A nursing shortage occurs when the demand for nursing professionals, such as registered nurses (RNs), exceeds the supply locallywithin a healthcare facilitynationally or globally. It can be measured, for instance, when the nurse-to-patient ratio, the nurse-to-population ratio, the number of job openings necessitates a higher number of nurses than currently available, or the current number of nurses is above a certain age where retirement becomes an option and plays a factor in staffing making the workforce in a higher need of nurses. The nursing shortage is global according to 2022 World Health Organization fact sheet.
The nursing shortage is not necessarily due to the lack of trained nurses. In some cases, the scarcity occurs simultaneously with increased admission rates of students into nursing schools. Potential factors include lack of adequate staffing ratios, lack of placement programs for newly trained nurses, inadequate worker retention incentives and inability for students to complete schooling in general. This issue can continue further into the workforce with veteran workers as well as burnout in the healthcare field is one of the largest reasons for the nursing shortage in the U.S. today. The lack of nurses overall though can play a role in the shortages across the world today.
As of 2006, the WHO estimated a global shortage of almost 4.3 million nurses, physicians and other health human resources worldwide—reported to be the result of decades of underinvestment in health worker education, training, wages, working environment and management. These will continue to be reoccurring issues if not disentangled now.
A study in 2009 by Emergency Nurse has predicted that there will be a shortage of 260,000 registered nurses by the year 2025. A 2020 World Health Organization report urged governments and all relevant stakeholders to create at least 6 million new nursing jobs by 2030, primarily in low- and middle-income countries, to off set the projected shortages and redress the inequitable distribution of nurses across the world.
While the nursing shortage is most acute in countries in South East Asia and Africa, it is global, according to 2022 World Health Organization fact sheet. The shortage extends to the global health workforce in general, which represents an estimated 27 million people. Nurses and midwives represent about 50% of the health workforce globally.
2022 overview A March 2022 WHO fact sheet reported that about 50% of the global health workforce was experiencing a global shortage. Of the 27 million people who make up that workforce, approximately 50% are nurses and midwives. This is most acute in countries in South East Asia and Africa.
Causes Nursing shortage is an issue in many countries. To interpret the problem, psychological studies have been completed to ascertain how nurses feel about their career in the hope that they can determine what is preventing some nurses from keeping the profession as a long-term career. In a study completed by sociologist Bryan Turner, the study found that the most common nursing complaints were: subordination to the medical profession on all matters, even over standardized regulations difficult working conditions A report from the Commonwealth of Australia identified a few other matters that led to nurse dissatisfaction: constant schedule changes work overloads due to high number of patients and paperwork, according to a 2002 journal article; shift work lack of appreciation by superiors lack of provided childcare inadequate pay lack of interest to join the field in countries with inadequate pay, according to a 2020 "systematic review and meta-analysis"; Another study found that nurse dissatisfaction stemmed from: conflicting expectations from nurses and managers due to regulation of cost inability to provide comprehensive nursing care due to work loss of confidence in the health care system, based on a 2014 Russian non-academic paper. A couple articles mention how nursing burnout could happen from the demand of being compliant with the technology used in the healthcare setting:
The Electronic Medical Record (EMR) is becoming much more popular to use for health professionals; but this is removing health professionals from the direct patient care areas. The nursing population is also an aging population, with approximately one million registered nurses older than the age of 50. These seasoned nurses may struggle with the evolving technology and leave the profession. Other consequences of utilizing the EMR is the difficulty in adoption and implementation, this can include disruption of organizational workflows, tool failure, maintenance issues, and users being resistant to change.
Another study reported in a 2020 British Journal of Nursing article, conducted by Peate and colleague, found that the inability to provide effect and efficient care to patents caused nurses to question their job abilities and fear that their job was at stake.
In many jurisdictions in the United States, by 2003, administrative/government health policy and practice had changed very little for decades. A 2003 Nursing Science Quarterly article said that one of the priorities at that time was cost-cutting and that patient loads were uncontrolled, and nurses were rarely consulted when recommending health care reform. As of 2004, the major reason for nurses planning to leave the field, according to a 2004 Emerging Infectious Diseases journal article, was because of working conditions. With the high turnover rate, the nursing field does not have a chance to build up the already frustrated staff. The American Nurses Association website has listed many strategies on how to combat thee grouping nursing turnover rate. Eliminating Mandatory overtime, provide employee wellness programs and creating a flexible culture are just a few. These changes would help nurses receive the help and benefits to ensure a better work environment. Aside from the deteriorating working conditions, the real problem is "nursing's failure to be attractive to the younger generation." A 2004 Journal of Nursing Education article said that there was a decline in interest among college students to consider nursing as a probable career. At that time, more than half of working nurses said they "would not recommend nursing to their own children" and a little less than a quarter would advise others to avoid this as a profession altogether.Wieck, K. L. (2003). Faculty for the millennium: changes needed to attract the emerging workforce into nursing. [Electronic Version]" Journal of Nursing Education 42(4), 151-8. Retrieved October 25, 2006 from Pubmed (12710805).
