A Great article about quelling the nursing shortage. Short and sweet

[Doctors of Nursing Practice, Inc.]

Have a look at this article shared by a colleague in INANE (International Academy of Nursing Editors). Click here to view this article. What are your thoughts?

[Gabriela Baker]

Nursing shortage has been a problem for a long time. It seems that there are never enough of us, like the article states. One way that enticed students to choose nursing during the war was to offer nursing education free to students willing to serve in the army as nurses. In today’s world one way to encourage more students to choose nursing is to make schooling more cost attainable. Many students today are terrified of getting into student loan debt especially after seeing how the recession in 2008 left many new graduates without job prospects. Showing students the job security that a career in nursing can offer and the different areas of work they can do as a nurse will help to entice more students into choosing it as a career. Also reducing the cost of higher education would enable more students to choose nursing. However, I have read in many articles that some nursing programs are having to turn away qualified students because there is a lack of educators and clinical rotation spots to place students in. Even while I was in school, there was difficulty attaining clinical rotation spots in certain areas that are needed in order to complete a nursing degree. Having more areas open to the idea of having students in their site for clinical rotations would help to solve the issue of limited rotation spots creating room for additional students. These are all suggestions that I’m sure have been tried and new solutions are always being thought of. In the meantime, nurses currently in the field can encourage students to choose careers in nursing to help with the shortage.

[Ji B.]

Like many ideas near the beginning of the pandemic in the US, this article provides some very good, albeit possibly idealistic, suggestions for how to address nursing shortages specifically. The part that was most impactful was the discussion on how barriers to the nursing profession need to be removed immediately; this is because it took a pandemic in order for anyone to consider that there are too many barriers to becoming a nurse of any level, and to practice accordingly, which applies to education in general within the States. One such barrier is the shortage of nursing educators in the field, as Gabriela addressed in her response, which creates a sort of catch-22 situation where a shortage of nurses is always inevitable. Adjusting state practice regulations for nurse practitioners may help address both parts of that situation (broadening an NP’s scope of practice could include teaching privileges). The author’s suggestions of utilizing senior nursing students for some of the more basic hospital care, and setting up a national nursing reverse corps could help address the issues surrounding the nursing shortage as well.

• This reply was modified 4 years, 3 months ago by Ji B..

[Avery H.]

The nursing shortage, that has been echoed throughout our undergraduate education, which continues to echo now throughout our graduate programs and APRN practice, finds itself on centerstage once again but this time it’s hard to ignore it or drown it out due to the fact that we are in the middle of the coronavirus pandemic and the shortage of nurses is apparent now more than ever. I love that this article mentions the history of our nation and how we dealt with war and previous health crises. I also appreciate the recruitment tactics that were mentioned because I believe that it had a huge role to play in the nursing shortage now and then. When dealing with a pandemic or anything that you haven’t experienced before, I believe it is important to learn from the past as much as you can but also be creative and open-minded to new ways to solve a problem. Although circumstances may not be ideal, it provides you with an opportunity to move away from the thought process of “things have always been done this way,” and allows for more innovation. A nurse reserve list or group to assist and respond to healthcare emergencies is a great idea, I’m not sure how it would work, but I love the thought. Moving forward, I think we need to continue to identify and dismantle the segregation, discrimination, racism, and any other barriers that prevent the progression of our nursing profession. In addition to identifying and dismantling the barriers, we need to also create new initiatives and be more intentional in our efforts to bring more diversity and quantity to nursing.

[Francis Tesoriere]

Thank you for sharing this thought-provoking opinion piece. Reading it for the first time here in August, it’s interesting to point out that it was written in March and essentially predicted the biggest problem our healthcare system is facing at present: a nursing shortage. Many parallels were drawn between today’s coronavirus pandemic and previous pandemic/epidemics of the past century. It’s disheartening to realize that more could be done to combat this nursing shortage than what we’re seeing today. If the number of coronavirus cases continues to rise, we can anticipate the nursing shortage only getting worse. In times like this, we should be encouraging and providing a pathway for nursing students or those wishing to get into a career like nursing. We should also be allowing APRN’s to practice to the fullest extent of their capabilities, as stated in the article. In California, the California Health Corps took an interesting first step at directing current and future nurses (and other healthcare professionals) towards the collective effort to combat COVID-19 at the onset of this pandemic.

