Running head: THE NURSING SHORTAGE Khan 1

The Shortage of Nurses in Health Care

Marium Khan

Youngstown State University

NURS 2610: Contemporary Nursing

Dr. Louise Aurilio

Fall 2015
THE NURSING SHORTAGE Khan 2

Abstract

The nursing shortage is not just a problem we face today, it has been a problem left unaddressed

since the mid-1930’s with the most severe drop in the 1990’s. It has now become more than just

a nationwide problem, causing the number of nurses in Canada to decline as well. One of the

causes of this is an economical decline due to the economy not being stable enough to support its

health care workers in a professional environment. Dissatisfaction in the workforce has also

caused a rapid decline in the health care system due to nurses not receiving enough respect and

credit for what they do. This can all be fixed by taking small steps like the mandate California

passed in 1999 that became effective in 2004 that mandated hospitals to have an equal patient to

nurse ratio to make sure nurses were not being overworked. This mandate allowed the number of

nurses to increase and the numbers of patients-to-nurses become lower than the number of nurses

on call. Also, Nurses are expected to rise as a profession by 2022 according to the Bureau of

Labor Statistics’ Employment Projections. Nursing shortages are hard to foresee and can be easy

to overcome with the right steps in the correct direction.

The Nursing Shortage

The History of the Nursing Shortage

Nurses have always been in high demand and in short supply and this nursing shortage

started around the mid-1930s during the hardest time in the history of the United States, the

Great Depression (Whelan 2015, para.1). During this time, many nurses were let go due to the

economy being so bad that they could not afford to pay them anymore. The unemployment rates

of nurses during this time skyrocketed drastically and it was during this time that nurses were

also in great demand. Nurses all around the United States were expected to work long hours and

keep up with their professional image even if they were not employed. Even though nurses were

being let go due to the economy “some blamed nurses themselves for creating the shortage by

failing to live up to the ideals of their profession and refusing to work” (Whelan 2015, para. 6).

As quoted by Whelan, nurses were sometimes often seen as the culprits for the problem facing

the health care field even though they wanted to help as much as they could.

The Cause of the Shortage

“The U.S. healthcare system has experienced periodic nursing shortages over the past

fifty years. The most recent shortage, however, which began in the late 1990s, is more severe

than previous ones and promises to have long-term percussions” (Clark 2007, pg. 299). These

percussions usually are due to many causes that result in the shortage of nurses around the world.

Two of the main causes that have affected the nursing shortage are the economic instability and

the dissatisfaction faced by nurses in the workforce. Economic instability has caused nursing

shortage due to the fact that there is not enough money to pay all the nurses in a full time

position. “To reduce costs, organizations, including those in health care, have moved toward a
THE NURSING SHORTAGE Khan 4

more flexible contingent workforce, resulting in a significant increase in part-time (PT) and

casual employment over the past decade” (Baumann 2012, pg. 168). Baumann explains in his

journal that many health care facilities, especially hospitals, had to cut back on all of its full time

nurses and also had to limit the type of workforce that was expected of the nurses. This included

how much direct contact with the patients each nurse experienced and the hours a day they

worked. It is not just in the United States that there is a shortage of nurses, “for example, health-

care restructuring in the 1990s resulted in a loss of nurses from Ontario's labour market.

Hospitals and long–term care facilities were most affected, losing close to 10 percent of their

nursing workforce” (Baumann 2012, pg. 168). In his journal, Baumann explains that this loss

happened because the economy short-circuited and was unable to keep up with the demands of

its people and this caused a great loss and resulted in a lot of cutbacks in the health care field.

The reduction in cost and the decrease in economy also caused a decrease in acceptance for

nurses in the baccalaureate nursing programs around the nation because of the insufficient

number of nurses in staff at the universities to teach the program to incoming nursing students.

