There’s a nursing shortage.
Nursing is the single largest profession in the entire U.S. healthcare workforce. While there is expected to be 3.4 million RNs working by 2026, this isn’t enough to combat the need of the aging U.S. population. U.S. healthcare systems rely on nurses to enforce the highest standards of quality and compassionate care. The number of qualified, competent nurses is directly related to positive patient outcomes. Since the U.S. nurse shortage is expected to continue to worsen through 2030, this not only affects a healthcare system’s day-to-day operations but also negatively impacts patients’ health outcomes.
The current U.S. nurse shortage is due to a combination of factors — one being an aging population and workforce. The U.S. Census Bureau found the number of U.S. residents 65 and older will almost double to an estimated 83.7 million Americans. These seniors will increase the need for geriatric and other types of healthcare. The median age of nurses is also rising, with over 50% of RNs being 50 years of age or older in 2018. Researchers for the Journal of Nursing Regulation project one million RNs will retire by 2030. Due to this wave of retirements, healthcare systems are facing a significant loss of nursing knowledge.
This lack of experienced nurses is coupled with the loss of experienced faculty at nursing colleges. Nursing faculty is aging along with the rest of the population and is unable to be replaced. Due to non-competitive salaries, astronomical education costs and other factors, nurses with higher professional degrees, such as doctorates, are choosing to work in more lucrative fields like quality assurance programs and healthcare studies. According to the American Association of Colleges of Nurses, in 2018 more than 75,000 qualified applicants were turned away from baccalaureate and graduate nursing programs due to lack of faculty, clinical sites, classroom space and budget constraints.
While a national concern, qualified nurse shortages in both the clinical workplace and nursing academia vary state to state. A 2017 joint report from the U.S. Department of Health and Human Services, the Health Resources and Services Administration, and the National Center for Health Workforce Analysis states the nursing shortages are rooted in problems with workforce distribution. Projections of the 2030 RN workforce shows glaring state-by-state shortages and surpluses across the U.S. If the need for healthcare continues at its current trajectory, the states with the largest deficits of RNs in 2030 will be South Carolina, New Jersey, Texas and California. California alone would have a shortage of 44,500 qualified nurses to care for its citizens. Other states are projected to have a surplus of RNs in 2030 including Florida, Ohio, Virginia and New York. Florida is estimated to top the charts at 53,700 excess nurses. This substantial variation by state is due to many factors including changing demographics, preferred lifestyles of younger generations, and aging populations per state.
The connection between sufficient registered nurse staffing and positive patient outcomes is well-documented. Qualified nurses are on the front lines of patient care. Their attentiveness and medical knowledge monitor each patient’s progress and catch changes and complications in their earliest stages. If nurses are overwhelmed or hospitals are understaffed, the health of patients will suffer as a result. The American Journal of Infection Control found that adding just one extra patient to a nurse’s patient load was associated with higher risks of infection. Additionally, the New England Journal of Medicine published findings in 2011 that indicated insufficient nursing staffing was related to higher patient mortality rates. More research clearly links baccalaureate-prepared nurses to lower mortality and failure-to-rescue rates. The need for qualified clinical nurses and nursing faculty has never been greater as the current majority of the American population ages.
Recruiting qualified nurses for your healthcare system requires strategic initiatives centered on educational leadership, passion for the profession and workforce redistribution.
Solutions to recruit more nurses
1. Educational Leadership
Attracting qualified nursing talent means offering a variety of educational opportunities to your nursing staff. The millennial and Gen-X generations consider themselves lifelong learners and highly value educational opportunities that can lead to career advancement. By branding your healthcare system as a workplace that values nursing education, younger nurses will be attracted to your institution. There’s a myriad of ways your healthcare system can support nursing education. Strategies should be based on regional gaps in your localized healthcare market while also working towards national recognition for your innovative programs.
Partnering with regional nursing colleges ensures that your healthcare system has a pool of talented, qualified nurses who are already aware of or have worked with your healthcare system. Long-term relationships and partnerships with academic institutions in your region are a sustainable solution for nurse staffing. Integrating practicums for nursing students at your healthcare systems familiarizes them with your work environment. Providing scholarships and loan forgiveness to the best and brightest students who commit to working for your institution for several years after they graduate ensures new, qualified nursing staff. Offer to address faculty shortages by integrating your organization’s nursing leadership into teaching positions.
Creating a mentorship program with nursing students not only builds relationships between students and your healthcare organization but also empowers your nursing staff to take pride in their profession. With nursing faculty shortages, there is a direct and imperative need for academic nursing leadership. An article on nurse leadership in The Online Journal of Issues in Nursing states, “Without intentional guidance, formal coaching, and role modeling… the future of nursing leadership could be in jeopardy.” Learning daily requirements of the profession firsthand from an experienced nurse gives students a more realistic view of their future. This awareness can increase the longevity of your newly graduated nursing staff as they already know what to expect in your work environment. A nursing mentorship program also demonstrates your organization’s commitment to educational leadership and the nursing profession. By integrating into the educational institutions in your region, your brand receives more positive recognition throughout your local community which can in turn attract more qualified nurses.
Center for Support and Education
If there are no viable academic partnerships, create an internal center for nursing excellence within your organization. Nurses often face a lack of leadership and support. An article in The Online Journal of Issues in Nursing notes the “absence of an adequate leadership pipeline.” By intentionally creating a resource for your staff and a community that celebrates nursing and encourages leadership, nurses looking for professional growth will be attracted to your organization. This center can offer nurses mentorship roles, leadership opportunities, educational speakers within and outside of your organization, and other community initiatives. Offering support, guidance and education to your nursing staff not only increases their job satisfaction and your patient outcomes but can also show interested nursing talent that your organization prioritizes the nursing profession.
