EditorialLife at WorkStaffingWorkplace Management

Advantages of a nursing shortage


Since the day I became a nurse, it seems there’s been a nursing shortage. No matter where you practice, everybody talks about it. Is it because we never seem to be able to fill all of our patient care, academic, teaching, or research needs? Perhaps. The reason may change over time, but I do know this: I’ll never see the headline We’ve Stopped Hiring! We Have Plenty of Nurses! Of course not, it’s an absurd idea, because patient care demands continue to increase, career opportunities for nurses continue to expand, and professional development pathways continue to grow.

The American Nurses Association’s Nurses by the Numbers™ illustrates positive trends for the nursing profession but cites the U.S. Bureau of Labor Statistics projection that 1.13 million vacancies for RNs will emerge between 2012 and 2022. Addressing that gap is called, by some, healthcare’s impending “gloom and doom” issue. I prefer to call it the silver lining in the storm clouds. Take a look at how the shortage has helped us in the past and is actually helping us now.

Increased professional recognition

Nurses’ important role becomes more visible during times of scarcity. Appreciation grows as healthcare leaders reward the hard work of managers and frontline caregivers. In addition to salary increases, the past 30+ years have seen the creation of clinical ladders, shared governance structures, flexible staffing systems, and advanced practice roles. Professional recognition for individuals and entire teams has grown through the years, especially as the scientific evidence base demonstrates the link between care and outcomes. The consistent acknowledgement and continual celebration of high professional performance by leaders and peers has come a long way in actions, words, and deeds.

Marginal performers, bullies, and culture assassins

The past few years have seen more attention paid to dealing with staff who don’t perform to expectations and standards of care. The characteristics of a healthy work environment and the consequences of bad behavior are well documented. Poorly performing colleagues, sometimes called marginal performers, actually increase other team members’ workload, causing resentment and turnover.

Tom Olivo, the CEO of Success Profiles and an accomplished athlete and respected measurement guru, identifies, measures, and compares the commonalities of highly successful people and organizations, emphasizing the importance of high performance standards consistent with best business practices, including human resource management. He uses the term “paid assassin” to describe employees who thwart operational achievement and still earn a paycheck.

A nursing shortage increases the spotlight on dysfunctional staff, and I see efforts to deal with them more earnestly. Investing in quality staff by divesting of poor role models supports quality care, retention, and morale.

Right person, right role

Organizations have struggled for years to adequately design and implement systems to ensure professional nurses aren’t burdened with nonlicensed duties. Restructuring workflows, analyzing the work of different skill levels, and redesigning roles to ensure the right person is performing the right function is occurring at a heightened pace. Solving this problem eases the impact of shortages, increases productivity, and improves care.

Success will take a “village of solution architects”—nurses, engineers, and designers—who work together to eliminate the waste. If health care is the ultimate people business, then hiring the right people and putting them in the right roles is mission critical.

A question of control

Controlling the weather or stopping storm clouds from forming is out of my realm, but strengthening my profession is not. Will the next nursing shortage be a matter of perception or reality? Probably a little of both. Either way, I know whoever creates solutions will control the situation. Which side do you want to be on?

Lillee Gelinas, MSN, RN, FAAN

Editor’s note: This editorial is adapted from Lillee’s original Speaking Out article: “The Nursing Shortage: How It’s Helping Us” published in NursingLife, November/December 1987, p. 16.


  • Brandy Jones, RN, BSN student
    September 20, 2017 9:04 am

    I would like to thank you for your perspective in the article “Advantages of a Nursing Shortage” found in Volume 12, Issue 7 (July 2017). Nursing shortage has been an issue that has affected nurses for years and continues to be a problem that nurses face. The positive perspective of this article was very refreshing. There is always a positive and a negative way of looking at a situation. However, the critical consequences of nursing shortages should not be ignored. The purpose of this letter is to address some of the disadvantages of a nursing shortage.

    Nursing shortages can lead to a negative cascade of effects. As a result of nursing shortage, nurses are faced with increased rates of burnout and fatigue. Units suffer from decreased retention rates which can negatively affect nurses. New employees must be trained, therefore increasing the nurse’s work load. Unit departments face low morale which leads to job dissatisfaction. Most importantly, nursing shortages can lead to adverse effects on patient outcomes and lead to unsafe nursing care. Under no circumstance should patient care ever be compromised.

    As a nurse of fourteen years, I have experienced a fair share of repercussions from the lack of appropriate nursing staff. A major downfall of the nursing shortage that I can speak directly to is staffing in other departments outside of areas of expertise. The care we provide in labor and delivery is very specialized. When nurses are expected to travel to an area that they are not trained or feel competent in, nurses tend to become dissatisfied and potentially seek employment elsewhere, ultimately becoming a contributing factor to the nursing shortage issue. Another factor that contributes to the nursing shortage is that nurses are being removed from bedside nursing and put in other non-clinical nursing positions that are needed to meet regulatory requirements and guidelines.

    Implementing a safe nurse to patient staffing matrix would help with the issue of nurse retention. A safe staffing matrix will help nurses feel their workload does not exceed their capacity to complete the job adequately. Job satisfaction will therefore increase when nurses feel they are able to perform their jobs safely and proficiently. Another solution to the nursing shortage would be to recruit more nursing students. Utilizing experienced nurses to educate nursing students would help resolve the decreasing number of nursing instructors.

    My purpose for writing this letter is to emphasize that although the positive viewpoint of this article is true, the negative effects of nursing shortages far out way the positive ones. It is important that this critical nursing issue is addressed and potential solutions begin to develop so that the healthcare crisis can change in the right direction. In conclusion, nursing shortages ultimately can lead to adverse effects on patient outcomes and lead to unsafe nursing care.

    Brandy Jones, RN, BSN student

  • In some places the shortage is artificially constructed as in Jamaica where the US health sector is poaching their skilled nurses. Shortage there impacts severely the delivery of timely care. In Britain there is also a shortage because, again, the US, Canadian and Australian health sectors are recruiting nurses and this is constraining the delivery of patient centered care. In the private sector, underperforming employees more often than not when the labor market is tight, receive increased development experiences and not rushed to the exit ramp.

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