Reasons, consequences, and suggested solutions for nursing workforce shortage
A review of literature
Keywords:
Nursing shortage, Nursing workforce, Nursing career, Quality careAbstract
Nurses are an integral part of the health care system. Studies have shown that when hospitals and other health facilities have the right number of nurses, it improves patient safety, mortality rates, and overall patient outcomes. The lack of nurses is a complex problem with several causes. There are many aspects to play, from the aging population of nurses, fatigue from work overload, stressful working environment, low wages and work dissatisfaction. The combination of these factors causes a shortage of nurses and causes them to grow over time. The mental and physical pressure on nurses can increase their burnt out and is the main reason for the hectic retraction of nurses from their professions. This literature review is discussing the main reasons for the nursing shortage, and its negative impact on health systems and patient care, then finally discusses the solutions for this problem from the literature.
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Aiken, L, Clarke, S & Sloane, D 2002, For the International Hospital Outcomes Research Consortium, Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction, Journal of American Medical Association, vol. 288, no.16, pp.198-199.
Aiken, L, Clarke, S, Sloane, D, Sochalski, J, Busse, R & Clarke, H 2001, Nurses` reports on hospital care in five countries: the ways in which nurses` work is structured have left nurses among the least satisfied workers, and the problem is getting worse, Health Affairs, vol. 20, no. 3, pp. 43-53.
Aiken, L, H, Clarke, S, P, Sloane, D, M, Lake, E & Cheney, T 2008, Effects of hospital care environment on patient mortality and nurse outcomes, Journal of Nursing Administration, vol. 38, no. 5, pp. 223-229.
Andrews, J, Manthorpe, J & Watson, R 2005, Employment transitions for older nurses: a qualitative study, Journal of Advanced Nursing, vol. 51, no. 3, pp. 298‑306.
Atkins, R 2009, Getting the Most from Nursing School: A Guide to Becoming a Nurse, Jones and Bartlett, Ontario, Canada.
Australian Bureau of Statistics 2008, 2006 to 2101 Population Projections Australia, Cat, No. 3222.0, Canberra: Australian Bureau of Statistics, viewed 17 April 2022, <http://www.abs.gov.au/Ausstats/abs@.nsf/mf/3222.0>
Australian Health Workforce Advisory Committee (AHWAC) 2004,The Australian nursing workforce ‑ an overview of workforce planning 2001‑2004, Sydney, AHWAC Report 204.2, viewed 18 April 2022, <http://www.ahwo.gov.au/publications.asp>
Australian Institute of Health and Welfare (AIHW) 2006, Australia’s health 2006 (AIHW cat. no. AUS 73), viewed 18 April 2022, <http://www.aihw.gov.au/publications/index.cfm/title/10321>
Australian Institute of Health and Welfare (AIHW) 2011, Nursing and midwifery labour force 2009, AIHW bulletin no. 90. Cat. no. AUS 139, Canberra: AIHW, viewed 19 April 2022, <http://www.aihw.gov.au/publication-detail/?id=10737419682>.
Australian Nursing Federation 2004, Submission to the Productivity Commission Research Study: Implications of the ageing of Australia’s population, viewed 19 April 2022,
Australian Institute of Health and Welfare 2005, Australia’s welfare 2005. AIHW cat. no. AUS65, Canberra: AIHW, viewed 18 April 2022, pp.10-26
Australian Nursing Federation 2005, More nursing undergraduate places needed, viewed 17 April 2022, <http://www.anf.org.au/html/media/news_media_050718.html>
Baldwin, D, C & Daugherty, S, R 2004, Sleep deprivation and fatigue in residency training: results of a national survey of first- and second-year residents, Sleep Journal, vol. 27, no. 2, pp. 217-223.
Baldwin, D, C 2003, A national survey of residents’ self reported work hours: thinking beyond specialty, Academic Medicine, vol.78, no. 11, pp. 1154-1163.
