How to Fix Short Staffing in Nursing
The reports surrounding the problem of short staffing in nursing are troubling. In a 2024 survey, IntelyCare’s Nursing Trends Report predicted the crisis will have a devastating effect on patient safety and the future of the nursing labor force if the current crisis isn’t properly addressed.
How can healthcare organizations tackle this multifaceted and complex issue? We’ll help you start to answer this critical question by reviewing the impact of nurse staffing on patient care, assessing nursing supply and demand, hearing what nurses say about the crisis, and exploring some proposed solutions to short staffing in nursing.
Impact of Nurse Staffing on Patient Care
Nurse staffing and patient care quality and safety are closely connected. Short staffing in nursing occurs when the number of nurses is insufficient to safely and adequately provide quality care to patients. The Agency for Healthcare Research and Quality (AHRQ) completed an extensive research review, examining the full impact of nurse staffing, summarized in the table below.
| Adequate Nurse Staffing | Nurse Understaffing |
|---|---|
| Improved patient outcomes at hospitals
Improved quality measures at Skilled Nursing Facilities (SNFs) Decreased mortality risk at SNFs Decreased hospitalization risk at SNFs Decreased risk of urinary tract infections (UTIs) risk and pressure ulcer risks at SNFs |
Decreased patient safety at hospitals
Increased morbidity risk Increased mortality risk at hospitals Increased workload and hours increase risk of errors at hospitals Nurse delaying, partially completing, or not providing care increases with more patients, leading to:
|
The Dilemma of Nursing Supply and Demand
The nursing staff demand is rising with the aging of the baby boomer generation. By 2034, there’ll be 77.0 million U.S. adults aged 65 years and older who’ll have an increased need for nursing care.
When asked about their future in the nursing profession, our Nursing Trends Study revealed that 77% of surveyed nursing professionals were actively looking for a new nursing job and 45% were looking to leave nursing altogether. With over 93% of nursing facilities reporting staff shortages, the aging of America and nurse retirement exacerbate an already strained workforce.
High nurse turnover also contributes to a decreasing number of nursing professionals. Both experienced and newer nurses are leaving their positions every year. Consider the following nursing turnover rates — percentages represent the number of clinicians who left the bedside in just one year:
- CNAs: 35.5%
- ACNPs: 15.3%
- RNs: 27.1%
- New nursing school graduates: 45.5%
A reasonable solution to this supply and demand issue is to increase the number of nurses. However, this is not easily feasible given the nursing faculty shortage, which is the primary reason nursing programs have turned away over 91,000 qualified applicants.
What Nurses Are Saying
The following data summarizes findings for long-term and acute-care hospital nursing professionals that responded to our most recent Nursing Trends Survey. Mental health and wellness, organizational support, and reasons for leaving were some of the key topics addressed.
Mental Health and Wellness
Short staffing in nursing is a leading cause of burnout. Most nurse respondents (85%) were asked to cover extra shifts every week, and 75% felt consistently burned out.
The survey also found that the job demands of nurses continue to impact their safety and well-being. When asked how safe they feel at work, 28% of nurses reported feeling “unsafe” or “very unsafe.”
Organizational Support
The 2024 survey also revealed information about the changing dynamic between nursing respondents and their employers. Nearly 40% of nursing staff felt unsupported by their healthcare leaders, and 42% weren’t able to provide the quality of care they felt was necessary.
However, nursing staff did appreciate their employers’ efforts to address short staffing. The solutions nurses found most compelling were staffing strategies, increased pay, and increased safety measures. They also reported the most important factors attributing to their work satisfaction were a healthy work-life balance, compensation, safe staffing ratios, and more decision-making power.
Reasons for Leaving
Over 50% of long-term care and hospital nurses reported contemplating leaving their job in the next six months. The top reasons nurses in hospitals and long-term care facilities cited for wanting to resign include:
- Insufficient staffing
- Work negatively impacting health and well-being
- Inability to consistently deliver quality care
- Need for higher income
Solutions to Short Staffing in Nursing
There isn’t an easy fix to short staffing. Fortunately, from what nurses shared, there are identifiable ways to help you retain a happy and healthy staff. Exploring how to improve short staffing in nursing can start with these three strategies.
1. Develop a Resilient Staffing Strategy
Nursing professionals aim to provide quality care to patients while maintaining balance in their lives. The best way to achieve this is by developing a staffing strategy that supports a manageable workload and withstands the constant changes in healthcare.
The more diverse your strategy is, the better equipped you are to fix the fluctuating scheduling issues that arise. In addition to having an effective process for hiring full-time staff, consider adding the following solutions to your staffing plan.
- Partner with a W2 staffing agency (and understand the risks of 1099 contracts) to provide nurses to fill short-term and permanent shifts.
- Create or add to your existing float pool.
- Adapt your staffing model to optimize scheduling flexibility.
- Maintain a talent pipeline throughout your recruiting efforts and keep in touch with promising candidates.
2. Support Mental Health and Wellness
Nurses are strong, but they are also human. To safeguard their health, protect them from burnout, especially when challenged by short staffing in nursing facilities. Consider incorporating mental wellness as a part of your company’s core values. Some example strategies for achieving this include:
- Encouraging human resources (HR) to meet with your team to review and encourage mental health benefits.
- Creating a committee with your nurses to promote mental wellness.
- Train management and staff on how to help at-risk nurses.
3. Cultivate a Positive Work Culture
Many nurses would like to change their current work environment. Establishing trust and demonstrating care is the first step to cultivating a positive work culture where nurses feel safe, appreciated, and set up for success. It takes time and patience, but is well worth the effort. Here are some ways to help achieve this foundation:
- Engage your staff through daily rounding and regular check-ins.
- Invite your nurses to organization committees so they can participate in the solutions.
- Train staff and enforce rules for workplace incivility, bullying, and violence.
- Provide your nursing management with resources to build a positive work environment.
4. Re-evaluate Compensation Packages
Nurses rated compensation high among factors most important to their work satisfaction and as a reason they’re considering leaving their jobs. To ensure your organization provides a fair and equitable pay and benefits package, consider comparing it to your competitors. Work with your staff to bridge any gaps. For example, offer planned incremental raises or provide tuition reimbursement for professional development.
5. Ease the Workload
Conduct an assessment of your nurses’ duties and unburden the staff with any unnecessary tasks. In addition, if administrative tasks decrease the direct care nursing staff provides to residents or patients, transfer those tasks to a different role. For instance, nurse coaches help patients who need detailed advice about important lifestyle changes and other types of guidance that involve hands-on interactions. They can help ease the burden on RNs and LPNs.
Need Help Developing a Resilient Staffing Strategy?
Trying to enlist a full schedule of highly qualified nursing professionals and contending with short staffing in nursing is a formidable task. Thankfully, you’re not alone. Find out how your organization can protect your nurses and improve patient outcomes through strategic staffing solutions by partnering with IntelyCare.