The National Nursing Shortage: Impact on Rural Areas
The national nursing shortage is having its biggest impact on small, rural communities. When it comes to recruiting, these small communities simply can’t compete. As a result, hospitals in these areas are forced to stop offering certain procedures and require their staff to work multiple jobs at once.
A recent study conducted by the Nebraska market research and consulting company PRC revealed that less than half of U.S. nurses feel fully engaged while on the job. Approximately 14% of nurses surveyed described themselves as unengaged. The findings are part of the 2023 National Nursing Engagement Report, which surveyed 1,923 registered nurses from 37 hospitals across the country. The survey asked nurses 34 questions about nurse quality indicators, engagement, burnout, and retention.
Burnt Out and Getting Out: American Hospitals Struggle with Increasing Nurse Shortage
According to the report, the nurses evaluated the following nurse quality indicators:
- Fundamentals of quality nursing care
- Autonomy
- Teamwork and collaboration among nurses
- Adequacy of resources and staffing
- Interpersonal relationships
- Leadership access and responsiveness
- Professional development
Fully engaged nurses, as defined by PRC, are emotionally and intellectually connected to their hospitals and invested in their success. They have a positive influence on patient care, experience fewer absences from work, and actively participate in mentoring other nurses and advocating for their hospital. On the other hand, unengaged nurses are more focused on ending their shifts, look forward to breaks, call off work during stressful times, and see patients as diagnoses or tasks.
The report emphasizes the need for nurses to be provided with more opportunities for staff development, engagement with leadership, and autonomous nursing practice. According to Candice Whealon, an advanced practice registered nurse and assistant clinical professor, nurses typically work in fast-paced, high-stress environments. To increase engagement, they must be given time and opportunities to participate in decision-making. Health care organizations should also support nurses’ professional development so they can effectively communicate the realities of their work environment and advocate for their departmental needs.
The report also revealed that among different age groups, millennial nurses have the highest rates of unengaged nurses at 17.1%, followed by Generation X at 14% and baby boomers at 10.5%. Rhonda Collins, a registered nurse and chief clinical officer, noted that turnover rates are highest among nurses with less than two years of experience, many of whom graduated during or right after the COVID-19 pandemic without significant clinical practice.
The study found that night shift nurses have higher rates of unengagement at 18.4% compared to day shift nurses at 12.8%. Emergency departments had the highest rate of unengaged nurses at 18%, followed by inpatient settings at 14.7% and other settings at 14.3%. This can be attributed to the physically and mentally taxing nature of the night shift, as well as limited administrative support during that time.
Although the U.S. Bureau of Labor Statistics projects an average of 194,500 annual openings for registered nurses through 2030 with a growth rate of 9%, it’s important to note that many unengaged nurses do not plan to leave their organizations. In fact, 82% of all nurses surveyed plan to remain at their current organizations for the next two years, including 50% of unengaged nurses. This highlights the need for further research to understand this unique population of nurses who feel a sense of duty and dedication to their patients.
To combat the lack of engagement and burnout in the nursing workforce, Elaina McAdams Hall, a registered nurse and chief quality officer, offers four strategies:
- Invest in education and training, with a focus on reskilling and upskilling opportunities within the organization.
- Improve work-life balance by implementing flexible scheduling, reasonable shift lengths, and adequate time off.
- Enhance compensation and benefits by offering competitive salaries, benefits packages, and performance-based incentives.
- Create a supportive work environment by fostering a culture of appreciation, respect, and open communication. Provide access to mental health resources and involve nurses in decision-making processes. Offer opportunities for specialization, leadership roles, and ongoing professional development.
Addressing the nursing workforce shortage requires a comprehensive approach that combines these strategies with ongoing research and advocacy for the nursing profession at both local and national levels. With the growing demand for qualified nurses, it’s crucial to find solutions that will attract and retain nursing talent.
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