A nurse reviews a patient file with a doctor.

Effects of the Continuing U.S. Nursing Shortage


U.S. health care faces many challenges related to the effects of the nursing shortage. Precipitated by aging on the part of the baby-boom generation, the nursing shortage affects the quality of patient care and nurse morale, as well as the financial position of health care organizations in various clinical, home care, and long-term care settings.

Individuals who pursue an advanced degree in nursing have a unique opportunity to help lead the charge to address the effects of the nursing shortage.

A Look at the Nursing Shortage

The effects of the nursing shortage are notable in both its size and origin.

The Size of the Nursing Shortage

The U.S. Bureau of Labor Statistics (BLS) projects that employment in health care occupations will grow by 15% from 2019 to 2029—significantly exceeding the 4% projected growth in all occupations. Within health care occupations, the BLS projects the following:

  • The employment of registered nurses (RNs) will grow by 7% between 2019 and 2029.
  • The employment of nurse anesthetists, nurse midwives, and nurse practitioners will grow by 45% between 2019 and 2029.

Examining particular health care sectors reveals more specific information about the nursing shortage. For example, in the sector that provides long-term services for individuals to live independently and complete daily self-care tasks, RNs are expected to experience a 46% increase in demand between 2015 and 2030, according to the National Center for Health Workforce Analysis.

The nursing shortage also is not uniform across the country. For example, according to Projections Central that collects state data on occupational growth, from 2018 to 2028, Arizona expects a 35% increase in RN employment, while Michigan expects a 9.8% increase.

Causes of the Nursing Shortage

Many factors contributed to the nursing shortage. By the mid-2030s, according to the U.S. Census Bureau, individuals who are at least age 65 will outnumber those ages 18 and younger for the first time. As the U.S. population ages, the number of patients with chronic conditions, such as diabetes and obesity, increases, elevating the demand for nurses. As nurses age, they retire, and the health care industry loses their experience and expertise.

Nursing schools also have difficulty luring faculty away from nursing jobs to teach new nurses. Schools have difficulty competing with the salaries received by nurses. In addition, nursing is a demanding field where stress and burnout contribute to professional turnover.

Unfortunately, the COVID-19 pandemic only exacerbated the nursing shortage. Hospitals struggle to find sufficient nursing staff to address the increase in COVID-19 cases, a problem especially troublesome in rural areas. Nurses also have left the profession either temporarily or permanently fearful of contracting COVID-19 or needing to care for their families.

The Effects of the Nursing Shortage

The effects of the nursing shortage on the quality of care illustrate the importance of addressing this problem. Consider the following:

  • Patient mortality rates are higher for those in hospitals with lower nurse-to-patient ratios. A 2019 study by BMC Health Services Research linked an unexpected death rate of 1.80 per 1,000 patients to lower nurse staffing levels. 
  • Nursing shortages can lead to increases in the length of patients’ hospital stays and readmissions.
  • The burnout that nurses experience as a result of shortages can result in patient safety issues.
  • When nurses work longer shifts, they can make more errors that affect the quality of care.
  • Not having sufficient nursing staff can increase the time that patients must wait to receive care.

In addition to affecting the quality of care, the nursing shortage has taken a toll on health care organizations’ financial positions. To be competitive in recruiting nurses, for example, hospitals have increased pay, offered bonuses, and enhanced benefits, all of which eat into their profit margins. Turnover among nurses also resulted in health care organizations paying overtime to ensure that they have sufficient staff to cover all shifts.

Strategies to Combat the Nursing Shortage

Numerous approaches can help alleviate the effects of the nursing shortage. For example, health care organizations can promote greater communication across all staff levels to strengthen employee retention. They also can capitalize on their nurses’ experience and skills by involving them in strategic planning about issues such as staffing and recruitment. Encouraging nurses to take advantage of employee assistance programs and mental health counseling can help reduce burnout. As an alternative to hiring contract nurses to fill staffing gaps, some hospitals have collaborated with nearby colleges to train nurses who can eventually work in the hospitals.

