The Current State of Nursing: A Call to Action

From the front lines to the C-suite, staffing troubles have been plaguing the nursing profession. Over the past couple of years, nurses have faced immense staffing challenges fueled by the pandemic, employee burnout, and changing demographics, among other things. It’s no secret that nurses are struggling, but before we figure out a solution, we must recognize why we’re here in the first place. 

In a recent episode of Practicing Excellence’s This Clinical Life Podcast, former CEO of the American Nurses Association Enterprise (ANA) and the current strategic advisor to the Nursing Experience Project (NEP) Marla J. Weston, Ph.D., RN, FAAN, discussed the current state of nursing and the three main factors that contributed to the nurse staffing crisis.

An Aging Population

Every day, 10,000 new patients apply for Medicare. Even without the pandemic, this number poses an immense obstacle, as it highlights our aging population, leading to an increased burden on our nurses. Nurses themselves are not immune to this statistic – as the population ages, we can expect more retirements coupled with an insufficient number of nursing students in the pipeline. The unfortunate inevitability of this trend means we desperately need to care for, support, and retain our current nurses, especially our younger workers.

Marla’s Take: We need to revisit structures and processes with a fresh set of eyes in light of this new reality. Recruiting new staff with the same approach that you had with an 8% vacancy rate may not be as effective in filling your current 18% vacancy rate. We must also rethink how we orient novice nurses in an environment where there is a loss of tenured colleagues – only then can we help them mature and develop critical thinking. 

Burnout by the Numbers

To enable nurses to feel valued and supported, we need to look at burnout. Pre-pandemic, a third of nurses reported feeling burnt out. That’s one out of three nurses coming to work unengaged and unmotivated. To make matters worse, 100,000 nurses left the field in the past year, with a disproportionate amount of them being under the age of 35. Reasons cited for leaving include more well-known issues such as burnout, COVID infection rates, an increase in workplace violence, as well as familial duties. To retain nurses, we must reassess the current nurse workload, safety protocols, and organizational processes to promote a workplace that is conducive to the needs of our nurses.

Marla’s Take: When I was a young nurse, there was far more flexibility when it came to scheduling. There were weekend-only shifts or nine-month shifts for nurses with families to be home with their kids. Bringing back more family-friendly shifts, as well as experimenting with new models of care delivery (such as virtual nurses or NP > RN > LPN care structures) are two quick, practical ways to introduce burnout relief to nurses.

The Electronic Health Record Burden

Another contributor to nursing burnout is the electronic health record (EHR). It’s been proven that health care systems with an ineffective EHR lead to greater nurse dissatisfaction, intent to leave, as well as worsened patient outcomes. The EHR takes up to a third of a nurse’s time – something that gets in the way of valuable time with patients. What’s more, that lost time leads to significantly higher odds for patients to become readmitted within 30 days. Addressing EHR inefficiency not only enables us to combat burnout among nurses but also ensures greater patient safety.

Marla’s Take: A fantastic solution to this that I have seen is having a dedicated support line for nurses working with technology. Having a nursing “Geek Squad” that can field questions and complaints, then go through and solve the issues for nurses will not only reduce dissatisfaction, but it will also boost productivity while signaling to nurses that they and their voice are valued by the organization.

While staffing issues aren’t new for health care, it’s definitely the most pressing. If we can take away something positive that came out of the COVID-19 pandemic, it’s that it highlighted the myriad of issues that continue to burden our nursing workforce. As we begin another year, let’s take this as an opportunity to raise awareness and find solutions to reverse the trends that we are seeing today. It’s one that we cannot fail to take.