The Nursing Shortage in the U.S. and Its Impact on Patients

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A nurse cares for a smiling patient.

The demand for nursing talent sharply outpaces supply, with a projected need for 3.6 million registered nurses (RNs) by 2030, according to a report by the U.S. Department of Health and Human Services. This shortage intensified during the coronavirus pandemic, an issue that compelled the American Nurses Association (ANA) to send a letter to the U.S. Department of Health and Human Services (HHS) in 2021 asking the department to call the nursing shortfall a national crisis.

The nation also faces an estimated shortage of between 37,800 and 124,000 physicians by 2034, according to the Association of American Medical Colleges (AAMC). These shortfalls are already negatively affecting the nation’s health care system, with staffing shortages leading to nurse burnout. The shortages are affecting rural communities especially.

This means ample opportunity for prospective nurse practitioners (NPs) equipped with a Master of Science in Nursing (MSN). With the U.S. Bureau of Labor Statistics (BLS) projecting 52% job growth for NPs between 2020 and 2030, future nurse leaders will be in a unique position to shape the future of health care delivery.

Factors Influencing the Nursing Shortage

One of the biggest factors associated with the nursing shortage in the U.S. is the aging of the American population. The U.S. Census Bureau predicted that an estimated 73 million Americans will be 65 and older by 2030.

However, while baby boomers’ retirement is the most cited reason for the impending nursing shortage, several other factors contribute to the gap. According to research by the National Council on Aging (NCOA), 80% of retirees have at least one chronic condition and 68% have two persistent illnesses and require more service compared to patients with one illness. Additionally, some states have experienced steep population growth, and a great number of those individuals now qualify for affordable health care. Many of the nurses qualified to handle this increased workload will soon retire.

Nursing represents the largest occupation in the U.S. Despite this, unfilled job openings continue to rise. Current shortages have already left a significant number of communities underserved. This is particularly significant in rural areas, where the residents are typically older than those in urban areas, according to data gathered by the Rural Health Information Hub. A continued staffing shortage will force the federal government to declare more underserved communities as health professional shortage areas (HPSAs).

Researchers forecast varying shortage levels and propose different solutions for the talent problem. The current nursing shortage is sporadic, being prevalent mostly in rural communities. Some nursing advocates propose that a single national licensing standard will alleviate this circumstance, citing that many advanced practitioners avoid working in communities that limit the scope of nursing practice.

ANA proposes that private and government institutions offer incentives to encourage nurses to work in underserved communities and nurse educators to develop talent from within those populations. As a short-term solution, some health care advocates recommend merging existing talent pools into larger teams with clear and newly defined job responsibilities.

Impact of the Shortage on Nursing Schools

America’s nursing schools must produce a large group of trained staff members in an extremely short amount of time. Schools and medical institutions do what they can to encourage nursing as a career, but the outlook for the future is uncertain.

Many nurse educators will also retire soon, making it difficult for schools to train new nurses. Even if schools were able to train enough talent, care providers are reluctant to hire so many untrained nurses without veteran staff to supervise them.

The shortage persists, despite the sharpest enrollment gains that nursing programs have experienced in years. According to the American Association of Colleges of Nursing (AACN), 2020 enrollment in bachelor’s, master’s, and doctoral programs increased by 5.6%, 4.1%, and 8.9%, respectively.

Understaffed nursing schools have had to turn prospective students away, despite warnings by industry watchdog groups that schools will have difficulty producing sufficient candidates within the remaining time frame. This is perhaps the most damaging roadblock to nurse candidate advancement.

Due to faculty shortages, U.S. nursing programs turned away more than 80,000 academic candidates in 2019, per the AACN. The schools reported more than 1,600 full-time vacancies going into the 2014-15 academic year. Also, more experienced nurses have waited until later in their careers to pursue advanced specialties.

Impact of Nursing Shortage on Patient Care

The lack of nurses can have a debilitating effect on patient care. It means that fewer nurses must care for more patients, possibly leading to an increase in errors and higher rates of mortality and failure-to-rescue situations.

This nursing shortfall can lead to more errors and higher patient fatality rates. It can also lead to lower patient satisfaction rates and increased dissatisfaction among the nurses themselves. Overworked caregivers who are unable to take time for themselves can experience compassion fatigue and suffer from a lack of sleep.

Rural areas face an even greater challenge as fewer health care practitioners choose to live in these communities. Hospital closures in rural communities have also led to a shortage of care providers and limited access to health care. Programs that are designed to give medical and nursing school graduates incentives to assume positions in rural areas can help increase the level of care available to these communities, but those programs aren’t meeting the need.

One solution may be to give nurses the right to provide broader care, which can help alleviate the pressure on rural physicians.

How Nurse Leaders Can Help

Nurses in leadership positions can work to lighten staff workloads as much as possible to help prevent burnout. They need to promote professionalism, teamwork, and clear communication so nurses willingly help one another in busy times. A nurse leader needs to be able to juggle numerous tasks, ranging from delegating responsibilities and creating shift schedules to overseeing patient care.

NPs can assume many of the tasks that are traditionally left to physicians. While some states allow NPs to evaluate and diagnose patients, order and assess patient tests, and prescribe medications, other states and territories require them to work with a doctor in one form or another.

NPs can lessen the load on physicians by caring for adults with chronic conditions, such as diabetes and hypertension. To become an NP, a nurse must earn a Master of Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) in addition to completing additional training.

Another factor contributing to the nursing shortage involves the number of academic nursing faculty. This number is declining as many teachers reach retirement age themselves. With fewer nursing instructors, fewer nursing students can be accommodated. Becoming a nursing instructor can help alleviate this shortage, thereby allowing for more registered nurses to enter the workforce. Nursing professors need at minimum a master’s degree in nursing as well as several years of clinical experience.

Shape the Future of Health Care

Those now entering advanced nursing have the unique chance to help decide the next stages of a crucial industry. By coming into the field at a moment when professionals are in high demand, they can emerge as leaders in the push toward more effective patient care and improved outcomes.

Ohio University’s fully online MSN program is designed to meet the needs of practicing RNs like you: hardworking professionals with the drive to advance their expertise. The robust core curriculum integrates advanced nursing theory with evidence-based nursing practice, allowing you to immediately apply new skills in the field. Learn how Ohio University can help you become a leader in a field primed for new leadership.

Recommended Readings

Healthy Exercise and Nutrition Guide for Nurses

Nurse Burnout Prevention Strategies for Nurse Leaders

Bedside Nursing: Key Roles and Responsibilities for Nurses


American Association of Colleges of Nursing, Nursing Faculty Shortage

American Association of Colleges of Nursing, Nursing Shortage

American Association of Colleges of Nursing, Student Enrollment Surged in U.S. Schools of Nursing in 2020 Despite Challenges Presented by the Pandemic

American Association of Nurse Practitioners, State Practice Environment

Association of American Medical Colleges, AAMC Report Reinforces Mounting Physician Shortage, HSPA Find

Healthcare Finance, “Nurses Urge HHS to Declare the Staffing Shortage a National Crisis”

National Center for Biotechnology Information, “Nursing Shortage”

National Council on Aging, The Top 10 Most Common Chronic Conditions in Older Adults

Rural Health Information Hub, Demographic Changes and Aging Population

United States Census Bureau, By 2030, All Baby Boomers Will Be Age 65 or Older

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

U.S. Department of Health and Human Services, Supply and Demand Projections of the   Nursing Workforce: 2014-2030