Besides, nurses in leadership positions can draw on the problem-solving, analytical, and communication skills developed throughout their careers to spearhead efforts to address the nursing shortage. Being proactive in sharing ideas, advocating for nurses through proposals, and promoting the empowerment of nurses to help solve the nursing shortage are just a few ways how leaders in the nursing profession can help address the challenge.

Advances in technology also offer a wide range of approaches to address the nursing shortage. Nurses need to ensure that their skills keep pace with the expansion in technology use. The following are examples of how technology can address the nursing shortage:

  • Developing mobile apps for tasks ranging from nurse scheduling to credentialing can help improve efficiency.
  • Expanding the use of electronic medical records can enable nurses to reduce time spent on paperwork and more on patient care.
  • Creating simulation training for nursing students can help expand students’ ability to get hands-on training.

Expand Your Nursing Expertise to Address the Nursing Shortage

For nurses looking to expand their expertise and advance into leadership roles to address the effects of the nursing shortage, Norwich University offers an online Master of Science in Nursing program with concentrations in Healthcare Systems Leadership, Nursing Education, Nursing Informatics, and Nurse Practitioner. There are three Nurse Practitioner track options available: Family Nurse Practitioner, Adult Gerontology Acute Care Nurse Practitioner, and Psychiatric Mental Health Nurse Practitioner.

Since 1819, Norwich University has offered academic programs that reflect the highest standards in teaching, curriculum development, and online education delivery.  Learn how to advance your nursing expertise and help address the nursing shortage today.


Recommended Readings

Leading Nurse Teams Through Change
Preparing for the Future of Nursing Informatics
Six Emerging Healthcare Technologies for Leaders in Nursing


Healthcare Occupations, U.S. Bureau of Labor Statistics
Registered Nurses, U.S. Bureau of Labor Statistics
Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners, U.S. Bureau of Labor Statistics
Long-Term Services and Supports: Nursing Workforce Demand Projections 2015-2030, U.S. Bureau of Health Workforce
Long-Term Occupational Projections (2018-2028), Projections Central
Older People Projected to Outnumber Children for First Time in U.S. History, U.S. Census Bureau
Flatten the Nursing-Profession Exodus Curve: Discussing the Long-Term COVID-19 Impact on Nursing Shortage, Becker’s Hospital Review
What the Nursing Shortage Means for Healthcare, The Atlanta Journal-Constitution
The Dreaded Nursing Shortage: 1.9 Million RNs Needed By 2022, The Journal of Advanced Practice Nursing
Nursing Shortage Will Continue to Pinch Hospital Margins, Modern Healthcare
3 Ways Nurse Leaders Influence Change in Healthcare, HealthLeaders
How Technology Will Disrupt the Nursing Shortage, Forbes
To Fight Nurse Burnout, EHRs Must Use AI, Reflect RN-Specific Workflows, Healthcare IT News
Strategies to Mitigate Healthcare Personnel Staffing Shortages, Centers for Disease Control and Prevention
Hospitals Are Competing for Nurses as Coronavirus Surges Across the Nation, Chicago Sun-Times
COVID Spikes Exacerbate Health Worker Shortages in Rocky Mountains, Great Plains, Kaiser Health News
The Impact of Nurse Staffing Levels and Nurse’s Education on Patient Mortality in Medical and Surgical Wards: An Observational Multicenter Study, BMC Health Services Research
Nursing and Patient Safety, Agency for Healthcare Research and Quality
Why Do I Have to Wait So Long to Be Seen in the Emergency Room?, U.S. News & World Report
Nursing Shortage Effects Can Be Mitigated by Fine-Tuning the Little Things, Healthcare Finance
What’s Behind the Nursing Shortage? How Can We Fix It?, Texas Medical Center
How Virtual Training Is Set to Change Nursing Education, HealthTech

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