[Prerna Wilson-Pauliah]

Thank you for sharing this post. It is thought-provoking, especially now – almost a year since the pandemic started in the United States. Like the article mentions, in a time like this nurses are required more than ever. However, while the need for nurses is much more pronounced now, I cannot remember a time when there were enough nurses. The pandemic only exacerbated a problem that seems like has existed for a very long time. Further, there must be more done to prevent nurses from leaving – dealing with burnout that can usually be due to understaffing, toxic work environments, lack of support, or compassion fatigue. I believe helping nurses stay in the job (and remain satisfied) might help with the shortage a lot faster than trying to bring them back from retirement or entice more people to go nursing school. Supporting them in the workplace is a more long-term solution.

[Savannah Sharp]

As the article mentions, there have been many times throughout history that have shown the great nursing shortages that we have been faced with in times of need. The article proposes three solutions, (1) remove all barriers to nursing practice, (2) utilize senior nursing students, and (3) create a national nursing reserve corps. The first two solutions I have heard mentioned many times before in an effort to do away with nursing shortages. During COVID-19, legislative officials quickly realized the great shortage of APRN’s and the ability for nurse practitioners to be autonomous entities was finally passed! This was in the works for quite some time but had never gone far enough to be passed into law until the COVID-19 pandemic illuminated the great need for more APRN’s to service the people. This is a great step forward for the nursing profession! But, why did it take this long? Why did it take a national pandemic for legislative officials to break down this barrier to nursing practice?

The second solution of offering the services of senior nursing students is also interesting. In fact, I graduated nursing school in the middle of the COVID-19 pandemic so I remember getting emails about working as a RN under a conditional license before taking my boards. I graduated in June of 2020 and I was not able to sit for my boards until September of 2020. That was 2 months that I could have been offering much needed help in the hospital setting but was unable to do so since I did not take my boards yet. Although I think this is a good idea to some extent, I also feel like it may not offer the safest care to patients since new nurses need training at the very beginning. I do however think that there are CNA duties that new nursing students could help out with, freeing up the nurse to focus on their sickest patients and less on administrative duties.

The idea that peaked my interest in this article was the formation of a national nursing reserve corps! I think that is a great idea and that would significantly help lessen nursing shortages that are inevitable in the future. But I couldn’t help but wonder if there are even enough trained nurses to make up a decent size reserve corps? During COVID-19, all nurses that were able to work were working. The only other people to pull from for help included nursing students and retired nurses. Would that still have been enough to alleviate the shortage? Strengthening and growing the nursing profession should be the focus in order to have an ample amount of trained nurses for situations like these. I enjoyed reading this article and participating in this discussion. It was very thought provoking. Thank you for reading!

[Aida Girma]

During the pandemic, nurses rose to the challenge they had in the past to address the nursing shortage. In our ICU, many of our nurses worked endless hours to meet the needs of our many COVID patients. Many nurses throughout the U.S. assisted by traveling to states with a critical nursing shortage. With the cancellation of elective surgeries, OR nurses floated to other departments to assist with care. Many nurses also came out of retirement to help. As the author suggested, many nursing students (and medical students) also stepped in to assist bedside nurses as they were able. Many states, including California, New York, and New Jersey removed barriers to ARNP practice, but these adaptive measures were temporary. These efforts helped but were not enough to meet the need. The pandemic exposed the need for robust public health education, research, and workforce for prevention measures and home monitoring to keep hospitals from becoming overwhelmed in the next pandemic.

[Adrienne Nola]

Thank you for sharing that article David. I agree that nursing shortage have always been and always will be a problem unfortunately. During the pandemic, our hospital hired a lot of nurse travelers and we are so grateful for them. After dealing with very critical covid patients, we needed all the help we could get because it was just physically, mentally, and emotionally exhausting. We dealt with so much loss that it wasn’t healthy anymore. The great thing about it is that nurses from other units such as pre/post procedural or PACU nurses helped out in our units the best they can. We also had a prone team which helped a lot during the first surge when we were proning a lot of our patients. But yes much is still to be done to solve the nursing shortage problem.

