American Association of Colleges of Nursing reports that the United States is expected to experience a shortage of registered nurses: nursing colleges cannot meet the increased demand while baby boomers are aging. As the shortage is projected to continue through 2030, safe patient care is at risk, while nurse-working relations are also affected. Adequate staffing is a healthcare issue that should be addressed if the health system is to achieve safe and quality care in every work setting. This paper will review the challenge of nurse shortage to the health system, the social determinants of the challenge, and how my organization has addressed the challenge.

Nurses play a crucial role in patient care, and when there are not enough nurses to the work, there are serious consequences. It is projected that the US health system will be experiencing nurse shortages up to 2031 if the issue is not appropriately addressed. Inadequate staffing occurs when the staffing level does not effectively and efficiently meet the needs of patients seeking medical services (Norful et al., 2018). The challenge has affected the work setting: nurses have experienced a high workload, thus increasing burnout and stress among the staff. Inadequate staffing also harms the quality of care provided: nurse shortage results in longer hospital stays, patient dissatisfaction, higher rate of readmissions, and higher mortality rate (Delgado, 2021). Inappropriate staffing results in nurse dissatisfaction and lower productivity, further propelling nurse shortages from high nurse turnover rates (Delgado, 2021).

Various factors are contributing to the high nursing shortages and inadequate staffing levels. At the organizational level, the working conditions contribute significantly to high attrition: employees’ well-being determines whether they stay within the profession or not, as those who enjoy general well-being tend to retain employees (Jacobs et al.,2018). When nurses are exposed to toxic work conditions and experience burnout or stress, they tend to leave their jobs in their entirety or change workplaces (Haddad et al., 2022). At the individual level, the nurse shortage results from nursing staff choosing to leave their careers to take care of families: this is especially true for female nurses, who are the majority (Haddad et al., 2022).

The facility has put several measures to address the inadequate staffing level: nurse management sought to improve nurse retention and reduce workload. Management had begun to restructure their compensation structure for all APRNs: nurses were offered retention bonuses for those who had stayed for more than three years, while the rest of the staff were given one-off bonuses during the pandemic. To improve the workload on the APRNs, management implemented a co-management model: the model entails ensuring that two primary care professionals share the responsibility of all patient care tasks as they can perform similar tasks (Auerbach et al., 2018). Under co-management, nurses and physicians share the administrative workload, care coordination, and patient care tasks, thus reducing the nurse’s workload (Norful et al., 2018). If successful, the co-management strategy is critical in improving the quality of patient care and reducing nurse workload, preventing burnout, and improving patient outcomes. In addition to monetary incentives to improve nurse satisfaction, the management sought to include nurses in the decision-making process to determine the acceptable nurse-patient ratio (Haddad et al., 2022). Addressing the nurse shortage is a complex process that still needs the participation of all stakeholders to motivate nurses to stay in the profession while still meeting the needs of the patients. Adequate staffing level is critical to ensure nurses effectively and efficiently meet the needs of their patients.


Auerbach, D. I., Staiger, D. O., & Buerhaus, P. I. (2018). Growing Ranks of Advanced Practice Clinicians – Implications for the Physician Workforce. The New England journal of medicine, 378(25), 2358–2360. to an external site.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing Shortage. In Stat Pearls. Stat Pearls Publishing.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging Employees in Well-Being: Moving From the Triple Aim to the Quadruple Aim. Nursing administration quarterly, 42(3), 231–245. to an external site.

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain. Annals of family medicine, 16(3), 250–256. to an external site.

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