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Senior Nurse WriterJoelle Jean, RN, FNP-BC has been a nurse for more than 10 years and family nurse practitioner for over three years. She has a background in pediatric emergency room, labor and delivery, and primary care medicine. Her passion fo...
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Updated April 19, 2023 · 3 Min Read
As a way to potentially stop the hemorrhage of nurses leaving the profession, states are proposing new measures to protect them. Learn more about what states are doing to support the nursing profession.
Credit: Solstock / Getty Images
Credit: Solstock / Getty Images
- Nurses have responded to the nursing shortage by planning and executing union-led strikes nationwide.
- Due to the growing need for nurses, states are proposing and passing legislation to support nurses and their concerns about unfair wages, unsafe working conditions, and unsafe staffing.
- Nurses are responding favorably to the proposed measures.
In 2022, just over one-third of strikes in the U.S. occurred in the hospital sector. This includes the largest strike in history. In September 2022, more than 15,000 nurses employed by the Twin Cities Hospitals Group in Minnesota went on a three-day strike.
Nurses' outcry for fair wages, better working conditions, and fair contracts from hospital employers are receiving national attention. States are now proposing laws to protect nurses. Discover what new measures states are putting in place to support nurses.
How Nurses Have Responded to the Nursing Shortage
Nurses have responded to the nursing shortage in various states by planning and executing strikes. In the past few years, union-led strikes have occurred nationally and globally. Many are due to the 2020 pandemic that had nurses either leaving the profession, retiring earlier than expected, or dying from COVID-19.
Nurses are also walking off the job to protest, citing:
- Unfair wages
- Unsafe staffing
- Unfair health benefits
- Lack of respect
- Nursing shortages
There are consequences to striking. One is how nursing strikes impact patient care. Leaving the bedside where staffing is already short disrupts the continuation of care. But nurses are demanding change and a fair contract from hospital administrators. One way to get it is through a strike.
Luckily, many hospitals and union leaders reach tentative agreements to avoid strikes. Nurses can ratify new contracts — at least for the next three years — without having to leave their patients or the profession.
States Propose New Measures to Support Nurses
States have proposed new measures to address the nursing shortage and support nurses. For example, states like Arizona, Idaho, and Utah used coronavirus relief funds to increase hospital staffing.
Last October, the U.S. Department of Labor announced an $80 million nursing grant program to expand "bottlenecks in training" and increase diversity in the nursing workforce.
More recent measures are aimed at nurses rather than institutions. Here are a few bills/proposals that speak to nurses.
The federal government reports healthcare workers are five times more likely to experience workplace violence at healthcare facilities than any other industry. In Texas, according to the Texas Hospital Association, 98% of Texas hospitals report that violence in the workplace has increased dramatically or stayed the same since the start of the pandemic.
Texas State Rep. Donna Howard (D-Austin), a former nurse, supports the need for hospitals to have a workplace violence protection plan. HB 112 would require hospitals to have this plan in place and make it easier for healthcare workers to report violent incidents to the police.
Mental Health Support
Nurses, doctors, and other healthcare workers experience the burden of suicide greater than the general public. Nurses report feelings of anxiety, depression, and suicidal thoughts because of the stress that comes with their role.
Legislative sessions in Washington State recognize nurses still feel the aftershock of the COVID-19 pandemic. Sen. Annette Cleveland, D-Vancouver, sponsors Bill 5454. She believes services need to be put in place for the mental health of nurses, specifically those with post-traumatic stress disorder (PTSD). The bill would provide workers' compensation insurance coverage for nurses with PTSD.
Safe Staffing Ratios
In February, Keeping Nurses at the Bedside Act (SF1561) was proposed by Minnesota nurses and legislators as a way to combat the nursing shortage, retain nurses, and keep them safe at the bedside. On March 8th, nurses, administrators, and the public testified in the first hearing supporting the bill.
The bill would create two new hospital committees consisting of nurses, managers, and other direct care workers. They would be in charge of creating requirements for:
- Nurse staffing
- Patient care
The bill mirrors many nurse-to-patient staffing ratio laws and regulations that are in effect.
