The aging Baby Boomer generation is retiring from the workforce and increasing the healthcare needs of our nation. Obamacare also brought a sudden influx of roughly 30 million people into the healthcare system, without adding a single doctor or nurse. Further, the American Nurses Association (ANA) is estimating there will be more nursing jobs available than any other profession.
To prevent a severe nursing shortage, the U.S. Bureau of Labor and Statistics is projecting that 1.1 million nurses will need to be replaced by 2022. A nursing shortage is alarming, but let’s look specifically at how nursing shortages impact healthcare.
The effects of the nursing shortage have been and will continue to be felt. Many of the projections are for the future, but the impact is here and now.
For example, consider the nursing turnover and recruitment challenges. As noted in fairly comprehensive data collected by Bradley University, hospitals in 2016 experienced an estimated 16.5% turnover rate, indicating that nearly 1 in 5 nurses switch jobs annually. This might not seem too significant, but turnover can be quite costly to healthcare organizations.
The same data estimates turnover costs for one registered nurse (RN) to be between $44,000 and $63,000. Plus, it can take an average of 54-109 days to recruit an experienced RN, further intensifying the shortage. Turnover means less staff members are available, and it requires an extensive training process to onboard new ones, which adds additional workload to the current staff. Fully training a new RN could take six months or longer.
Medicating patients effectively is another area impacted by the nursing shortage. The data notes nearly half (46.8%) of nurses have committed a medication error in the past year.
Contributing factors to medication errors include fatigue resulting from hard work, illegibility of patient records, high patient-to-nurse ratio, and false medical calculations. The most reported was insufficient education.
All of these factors can be directly or indirectly tied to nursing shortages. The stress of being understaffed certainly leads to a physical and emotional burden on nurses. Combining this with the fact many nurses and most intensive care unit (ICU) staff work 12-hour shifts, often switching from days to nights, it’s easy to see how the patient care environment is ripe for errors.
Patient Mortality Rates
The Bradley University data also paints an unfortunate picture for patient mortality rates, as patient care and outcomes take the brunt of the nursing shortage burden.
On the positive side, simply increasing one full-time RN per 1000 inpatients was associated with a 4.3% decrease in patient mortality. Conversely, ICUs that were below target in RN staffing levels had a 2% to 7% increase in mortality. And worse, non-ICU patients had a 12% increase in mortality rates when RN staffing was below target levels.
While the correlation between fewer nurses and higher patient mortality rates seems obvious, these statistics clearly indicate that when staffing levels are not met, patient mortality is increased significantly.
On a different front, rural areas are having a difficult time attracting and retaining nursing stuff due to their inability to offer competitive pay, as well as typically offering a less-attractive social scene.
Oftentimes, larger hospitals don’t face this problem since they are built in urban areas, providing them with the necessary incentives to attract talent, especially those of the millennial generation.
Given that the quality of healthcare depends on the availability of skilled medical personnel and the right infrastructure to provide needed services, rural areas have a hard time functioning at a high level and providing many specialized services, especially compared to urban facilities.
This is due in large part to staffing shortages, particularly with physicians and RNs. About one in five Americans lives in a rural area, which means that nearly 60 million people don’t reside near a medical facility and live even further from one that is fully equipped with modern equipment and practices.
Clearly the nursing shortage has an even greater impact on rural areas of the country.
This list is not comprehensive by any means, but does represent some significant areas of impact. There are numerous other effects of the nursing shortage playing out on a smaller scale.
It seems the growing pains of the healthcare industry will continue to be felt as our nation tries to find solutions for many of the issues we face. Many organizations have made significant progress in helping to address the nursing shortage by offering incentives and better opportunities; however, the gap remains.
One thing is clear: Our nation needs affordable, high-quality healthcare. And ensuring an adequate nursing workforce is a surefire way to help achieve this goal.