Addressing the Nursing Shortage: Strategies for Improving Recruitment and Retention in Nursing Education

For years, the nursing shortage has brought the healthcare industry to a screeching halt. Hospitals found themselves short-staffed at the exact moment they needed all hands on deck. It’s easy to blame Covid for the problem — easy to blame Covid for any problem, in fact — but the truth is more complicated than that.

Nurses have been in short supply for years now, and all evidence points to a deeper, more fundamental problem than the pandemic alone can account for.

In this article, we look at why people leave nursing, and what can be done to improve retention and recruit new hires. We also reflect on how to increase applications for nursing education programs.

The Situation

Nurses are leaving the profession in droves. This is a problem experts have actually been forecasting for almost a decade now. The number of nurses retiring has exceeded the number of people entering the field for years.

In 2020, the problem became much more pronounced when Covid-19 took the world by storm. Suddenly, a job that many were already having second thoughts about meant risking exposure to a virus that had literally brought the planet to its knees.

Now, we are three years removed from the start of the pandemic. Things have calmed down, but there is still a significant shortage of nurses. Below, we look at why that is, and what can be done about it.

Why Nurses Leave

What is it about nursing that drives so many people away? Below, we look at several of the most prominent reasons why people leave nursing behind.

• Compensation: Nurses aren’t exactly paid poorly. However, given the challenges and risks of the work, along with the amount of effort they put into it, the pay isn’t everything it could be. The average surgeon may makes between five to ten times more than the nurse standing next to them. Of course, they have different responsibilities and training, but both are invaluable components of the healthcare system. Many nurses leave looking for salaries that reflect their value.

• Shifts: Hospital scheduling will never be easy for the simple reason that illness doesn’t adhere to business hours or banking holidays. People will always be sick, which means nurses will always be needed around the clock. Night and holiday shifts are unavoidable. However, the twelve-hour scheduling blocks that most hospitals use could be reexamined. These long shift blocks first came about as a way to simplify the scheduling process. Instead of having three nursing rotations, hospitals only had to manage two. Good for administrators, perhaps, but not so good for nurses.

• It’s hard work: Finally, nursing is just really hard. Not only are you on your feet for many hours at a time, but the work that you are doing is mentally and emotionally exhausting. You encounter people at the hardest moments of their lives. Some days, you return home a mere hour or so after watching a person take their last breath. That’s a lot to live with.

Unfortunately, it’s also the most challenging aspect of the job to address. No matter how good their intentions are, no hospital can completely eliminate the emotional challenges of nursing work.

While these features of the job are challenging to address, there are ways to handle them that benefit nurses and hospitals alike.

Better Compensation

Better pay is more of a hospital-to-hospital consideration than it is an industry-wide initiative. During the height of Covid, many nurses were paid two to three times their usual salary to work at isolated hospitals that were short-handed.

Of course, that isn’t sustainable. However, many healthcare networks are increasing compensation and sign-on bonuses to make the work more appealing. Compensation also depends on where the nurse chooses to work. For example, nonprofits will always offer modest salaries, while wealthier hospitals will be able to pay more competitively.

Nevertheless, more competitive pay may help keep nurses on board. In a similar vein, competitive scholarship, stipend and remote learning opportunities may help attract more new nursing students to the profession in the first place. People don’t get into nursing for the money, but it certainly doesn’t hurt.

Sensitive Scheduling

Hospitals may also consider reverting to a three-shift scheduling cycle. Eight-hour working days are much easier to handle for nurses. They will also probably be better for patients. Study after study shows that the average person only has about four hours of sustained deep concentration in them during the working day.

This doesn’t mean that most people are burned out by twelve (although if they have young kids, there’s a decent chance that they are). It does mean that at work, four hours will be intensely productive and everything else will be a question of diminishing returns. By reducing the shift times, hospitals can help ensure that their staff is a little fresher on the job.

Improved Mental Support

As mentioned earlier, healthcare work is intensely draining. It’s easy for nurses and doctors to feel cornered. They are stressed out and maybe even overwhelmed, but to say as much may feel like a dangerous admission. Something that will undermine their professional credibility.

Hospitals can reduce this stigma by providing more emotional support resources. Not only will this help people handle their short-term problems of anxiety, but it can also help promote a healthier culture for the entire network. Mental and emotional health resources demonstrate that hospitals care about their employees and are willing to support them in good times and bad.

In terms of employee retention, that is enormous. Workers in all industries respond very strongly to support and recognition from their employers. In fact, many consistently rank employer recognition and support above compensation when they list what is important to them in a new job.