The nursing staff shortage continues to reveal the growing need to train and retain nurses. In Mississippi, there are about nine nurses per 1,000 population. Legislature proposed Senate Bill 2373. This bill offers a loan repayment program for $6,000 per student for up to three years. In exchange, nurses must work in a Mississippi hospital or nursing home. Mississippi Governor Tate Reeves signed the bill, and it will go into effect.
How Nurses Respond to Proposed Measures
Nurses have responded favorably to the proposed measures. The effective bills and those pending show promise for the nursing profession.
Tammy Stafford, DNP, assistant clinical professor and graduate program coordinator at Angelo State University in Texas, believes the Texas House bill to protect nurses regarding workplace violence is a step in the right direction.
"Nurses should not have to worry about being assaulted when they are doing their job," Stafford says. "This would not be acceptable in another environment, and healthcare should be no different."
But Stafford believes the bill should extend to all healthcare workers and the entire organization as violence can occur in any department, she points out.
Karen Chung, FNP-BC, also agrees with the proposed measures to support nurses. Nurses are a vital piece of the healthcare puzzle, she points out.
"At this critical time of extreme nursing shortages throughout the country, it is imperative new legislation is passed that will protect and empower nurses to give the best care to our patients," Chung says.
Chung is looking forward to more sweeping changes in the healthcare system.
She says, "Change to the nursing profession gives more merit and safety measures to a rewarding but tough career."
Meet Our Contributors
Tammy K. Stafford, DNP, MSN, MBA, RN, NEA-BC
Tammy Stafford has 29 years of experience in both inpatient and outpatient settings caring for end-stage renal disease patients with 18 years of leadership experience. In fall 2018, Stafford joined the Department of Nursing at Angelo State University as an assistant clinical professor and graduate program coordinator. Stafford is proud to have the opportunity to teach nurses and prepare them for advanced practice.
Karen Chung, RN, FNP-BC
Karen Chung worked as an emergency room nurse for six years before becoming a nurse practitioner. She has been an NP for the past six years and currently works in the retail health industry.
HB 112. (2023). Texas Legislature Online
Health and care worker deaths during COVID-19. (2021). World Health Organization
Keeping Nurses at the Bedside Act will solve retention and care crisis in Minnesota hospitals. (2023). Minnesota Nurses Association
Major strike activity increased nearly 50% in 2022. (2023) Economic Policy Institute
Original research: Suicidal ideation and attitudes toward help seeking in U.S. nurses relative to the general working population. (2021). American Journal of Nursing
SB 5454. (2023). Washington State Legislature
Senate bill 2373. (2023). Mississippi Legislature
THA white papers & reports. (2023). Texas Hospital Association
US department of labor announces $80M funding opportunity to help train, expand, diversify nursing workforce; address shortage of nurses. (2022). U.S. Department of Labor
Facts About the U.S. Nursing Shortage
More than half of current RNs are over the age of 50. In 2021, U.S. nursing schools turned away more than 91,000 qualified applicants due to a lack of faculty, education space, and resources.
Nursing shortages lead to errors, higher morbidity, and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout, dissatisfaction, and the patients experienced higher mortality and failure-to-rescue rates than facilities with lower patient-to-nurse ratios.How can we improve healthcare shortage? ›
- Increase the number of doctors, nurses, and other health care professionals being educated. ...
- Intentionally recruit and train more students who reflect communities. ...
- Encourage newly minted health care workers to practice in underserved areas.
There's a direct link between patient mortality, or risk of death, and a shortage of nurses. Facilities with fewer nurses tend to witness a 2-7% increase in mortality. When there are fewer nurses caring for patients, there's reduced patient safety, more medical errors, and failure-to-rescue situations.What workplace factor has been found to contribute to the nursing shortage? ›
Aging Nurse Population
Nurses retire at a higher rate as they get older. This causes a nursing shortage and makes it difficult for hospitals to find replacements. The average age of nurses in the United States is 52, implying that many will retire soon.
- Train Leaders to Recognize and Address Burnout. ...
- Improve Nurse-to-Patient Ratios. ...
- Include Nurses in Policy Discussions. ...
- Implement Support Programs. ...
- Involve Nurses in Scheduling. ...
- Reduce Non-Clinical Tasks.
