Change is 'Non-Negotiable' in Tackling the Nursing Workforce Crisis

92% of survey respondents suggest nurse labor shortage will get worse without swift action, new study says.

An extreme shortage of nurses and supportive care personnel has created a "devastating" effect on the entire healthcare system, with drastic change "long overdue," new research says.

"We are beyond the point of no return," according to the new study, Nursing's Wake-Up Call: Change is Now Non-Negotiable. "We must implement swift and meaningful actions if we are to move beyond the paralysis."

The study, published by Wolters Kluwer in partnership with UKG, surveyed 300 U.S. nurse leaders in late 2021 to examine how COVID-19 has run roughshod over current labor models and how an intensifying labor shortage will affect future nursing labor models.

Study findings include:

• 92% of respondents predict they will be short of budgeted headcount over the next 18 months.
• Due to financial constraints, 58% of respondents do not expect to bring in additional staff or new roles but are instead focused on retaining their current workforce.
• The average shift remains 12 hours for nurses in acute and post-acute settings, despite widely reported burnout.
• Acute settings have been slow to embrace new models of care, except for float pools; 92% of respondents in the acute setting plan to expand or establish float pools in the next 18 months.
• Though 75% of respondents use staffing technology in some capacity, but day-to-day staffing is often handled manually.

Key components to positive changes include staffing levels, workforce flexibility and resiliency, and technology implementation to optimize productivity, the research says.

Yet, a "wide disconnect" exists between the challenges healthcare facilities acknowledge they’re experiencing and the plans they already have in place—or that they plan to put in place in the future—to respond to workplace challenges, according to the study.

"Results show that healthcare leaders have a grasp on the day-to-day challenges but not on all of the levers of change they have available to them," the study says.

"The results also show respondents have deprioritized or remain status quo on opportunities to (1) improve staffing levels; (2) foster more flexibility and more resiliency into the workplace, thus affecting retention and workplace satisfaction levels; and (3) optimize productivity through tools and technology available to them," it says.

Nurse leaders can steer toward positive change, thereby improving workplace satisfaction and care quality, by taking a more active role in understanding the challenges on the front lines, the study advises.

"Dramatic action to support our nurses is long overdue. Experts have forecast nursing shortages for years, but few could have predicted the impact that COVID-19 would have on this workforce," said Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, chief nurse of Wolters Kluwer, Health, Learning, Research and Practice.

"To ensure the best care is delivered to all patients across care settings, healthcare organizations need to rethink care models to achieve greater agility within the nursing workforce," she said. "Nurses can’t do more, so we need to ensure we’re doing more to make care delivery models sustainable."

One solution the study offers is adopting a team-based model using unlicensed assistive personnel (UAPs), licensed practical nurses (LPNs), and less-experienced RNs to allow nurses to practice at the top of their license.

Healthcare organizations also should consider offering flexible shift options, other than the regimented 12-hour shifts, to provide better work-life balance, the study suggests.

Much more, however, is required, according to the study authors.

"There is recognition that nursing care delivery has to be as efficient and effective as possible," the study reads. "But completely changing the paradigm requires novel innovation, which would start with taking a collaborative approach to changing care models that are no longer sustainable."

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