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Nursing Shortage: A Critical Discussion

Issue Definition

Although there are persistent accounts of labor shortages in many other professional domains, nursing seems to enjoy the dubious distinction of perennially suffering from this condition. Nursing literature, however, demonstrates that there is no single definition or measure of nursing shortages (Buchan & Aiken, 2008), thus the need to define the issue from two fronts – economic and professional. From the economic view, a nursing shortage is defined as a deficit brought about by the lack of enough nursing professionals to fill open and budgeted positions. This implies that funds to open additional positions may be available but there are not enough professionals in the market to fill these positions. From the professional view, a nursing shortage implies the lack of adequate nurses to avail a certain level of quality care (Fox & Abrahamson, 2009).

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Influencing Factors

Available literature demonstrates that nursing shortage is caused by an intricate web of factors rather than one isolated incidence (Fox & Abrahamson, 2009). One of the major factors is low demand from qualified school graduates who regard nursing as a less attractive career choice, mainly due to the stress and work demands associated with the profession. The second factor the is lack of funding of nursing schools by the government and other relevant agencies, which constricts the availability of faculty and resources to train more nurses. Thirdly, the nursing shortage has been aggravated by an aging labor force, which continues to be faced with a high level of retirements and attrition due to natural causes (Barnett et al., 2010). Additionally, the increase in patient census, along with multiple health-related needs and function-based care sought after by an aging population, creates a nursing shortage by directing pressure on the professional nurse workforce (Fox & Abrahamson, 2009). Lastly, it has been noted that low nurse wages, along with inadequate professional benefits such as career mobility and work-life balance, lead to nursing shortage through turnover (Buchan & Aiken, 2008).

Data to Demonstrate the Importance of the Issue

Fox and Abrahamson (2009) note that the U.S. has been facing the problem of nursing shortage for over 50 years now, with the vacancy rate for Registered Nurses (RNs) reaching 13 percent in 2001 and has not receded ever since. Barnett et al (2010) demonstrate the need to address the problem of nursing shortage in Malaysia to take care of the aging population because the proportion aged 65 years and over is expected to double by the year 2030, implying that more nurses will be required to provide specialized care to the ageing population. It is projected that the U.S. will have a shortage of one million RNs by 2020, especially in specialty practice areas such as oncology, if the issue of nursing shortage is not addressed (Dolan, 2011). Lastly, in 2009, more than 54,000 qualified nursing school applicants were denied admission to nursing institutions in the U.S., primarily due to lack of faculty and resources to train them (Dolan, 2011).

Challenges & Consequences of not addressing the Issue

Failure to address the nursing shortage means that the general population will not have access to quality healthcare delivery systems (Fox & Abrahamson, 2009), but also the aging population will continue to experience morbidity and chronicity from known illnesses such as cancer (Dolan, 2011). Failure to address the nursing shortage also implies that the disease burden will rise among the population, triggering health agencies to make huge investments to contain the situation. Additionally, the quality of life will certainly decrease due to lack of quality care, not to mention the possibility of loss of life to preventable causes due to inadequate accessibility of care (Barnett et al., 2010). Overall, it has been noted in the literature that failure to deal with the nursing shortage will not only obscure the achievement of health system effectiveness, but will lead to deterioration of care (Buchan & Aiken, 2008)


A common priority in addressing this issue would be “…to increase the pipeline of nurses by boosting enrollment numbers in nursing schools” (Dolan, 2011, p. 10). To boost enrollment numbers, however, the government and health agencies must first address the issues of inadequate faculty and resources by training more nurses to attain PhD status and by allocating more financial and material resources to nursing institutions. To spur enrollment levels, health agencies must also engage in awareness campaigns to disassociate the nursing profession with stressful activities with the view to at least minimize the often misplaced perception that nurses are exposed to stressful events on daily basis (Fox & Abrahamson, 2009). Lastly, boosting nurse pay and other rewards will most certainly encourage more qualified students to enroll in nursing schools (Clark & Allison-Jones, 2011).

Economic Investment Needed

As already mentioned elsewhere, the government and other relevant health agencies need to make huge financial investments not only to train the faculty at nursing schools, but also to avail adequate resources for students who wish to enroll in these institutions (Dolan, 2011; Fox & Abrahamson, 2009). The bottom-line is to adequately fund these learning institutions to churn out qualified nursing professionals who will have the capacity to provide an effective level of care. The common people are the biggest consumers of healthcare services (Clark & Allison-Jones, 2011), thus the need to incorporate them in efforts aimed at addressing the nursing shortage.


Barnett, T., Namasivayam, P., & Narudin, D.A.A. (2010). A critical review of the nursing shortage in Malaysia. International Nursing Review, 57(1), 32-39.

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Buchan, J., & Aiken, L. (2008). Solving nursing shortages: A common priority. Journal of Clinical Nursing, 17(24), 3262-3268.

Clark, R.C., & Allison-Jones, L. (2011). Investing in human capital: An academic-service partnership to address the nursing shortage. Nursing Education Perspectives, 32(1), 18-21.

Dolan, T.B. (2011). Has the nursing shortage come to an end? ONS Connect, 28(8), 8-12.

Fox, R.L., & Abrahamson, K. (2009). A critical examination of the U.S. nursing shortage: Contributing factors, public policy implications. Nursing Forum, 44(4), 235-244.

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