5 Factors Impacting the Nursing Shortage

It is no secret that healthcare facilities have a high turnover rate for nursing staff and that there is also a nursing shortage for the increasing number of people who are in need of healthcare in the United States. As the baby boomer generation grows older and retires, their healthcare needs will continue to grow. The projection for the U.S. nursing shortage is that it will rapidly increase.

The healthcare industry is already feeling the impact of the nursing shortage. As the turnover rate increases, whether nurses resign from their job with their current employer or they retire, the amount of workload is still the same. More and more clinics are discovering that they are not able to recruit and retain enough nurses to keep up with the growing population. In addition, patients seeking medical treatment are feeling the effects of the shortage due to the lack of substantial staffing.

The Bureau of Labor Statistics and Lippincott Nursing Education projects a nursing shortage of more than 1 million registered nurses by the year 2022. Contributing factors are senior citizens, retiring workforce and limited school capacity. As the baby boomers continue to age and retire, their increased healthcare needs put additional stresses on an already stressed healthcare system. However, if nursing schools do not have the capacity to admit nursing students, the shortage is projected to triple in two years.

Nursing Shortage infographic

According to research from Bradley University, “Data indicates that 16.5% of all nurses employed in hospitals quit their jobs within the first year.” The University also stated that the demand for nurses will most likely increase to 3.2 million by the year 2024. With experience working in healthcare, or any field for that matter, it takes time, money and other resources to host orientation and train new hires. The University shows the average turnover cost is between $45,000 up to $63,000. Because of this, hospitals are losing $4 million to $6 million each year, solely because of turnover.

The American Association of Colleges of Nursing (AACN) has come up with Contributing Factors Impacting the Nursing Shortage; five of which are listed below:

  1. Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services.
  2. A significant segment of the nursing workforce is nearing retirement age.
  3. Changing demographics signal a need for more nurses to care for our aging population.
  4. Insufficient staffing is raising the stress level of nurses, impacting job satisfaction, and driving many nurses to leave the profession.
  5. High nurse retirement and turnover rates are affecting access to healthcare.

The below chart comes from registerednursing.org, where experts listed supply and demand of registered nurse shortages by state, projected by the year 2030.

RN Nurse Shortages by State

So, how will the clinics find more qualified nurses, and how will they retain those nurses once they have hired them?

Hiring experienced international RNs has proven to be a strategic recruitment solution for hospitals and healthcare facilities for some time now. The EB3 visa category is for skilled workers, professionals, or unskilled workers (other workers) with a permanent job offer from a U.S. company. Nurses petitioning for their green card must pass the National Council Licensure Examination (NCLEX) exam. This is the exam that all nurses (including U.S. citizens) must take in order to get their license. These nurses must also go through the Board of Nursing requirements for the state they are assigned to. This includes the language proficiency exam as well as meeting the same educational requirements in which a U.S. citizen would have to meet. If they do not meet the educational requirements, they must take the courses where they have deficiencies. These international nurses can be found working for the largest healthcare companies (e.g. dialysis clinics, long term care facilities, home health care and acute care hospitals) in the United States.

There are different types of staffing agency models in the United States—temporary staffing, temporary-to-permanent staffing and permanent direct hire staffing. Of the three of these models, permanent direct hire staffing is one of the best available options in order to reduce the national nursing shortage. Direct hire is a form of permanent placement staffing where the new staff members have been hired directly by the employer (not by a staffing agency for the employer) upon arriving to their new position. These experienced nurses go through the interview process, and once they are extended a job offer, they are hired for permanent placement in the assigned location that is in their contract. WorldWide HealthStaff Solutions Ltd. is a direct hire, permanent placement firm that facilitates international nurse recruitment for healthcare facilities that are struggling with the nursing shortage.

Below is a SWOT (strengths, weaknesses, opportunities, and threats) analysis for international recruiting:

STRENGTHS (Direct Hire)
• High success rate.
• Nurses are contractually obligated to complete their agreement, creating little to no turnover.
• Nurses have required years of experience.
WEAKNESSES (Temp Agency)
• Higher turnover rates.
• Higher costs.
• Not a solid career path for the nurse.
• Difficult for healthcare facilities to keep their productivity costs low.
OPPORTUNITIES (Direct Hire)
• Lower costs.
• Cultural diversity.
• Nurses have a variety of clinical backgrounds.
THREATS (Temp Agency)
• Direct hire offers permanent job placement (career) for candidates, whereas temp agencies only offer temporary job placements.
• Temp agencies do not ensure a low retention rate.

This analysis is an effort to demonstrate the pros of direct hire and the cons of temporary placement with international recruitment. Of the many benefits from using the direct hire model, the most notable is that it provides the healthcare employer a cost efficient long term recruitment pipeline with more control of the hiring and on-boarding process while it provides the nurse candidate more career stability and a path to citizenship.

WorldWide HealthStaff Solutions provides a direct hire recruitment model that ensures all nurses provided to our clients for interviews have the required years of experience working in their specialized departments. It also allows our clients to completely customize the nurse interviews to what works best for their HR talent acquisition teams. Because the United States is a ‘melting pot’, these nurses offer even more cultural diversity and have a variety of clinical backgrounds. Temp agencies offer temporary placements, which means a higher turnover rate. The costs are much higher in the long run and it is more difficult for healthcare facilities to keep their productivity costs low.

If you are a hospital or healthcare employer seeking to improve your nurse recruitment pipeline, click here to download the USA Client Presentation Guide to learn more about direct hire international healthcare recruiting.