Why Do We Have A Nursing Shortage?


When I finished nursing school ( the 3 year program) in 1982 I already had a job lined up.  There was a lot of talk about a nursing shortage guaranteeing any nurse wanting a job would have one. The 3 year nursing program I  attended was closing because the belief was that nurses needed a higher level of education i.e. Associate or Bachelors degree in Nursing.

My sister happened to be graduating the very next day with her BSN from a local university.  She too had a job already lined up at the same hospital where I would be working.  In fact all of the nurses in my class had jobs to report to soon after graduation.

Our paths to nursing were very different.  She graduated from high school and started college in the fall of that year.  I did not graduate high school but instead got my GED and after about a year at the local city college struggled to make the grades I needed to go to a university.

I chose instead to go to a technical school to get my Vocational Nursing License.  Since I was a member of the Army Reserve I had an opportunity to attend school on orders for a year with all expenses paid.   I lived at home with my husband and 2 children and was paid while I was a student.

Once I completed technical school I applied to a nursing school at the local Catholic hospital.  I was accepted and 3 years later I became an RN.  My sister and I started a job making the same pay doing the same work.  I was an OR nurse and she was in the ICU.

This was 1982 when the talk of a severe nursing shortage was on the horizon.

What is causing the shortage?

There are a few reasons we are experiencing this deficit.   We are seeing an aging population as the baby boomers reach their senior years.   With the aging population there is an increasing prevalence of chronic disease.  There is also an aging workforce compounded by limited capacity in nursing education programs.

Schools Turn Away Applicants

Today we are in the midst of that nursing shortage in the United States.  It has been reported that schools are struggling to expand class size to meet the demand.  The inability to expand classes has led to turning away thousands of qualified applicants.

According to AACN’s report nursing schools turned away 64,067 qualified applicants from BSN and graduate programs in 2016-2017.  They were turned away due to insufficient number of faculty, clinical site, classrooms and preceptors.

Retiring Nurses

As experienced nurses retire at a rapid rate the nations population is aging requiring more health care. Today there are not enough nurses to fill the current workforce need. This has led to a conundrum.  We have a huge demand by hospitals and clinics for nurses, a huge demand from students wanting to enter the nursing program,  but schools who can’t accommodate the demand

In the United States we have about three million nurses with the need for about one million more nurses by 2022.

The Problem

According to American Association of Colleges of Nursing more than 56,000 qualified applicants were turned away from undergraduate nursing programs. A decade ago that number was around 30,000 students rejected.

The competition is so great for the slots that even applicants with a 3.5 and higher GPA are turned away.  Community colleges, undergraduate and graduate programs are turning away large numbers of students.  Even individuals who have recent medical experience in supportive roles such as certified  nursing assistant are being rejected.

The hurdles to get into a program are many.  Programs will not even consider you if you score less than 80% on the entrance exam even if you met all other criteria.

One reason for the surge of applicants is the nursing profession is one profession that offers an entry level living wage.   A nurse can support a family on this salary not to mention the flexibility and mobility.   Another important reason is the tremendous growth opportunity.  A nurse can climb a professional ladder with few barriers.

Another Problem

Increasing class size to accommodate more student is not easy or practical.

In order to increase size you need more qualified teachers.  Just as in nursing there is a shortage of instructors.  Better pay for working nurses lures potential educators away from teaching.

Many states have made adjustments to the student to faculty ratio for training in hospitals and clinics.  Some have adjusted from 10 students per faculty to 6 students per faculty.  The change is to improve safety and prevent crowding in a clinical setting.

Critical areas that will suffer from these adjustments are obstetrics, mental health, and pediatrics.  Trying to cycle through all of the specialties and get the hands on clinical training will begin to create a bottleneck.  The available space  to train students is  becoming an issue.

Searching for a Solution

As the need for solutions becomes more evident the ideas to solve the problem begin to arise.  The search for ways to accommodate  more students will create new ways to bridge the gap.

Some are searching for new campuses or ways to partner with hospitals to allow their nursing staff to teach students.

Re instituting a program for accelerated nursing training for qualified paramedics or veterans with medical experience.   These programs existed years ago allowing someone with medical experience to get credit for that experience.  Some allow for these experienced medical personnel to go straight into the second year of the 2 year program.

Others created a program allowing for veterans with medical experience to enter an accelerated 16-month undergraduate program.  The program is designed  for those who want to transition into a nursing career.  My path to becoming a nurse was one of these type programs and that was in the late 70’s and early 80’s.

Bridge programs such as these could help with the nursing shortage.  This way of thinking outside the box will help to remedy the critical nursing shortage.


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Cheryl Roby, RN

Cheryl J. Roby is a Registered Nurse and retired US Army Reserve Nurse Major. She has more than 30 years of nursing experience and 26 years of military experience in the Army Nurse Corp. During her nursing career, she has traveled as part of her military experience visiting many of the 50 states and to South Korea. She was trained as an Army Medic during the Vietnam era and later as an OR tec. She went on to become a Licensed Practical Nurse and then completed her nursing training as a Registered Nurse. She was then commissioned as an officer in the Army Reserves. She appreciated the challenge of working in various specialties and expanding her clinical and professional skill sets. Her time in the Army Reserves and California National Guard gave her the opportunity to travel to most of the 50 states and work in other medical facilities. During her career, she had the opportunity to work in several specialties to include, OR, Occupational Health, Hospice, Sexual Assault Team, Forensic/ Correctional Nurse, Nurse Case Manager for developmental disabilities, Parish Nursing as well as a Nurse Entrepreneur.

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