Looking Ahead: The Nursing Shortage Isn't Going Anywhere

Burnout, contract labor opportunities, family care, retirement, and more are intensifying the shortage, experts say.

There's no reprieve in sight next year for the ongoing nursing shortage that has been exacerbated by COVID-19, experts say.

A shortage of nurses will be intensified as employees leave because of burnout, retirement, contract labor opportunities, taking care of family, or refusing to take the COVID-19 vaccine, according to a recent report by report released by Moody's Investors Service.

But the need for nurses will also intensify into 2022, particularly as patient acuity related to both COVID-19 and non-pandemic cases rises, requiring more advanced care, the report says.

By 2022, there will be far more RN jobs available than any other profession, at more than 100,000 per year, according to the American Nurses Association (ANA).

More than 500,000 seasoned RNs are anticipated to retire by 2022. The U.S. Bureau of Labor Statistics is projecting the need for 1.1 million new RNs for expansion and replacement of retirees, the ANA says.

"Over the past decade, the average age of employed RNs has increased by nearly two years, from 42.7 years in 2000 to 44.6 years in 2010," according to the ANA. "These factors, combined with an anticipated strengthening of the economy, will create a renewed critical shortage for nurses."

Part of the solution to the shortage is for nurse leaders to consider different staffing models, says Rachel Polhemus, a senior partner with WittKieffer, a global executive search firm headquartered in Chicago that specializes in senior-level, mid-level, and interim executive search.

HealthLeaders spoke with Polhemus about what nurse leaders can expect with staffing next year.

This transcript has been lightly edited for length and clarity.

HealthLeaders: How critical is the shortage going to be in 2022?

Rachel Polhemus: It's going to continue. It's an issue now and it doesn't feel as though there's any relief right now. So much is driven by the "Great Resignation" that's occurred, and I think there's a burnout factor for nurses as well. You've got both of those issues, and the vaccine mandate, which is an issue. COVID is not going away, so you have that factor. I don't believe there will be a change in the future, or at least for the next year.

HL: Do you see it getting worse?

Polhemus: Yes. The burnout factor alone is a huge issue. Nurses are frustrated because people have a choice to get vaccinated, but they're not getting vaccinated and they're showing up at hospitals, putting pressure on the staffing issues that they're already having. Nurses are finding more balanced nursing opportunities, whether they're becoming travelers, going to another organization, working with a private surgery center, going to a doctor's office, or working telemedicine. They're making sure to de-stress themselves.

HL: What is nursing's job growth expected to be next year?

Polhemus: There are a lot of programs being implemented [at healthcare organizations]. Pre-COVID, the focus was around having a staffing workforce that was all RNs, and now organizations are taking a step back and thinking about using LPNs and CNAs and looking at all the different types of staffing models. They're going to have to staff differently because you just can't find enough RNs. You've got to look at other types of nursing practice where you can plug them in, in a place where they will be practicing at top of license.

HL: One of the partial solutions has been travel nurses; what do you see happening with that industry next year, regarding growth?

Polhemus: That will continue to grow. Nurses have the opportunity to pick where they want to work and live, and I believe the travel industry will continue to grow based on the demand and the need for backfilling for the staffing services.

HL: How likely is it that travel nursing pay rates will begin to level out in 2022?

Polhemus:  Unfortunately, we've not seen them level out. It's a continual issue. The financial stress of using [agencies], regardless of scale, is a huge burden. And that's really where your cost is. And so, organizations, unfortunately, continue to need to be supported by staffing agencies. Unfortunately, it's a model that they're in a place where, because they have a supply and there's a real need for it, [agencies] can continue to demand the prices

HL: How do you anticipate nursing schools to help solve the staffing crisis over the next year or two?

Polhemus: They're already doing that. Hospitals and health systems are building relationships with community colleges and universities across the board and finding ways to start with recruitment at an earlier age, about the high school level, to encourage new graduates to look at nursing school and take a step at the associate degree or some type of nursing assistance degree. There's a real push there and there are opportunities where they're doing a lot to provide financial support. You'll see organizations say, "We'll pay for your college or your university or your degree, but you need to commit to us for a period of time." We're seeing a higher volume of this and it's a definite strategy to retain the staff and a way to build them as well.

HL: What is going to be the key to staffing, going forward?

Polhemus: It comes down to leadership. Even at the director level, there's a real need to continue to have great leaders help support the organization and, frankly, just build talent and retain the talent. It's a top-down and bottom-up approach for leaders to do what they can to provide an environment where their staff feels valued, where their staff has balance, and where the staff has wellness. It's not just about recruiting; it's about leaders engaging staff at all levels. That's really important.