Here are the Biggest Workforce Challenges in Nursing in 2024

CNOs and other healthcare executives are strategizing to address recruitment and retention, workplace violence, and virtual nursing challenges, say these nurse leaders.

Nurse leaders have had many challenges to face this year as the nursing shortage continues.

CNOs and other healthcare executives have been brainstorming ideas for addressing this shortage as well as disruptors such as AI and virtual care.

From Nov. 6 to Nov. 8, the members of the HealthLeaders Workforce Decision Makers Exchange will meet in Washington D.C. to discuss critical workforce issues in nursing, and innovative solutions to address recruitment and retention, technology, and workplace violence challenges.

Here are some of the biggest workforce challenges that nurse leaders are facing in 2024, according to Katie Boston Leary, senior vice president of equity and engagement at the American Nurses Association (ANA), Jean Putnam, chief nurse executive at Baptist Health South Florida, and Michele Szkolnicki, senior vice president and chief nursing officer at the Penn State Health Milton S. Hershey Medical Center.

Recruitment and retention

According to Putnam, one of the biggest hurdles for recruitment and retention is keeping the workload burden off of the direct patient care nurse.

"[They're] the largest part of the nursing workforce," Putnam said, "so how do we as individual health systems, hospitals, [and] clinics…listen to our first line nurses?"

Putnam uses the term "first line" rather than "front line" for a very specific reason.

"I think frontline sounds like a war zone," Putnam said, "and I don't want my nurses to think they're in a war zone every day, even though it's very difficult."

Another hurdle is generational differences. Gen Z nurses who are just now coming into the workforce have different expectations of the job than previous generations have had, and according to Putnam, recruiting Gen Z starts with technology.

"Gen Z-ers are our first truly digitally native generation," Putnam said. "The technology is important, and I think we have to figure out ways to utilize that in such a way that helps them and utilizes their skill sets."

Social media, diversity, flexible scheduling, and work-life balance are also top priorities for Gen Z, according to Putnam.

"The Gen Z-ers love work, but they also have other priorities in life," Putnam said. "Work needs to have purpose, and what better purpose is there than being a nurse?"

Workplace violence

Nurses face a lot on the job, and unfortunately workplace violence continues to be a large issue for nursing workforces in health systems everywhere. According to Szkolnicki, workplace violence impacts the workforce in a fundamental, traumatic way.

"Nurses [face] the emotional toll, the vicarious trauma, because they are feeling what their patient is feeling," Szkolnicki said. "The fact that our patients and their family members sometimes attack us, maybe even physically…it's horrible."

Szkolnicki emphasized the need for laws to catch up when it comes to harming a healthcare worker.

"Gratefully, in a lot of states, they are passing acts to make sure that it's a felony when you physically attack a nurse," Szkolnicki said.

For Szkolnicki, it comes down to having the basic need of feeling safe at work.

"We all have a basic need to feel safe where we are," Szkolnicki said. "It's something that is very serious and requires a very disciplined and deliberate approach."

Virtual nursing

The surge in new technology has been a large disruptor in nursing, particularly in the case of virtual nursing. According to Boston-Leary, virtual nursing has been growing exponentially in the past year or two.

"Some organizations have jumped in it fully with both feet, some are treading water and probably just letting come up to the waist," Boston-Leary said, "and some are still on the fence because they want to see the outcomes [of] implementing this technology."

Virtual nursing can be implemented in many different ways, which is why the ANA is establishing principles around virtual nursing, according to Boston-Leary.

"A nurse leader, a colleague of mine, said that it feels like the wild, wild west," Boston-Leary said. "So how do we tame this beast?"

Boston-Leary emphasized the concern about rural hospitals and health systems that cannot afford the technology. Part of the ANA's goal is to understand the various options and applications of virtual nursing, and how smaller systems can use and receive resources for virtual nursing programs.

"There's a Cadillac version that probably would not be affordable by most," Boston-Leary said, "but what's the American-made car version of this that's more available, accessible, and affordable to organizations that don't have a lot of the resources that large institutions do."

Looking ahead

Boston-Leary listed several immediate concerns facing CNOs, including the supply chain.

"The hottest issue is supply chain, with climate change and how that impacted our supply [of] IV solutions because our major manufacturing plants in the U.S were disrupted by Hurricane Helene," Boston-Leary said. "It's impacting care delivery [and] surgeries are being cancelled at this point."

Another concern is racism and discrimination in nursing, specifically because of legislative impacts on diversity, equity, and inclusion, Boston-Leary explained.

"There's data that show that because of the major shift after the murder of George Floyd that caused this [issue] to become front and center, a number of people of color, leaders, were hired into these roles," Boston-Leary said, "and a lot of these department roles have gone away."

Boston-Leary also described the growing divide in nursing between staff and leadership, and the general unease surrounding AI in healthcare.

"You have this divide that's growing between nurses and nursing leadership about [what's] important, and margin versus mission," Boston-Leary said, "and then you have AI where people are not sure what to do with it, whether they should be scared of it, or embrace it, or both."

All of these issues and more will be discussed at the Workforce Decision Makers Exchange, so stay tuned for more coverage.

The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.

Please join the community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.