America is Paying the Price for Critical Nursing Shortages


The shortage of nurses has reached a point where hospitals in the US are facing massively increased staffing costs, according to an analysis released by Reuters on October 20. These rising costs are due to the measures that hospitals are taking to recruit and retain sufficient nursing staff, rather than closing beds or risking patient safety.

Hospitals in rural areas, already facing financial deficits, appear to be the hardest hit. It was reported that West Virginia’s Charleston Area Medical Center, in the economically depressed coal country, spent $12 million on “travel nurses” this year, double that of three years ago. “I’ve been a nurse 40 years, and the shortage is the worst I’ve ever seen it,” said Ron Moore, recently retired vice president and chief nursing officer for the center.

The nationwide cost for travel nurses alone nearly doubled over three years to $4.8 billion in 2017, according to Staffing Industry Analysts.

Measures which hospitals are introducing to recruit and retain nurses include offering higher salaries – especially in difficult to fill specialist positions, signing-up and retaining bonuses, student loan repayments, free housing and career advancement opportunities. They are also increasingly relying on using travel nurses at high cost and recruiting foreign nurses to fill staffing gaps — that is if they can get their work visas.


While the shortage of nurses has been a constant problem, it is currently reaching critical proportions with no relief in sight. US Bureau of Labor Statistics reported that nursing is one of the most rapidly growing jobs in the market and projected that by 2024 nearly 450,000 new nursing jobs would have been created with an estimated over one million vacancies. Two of the factors driving the current shortage of nurses – the aging population, with its burden of chronic disease, and increased utilization of health care services – are also the reasons for the projected continuing rise in the demand for nurses.

A further factor which will worsen the shortage significantly is the pending retirement of large numbers of experienced nurses who started nursing in the 1970’s when it was a popular career choice for a woman. It is estimated that more than 700,000 nurses will be leaving the workforce by 2024. This will not only affect nursing numbers but also create a gap in accumulated knowledge, skill, and experience which contribute to the quality of patient care.

Even in the face of the critical nurse shortage, there is also a limited capacity for admitting all the qualified applicants to nursing schools, with nearly 80,000 applicants reportedly turned away in 2012. There are a shortage of faculty, classroom space, and clinical sites as well as budget constraints.

The American Nurses Association is lobbying Congress to increase funding for Title VIII of the Public Health Service Act which, among other things, provides federal grants for nursing schools and the advancement of other educational programs, as well as repayment of student loans. “We saw this money reduced by $2.15 million this year, and when you adjust for inflation, we’ve seen a 30 percent decline in that money since 1971,” reported by Pam Cipriano, president of the American Nurses Association. “To maintain our supply and the pipeline, Title VIII is critical.”


Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.

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