[Sintya Sintya]

Nursing forms the largest body of employees in the health care system. Nursing shortages have been happening around the globe even before the COVID-19 pandemic started. A shortage of nurses jeopardizes the provision of quality health care to clients. The current global nursing shortage challenges the provision of a well-qualified and sustainable health workforce to meet future population health needs. A competent, confident, and regulated health workforce is a critical part of a society’s health and wellbeing. Nursing shortages lead to poor work environment issues and insufficient staffing which can lead to burnout. COVID-19 pandemic affected everyone including frontline nurses who bear physical burdens as well. The coronavirus vaccine has increased some nurses’ sense of safety on the job but has not completely relieved their fear of bringing the virus home to their families or of contracting it themselves.

I like how the article mentioned utilizing senior nursing students who are just a few months away from graduation as one of the options to help with the nursing shortage. I was lucky to be able to finish my practicum and program before the pandemic hits. But for my other classmates and friends who were in their senior rotation of the nursing program, have fewer clinical and practicum hours. I agree that senior nursing students are pretty much equipped in providing all the nursing care hospitals provide. They may not be 100% equipped but they can pretty much handle a good amount of nurses’ roles with the exception, of course to do their role safely and to ask questions or help when needed. Overall I found this topic and the article provided to be very insightful and relatable!

[Megann Synnott]

It’s important to remember that hospitals exist specifically for nursing care. At first glance that seems like a ridiculous thing to say, however physician care exists in the community and in clinics. Hospitals are the place where nursing care is given en mass and that’s the differentiating factor. There are physicians who have a dislike of APRNs who try to insist that the nursing shortage is related to nurses leaving bedside to pursue advanced practice roles. APRNs are such a small factor of where the nursing shortage is coming from. We have an aging population and an aging workforce. We haven’t created enough spaces in nursing education to fill those needs. We can’t afford to train new grad nurses enough to hire them all right out of school. We struggle to retain the nurses that we do train beyond a year or two due to burn out. This is prior to the challenges that COVID-19 placed on the workforce. Experienced nurses are what we are seriously lacking. That’s not elevating critical care (ICU/ ED) as the only areas in need of experienced nurses. Acute care nursing has its own skillset and nurses who meet those challenges. We’re also lacking experienced home health and clinic nurses.
Those areas, home health and clinic, traditionally don’t attract experienced nurses due to the difference in wages.

We can’t be naive either that we have created barriers to many people entering the workforce. The push for an all BSN nursing workforce eliminates a large sector of nurses. Removing LPNs from the hospital eliminates a resource. Underutilizing EMTs as ED techs is also a strain on resources as their training has a huge amount of overlap with RNs. We create barriers to ourselves under the umbrella of supposed patient safety. However, fatigue and ratios are the biggest factors to patient safety. A lot of these decisions were political. It’s past time to reevaluate some of these structures we’ve created and allow nurses to do what we’ve always done as a profession: grow where the need is.

[Andrea M Whitchurch]

While I agree that the nursing shortage needs to be addressed, I disagree with the author’s solution of placing senior nursing students in hospitals to fulfill their graduation requirements and bridge the staffing gap. I work in an academic medical center. Today’s senior nursing students had reduced (if any) clinical experiences due to the pandemic. Much of their learning was remote or distant. We must continue to keep patient safety as a priority. Yes, those students are capable of performing some nursing tasks, but not all and not individually. If this is a viable solution, it definitely needs to be well planned out and executed to ensure that 1-patient care and safety isn’t compromised, and 2- that it doesn’t create even more of a burden on an already taxed nursing staff. Teaching while providing care adds another level of stress that not everyone is prepared for or wants to deal with at this point. Yes, we need more nurses, and yes we need to be prepared to educate them but we do have to be careful how we do it. State nurse practice laws do need adjusting, and nursing schools need more faculty in order to allow for more students. Hospitals aren’t the only places that are experiencing shortages of nurses, outpatient areas such as clinics and home health agencies, skilled nursing facilities, etc. are as well. Team nursing using LVN’s in tandem with RN’s is an also an option to be explored.

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