Why nurses are leaving the profession

The US has experienced a drop of 100,000 registered nurses from 2020 to 2021, according to a fact sheet from the American Association of Colleges of Nursing (AACN). More disturbing is that many of those were people under 35 who were working in hospitals.  

The fact sheet also shows a projection of 203,200 openings for RNs each year through 2031, just eight years from now. By all indications, the United States is moving into a long-term drought of healthcare workers that will devastate its aging Baby Boomer and Gen-X populations who are struggling with record numbers of chronic conditions. 

The nursing shortage in the United States is a complex issue with multiple contributing factors, which can vary in impact across different regions and healthcare settings; however, a number of key elements are contributing to this growing crisis: 

1. Aging Population: The U.S. population is aging, with the number of people aged 65 and older projected to nearly double from 52 million in 2018 to 95 million by 2060. This demographic shift is increasing the demand for healthcare services, including nursing care. This will have a massive impact on the growing 50-plus population who must help care for aging parents and other relatives. 

1. Chronic Disease Prevalence: The prevalence of chronic diseases such as diabetes, heart disease, and obesity is increasing. These conditions often require long-term care and management, further increasing the demand for nurses and skilled nursing facilities. 

1. Aging Workforce: Many current nurses are nearing retirement age. According to the American Nurses Association, more than half a million registered nurses are anticipated to retire by 2022. This is creating a significant gap in the workforce. 

1. Nursing School Capacity: Nursing schools across the country are struggling to expand capacity to meet the rising demand for care. Factors such as limited classroom space, clinical sites, and faculty can restrict the number of students that schools can admit. 

1. High Turnover and Burnout: Nursing is a demanding profession, both physically and emotionally. Long hours, high stress, and the emotional toll of patient care can lead to burnout, causing nurses to leave the profession. 

1. Workplace Environment: Issues such as inadequate staffing, long working hours, and lack of support from management can contribute to job dissatisfaction and high turnover rates among nurses. 

1. Policy and Regulation: Policies and regulations can also impact the nursing shortage. For example, regulations that restrict the scope of practice for nurse practitioners can limit the ability of the healthcare system to fully utilize these professionals. 

1. Geographic Distribution: There is a maldistribution of nurses across the U.S., with rural and underserved areas often facing greater shortages. This is due to factors such as lower wages, fewer job opportunities, and less access to education and professional development in these areas. 

1. Economic Factors: Economic downturns can temporarily alleviate nursing shortages as people seek stable jobs in healthcare. However, when the economy improves, the shortage often returns as people have more job options outside of nursing. 

1. Pandemics and Health Crises: Events like the COVID-19 pandemic have put additional strain on the healthcare system, leading to increased demand for nurses and exacerbating the existing shortage. 

Addressing the nursing shortage will require a multifaceted approach that includes improving working conditions, expanding nursing school capacity, revising regulations to expand the scope of practice for nurses, and implementing strategies to retain older nurses in the workforce. 

But what can healthcare leaders do about all this? There are four key areas where forward-thinking healthcare IT executives can leverage the massive course correction that’s needed to prevent the development of healthcare deserts in the next couple of decades: 

1. Improve Working Conditions Through Technology

Implement Advanced Scheduling Systems: Use AI-based scheduling systems to optimize shift scheduling. This can help ensure fair distribution of shifts, reduce overtime, and improve work-life balance, which can increase job satisfaction and reduce turnover. 

Enhance Communication: Implement secure, efficient communication systems that allow for real-time collaboration between healthcare professionals. This can improve coordination of care, reduce errors, and decrease stress. 

Invest in Ergonomic Technology: Use technology to reduce the physical strain of nursing. This could include lift-assist devices, wearable technology to monitor health and stress levels, and other ergonomic equipment. 

2. Expand Nursing Capacity Through Telehealth and AI

Implement Telehealth: Telehealth can extend the reach of nurses, allowing them to monitor and care for patients remotely. This can be particularly beneficial in rural and underserved areas. 

Use AI and Automation: AI can automate routine tasks, freeing up nurses to focus on more complex patient care tasks. For example, AI could be used to automate medication management, data entry, and even some aspects of patient monitoring. 

3. Revise Regulations to Expand the Scope of Practice for Nurses

Advocate for Policy Change: While IT executives may not have direct control over policy, they can advocate for changes that allow nurses to practice to the full extent of their training. This could include lobbying for changes to state laws or working with hospital administration to change internal policies. 

4. Implement Strategies to Retain Older Nurses

Implement Ergonomic Solutions: As mentioned above, ergonomic technology can help reduce the physical strain of nursing, which can be particularly beneficial for older nurses. 

Offer Flexible Scheduling: Use advanced scheduling systems to offer flexible scheduling options for older nurses. This could include part-time positions, job sharing, or flexible hours. 

Provide Ongoing Training and Support: Implement technology-based training programs to help older nurses keep their skills up-to-date. This could include virtual reality simulations, online courses, or other digital learning platforms. 

Implement Mentorship Programs: Use technology to facilitate mentorship programs, pairing older nurses with younger ones. This can help retain older nurses by giving them a sense of purpose and engagement, while also helping to train the next generation of nurses. Retired nurses may in the future work through partnerships between their former employers and local academic institutions to stay active as educators, passing along their valuable skills and institutional knowledge to improve the capabilities of recent nursing school graduates. 

While the nursing shortage is a complex issue that will require a multifaceted solution, there are many ways that hospital IT executives can use technology to help alleviate the crisis. By focusing on improving working conditions, expanding nursing capacity through telehealth and AI, advocating for policy changes, and implementing strategies to retain older nurses, healthcare IT leaders can steer the course of US healthcare toward smoother seas and greener horizons. 

 Building on extensive experience in the fields of journalism, media production, and learning design and development, John Marc Green’s newest adventure is serving as Director of CHIME Innovation. In this role, his ongoing conversations with CHIME Members and Partners provide insights and direction to serve their interests in a variety of ways, including digital healthcare innovation journalism, professional development events and program facilitation, and on-demand educational development through CHIME Innovation.