Faculty shortages at nursing schools across the country are limiting student capacity at a time when the need for professional registered nurses continues to grow. Budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this crisis.Is the nursing shortage getting better? ›
North Dakota saw an increase from 12.80 nurses per 1,000 people in 2020 to 15.24 in 2021, while California went from 7.77 per 1,000 people in 2020 to 8.27 in 2021, gaining over 17,000 more nurses over the year – the largest increase across states.What is the future for healthcare nursing shortage? ›
About 100,000 registered nurses left the workforce during the past two years due to stress, burnout and retirements, and another 610,388 reported an intent to leave by 2027, according to a study released by the National Council of State Boards of Nursing.How does nursing shortage affect evidence based practice? ›
Inadequate or insufficient nurse staffing levels increase the risk of care being compromised, adverse events for patients, inferior clinical outcomes, in-patient death in hospitals and poorer patient experience of care.
The nursing shortage is limited primarily to the United States. Downsizing for cost containment by hospitals contributed to the shortage. The use of unlicensed assistive personnel helped to supplement staffing shortages. Increasing the supply of nurses is an easy resolution to the shortage.What is the best way to improve healthcare? ›
- 1) Analyze your data and outcomes. ...
- 2) Set goals. ...
- 3) Create a balanced team. ...
- 4) Include Human Factors Inputs. ...
- 5) Create an executable plan. ...
- 6) Become Familiar with the PDSA cycle. ...
- 7) Communicate goals and progress. ...
- 8) Research other organizations and collaborate.
- Act on Employee Feedback. ...
- Implement Reskilling and Upskilling Initiatives. ...
- Promote Work-Life Balance. ...
- Improve Your Company Culture. ...
- Increase Company Perks and Benefits. ...
- Hire Short-Term Workers. ...
- Continue to Build a Strong Team.
- Assure an adequate local public health infrastructure. ...
- Promote healthy communities and healthy behavior. ...
- Prevent the spread of communicable disease. ...
- Protect against environmental health hazards. ...
- Prepare and respond to emergencies. ...
- Assure health services. ...
- Federal influences.
California has the worst nursing shortage in the United States. It's predicted that by 2030, California will be in need of over 44,000 nurses. Other states with major hospital staff shortages include New Mexico, Vermont, Rhode Island, West Virginia, and Arizona.How does the staff shortage in healthcare affect patient care? ›
Health care staffing shortages lead to poor patient outcomes that can include hospital-acquired infections, patient falls and increased chances of death, according to the American Association of Colleges of Nursing.Have we always had a nursing shortage? ›
Not surprisingly, the shortage persisted. In fact nurse shortage conditions existed well into the 1960s. At that point the federal government again took action, passing the 1964 Nurse Training Act intended to increase the supply of nurses by providing significant funding for nurse education.What are the top 3 causes of nurse burnout? ›
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care.What is the importance of reducing nurse burnout? ›
Burnout reduction programs can lead to more sustainable professional lives for nurses, less turnover, and positive impacts on the quality of patient care. Learn how integrated, evidence-based solutions at the point of care can support nurse leaders and their clinical staff.How do you retain nurses? ›
- Create a recognition program. Most employees, no matter what their job is, appreciate recognition in the workplace. ...
- Develop the right company culture. ...
- Allow for peer interviews. ...
- Listen to feedback. ...
- Create collaboration opportunities.
