Nursing is the largest health care profession in the United States – 4.3 million strong, including LPNs, RNs and advanced practice nurses. That number, impressive as it seems, is not high enough, however. The consistent nursing shortage over the past several decades can be attributed to several factors, including an overall increase in health care needs, an aging and more chronically ill population, baby boomers retiring from the profession and challenges in educating new nurses.
The Health Resources and Services Administration projects a shortage of 78,000 full-time RNs in 2025 alone. How are local nursing education programs responding to the need for new nurses and what methods are hospitals and other health care organizations to attract and keep their nursing staff.
From the educational perspective, one bottleneck that previously contributed to the shortage of nurses was the lack of faculty in collegiate nursing programs. In many programs, that issue has been remedied. According to Dr. Vicki Ball, dean of the College of Nursing at Charleston Southern University, there is neither a shortage of faculty nor of potential students who want to become nurses. A challenge she finds is that many students are simply not qualified academically to enter or progress in the program. She said that, for various reasons, this condition has worsened in recent years.
For example, Dr. Ball stated that four core science programs required of nursing majors, including anatomy and physiology 1 and 2; microbiology; and chemistry, are all offered during the first year of the four-year nursing program. At CSU, nursing students must maintain a grade point average of 2.9 to continue in the program and, unfortunately, many of them are unable to make the grades. To help address this problem and to directly affect the nursing shortage, CSU provides tutoring to current students and outreach to middle school and high school students to create awareness of the various careers available in the health care industry and to help guide them on an academic path that ensures their success.
Another issue Dr. Ball identified was that many nursing graduates immediately enter graduate-level programs such as nurse practitioner programs and, although this trend helps alleviate shortages in the advanced practice nursing realm, it also contributes to a shortage of bedside nurses in hospitals and other health care settings.
How are hospitals – the largest employer of nurses – responding to the nursing shortage? Jeff Wilson, president of Trident Health and the CEO of Trident Medical Center, a 321-bed acute care hospital and trauma center in the Charleston region, emphasized that nurses are the core workforce in a medical center. He said a specific initiative TMC takes is to involve nurses on the dynamic care teams that help guide care in the hospital. He added that TMC recognizes that there are a variety of ways to “nurse,” including traditional bedside nursing, clinical education, involving nurses in clinical research related to evidence-based care and outcomes and providing virtual nursing. At Trident, for example, virtual nurses aid in patients’ discharge planning and review their medications and follow-up care. This helps to free the primary nurse to care for other patients and balance the workload. Wilson stated that this is just one way technology is used to assist the nursing profession, pointing out that nurses are attracted to TMC because of the high-acuity patient care, an environment preferred by many of them. In addition, TMC nurses appreciate benefits such as tuition reimbursement or forgiveness, relocation assistance, subsidized day care on campus, the ability to progress in their career in HCA Healthcare’s 186-hospital network and even an on-site farmers market at the medical center, where nurses can purchase fresh groceries and avoid a stop at a supermarket on the way home.
Trident Health also provides outreach to middle school and high school students to generate interest in nursing and other health professions. Other traditional avenues to address the nursing shortage include providing a competitive salary and benefits, flexible work hours and other work-life balance initiatives.
Although there are no clear-cut answers to addressing the nursing shortage, many talented people and organizations are working together to innovate new solutions.
By D.J. Thatcher, RN, NRP