Borycki, E & Samuel, P 2001, Recruitment, retention and the battle for continued growth of nursing, Perspectives, vol. 25, no. 4, pp. 19–20.
Buerhaus, P, I, Staiger, D, O & Auerbach, D, I 2004, New signs of a strengthening U.S. nurse labor market?, Health Affairs, vol. 4, pp. 526-533.
Burke, R 2003, Hospital restructuring, workload and nursing staff satisfaction and work experience, Health Care Management, vol. 22, no. 2, pp. 99–107.
Burke, R, L 2005, When bad things happen to good organizations: A focused approach to recovery using the essentials of magnetism, Nursing Administration Quarterly, vol. 29, no. 3, pp. 228–241.
Cohen, D 2006, The aging nursing workforce: How to retain experienced nurses, Journal of Healthcare Management, vol. 51, no. 4, pp. 233–245.
Cohen, R, Ehrlich-Jones, L, Burns, K, Frank-Stromborg, M, Flanagan, J & Askins, D 2005, The nursing shortage: can we look to teachers as a source of support, Nursing Forum, vol. 40, no. 3, pp. 88–95.
Curran, C 2003, Nurse recruitment: A waste of postage, paper, and people, Nursing Economics, vol. 21, no. 1, pp. 5-32.
Dæhlen, M 2007,Job values, gender and profession: a comparative study of the transition from school to work, Journal of Education and Work, vol. 20 no. 2, pp.107–121.
Dimick, J, Swoboda, S, Pronovost, P & Lipsett, P 2001, Effect of nurse to- patient ratio in the intensive care unit on pulmonary complications and resource use after hepatectomy, American Journal of Critical Care, vol. 10, pp. 376-382.
Duffield, C & O’Brien-Pallas, L 2003, The causes and consequences of nursing shortages: a helicopter view of the research, Australian Health Review, vol. 26, pp.186–193.
Fitzgerald, D 2007, 'Aging, experienced nurses: their value and needs', Contemporary Nurse: A Journal for the Australian Nursing Profession, vol. 24, no. 2, pp. 237-243, viewed 17 April 2022, (CINAHL with Full Text).
Gardner, J & Walton, J 2011, 'Striving to Be Heard and Recognized: Nurse Solutions for Improvement In the Outpatient Hemodialysis Work Environment', Nephrology Nursing Journal, vol. 38, no. 3, pp. 239-253, viewed 17 April 2022, (CINAHL with Full Text).
Gaynor, L, Gallasch, T, Yorkston, E, Stewart, S, Bogossian, F, Fairweather, C, Foley, D, Nutter, H, Thompson, J, Stewart, L, Anastasi, J, Kelly, J, Barnes, L, Glover, P, & Turner, C 2007, 'The future nursing workforce in Australia: baseline data for a prospective study of the profile, attrition rates and graduate outcomes in a contemporary cohort of undergraduates', Australian Journal of Advanced Nursing, vol. 25, no. 2, pp. 11-20, viewed 17 April 2022, (CINAHL with Full Text).
Gottlieb, S 2003, Patients are at risk because of nurses' long hours, British Medical Journal, vol.15, no. 327, p. 1128.
Halm, M, Peterson, M, Kandels, M, Sabo, J, Blalock, M, Braden, R, Gryczman, A, Krisko-Hagel, K, Larson, D, Lemay, D, Sisler, B, Strom, L & Topham, D 2005, 'Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction', Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, vol. 19, no. 5, pp. 241-254, viewed 19 April 2022, (CINAHL with Full Text).
Huerta, S 2003, Recruitment and retention: The Magnet perspective, Journal of Illinois Nursing, vol. 100, no. 4, pp. 4-6.
Jacobsen, C 2002, Surviving the perfect storm: staff perceptions of mandatory overtime, Healthcare Law, Ethics and Regulation, vol.4, no. 3, pp. 57-66.
