Current Issues in Nursing Part 2: Gaps in Education and COVID-19

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

Introduction

Nursing is currently grappling with a series of intricate challenges that are significantly impacting job satisfaction and retention. These include education gaps, which the COVID-19 pandemic has exacerbated, and the critical need for organizational support. It is imperative that we address these areas with a sense of urgency to sustain a robust healthcare workforce and ensure optimal patient care. Your role in advocating for systemic changes is crucial in this process.

Gaps in Education

A gap in nursing education is one often overlooked factor contributing to the nursing shortage. In recent years, over 80,000 nursing applicants were turned away due to a shortage of educators (Flores-Montoya & Burwell, 2022). The role of these educators is crucial in shaping the future of nursing, as they are the ones who impart the necessary knowledge and skills to the next generation of nurses. Without enough qualified instructors, there are not enough new nurses entering the workforce to replace those who retire or leave the profession.

The diversity in nursing education—from Associate Degrees (ADN) to Doctorates (DNP)—complicates matters. Each hospital may hire nurses with different levels of training, and without standardization, it is difficult for healthcare organizations to know exactly what skills their nurses possess. Therefore, there is a need for standardization in nursing education to ensure that all nurses, regardless of their level of training, possess the necessary skills and knowledge. This variability in training and certification creates a disconnect between what nurses learn in school and the specific needs of the hospitals that employ them. It is important to note that nursing is becoming more specialized in training and function.

Moreover, nursing education does not always adequately prepare students for the emotional and psychological challenges of the profession. For example, many nursing programs focus on technical skills without addressing the mental health challenges nurses will face, such as moral distress and burnout. When do nursing schools emphasize being able to handle the psychological stressors of the occupation when they have so much information, skills, and policies to cover before preparing nurses for licensure exams and not the real thing? What was once "learned on the job" is no longer sufficient.

The COVID-19 Pandemic: A Catalyst for Change in Nursing

The COVID-19 pandemic placed immense pressure on nurses, exposing critical vulnerabilities in healthcare systems. Beyond physical risks, nurses faced moral and emotional distress as they navigated overburdened environments with insufficient resources.

One major challenge was moral distress, exacerbated by shortages of personal protective equipment (PPE) and chronic understaffing (Hoernke et al., 2020). Many nurses were forced to compromise standard infection protocols, creating ethical dilemmas that weighed heavily on their mental health. Balancing patient care, personal safety, and professional standards under these circumstances often leads to feelings of guilt, helplessness, and exhaustion (Buheji & Buhaid, 2020).

The long-term effects of this distress have significantly impacted job satisfaction. Already a profession prone to burnout, nursing saw heightened disillusionment and emotional strain levels during the pandemic (Taylor et al., 2019). Many nurses reported feeling unappreciated and overwhelmed, further contributing to turnover rates in a field grappling with a workforce shortage.

To address these challenges, systemic support for nurses is not just important, it is essential. Providing adequate resources, such as PPE and sufficient staffing, ensures they can safely fulfill their responsibilities. However, it is not just physical resources that are needed. Mental health support and resilience training are also crucial for helping nurses cope with the psychological demands of their work. The urgency and importance of advocating for more resources and initiatives in this area cannot be overstated. Equally important is empowering nurses by including them in decision-making, fostering a sense of autonomy and belonging.

The pandemic underscored the importance of addressing the root causes of nurse burnout and dissatisfaction (Smiley et al., 2023). By creating supportive, resource-rich environments and prioritizing mental health, healthcare organizations can retain nurses and improve patient outcomes. Investing in the well-being of nurses is no longer optional—it is critical for the sustainability of the healthcare system.

The Need for Organizational Support

Nurses need more than technical training—they need emotional and psychological support. Healthcare organizations must provide resources to help nurses cope with their work's mental and emotional challenges (Hofmeyer & Taylor,2021). This includes access to mental health services, opportunities for professional development, and training on handling moral distress.

The organization's support is not just beneficial, it is crucial in preventing burnout and promoting nurse retention. Nurses need to feel valued, supported, and empowered. Your role in fostering a healthy workplace culture, advocating for mental health resources, and promoting ongoing training will improve job satisfaction and patient outcomes and contribute to the healthcare organization's success.

Before the pandemic, research highlighted the importance of organizational support in nursing. However, the COVID-19 crisis has underscored the urgency of providing these resources. Nurses look to their employers for support in managing stress and burnout, and organizations prioritizing this will see higher retention levels and better overall outcomes (Diehl et al., 2021).

There is also a cultural shift, with people (Millenials and Gen Z) looking towards their employers for support, and the first healthcare corporation that facilitates this will be ahead of the curve.

Conclusion

The challenges facing the nursing profession, from education gaps to pandemic-induced pressures, underscore the urgent need for systemic change. By addressing these issues through improved education, better organizational support, and responsive leadership, healthcare systems can enhance nurse satisfaction and retention. Investing in the well-being of nurses is essential—not just for their health but for the sustainability of the entire healthcare system.

Citations

Buheji, M., & Buhaid, N. (2020). Nursing human factor during COVID-19 pandemic. Int J Nurs Sci, 10(1), 12-24.

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social and organizational resources. PloS one, 16(1), e0245798.

Fan, S., Zhou, S., Ma, J., An, W., Wang, H., & Xiao, T. (2024). The role of the nursing work environment, head nurse leadership and presenteeism in job embeddedness among new nurses: a cross-sectional multicentre study. BMC nursing, 23(1), 159.

Hofmeyer, A., & Taylor, R. (2021). Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practising in the era of COVID‐19. Journal of clinical nursing, 30(1-2), 298-305.

Flores-Montoya, A. & Moulton Burwell, P. (2022). Washington State Nursing Education Trend Report Academic Years 2014-2020. Published at Washington Center for Nursing.

Taylor, R. A. (2019). Contemporary issues: Resilience training alone is an incomplete intervention. Nurse education today, 78, 10-13.