2. Passion for the Profession
To recruit passionate nurses, commit to challenging stereotypes of the nursing profession and become a leader in changing the nationwide narrative of nursing. An article from The Online Journal of Issues in Nursing states, “Like other predominately female professions, the public undervalues nursing.” Nurses have a unique analytical skillset coupled with empathetic interpersonal skills that makes them integral to any care team. Nurses understand the importance of their profession. However, they have often been undervalued in the media and depicted as secondary “handmaidens” to doctors. While the narrative is slowly changing to represent the intellectual, caring professionals they truly are, positioning your organization as a crusader for this shift in perspective will encourage qualified nurses with leadership skills to be part of your organization.
Offer Nurses A Platform
Recruit passionate, qualified nurses by giving your organization’s nursing leadership a voice. Offer educational speaking opportunities to nursing staff and allow them to elevate the conversation around the nursing profession in your community. Educators claim that by fifth grade, students have often already made up their minds about desirable and undesirable careers. Giving nurses more vocal leadership roles offers a new perspective to the community, young and old. These unique opportunities will appeal to young, passionate nurses who want to grow within both the nursing and local communities.
To inspire and recruit the next generation of nurses, build and foster a digital community of nursing leadership that can extend beyond your geographic location. To position your healthcare system as a leader and resource for nursing support and education, it needs an authentic, robust digital presence. By having an active presence on LinkedIn, your organization can have a dynamic voice in a professional digital community. LinkedIn has over 500 million active and passive job-seeking members.20 Young professionals who want to engage with others and grow in their career field join and interact on LinkedIn’s professional groups. Develop a recruiting strategy that involves not only your organization’s account but the LinkedIn accounts of key stakeholders and your nursing leadership. As your organization’s “micro-influencers” strategically connect, post, comment and engage within the platform and these professional groups, your organization gains authentic, positive referrals and references that are then seen by potential hires. Younger generations in the U.S. are more loyal to their “work” versus their employer. If passionate nurse professionals see your healthcare system’s commitment to the nursing profession displayed time and time again online, it will influence their decision when they’re looking for a new job opportunity.
3. Nursing Workforce Redistribution
Historically, the U.S. supply and demand for nurses has been cyclical. The future demand for nurses is affected by aging population, economic conditions, expanded health insurance coverage, changes in healthcare reimbursement, and other factors. The current shortage is expected to continue until at least 2030. However, this inequity of qualified nurses grossly varies by state, with some states projected to have an excess of nurses. Knowing your state’s projected deficit or surplus gives your healthcare system an exact map of where to look for talent.
Recruit in Surplus States
In the coming decade, not all states will have a deficit of qualified nurses, some states will have too many. Research the states surrounding your location to see which ones are most likely to have a surplus of RNs. A 2017 joint report from the U.S. Department of Health and Human Services, the Health Resources and Services Administration, and the National Center for Health Workforce Analysis projects that Florida, Ohio and Virginia will each have surpluses of over 20,000. Targeting these surplus states, and other surplus states in your region, for nurses willing to relocate should be integral in your organization’s recruitment initiatives.
Add Insight to Your Messaging
Use your most valuable resource, your nurses, to learn about their perceived benefits of relocating for your healthcare system. Polling and interviewing current nursing staff, especially those who have relocated for your organization, is imperative to obtain the psychological rationale of the nurses you aim to recruit. There’s no better window into the decision-making process than hearing from nurses who’ve made the choice before. Create a carefully curated list of questions that pinpoints their motivations. Are nurses relocating for affordability? Do they want a slower pace of living and to be able to be part of their patients’ community? Is the ability to easily travel important to them? Seek to understand which of their expectations your organization has fulfilled and where they see your healthcare system is lacking. This vital information can then be used when developing recruitment strategies and campaigns.
Once your organization has identified why nurses are excited to relocate to your area, use those key insights in your messaging. Design and implement a recruiting strategy that exemplifies the unique lifestyle your area has to offer. In order to recruit passionate, longtime staff, your recruitment team must prioritize the culture fit of each staff member. Nurses who are willing to relocate need to be enthusiastic about the community where they will live and work. Create partnerships with local programs and teams that can plug newly arrived nurses into the community. By offering new nurses opportunities outside of work to make friends and learn more about their new home, they can make critical social connections that will help them stay in your area.
Nurses seek opportunities to provide compassionate, professional care in a work environment where they are valued for their knowledge and skill. To recruit qualified, passionate nurses, your healthcare organization must:
- Become an educational leader through academic partnerships and an internal center for education and support.
- Advocate for the nursing profession.
- Amplify your current nursing staff’s voice and leadership.
- Digitally connect with other passionate nursing professionals.
- Recruit in nearby states that have a surplus of nurses.
- Learn why current staff chose to relocate for your organization and incorporate those findings into your messaging.
With vast inequity between supply and demand of RNs by state, recruiting passionate, qualified nurses will be a major challenge for the next decade and beyond. Strategic initiatives must be centered on educational leadership, passion for the profession and workforce redistribution.
Have a question about nurse recruitment? Let's talk.
Want to learn more insights from industry experts? Join our email list.