Janney, M, A, Horstmann, P, L & Bane, D 2001, Promoting registered nurse retention through shared decision making, Journal of Nursing Administration, vol. 13, no.10, pp. 483–88.
Kazanjian, A, Green, C, Wong, J & Reid, R 2005, Effect of the hospital nursing environment on patient mortality: a systematic review, Journal of Health Services Research and Policy, vol. 10, no. 2, pp. 111‑117.
Khowaja, K, Merchant, R, J & Hiram, D 2005, Registered nurses' perception of work satisfaction at a tertiary care university hospital, Journal of Nursing Management, vol.13, no, 1, pp. 32-39.
Lambert, V & Lambert, C 2001, Literature review of role stress/ strain on nurses: An international perspective, Journal of Nursing Health Sciences, vol. 3, pp.161–172.
Laschinger, H & Leiter, M 2006, 'The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement', Journal of Nursing Administration, vol.36, no. 5, pp. 259-267, viewed 20 April 2022, (CINAHL with Full Text).
Lu, H, While, A, E & Barriball, K, L 2004, Job satisfaction among nurses: a literature review, International Journal of Nursing Studies, vol. 42, pp. 211-227.
McGillis-Hall, L, Doran, D & Pink, L 2008, Outcomes of interventions to improve hospital nursing work environments, Journal of Nursing Administration, vol. 38, no. 1, pp. 40-46.
Milisen, K 2006, Work environment and workforce problems: a cross-sectional questionnaire survey of hospital nurses in Belgium, International Journal of Nursing Study, vol. 43, no. 6, pp. 745–754.
Mooney, M, Glacken, M & O'Brien, F 2008, Choosing nursing as a career: a qualitative study, Nurse Education Today, vol. 28, no. 3, pp. 385–392.
Moseley, A, Jeffers, L & Paterson, J 2008, 'The retention of the older nursing workforce: a literature review exploring factors which influence the retention and turnover of older nurses', Contemporary Nurse, A Journal of the Australian Nursing Profession, 30, 1, pp. 46-56, viewed 20 April 2022, (CINAHL with Full Text).
Needleman, J & Hassmiller, S 2009, The role of nurses in improving hospital quality and efficiency: Real-world results, Health Affairs, vol. 28, p. 625-633.
Needleman, J, Buerhaus, P, Mattke, S, Stewart, M & Zelevinsky, K 2002, Nurse-staffing levels and the quality of care in hospitals, The New England Journal of Medicine, vol. 326, no. 22, pp.1715-1722.
Neilson, G, R & Jones, M, C 2011, What predicts the selection of nursing as a career choice in 5th and 6th year school students?, Nurse Education Today, vol. 2, pp. 1-6.
Nevidjon, B & Erickson, J 2001, The nursing shortage: Solutions for the short and long term, Online Journal of Issues in Nursing, vol. 6, no. 1, pp.1 –13.
O’Brien-Pallas, L, Duffield, C & Alksnis, C 2004, Who will be there to nurse? Retention of nurses nearing retirement, Journal of Nursing Administration, vol. 34, pp. 298–302.
Preston, B 2009, 'The Australian nurse and midwifery workforce: issues, developments and the future', Collegian, vol.16, no.1, pp. 25-34, viewed 17 April 2022, (CINAHL with Full Text).
Priest, A 2006, What’s ailing our nurses? A discussion of the major issues affecting nursing human resources in Canada, viewed 17 April 2022,
Rafferty, A, Clarke, S, Coles, J, Ball, J, James, P, McKee, M & Aiken, L 2007, 'Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records', International Journal of Nursing Studies, 44, 2, pp. 175-182, viewed 17 April 2022, (CINAHL with Full Text).
Rogers, B 2004, Improving safety in health care environments – Institute of Medicine report, American Association of Occupational Health Nurses Journal, vol. 52, no. 10, pp. 417–419.
