Hiring in Healthcare: Does a Nursing Shortage Exist?
There’s a nursing shortage! I don’t know when I started hearing about it, but it was probably in the early 2000’s right before I set off for college. I distinctly remember hearing that nursing was a great career choice. And I once considered pursuing it–even after the movie, Meet the Parents, played up the stigma around male nurses. There was a shortage of nurses, I was told. There was good pay and job security, and it was a respectable vocation.
I didn’t go into nursing, but I continued to hear about the shortage of nurses, and I believed the stories. In fact, I still hear about it today. So I thought I’d take a closer look at what’s driving the shortage , since employment trends and hiring challenges are kinda my thing.
The Nursing Shortage is Complex
I had no reason to doubt the nursing shortage. I expected to find clear reasons behind it, and I was hoping to come up with a few solutions to address the challenges. Most articles made a simple, straightforward (and quite urgent) case that there is and/or will be a shortage of nurses. It’s an easy story to tell that gets people’s attention–the type of story that when told frequently will eventually evolve into common knowledge.
However, I quickly discovered that the nursing shortage is not straightforward. It’s a multifaceted issue with many viewpoints and considerations that don’t make it into our newspapers or favorite news sites. Trying to make sense out of the disparate views was challenging. Researching this topic was confusing to say the least.
Past studies predicted a shortage that never came. There are stories of nurses who left the profession because they could not secure a position. Some studies are conducted by organizations that likely have a conflict of interest. And in 2017, the U.S. Health Resources and Services Administration (HRSA) predicted a surplus of nurses for 2025! And yet, the prevailing coverage is: “it’s a well-known fact that the U.S. suffers from a nursing shortage.”
To be fair, predicting the future is not easy. You use the information you have at hand, and your predictions can only be as accurate as that information. However, it seems that too many stories on the nursing shortage are either omitting crucial information, or worse, misrepresenting the facts. To better understand the nursing shortage (or lack thereof) it’s helpful to consider the following perspectives:
Delayed Retirement of Baby Boomers
“The nursing shortage is real…or at least it will be.”
Proponents of this perspective believe that all the talk in the early 2000’s and today about a looming nursing shortage was accurate; however, a generational change in views on retirement combined with the economic realities of a post-recession world caused many veteran nurses to delay retirement or rejoin the workforce.
It is true that the baby-boomer generation is retiring later in life than predicted. This is the case for the majority of occupations, not just nursing. However, they will retire at some point (and eventually require more healthcare). According to a National Nursing Workforce Study, 50% of nurses are age 50 or older, which means a significantly larger portion of nurses are closer to retirement than are not. So it makes sense that a shortage could occur when a large increase in healthcare demand coincides with a large decrease in nurses.
Underserved Areas
“The nursing shortage is real…but it depends on location.”
Smaller towns and rural areas often struggle to find workers when compared with larger, metropolitan areas. Many nursing graduates or re-locating nurses may find it difficult to secure a job in a particular metropolitan area. This does not mean that a shortage of nurses doesn’t exist, it simply means that to find job opportunities, job seekers must be willing to commute or relocate–many are not.
Unfortunately, this fact is seldom disclaimed alongside proclamations of a nursing shortage, and nursing graduates are often blindsided when local demand for nursing is non-existent. According to the HRSA, only seven states are predicted to carry a nursing shortage through 2030: California, Florida, New Jersey, Ohio, South Carolina, Texas, and Virginia.
Artificial Shortage
“The nursing shortage is FAKE NEWS…hospitals want to ensure a surplus of nurses.”
Some of the more cynical may posit that the nursing shortage is part of a conspiracy led by hospitals. The thinking goes that if a hospital can ensure a surplus of nurses (its largest employment cost), then it can better control overall operating costs. Without a single, unified nurses union in the United States, a labor surplus provides hospitals with leverage in establishing wages, hours, benefits, and working conditions.
Would hospitals prefer to have too many nurses rather than too few? The answer is most certainly, yes. Are hospitals overselling or even lying about a shortage? With changes in healthcare legislation, an economic recession, and a generational movement away from previous notions of retirement, it is more likely that the complexity of the issue has caused the disconnect between studies, predictions, and reality.
So…does a real nursing shortage exist? Is it looming?
The above perspectives are just a few examples that add color to stories around the nursing shortage. While claims of a nursing shortage may sound like “crying wolf” to some, healthcare continues to grow faster than any other industry, and any change in the supply of nurses (entry of new graduates or the exit of retiring nurses) could quickly make a nursing shortage a reality.
So I predict that we will continue to see news stories and press releases that announce an emerging nursing shortage. I also suspect that the reasons for the shortage will begin to vary–a lack of nursing faculty and lower acceptances/enrollments at nursing schools seems to be the popular cause for concern today. However, regardless of how the story trends, there are a few key takeaways for employees and employers.
What you need to know about the nursing shortage:
- For aspiring nurses: Understand how the demand for nurses will vary by region. Finding the right job may require moving to the right region. Additionally, depending on the area, available nursing positions may vary by specialty; it may be necessary to target more niche areas of nursing and to look beyond hospitals, especially for those who are just starting their careers.
- For employers: Invest more resources in recruiting qualified applicants to “shortage areas.” This could include partnering with local governments and educational institutions to develop strategies for attracting talent. Of course, more attractive and competitive compensation packages will also be necessary to retain talent. This is especially true if nursing shortages begin to develop in more attractive areas.
Both employers and employees alike must understand the reality as it relates to their particular set of circumstances. When employers, employees, job seekers, and students can separate crisis from “crying wolf”, everyone is in a better position to make employment decisions that advance their respective goals.
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