Current Issues in Nursing Part 1: Staffing Shortages & Mental Health Struggles

By Jordan C. Kabins, Ph.D., MBA

Introduction

Did you know that in 2023, one in four nurses in the U.S. planned to leave the profession?

Hospitals and nursing associations have been sounding the alarm about the urgent and escalating staffing shortages across healthcare settings globally. This is not a problem we can afford to ignore. The issue, which predates the COVID-19 pandemic, has only worsened in its wake. It's a complex issue deeply ingrained in the structure of the healthcare system, and it demands our immediate attention and understanding of its root causes.

Why is there a Nursing Staffing Shortage?

The nursing industry's staffing shortage is a complex issue that requires urgent attention. We all need nurses at some point or another. Nurses provide essential care, often in life-or-death situations, and their role is fundamental to the health and well-being of individuals. The shortage of nurses not only affects the healthcare system but also directly impacts patient care, potentially leading to longer wait times, decreased quality of care, and increased risk of medical errors. Improving the nursing profession ultimately strengthens the entire healthcare system.

Several factors drive staff shortages. First, the nursing workforce is aging. The majority (85%) of nurses are women between the ages of 25 and 44—many of whom are within the childbearing age group. While family events like pregnancies are celebrated, they also contribute to the growing gap in staffing when nurses take time off. However, this is just one piece of a much larger puzzle. Recent surveys regarding the nursing workforce have shown that the population is shifting, with the average age of LPNs in 2022 being 50-54 years compared to 65 years of age in 2020. The same can be said about the gender of LPNs, the percentage of male LPNs has increased from about 7.5% in 2020 to nearly 10% in 2022 (Smiley et al., 2023).

The root causes of the staffing shortage are deeply tied to the nature of the nursing profession itself, a culture of burnout, and systemic issues within healthcare. These systemic issues can include inadequate funding for healthcare institutions, lack of government support for nursing education, and a hierarchical structure that often undervalues the contributions of nurses. To address this, we must look closely at how job demands, inadequate training, and a lack of institutional support exacerbate these ongoing problems.

The Demands of the Nursing Profession

Nursing is a profession that demands not just physical stamina, but also emotional resilience. It's not just about clinical care, but also about managing emotional challenges, physical exhaustion, and administrative duties. This multifaceted workload, while rewarding, can also be taxing, leading to high burnout and attrition rates.

While many professions can be stressful, few are as physically dangerous. Nurses often face exposure to infectious diseases, putting their health at risk and, in turn, exposing their families and communities to potential harm (Falahat et al., 2021). This constant stress wears on nurses mentally and physically, and it is time society begins viewing them through the same lens as first responders—firefighters, law enforcement, and military personnel. All these professions face risks to their health, experience high levels of burnout, and have higher rates of PTSD, depression, and anxiety.

Nurses are tasked with balancing patient care, emotional support, physical demands, administrative responsibilities, and constant communication with medical teams. This level of responsibility requires multitasking, quick decision-making, and emotional resilience. When understaffed, nurses are expected to meet these demands without the necessary support, often resulting in burnout and a cascading effect on the work environment. Without proper coping strategies for stress and conflict management, this leads to a cycle of emotional exhaustion, and eventually, nurses quit the field (Sheppard et Al., 2022).

The Hospital Working Environment

Research has shown that poor working conditions significantly contribute to nurse turnover. In a 2023 study, nearly 41.4% of nurses left their positions due to feeling overworked, and many cited low wages and lack of opportunities for advancement as key reasons for their departure. Similarly, nurses left their roles in South Korea due to poor work environments and limited career progressions following multiple SARS outbreaks (Park & You, 2023).

Hospitals and healthcare organizations need to understand that improving the work environment is not just about meeting basic needs. It's about creating a supportive and motivating culture that values the contributions of nurses and prioritizes their well-being. This is a crucial step in reducing turnover rates and ensuring a more robust and effective healthcare system.

As an Industrial and Organizational Psychologist, nurses must be empowered to participate in hospital affairs and see their input valued are more likely to experience greater job satisfaction and, in return, produce at a higher level for their employers. This, in turn, can reduce turnover rates. Nurses need a work environment where their emotional well-being is prioritized, and they are given opportunities for professional development.

A study by Torlak and Göktepe (2024) found that nurses are most satisfied when they feel included in decision-making, are satisfied with their workplace, and have access to career growth opportunities. Nurses who perceive a positive working environment report a better overall quality of life, suggesting hospitals should invest in improving their organizational culture and nurse leadership development.

Conclusion

The nursing shortage is a pressing issue rooted in systemic challenges, burnout, and poor workplace conditions. By addressing these factors, healthcare organizations can create supportive environments that retain nurses, ensuring a more robust and effective healthcare system that would benefit everyone.

Citations

Falatah, R. (2021). The impact of the coronavirus disease (COVID-19) pandemic on nurses’ turnover intention: an integrative review. Nursing Reports, 11(4), 787-810.

Lavoie‐Tremblay, M., Gelinas, C., Aube, T., Tchouaket, E., Tremblay, D., Gagnon, M. P., & Côté, J. (2022). Influence of caring for COVID‐19 patients on nurse's turnover, work satisfaction and quality of care. Journal of nursing management, 30(1), 33-43.

Park, Y. D., & You, S. J. (2023). Effect of the Nursing Work Environment on Turnover Intention: Serial Mediation Effects of Career Motivation and Job Satisfaction. Journal of Korean Academy of Nursing Administration, 29(5), 529-539.

Sheppard, K. N., Runk, B. G., Maduro, R. S., Fancher, M., Mayo, A. N., Wilmoth, D. D., Morgan, M. K., & Zimbro, K. S. (2022). Nursing Moral Distress and Intent to Leave Employment During the COVID-19 Pandemic. Journal of nursing care quality, 37(1), 28–34. https://doi.org/10.1097/NCQ.0000000000000596

Smiley, R. A., Allgeyer, R. L., Shobo, Y., Lyons, K. C., Letourneau, R., Zhong, E., ... & Alexander, M. (2023). The 2022 national nursing workforce survey. Journal of Nursing Regulation, 14(1), S1-S90.

Torlak, K., & Göktepe, N. (2024). Effects of individual, institutional and nursing work environment variables on nurses’ quality of work life. International Journal of Healthcare Management, 17(3), 624-632.