Collaboration in planning, action, and investment at the federal and state levels can turn the nursing shortage around, new report says.
If policymakers at all levels think more boldly about solving the nursing shortage and improving racial equity, more patients will have access to safe, high-quality nursing services, resulting in healthier populations and stronger communities.
That's the conclusion of a new report issued this week by the Center for American Progress (CAP) that examines the factors driving the U.S. nursing shortage and what can be done about it.
While the shortage has long been a challenge, it has become increasingly urgent, given that the nursing workforce declined by 3% from 2020 to 2021 during the COVID-19 pandemic—the largest such decline in more than 20 years, the report says.
Though COVID-19 narrowed the focus on the nursing shortage, other conditions have contributed to it far longer than the pandemic: a higher education system that is training too few nurses; workforce conditions; and demographic factors, such as aging Baby Boomers and increased life expectancy, the report notes.
Despite recurring nursing shortages, the United States has not adopted a coordinated approach to preventing or responding to the issue, nor has it designated responsible entities at federal and state levels to do so, the report says.
"As policymakers look to fortify our healthcare system in the wake of the pandemic, fixing the national nursing shortage by investing in America's higher education system to graduate more nurses, boosting national and state coordination efforts to support the nursing pipeline, and retaining nurses should be top priorities,” said Jesse O’Connell, CAP's senior vice president for education.
Indeed, federal and state policymakers can take steps to address these challenges through coordinated planning, action, and investment, the report says.
The three main recommendations are:
1. Expand the capacity of educational institutions to enroll and graduate nurses while improving access and outcomes for student nurses of color and overall population health.
- Congress should pass the Future Advancement of Academic Nursing (FAAN) Act (H.R. 851/S. 246), which would award competitive grants to nursing schools to enhance nursing education programs. It also prioritizes historically Black colleges and universities, tribal colleges and universities, other minority-serving institutions, and regions with low numbers of medical professionals.
- Congress should pass the Black Maternal Health Momnibus Act of 2021 (H.R. 959/S. 346), aimed at addressing the United States' maternal mortality crisis and eliminating racial disparities in maternal health outcomes.
- Congress should increase funding for programs authorized under Title VIII of the Public Health Service Act. This legislation is a critical source of loan repayment and scholarships for nurses; loans for nursing faculty development; and grants for advanced education, increasing diversity, and improving outcomes for nurse education.
- Congress should provide funding to help nursing schools pay for capital projects, such as buildings, laboratories, and equipment.
2. Federal and state policymakers should introduce new proposals to expand clinical placement capacity and fund pathways from ADN programs to BSN programs.
- Congress should directly fund clinical placements for nursing students from historically disadvantaged backgrounds and for those at underfunded higher education institutions.
- Congress, state legislatures, and employers should invest in pathways and support services, such as transportation and childcare, to help nurses with an associate degree in nursing obtain a bachelor of science in nursing. They should also help workers in healthcare support roles, such as licensed practical nurses and certified nursing assistants, transition into registered nursing.
3. Create standing bodies to document and advise on issues of recruitment, training, and retention.
- Congress should fund the National Health Care Workforce Commission, initially authorized by the Affordable Care Act in 2010. Although members were appointed in 2010, Congress has never appropriated funding to make the commission operational.
- Further, Congress should fund and deputize state-level nursing workforce organizations to address state-specific nursing shortages.
“Fixing the national nursing shortage by investing in America's higher education system to graduate more nurses, boosting national and state coordination efforts to support the nursing pipeline, and retaining nurses should be top priorities.”
— Jesse O'Connell, senior vice president for education, CAP
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
The U.S. should adopt a collaborative approach to addressing the nursing shortage.
One solution is to invest in America's higher education system to graduate more nurses.
Another is to increase funding for loan repayment and scholarships for nurses.