Nursing Shortage Crisis Deepens in the US: Growing Burnout and Staffing Challenges Propel Nurses to Exit Profession

The nursing shortage in the United States has reached a critical point, exacerbated by the COVID-19 pandemic, as indicated by two recent reports. The surveys highlight the growing number of bedside nurses who are experiencing fatigue, burnout, and contemplating leaving the profession. The outlook from the reports may make it difficult for those who want to start to become a nurse or enter similar career fields.

One report from AMN Healthcare, a staffing company, reveals that approximately 30% of registered nurses are considering leaving their careers due to the pandemic. Another study conducted by the National Council of State Boards of Nursing found that around 100,000 registered nurses have already left the profession since 2020, with over 600,000 more intending to do so by 2027 due to stress, burnout, and retirement.

These reports shed light on the perspectives of nurses after a prolonged public health emergency, during which hospitals faced overwhelming patient loads, nurses experienced increased workloads, and staffing shortages became the order of the day. The convergence of these factors has created a “perfect storm” situation, according to Lesley Hamilton-Powers, Vice Chair of the American Association of International Healthcare Recruitment. The high number of retiring Baby Boomers, along with the physical and emotional burnout resulting from the pandemic, has contributed to the current crisis.

The AMN survey conducted in January, which involved 18,226 nurses, revealed a decline in the job satisfaction of nurses over the past two years. Only 33% of nurses reported having sufficient time to spend with patients, a decrease from 43% in AMN’s 2021 survey. The satisfaction with the quality of care they provide also declined, and nurses expressed concerns about how the staffing shortage is affecting patient care.

Mental health has become a significant burden for nurses, with 80% reporting a “great deal or a lot of stress,” representing a 16-percentage point increase since 2021. Nurses also reported a higher likelihood of job-related health issues and emotional exhaustion compared to two years ago.

The survey conducted by the National Council of State Boards of Nursing, which included over 50,000 registered, licensed practical, and vocational nurses, found that slightly over half felt emotionally drained or used up, and nearly half experienced fatigue or burnout.

The satisfaction levels of nurses varied based on experience, with those having at least five years of experience reporting higher job satisfaction compared to newcomers. This trend was consistent across different age groups, with approximately 8 out of 10 Baby Boomers satisfied with their jobs, in contrast to around 6 out of 10 Generation Z nurses. Additionally, younger nurses are less likely to recommend nursing as a career, which is concerning, as they will be replacing retiring nurses.

The setting in which nurses work also plays a role in their decisions. Around 36% of nurses working in hospitals plan to remain in the profession but seek new employers, while only 15% of hospital nurses intend to continue working as they currently are. Nurses in other settings, such as medical offices, are more likely to remain in their positions.

Nursing homes and long-term care centers have experienced significant declines in the number of licensed practical nurses or vocational nurses. According to the Council of State Boards of Nursing, these facilities employed nearly 34,000 fewer licensed practical nurses or vocational nurses in March 2020 compared to the pre-pandemic period.

To exacerbate the situation, the federal government’s visa cap for international nurses has limited their availability to assist hospitals, nursing homes, and other healthcare facilities. The American Association of International Healthcare Recruitment is urging the government to lift this cap, as it is impeding the recruitment of international nurses. The unavailability of green card visas for these nurses, as reported by the State Department in May, has left some facilities no choice but to close units or face severe staffing shortages.

The outlook for nursing staffing in the United States appears grim. The AMN survey indicates that 9 out of 10 nurses believe that staffing shortages are worse now than they were five years ago. And about 4 out of 5 nurses expect the shortage to worsen in the next five years.

According to survey by the Council of State Boards of Nursing, from the beginning of the pandemic through 2027, it is projected that nearly 900,000 nurses will exit the industry. In other words, almost 1 in 5 of the nation’s 4.5 million registered nurses plan to leave, further exacerbating the already critical staffing crisis.