THE CAUSE AND EFFECT OF NURSING SHORTAGES

Nguyen 1

Abstract
Nursing as a profession is where health care focuses on the care of its patients to maintain their
optimal health and achieve the highest quality of care. Nursing has now become one of the
fastest growing professions throughout the world and is constantly in demand. An estimated four
million additional nurses are needed and the ratio of patient to nurse is staggering. The need for
nurses becomes more crucial, as the population ages. In addition, the population is rapidly
increasing, which leads to more people needing healthcare. Even with rapid advances in medical
sciences and technology, the current healthcare system has been proven to be unsuccessful in
providing high quality care to all because the shortage of nurses continues to increase. The goal
of education is to help students strive for their future careers and help support their personal
development. Solving this problem should be one of societys top priorities.

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Nguyen 2

Nursing is a profession where health care focuses on the care of its patients to maintain
their optimal health and achieve the highest quality of care. Nursing has now become one of the
fastest growing professions throughout the world and is constantly in demand. According to the
U.S. Bureau of Labor Statistics, Registered nurses represent the largest profession within the
U.S. health workforce, with over 2.7 million RNs employed in 2010 (Spetz, 2014). That
statement alone shows how important health care is and the constant need for registered nurses.
The day when people stop caring about their health will be the day registered nurses will not be
in demand. According to the World Health Organization, an estimated four million additional
nurses are needed and the ratio between patient per nurse are staggering. One of the biggest of
many problems in the medical field is that the United States are experiencing a critical shortage
of registered nurses and is only getting worse. By 2012, there will be an estimated one million
vacant positions for registered nurses, and approximately 40% of employed registered nurses
will be over age 50 (Cohen, 2011). Due to the shortage of nurses, society has made an effort to
resolve the decline in the nursing profession. This paper will discuss how the depletion of nurses
is causing an impact on the education of nursing practice, nursing as a career, the criteria to
become a registered nurse and the opportunity for younger registered nurses.
Shortages of Nurses
One of the major contributors to the shortages of nurses is the increasing size of our
population. An increase in population leads to more people demanding health care. Most people
dread getting sick or injured, but it is inevitable and they may require medical attention
depending on the severity. The population today consists primarily of Baby Boomers. Baby

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boomers are adults born [between] 1946 and 1964[...] making up 45% of the U.S population
(Weigelt, 2012). Healthcare will need to expand in order to ensure quality care for adults ages
65 years and older. Diseases and illnesses are major concerns. The most detrimental of all are
cancerous diseases. The most common and leading cancer in women is breast cancer, facing
44.2 percent [of the population] aged 65 or more and 22.5 percent [of the population] aged 75
or more years [are affected with breast cancer] (Anderson, Blair, Folsom, Lazovich, Sweeney,
2004). The leading cancer in men is prostate cancer estimating 2,617,682 men currently living
with prostate cancer in the United States (National Cancer Society). Patients with cancer are
more likely to have treatment with minimal chance of benefit rather than people who do not have
cancer. With a large portion of the population affected with cancer, more nurses are needed to
care for these patients. However, the problem is that there are not enough nurses to properly treat
all of them. Nursing is a high stress field requiring nurses to be fast paced and capable of
multitasking. This is one of the reasons why nursing as a career is difficult.
The Decline of Nursing as a Career
Nurses are expected to provide optimal care by ensuring the patients safety and recovery
from illnesses. A study done by the National Cancer Society indicated more patients are dying
due to the lack of qualified professionals. According to Joint Commission on Accreditation of
Healthcare Organizations, 1,609 hospital reports of patient deaths and injuries [have occurred]
since 1996 and found that low nursing staff levels were a contributing factor in 24% of the
cases.
As a result, nurses have to cope with the stress the job entails. With rapid advances in medical

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sciences and technology, the current healthcare system has been proven to be unsuccessful in
providing high quality care to all. The shortage of nurses demands that a specific protocol take
place, which is to give priority to the most ill patients. [A] study indicated that every extra
patient added to a nurses average workload increases the chance of [...] patients dying within 30
days of admission by 7 percent (Patients more likely to die, 2014). The result shows that
nurses are losing their integrity because of the stress of having a patient die. Maintaining
integrity is essential because it defines a professions identity, autonomy, goals and expectations.
Integrity in nursing requires nurses to practice in accordance with the standards and values of the
professions particular code of ethics. Aarons and Sawitzky (2006) state, Professional integrity
of nurses has been destroyed and consequently they have become more susceptible to anxiety,
stress and exhaustion, potentially affecting care delivery (35). Thus the interactions with the
patients lead to reasoning, emotional, and behavioral alterations because of the failure in
providing optimal care for the patients. It has become difficult to maintain high professional
standards when the demands are constantly increasing causing high levels of stress in healthcare
professionals. Stress refers to a dynamic interaction between the individual and the environment.
High levels of stress can have negative effects that can lead to a decrease in performance.
Nurses experience a lot of hardship and dealing with stress is only a small fraction of the many
problems nurses have to encounter. McIntosh & Sheppy (2013) note, Nurses need to develop
effective coping strategies to manage stress. Considering the responsibilities of registered
nurses is vital, and minimizing the stress on nurses will help provide high-quality care to
patients. This is where the experience, the knowledge and the ability to cope with stress play a

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role in becoming a successful nurse.