This decrease in growth also caused a shortage of nurses in the health care field and caused many

hospitals to have to cut back on how many nurses it kept on staff. Mee mentions in her journal

that due to “hospital restructuring and cost cutting in the early nineties eliminated a lot of RN

positions, leaving remaining staff overburdened and accelerating the flight of nurses from the

profession” (Mee 2003, pg.52). This process left nurses unsatisfied with their professions.

When nurses become dissatisfied with their profession, it leads to nursing shortages

around the nation and causes hospitals to downsize. “A British study (Shields, 2001) determined

that nurses who report job dissatisfaction have a 65% higher probability of leaving their job”

(Mee 2003, pg. 52). This study explains that the dissatisfaction of nurses is very high in health
THE NURSING SHORTAGE Khan 5

care facilities and this causes most of them to leave their desired profession. This dissatisfaction

can be classified under that fact that nurses do not receive that respect that they are owed of their

nursing roles by their employers, physicians, and others in the health care system. Another form

of dissatisfaction that nurses face in their work is that they are usually caught up in work that it

not related to nursing and that they do not have enough direct contact with the patients that are

present in the clinics and hospitals. Mee also goes on to tell the reader that nurses usually

complain more about their working circumstances rather than the pay they receive. Nurses

usually leave once they see no satisfaction or respect in the hard work and long hours they put

into their professions.

How to Fix the Shortages

In order to see the shortage subside, there are many forms of actions that can be taken to

increase the economy and the nursing satisfaction ate in clinics and hospitals. In order to fix the

patient-to-nurse ration in California, it implemented a mandate that required a specific patient to

nurse ratio and there was a specific number they could not fall under. Mathew explains in his

journal that nursing situations got so good that there were less patients per nurse and that

increased staffing options for California nurses (Mathew 2012, pg. 160). Also “according to the

Bureau of Labor Statistics’ Employment Projections 2012-2022 released in December 2013,

Registered Nursing (RN) is listed among the top occupations in terms of job growth through

2022” (Rosseter 2014, pg. 1). This projection will increase nurses workforce everywhere and

open up a lot more opportunities that will help nurses advance in their field.

In conclusion, the nursing profession has been seeing shortages for a long time due to

economical declines and dissatisfactions. These can be fixed only by helping the economy and

by making sure that nurses are doing what they have trained for from the beginning.
THE NURSING SHORTAGE Khan 6

References

Baumann, A., Hunsberger, M., & Crea-Arsenio, M. (2012). Impact of Public Policy on Nursing

Employment: Providing the Evidence. Canadian Public Policy / Analyse De Politiques,

38(2), 167-179. Retrieved October 25, 2015, from http://www.jstor.org/stable/41756753

Clark, D. (2007). Nurses on the Move: Migration and the Global Health Care Economy by

Mireille Kingma. Industrial and Labor Relations Review, 60(2), 299-301. Retrieved

October 25, 2015, from http://www.jstor.org/stable/25249083

McHugh, M., Carthon, M., Sloane, D., Wu, E., Kelly, L., & Aiken, L. (2012). Impact of Nurse

Staffing Mandates on Safety-Net Hospitals: Lessons from California. The Milbank

Quarterly, 90(1), 160-186. Retrieved October 25, 2015, from

http://www.jstor.org/stable/23209090

Mee, C., & Robinson, E. (2003). What's different about this nursing shortage? Nursing2015,

33(1), 51-55. Retrieved October 25, 2015, from

http://www.nursingcenter.com/journalarticle?Article_ID=289535

Rosseter, R. (2014, April 24). Nursing Shortage. Retrieved October 25, 2015, from

http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage

Whelan, J. (2015). "Where Did All the Nurse Go?": Mid-Twentieth Century Nurse Shortages,

Causes, Solutions, and Continuing Problems. Retrieved October 27, 2015, from

http://www.nursing.upenn.edu/nhhc/Pages/WhereDoAlltheNurseGoMid-

TwentiethCenturyNurseShortagesCausesSolutionsandContinuingProblems.aspx