Nursing Shortage as a Challenge in Healthcare

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Nurse leaders have a crucial responsibility in assisting the nursing staff in attaining quality healthcare that is client-based hence, high-quality standards that make patients have a positive outcome. Despite considerable efforts to establish high-quality healthcare standards, numerous healthcare facilities in the U.S. have experienced poor client results due to low-quality nursing care. As a result of inadequate healthcare and patient safety, healthcare organisations in America suffer overall yearly losses of $30 billion (American Organization of Nurse Executives, 2015).

The signification of establishing quality patient healthcare will be examined depending on the challenges experienced by a prominent healthcare organization in a major town in the U.S.A. The hospital's central role is to offer short-term healthcare for client's with adverse health problems due to infections, injury or genetic disorders. The facility is open 24 hours seven days a week. Apart from highly skilled and experienced nurses, the hospital consists of medical administrators, specialised physicians, technicians and healthcare equipment to deliver healthcare to patients with chronic and acute health circumstances. Other services offered by the hospital include patient counselling, emergency healthcare, laboratory services, scheduled surgeries, maternity services and therapeutic testing.

The hospital has been facing issues in healthcare delivery related to nursing understaffing which impairs its ability to monitor patients and execute treatment.  

Nursing Staff Shortages as a Challenge in the Healthcare System

            Registered nurses are the largest group of medical care practitioners in the U.S.A; however, the nursing vacancy rate continues to increase rapidly at a rate of 7.2% (Clancy, Effken & Pesut, 2008). The demand for nurses continues to grow not only in healthcare organisations but also in the community. By 2024, the enrollment rate for nurses is set to increase by 16%.

 The critical roles of nurses in this healthcare organisation include offering elderly care, educating and caring for patients with chronic health conditions for example obesity, arthritis, diabetes and dementia among others. 

            There are various reasons that explain nursing staff shortage at the hospital. The first is the diminishing rate of nurse intake at the facility because of a deficit in the nurse faculty which stems from thousands of potential nursing students being rejected at healthcare training institutions (Mitchell, 2013). Deficiency of the nursing staff also occurs because of the retirement of a significant number of nurses.

            Demographic changes are also another major challenge that pushes the expansion of the nursing staff. However, a significant amount of time is occupied to train and educate new nurses to fill the gap of retired nurses at the facility. In America, the nursing shortage is affected by the inability of nursing institutions to increase their nurse student enrollment rate because of the scarcity of nursing school trainers.

In the year 2012, the American Association of Colleges of Nursing (AACN) revealed that the U.S.A. nursing institutions rejected 79,659 qualified nursing students from baccalaureate and programs for graduate nurses because of an inadequate number of clinical training facilities and faculty, low budget, small classroom spaces and insufficient clinical tutors (Sherman & Pross, 2010). The factors that increase nursing staff shortages include the following: i) high retirement rate of the currently experienced nursing tutors; ii) age-delayed route of nursing staff acquiring high-quality healthcare education; iii) inability to occupy available training roles; iv) low compensation for nurses compared to other clinicians; v) delayed career development for nurses who want to partake tutor roles; vi) increasing hospital acuity due to lack of innovative technology which causes delayed patient diagnoses, treatment and discharge; vii) healthcare costs pressure which forces the hospital to decrease staffing; and viii) increased hospital workload that impairs nurses’ decision to remain in their profession.

The Influence of Nursing Staff Shortages on the Hospital’s Patient Care

            Because of the shortage of nurses, the facility’s remaining nurses usually work extremely long hour shifts under tense conditions, which leads to job dissatisfaction, fatigue and distress. Afflicted nurses incur high risks of making errors and mistakes in patient care delivery. As a result, patient quality begins to suffer leading to various complications that could have been prevented such as increased patient death rates, emergency room congestion, and medication inaccuracies (Azaare & Gross, 2011).

            However, the different incidences happening at the hospital and among the nursing professionals counteract the critical value statements, mission and vision. According to Clancy et al. (2008, p. 250), systems theory indicates that organizations have intrinsic drawbacks or inferential failures that can lead to extreme incidences in patient healthcare.