Lack of Opportunity for Younger Nurses
Nursing is a profession as well as a passion. Some nurses remain dedicated to their field
for as long as possible. Within 10 years, 40 percent of working RNs [Registered Nurses] will be
50 years or older (National Cancer Society). Organizations tend to keep older registered nurses
for their extensive knowledge, critical thinking capabilities, and excellent patient care skills of
experienced nurses (Hendren). Older nurses have an advantage over the newer nurses which
results in a shortage of nurses. The nursing faculty shortage is due to [...] an aging faculty, a
reduced younger faculty hiring pool, decreased satisfaction with the faculty role, lack of funding
and poor salary (Nardi & Gyurko, 2013). Hospitals prefer nurses with a high level of
experience to work with patients and keeping older experienced nurses provides hospitals with
less risk, rather than to invest in new inexperienced nurses. Hiring a large group of new nurses
could be costly due to the training involved and the lack of a budget. By 2012, the AACN
reported that there was a 7.6% national faculty vacancy rate (AACN 2012). Hospitals
preference in experienced nurses means that new nurses are out of jobs. One possibility for
nurses being out of work is that higher standards and criteria are now implemented in order to
put out quality nurses.
Harder Criteria for Registered Nurses
The curriculum for nursing tends to be more competitive even with shortages of nurses
being a problem. Over 75,000 qualified applicants to nursing programs in the United States
alone are turned away each year (Nardi and Gyurko, 2013). Applicants are turned away due to

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the lack of nurses, faculty, clinical sites and inadequate budgets. The goal of education is to
help students strive for their future careers and as well help support their personal development.
The lack of training causes a shortage of incoming nurses achieving their goals. Academically,
nurses are required to apply their knowledge toward the work field to collaboratively solve
problems and reflect on their experiences in the clinical practice. The performance of nursing
requires a cognitive ability that includes problem solving, decision-making, and clinical
judgment. (Gabr & Mohamed, 2011). Current nursing education appears to be set in a 19th and
20th century style, in which the student nurse follows a clinical instructor around the hospital for
instructions to achieve experience. As students follow the instructor to gain experience, this
procedure could help benefit the student in acquiring knowledge. On the other hand it could be
disadvantageous because it is costing more money just to chaperone a student nurse. Nursing
education, with the additional clinical practices, is very expensive and time-consuming. Limited
faculties means there would be limited seats and clinical sites, therefore making it tougher for
nursing students to further their education. With fewer students admitted, more applicants are
turned away.
Nursing school has a limited admittance rate because of the curriculum and standards.
Admission into a nursing program is getting more competitive because of the responsibilities the
position entails. According to CSUSB Department of Nursing, a guaranteed admission requires:
high school cumulative weight GPA of 3.5 or higher, 1100 or higher on the SAT I (only in critical
reading and math scores), 26 or higher on the ACT, and needs to top 10% of final High School
Graduating Class rankings. These requirements display the competitiveness the admittance into

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the nursing program entails. The requirement for Bachelors of Science in Nursing at California
State University of San Bernardino is as follows: one must have a C or better in all courses
prerequisite to the major and a completion of the ATI-TEAS pre-admission examination. Nursing
school requirements are not growing fast enough to meet the projected demands for registered
nurses. A shortage of nursing school faculty is restricting nursing programs enrollment.
Insufficient staffing is impacting the field because it is raising stress levels for nurses prompting
many nurses to leave their profession.
Although there is a call for higher education, the nursing workforce is shrinking due to
the associate degree program model. In the United States more than half of nurses only have
an associate degree in nursing. Today, the required educations for nurses have increased. The
author noted at the Roanoke, Virginia Carilion Health System, Only 25.9 percent of nursing
staff at the health system held baccalaureate degree in nursing or higher (19). The author
explains that the education level for nursing has a higher demand. Hospitals are expecting more
nursing staff to have a minimum of a baccalaureate degree. Nursing organizations have
recommended the Bachelor of Science in Nursing (BSN) for years but the problem is obtaining
the associate of science in nursing (ASN) degree. Nurses need to pursue higher education to
lessen the shrink of faculty shortage.
Raising the education requirement makes things more complicated for students. Students
must pass an entrance exam to qualify for the nursing program. With shortages already being a
problem, undergraduate programmes require evidence of baseline numeracy skills as a
condition of entry (83). The numeracy focuses on the development of mathematical skills,

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reviewing some basic mathematics principles and applying these calculations encountered in
clinical practice. According to universities, the numeracy test opens a bigger gap to higher
education for nursing students. Students noted that schools that offer these entrance tests found it
to be an issue. Results showed that the program had short- and medium-term success in helping
students to prepare for the numeracy entrance test and developed students confidence and selfesteem in relation to their numerical ability (Dray, Perkins, Faller Fritsch & Burke, 2010).
Education for nursing is important because it allows students to have a well-rounded
background. This positively influences nursing students to think in a higher order such as
creative thinking, problem solving, logical thinking and decision-making (Gabr & Mohamed,
2011).
By the results the shortage of nurses is impacted in every aspect. The need for nurses is
crucial because healthcare is important. A shortage of nurses defeats the goal of nurses providing
optimal care and causes a decline in nursing as a career. For example, raising the educations
requirement will make things more complicated for nursing students, such as, creating a
competitive admittance into nursing school. A study done by the National Cancer Society
indicated more patients are dying due to the lack of qualified professionals causing the healthcare
system to be unsuccessful in providing high quality care to all. Older nurses with high levels of
experience cause hospitals to have less of a preference of hiring new nurses affecting the chances
for new graduates. Nursing has now become one of the fastest growing professions throughout
the world and is constantly in demand.

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