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The Nursing Shortage and Its Impact on Patient Safety

Current State of Nursing Shortage

Nursing shortage statistics confirm that the healthcare industry is facing an urgent need for additional nurses. And, according to the American Association of Colleges of Nursing (AACN), the current shortage of RNs in the U.S. is only expected to increase as the need for healthcare expands and Baby Boomers age and ultimately retire. By 2022, there will be far more RN jobs available than any other profession. With more than 500,000 seasoned nurses leaving the profession (to retire) by 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs for expansion and replacement of retirees.

In fact, by 2026, the Bureau of Labor Statistics’ Employment Projections 2016-2026, lists RNs among the top occupations in terms of job growth, expected to reach 3.4 million by 2026 — equaling 438,100 new registered nurses, a roughly 15% increase. This estimate, however, does not include the Bureau’s projected need for an additional 203,700 new RNs each year (through 2026) to account for the Baby Boomers’ retirement rate and standard demand for newly created positions. The nursing community is working collaboratively to address the nursing shortage hospitals are facing, as the crisis is only growing.

Insights Into the Nursing Shortage

Solving for the current nursing shortage, while also preparing for the future increased demand for nurses, is an extremely complex challenge. With many different reasons for nursing shortage, the nursing community must consider a multifaceted approach. The causes of nursing shortage vary, but all ultimately contribute to the current crisis, including:

Baby Boomers Retiring

Baby Boomers make up the largest generation in the country, many of whom are nurses (500,000 are expected to retire by 2022). As veteran nurses leave the healthcare industry and begin retirement, organizations are struggling to replace them quickly enough.

Need for Training/Education

Nurse faculty are not exempt to the nursing shortage, creating an initial hurdle to getting new nurses in the door. With a decrease in nurse faculty, classroom space, and training resources, nursing students are in need of receiving education/training in an efficient and effective manner.

High Turnover Rates

With a national average of 17.1% for registered nurse (RN) turnover year over year, healthcare leaders are struggling to keep up with staffing ratios. As an added concern, new graduate nurse retention statistics suggest that as many as 30% of new graduate nurses will leave during their first year of practice, increasing to as many as 57% within the second year.

Increase in Life Expectancy

As modern medicine improves, so does the average life expectancy for individuals, creating an increased need for nurses caring for older, aging, and more complex patient populations.

Impact on Patient Safety

Given that nurses spend more one-on-one time with patients than any other healthcare worker makes their ability to perform at the highest level essential to providing safe patient care. As such, when a nurse’s time or resources are reduced, patient safety is negatively impacted. The relationship between nursing shortage and patient safety has been linked in various studies, as healthcare leaders struggle to minimize the effects of short staffing in nursing on patient care. Patient safety has been linked to the nursing shortage impact on the nursing profession through:

  • Decreased quality of care
  • Lower patient satisfaction scores
  • Higher patient mortality
  • Overcrowded emergency departments
  • Additional medication administration errors

Due to the high-intensity nature of nurses’ work, nurses become at risk of committing errors while providing routine care. Without adequate staffing ratios, nurses are responsible for caring for more patients, often leading to additional interruptions which is shown to increase patient safety errors as well. Units without enough nurses on staff may require excessive overtime shifts, or routine double shifts. In one particular medication error that proved fatal, the nurse noted that her fatigue from working a double shift the previous day played a major role in the negative patient safety outcome.

Interested in Learning More About Nurse Turnover & Retention Strategies?

With the current nursing shortage and growing need for additional nurses, the healthcare industry must focus on retaining current nurses, both from the perspective of the whole organization as well as patient safety. Relias offers assessment and learning solutions to assist in improving nurse retention, streamline onboarding programs, evaluate competency, and develop the next generation of nurse leaders.

Providing new nurses with a supportive environment will certainly help their onboarding process, but a foundation for success must include much more than just that. Placing nurses in the right specialty at the start of their nursing practice will not only leverage their unique skills, critical thinking, and personality attributes — it will also increase their job satisfaction, thereby decreasing turnover rates.

Relias Assessments (formerly Prophecy) is the national leader in holistic, healthcare assessments. Using assessments to make informed hiring and placement decisions, results in long-term nurse success, satisfaction, and retention. Covering 40+ nursing specialties, Relias Assessments identifies and matches top performers in roles that best fit their strengths.

Designed by nurses and validated by clinical researchers, its power lies in predicting a candidate’s likelihood of success in the specific role by evaluating three areas:

  • Clinical Competency: provides insight into specialty-specific job knowledge and key skills needed for independent practice
  • Situational Competency: measures critical thinking and assesses how a candidate would respond in various clinical scenarios
  • Behavioral Characteristics: assesses individual personality attributes to match with a particular unit or preceptor, Relias Assessments’ reports generate rich data on the individual nurse, which is used during the hiring process to screen candidates and shape interviews.

In addition, this data is useful during post-hire for customized onboarding, enhanced life-long learning, and leadership succession plans.



Nurse Hiring and Onboarding Resource Kit

Organizations are facing an increasing need to recruit nurses who can adapt to rising demands related to complex patient populations while continuing to provide safe and effective care. Download this resource kit to help nurse managers hire better and onboard faster.


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