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1. Virtually all registered nurses (RNs) in the United States
believe that there is a nursing shortage, and the vast majority have witnessed
its effects firsthand. Most RNs also report that staffing problems at
the place where they work have gotten worse in the past year. (Table ES-1)
- Virtually all (95%) RNs who currently work as nurses agree that there
is a nursing shortage.
 An
overwhelming majority (88%) believes that in their community, the
supply of registered nurses working in patient care settings is less
than the demand.
- In the past year, at least two out of three working RNs have observed
an increase in the turnover of experienced nurses (72%), a greater number
of patients per nurse (68%), and increases in overtime or double shifts
for nurses (66%). Most (57%) have also witnessed increases in the use
of agency, internal float pool, or traveling nurses.
2. A large majority of RNs who work in hospitals believe that
the nursing shortage -- and staffing problems that are a direct consequence
of the shortage -- is having a negative impact on the quality of patient
care. Compounding these problems is an increasingly sick patient population
to contend with. (Tables ES-2a and ES-2b)
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- At least six out of ten RNs working in hospitals say that in the past
year they have witnessed a negative impact on the quality of patient
care as a result of:
"a greater number of patients per nurse" (74%),
"increases
in the turnover of experienced registered nurses" (73%),
"a
more acutely ill patient population" (71%),
"increases
in overtime or double shifts for nurses" (61%),
- Large majorities of RNs in hospitals believe that the nursing shortage
has been a major problem for:
"the
amount of time nurses have to devote to each of their patients"
(89%) and
"the
quality of patient care provided by nurses" (76%).
- A majority of hospital RNs also believe that the nursing shortage
has been a major problem for:
"the
ability of nurses to maintain patient safety" (64%),
"the
early detection of patient complications by nurses" (60%),
"the
amount of time nurses have to carry out physician orders" (56%),
and
"the
amount of time nurses have to collaborate with other team members"
(54%).
3. Barring a reversal of current trends, the nursing shortage
can be expected to worsen as RNs reduce their active participation in
the nursing workforce through retirement and the pursuit of jobs outside
the nursing profession. (Tables ES-3a, ES-3b, and ES-3c)
- More than eight out of ten (87%) RNs below the age of 65 are currently
working as paid nurses, including nine out of ten (90%) below the age
of 55 and more than seven out of ten (73%) between the ages of 55 and
64.
More than four out of ten (43%) RNs who are now working as nurses
say that they plan to leave their current positions within the next
three years. Most (61%) of these RNs plan to remain in the profession.
However, one in three (33%) who say they will leave their positions
say they plan to leave nursing altogether.
––RNs who plan to leave the profession within the next
three years account for one-seventh (14%) of the current nursing
workforce. Approximately one in ten RNs (9%) who are currently working
as nurses plan to pursue a job in another profession and 6% plan
to retire.
- RNs working longer hours cannot be expected to mitigate the effects
of the shortage. Almost one in five (18%) RNs say that they plan to
decrease the number of hours that they will work in the next year, compared
to just one in seven (14%) who plan to increase the number of hours
they will work.
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