In a 2006 Journal of Advanced Nursing article, Australian nursing researchers John Buchanan and Gillian Considine described hospitals as "being run like a business" with "issues of patient care… of secondary importance." Emotional support, education, encouragement and counseling are integral to the everyday nursing practice. However, these practices are not easily quantified and are considered by managers as unjustified cost for the patients, who are viewed as consumers. Therefore, only clinical responsibilities, such as medication administration, dressing changes, foley catheter insertions, and anything that involves tangible supplies, are quantified and incorporated into the organization budget and plan of care for the consumers.
In Australia, the capacity for students to complete programs of professional experience placements known as clinical placements have been a major barrier for nursing and other health students. Placement poverty has been described as one major barrier for healthcare course completion. An editorial published in 2024 highlighted factors surrounding insufficient and inequitable government supports which could be a barrier to students completing healthcare degrees and entering the workforce. Research studies have demonstrated that placement poverty is a significant burden to Australian healthcare students including nursing students. The Australian Government launched the Commonwealth Prac Payment in 2025 to support students in nursing, midwifery, teaching, and social work programs of study during clinical placements. The Commonwealth Prac Payment has faced criticism for its inadequate financial support, lack of access by the broader healthcare student population.
By 2004, the undersupply of nurses in health care facilities in the United States was predicted to become even more critical over the following twenty years. Along with more aggressive "efforts to attract and retain nurses" in the United States, many institutions increasingly recruited foreign nurses. While this created a domestic and international lucrative business opportunity, a 2004 Health Affairs journal article raised ethical concerns in terms of how nursing shortages affected African countries and the Philippines, for example, as American recruiters risked diminishing their own domestic supply of trained nurses. In response, in 2010 the WHO's World Health Assembly adopted the Global Code of Practice on the International Recruitment of Health Personnel, a policy framework for all countries for the ethical international recruitment of nurses and other health professionals.
Impacts of nursing shortage Nursing shortages (including low hospital-level nurse-to-patient ratios) have been linked to the following effects: Increased nurses' patient workloads Increased risk for error, thereby compromising patient safety Increased risk of spreading infection to patients and staff Increased risk of adverse outcomes such as falls, pneumonia, shock, cardiac arrest, and urinary tract infections Increased risk for occupational injury Increase in nursing turnover, thereby leading to greater costs for the employer and the health care system Increase in nurses' perception of unsafe working conditions, contributing to increased shortage and hindering local or national recruitment efforts There is an alarming increase in the number of nurses suffering from nurse burnout due to the extreme stress caused by nursing shortages. Extensive amounts of stress on the human body lead to psychological, mental and, physical health effects such as headaches, body aches, sleep disruption, chronic fatigue which in the long run can lead to anxiety, depression, somatic symptoms.
Nursing shortages have an impact on the healthcare environment in all aspects of nursing, but it does impact other nurses directly causing the nursing community to face issues of burnout. Burnout is a feeling that nurses experience when an overwhelming amount of workload is placed on a nurse. Usually this causes nurses to experience exhaustion in many different aspects, a sense of not feeling like themselves, and a sense of not feeling accomplished enough. Sometimes, burnout can interfere with good professional behavior and play a factor in the quality of care nurses give their patients. The feeling of burnout tends to contribute to feelings of stress as well. In relation to burnout, nurses are known to experience sleep disturbance which consist of trouble falling asleep as well as experiencing poor quality sleep. Sleep disturbance correlates directly with stress and burnout presenting that nurses with a higher level of sleep disturbance have lower levels of stress management. The issue of burnout tends to be a common factor that many nurses face due to the stress from an overwhelming workload, which can make it hard for some nurses to fall in love with their career field. Poor working conditions can place nurses at a higher risk for being a victim of workplace violence, such as not taking the proper vacation time, causing increased patient exposure as well as stress and exhaustion. This can have a negative effect on patient care as some nurses may resort to bringing self-defense weapons to work to protect themselves.
Global shortage and international recruitment