“The lack of sufficient time for reading the studies,” “the lack of sufficient time to implement the new ideas,” “the lack of adequate facilities to implement the ideas,” “nurses' little interest in conducting studies,” and “the lack of authority to change the methods and patterns of care” with, respectively, 85%, 84.6 ...What are the factors impacting on the nursing profession? ›
Six factors were identified that affected the development of nursing competence in our systematic review: (1) work experience, (2) type of nursing environment, (3) educational level achieved, (4) adherence to professionalism, (5) critical thinking, and (6) personal factors.What factors affect nursing education today? ›
Sources of external factors in a nursing program include financial funding, rules and regulations, accreditation, availability of clinical sites, and institutional factors. Let's look at these in more detail.What do you think the future of the nursing workforce will look like in 50 years? ›
The Bureau of Labor Statistics expects nursing job growth of 12 percent through 2028—much faster than the average occupation. That's around 200,000 new RN positions that will need to be filled every year through 2026.Why is there a nursing shortage 2023? ›
The COVID-19 pandemic pushed these shortages to crisis levels, with demand outweighing supply nearly everywhere.What is the future need for nurses? ›
The U.S. Bureau of Labor Statistics (BLS) projects 9% job growth for registered nurses (RNs) and 45% job growth for nurse practitioners, nurse midwives, and nurse anesthetists between 2020 and 2030. Both percentages are significantly higher than the 8% average growth projected for all professions for the same period.What is the future of nursing now? ›
The nursing industry is changing at a rapid rate. With shifting technology, an aging patient population and new challenges brought on by federal legislation, the nursing industry is being forced to evolve to ensure that hospitals and other organizations are able to continue to provide the best possible care.How does the nurse shortage affect quality of care? ›
The nursing shortage affects patients, which has long been a problem for medical facilities. Patient care is frequently compromised due to nurse shortages and increased workloads. This can result in treatment delays, longer appointment wait times, and other issues with patient satisfaction.Why do nurses struggle to implement evidence-based practice? ›
The literature indicates that nurses value EBP; however, its implementation is inconsistent because it is often obstructed by many factors, such as paucity of facilities, time, resources, support, knowledge and skills, autonomy, and funding, as well as access limitations, which have been reported in several studies ...How many nurses are needed by 2025? ›
Dig Deeper. Researchers estimated that the US will have a 10 to 20 percent nursing gap by 2025 as the number of patients needing care exceeds the number of nurses. The RN supply could potentially see a low of 2.4 million, while the RN demand could be a low of 2.8 million nurses.
The shortage of nursing faculty and clinical sites contributed significantly to the shortage.Which factor is considered the greatest obstacle to solving the projected nursing shortage? ›
None of the other options were significant contributors to the nursing shortage that began in the late 1990s. Which factor is considered the greatest obstacle to solving the projected nursing shortage? Feedback: The nursing faculty shortage will likely be the greatest obstacle to solving the projected nursing shortage.How can the government address nursing shortage? ›
The government can address the nursing shortage by dealing with the workforce issues that contribute to the nursing shortage. Increased training and support for nurses is one way to accomplish this. It will provide opportunities for professional development and growth.Has the nursing shortage improved? ›
Line chart showing that the number of registered nurses per 1,000 people in the United States age 65 and older has declined from 68.9 in 2003 to 73.2 in 2021.How do nurses problem solve using the nursing process? ›
The nursing process is a systematic problem-solving approach used to identify, prevent and treat actual or potential health problems and promote wellness. It has five steps; Assessment, Diagnosis, planning, implementation and evaluation .What is the first step in dealing with nurse burnout? ›
The best way to manage nurse burnout is through prevention. Learning to identify the early warning signs is the first step toward avoiding a problem that puts you and your patients at risk.How bad is the nursing shortage in the US? ›
The national nursing shortage dates back decades, but the COVID-19 pandemic pushed it to crisis levels. One study predicts that, in the next two years, there will be a shortage of up to 450,000 bedside nurses in the U.S. In countries around the world, medical workers are pleading for more support.Is the nursing shortage a global problem? ›
However, there is an estimated shortage of up to 13 million nurses around the world. The world would need millions more nurses to achieve Sustainable Development Goal (SDG) target 3.Which state has the highest nursing shortage? ›
California has the worst nursing shortage in the United States. It's predicted that by 2030, California will be in need of over 44,000 nurses.Will nurse pay increase in 2023? ›
But as inflation peaked, nursing and health unions demanded as much as a 14% pay rise for 2023/24, which would now be an above-inflation pay rise. With inflation having recently stopped, and with the government confident about halving it from 10% to 5%, this pay rise now looks to be in line with inflation.
We use problem-solving approach in daily activities and nursing practice. For example, you use problem solving in deciding what to wear, when it is raining or while nursing a tracheotomy patient how to communicate. The problem solving process and the nursing process are cyclic (Burns and Grove, 1987).How do nurses overcome challenges? ›
Continuing professional education is an excellent way to manage stress and other challenges in nursing. Upskilling and training can offer fresh perspectives to health care practices and new career opportunities. Nurses who learn new skills, or invest in their careers, are typically more engaged with their work.What are the 5 steps of problem-solving in nursing process? ›
These are assessment, diagnosis, planning, implementation, and evaluation. Assessment is the first step and involves critical thinking skills and data collection; subjective and objective.