            Nurse leaders can offer a variety of solutions to solve the issues associated with nursing shortages such as employing foreign and minority nurses, increasing nurse compensation, conducting campaigns to enhance the image of the nursing profession and subsiding hospital funding towards nursing education (Bamford-Wade & Moss, 2010). The Affordable Care Act (ACA) recommends loan programs to the nursing student body and faculty members that can assist reduce the shortage of nurses. The primary loan programs include the following:

            The Nursing Education Loan Repayment Program (NELRP): It is a particular program sponsored by the U.S. government that assists in addressing the acute nursing staff shortage by presenting repayment of loans of up to 85% of current loans to registered and experienced nurses.

            The Nurse Faculty Loan Program (NFLP): The program addresses the need to increase the number of competent nurse tutors to simplify the training of student nurses.

SWOT Analysis of Organizational Factors

Due to nursing staff shortage, the hospital has been experiencing various drawbacks in delivering quality and safe patient care. The SWOT analysis helps the institution evaluate the drawbacks that have had major consequences on patient delivery and healthcare quality.

SWOT Analysis of Organizational Factors


A high training capability of the organizations to meet a wide range of nursing staff needs and the potential to enroll nursing experts.

Qualified and experienced nursing staff.

History of competent nursing care.


High retirement rate of nurses leading to nursing staff shortage.

Expenditure cut that causes short staffing of nurses.

Lack of cultural competency in nurses working with ethnic groups.

The hospital is diverting from primary nursing care training.

Inadequate regional nurse workforce training strategy.

The hospital’s system is underfunded therefore small donations, reimbursement and grants.

Nurses are unavailable to attend to patient needs often enough.

Inadequate direct remuneration services and nursing education.

Lack of technical assistance for nursing professions.

Limited strategic initiatives and healthcare funding.


Organize training programs for nurses at the hospital.

Ability to coordinate training resources with a low budget.

Use of technology such as telemedicine to leverage skilled professionals.

Nurses’ ability to collaborate to improve patient care.


Shortage of nurses that leads to inadequate primary care.

The need to increase nursing workforce by 2024.

Lack of significant nursing profession alternatives such as assistant nurses.


Competent nursing management is vital for the SWOT opportunities to be converted into actions that lead to positive change. Leaders are commissioners of change because they can translate plans into behaviour, motivate staff members to meet organisational goals and effectively communicate information of the change procedure to the hospital's staff (Huber, 2014).

Establishing the New Leadership Role at the Hospital

            The new leadership power that will be established at the hospital is the Chief Nursing Executive (CNE). The key responsibilities of the CNE will include implementing innovative systems in patient care exercises, guiding and directing the nursing staff to offer quality patient care, ensuring efficient and adequate training to nurses in offering patient care and integrating the best systems in nursing care to deliver quality healthcare (Tomlinson, 2012). The primary competencies of the CNE include skills, aptitudes and knowledge which are crucial for specifying the CNE’s impact at the facility.

Key Competencies for the Nursing Leadership Power

            According to the American Organization of Nurse Executives (2015), the five main leadership competencies that can effectively assist the Chief Nursing Executive (CNE) are proper knowledge of a healthcare setting, communication skills, business techniques, professionalism, relationship-establishment techniques and leadership skills.

            By building these competencies, the CNE will acquire a) awareness of systems comprehension and system theory; b) knowledge of quality nursing care and patient safety; c) detailed information from nursing professionals at the hospital and the techniques to implement for effective change; d) skills in team-building and relationship establishment; e) competent critical-thinking on worldwide trends in nursing care; and f) comprehension of hospital authority and politics, and power tendency (Grossman & Valiga, 2013).

Impact of Nursing Leadership Power on Patient Delivery

            Displaying proper authority and power is crucial for efficient nursing leadership. The presence of body enables nurse leaders to increase the recruitment and retention rate of nursing professions for increased patient output. Authority also allows nurse leaders to maintain nursing productivity by properly allocating training facilities without interference from the hospital management (Sherman & Pross, 2010). Additionally, these competent roles assist in regulating the hospital's financial performance hence positively influencing the outcome of patient care and cost-efficient healthcare delivery.


            Lucrative healthcare facilities are those that comprehend the effect of nursing professionals in patient delivery and include the nursing staff in dispatching healthcare issues. Nurse leaders are essential in the healthcare system as they portray nursing and organisational objectives to other stakeholders in the hospital. Proper knowledge of nursing responsibilities and assimilating them into a hospital's imperative outlining can help nursing professionals adapt to abrasive changes such as nurse shortages that impact quality and safety.  


American Organization of Nurse Executives. (2015). AONE Nurse Executive Competencies.

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October 05, 2023

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