Scott, L, D, Rogers, A, E, Hwang, W, T & Zhang, Y 2006, Effects of critical care nurses’ work hours on vigilance and patients’ safety, American Journal of Critical Care, vol. 15, no. 1, pp. 30–37.
Shader, K, Broome, M, E, Broome, C, D, West, M, E & Nash, M 2001, Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center, Journal of Nursing Administration, vol. 31, no. 4, pp. 210-216.
Sheward, L, Hunt, J, Hagen, S, Macleod, M & Ball, J 2005, The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction, Journal of Nursing Management, vol. 13, pp. 51–60.
Slater, P & McCormack, B 2007, An exploration of the factor structure of the nursing work index, World views on Evidence Based Nursing, vol. 4, no. 1, pp. 30–39.
Stone, P, W, Larson, E, L, Mooney-Kane, C, Smolowitz, J, Lin, S, X & Dick A, W 2006, Organizational climate and intensive care unit nurses’ intention to leave, Critical Care Medicine, vol. 34, no. 7, pp.1907-1912.
Stordeur, S & D’Hoore, W 2007, Organizational configuration of hospitals succeeding in attracting and retaining nurses, Journal of Advance Nursing, vol. 57, no. 1, pp. 45–58.
Takase, M, Maude, P & Manias, E 2005, Explaining nurses’ work behaviour from their perception of the environment and work values, International Journal of Nursing Studies, vol. 42, pp. 889–898.
Tellez, M, Spetz, J, Seago, J, A, Harrington, CH, M & Kitchener, M 2004, Do Wages Matter?: A Backward Bend in the California RN Labor Supply Policy, Politics and Nursing Practice, vol. 10, no. 3, pp.195–203.
Teng, C, Shyu, Y, Chiou, W, Fan, H & Lam, S 2010, 'Interactive effects of nurse-experienced time pressure and burnout on patient safety: A cross-sectional survey', International Journal of Nursing Studies, vol. 47, no. 11, pp. 1442-1450, 17 April 2022, (CINAHL with Full Text).
Thomas-Hawkins, C, Denno, M, Currier, H & Wick, G 2003, Staff nurses’ perceptions of the work environment in freestanding hemodialysis facilities, Nephrology Nursing Journal, vol. 30, pp.169-183.
Thomas-Hawkins, C, Flynn, L & Clarke, S, P 2008, Relationships between registered nurse staffing, processes of nursing care, and nurse-reported patient outcomes in chronic hemodialysis units, Nephrology Nursing Journal, vol. 35, pp.123-131.
Vahey, D, C, Aiken L, H, Sloane, D, M, Clarke, S, P & Vargas, D 2004, Nurse burnout and patient satisfaction, Medical Care, vol. 42, no. 2, pp. 57–66.
Van Bogaert, P, Meulemans, H, Clarke, S, Vermeyen, K & P 2009, 'Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model', Journal of Advanced Nursing, vol. 65, no.10, pp. 2175-2185, viewed 17 April 2022, (CINAHL with Full Text).
Van Saane, N, Sluiter, J, K, Verbeek, J, H, A, M & Frings-Dresen, M, H, W 2003, Reliability and validity of instruments measuring job satisfaction; systematic review, Occupational Medicine, vol. 53, no. 3, pp. 191-200.
Vander-Hulst, M 2003, Long work hours and health, Scandinavian Journal of Work Environment Health, vol. 29, no. 3, pp.171-188.
Ward‑Smith, P, Hunt, C, Smith, J, Teasley, S, Carroll, C & Sexton, K 2007, Issues and opportunities for retaining experienced nurses at the bedside, Journal of Nursing Administration, vol. 37, no.11, pp. 485‑487.
Whitman, G, Yookyung, K, Davidson, L, Wolf, G & Wang, S 2002, Impact of staffing on patient outcomes across specialty units, Journal of Nursing Administration, vol. 32, no.12, pp. 633-639.
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