout”
Harvard University Center on the Developing Child, “Lifelong Health”
Healthline, “Understanding the American Nursing Shortage”
Local 21 News, “Home nurse shortage affecting families”
McKinsey, “Assessing the lingering impact of COVID-19 on the nursing workforce”
National Association of Pediatric Nurse Practitioners, “NAPNAP Addresses Promoting the Pediatric Nurse Practitioner Workforce Pipeline”
National Library of Medicine, “Nursing Shortage”
New York Times, “To Keep Their Son Alive, They Sleep in Shifts. And Hope a Nurse Shows Up.”
ProQuest, “Predictable Consequences – How Do We Avert a Pediatric Nurse Shortage?”
Statista, “Share of child population in the total U.S. population from 1950 to 2020”
The Conversation, “1 in 6 kids are in families below the poverty line”
U.S. Bureau of Labor Statistics, “Fastest Growing Occupations”
U.S. Bureau of Labor Statistics, “Registered Nurses”
19th News, “Why the nursing shortage isn’t going away anytime soon”