Thinking Outside of the Box: Leveraging a Framework to Address the Nursing Shortage

Thinking Outside of the Box

Leveraging a Framework to Address the Nursing Shortage

By Serena Bumpus, DNP, RN, NEA-BC

What are the factors causing nurses to leave the bedside at such a large rate?

WITH THE DEMAND FOR NURSES exceeding 3.6 million by 2030, we must address the exodus of those leaving the profession. While many have expressed concerns over the baby boomers hitting retirement age and exiting the workforce, the number of RNs aged 65 and older employed in nursing hit its highest level in 2021. Meanwhile, the number of nurses aged 25 to 34 declined 5.2% in 2021. The decline was 7.4% for those aged 35 to 44 years (Haines, 2022). These statistics raise concerns that the shortage may worsen due to who is leaving the profession. Factors that impacted a nurse’s decision to stay in their current position included safe work environments, work-life balance, a caring and trusting team, doing meaningful work, flexible work scheduling, and feeling valued by their organization and their manager (McKinsey & Company, 2023). Nurses with less than ten years of experience placed particular importance on presence of a safe work environment; feeling valued by the organization; compensation; ability to care for family; access to development opportunities, including opportunities for advancement; and education benefits as top factors influencing their decision to stay (McKinsey & Company, 2023).

A PRACTICAL FRAMEWORK

In January 2022, five professional organizations came together to form the Partners for Nurse Staffing, which aimed to create a framework to address the nurse staffing shortages across the country. Known as the Nurse Staffing Think Tank, the partnership included the American Association of Critical Care Nurses, American Nurses Association, American Organization for Nursing Leadership, Healthcare Financial Management Association, and the Institute for Healthcare Improvement. Representatives from these five organizations identified high-priority areas for organizations to maximize their investment in nursing. After three months, they produced actionable strategies that organizations could implement within 12 to 19 months with measurable outcomes.

These priority topics and recommendations have the potential to be used by organizations to address common causes for nurses’ decisions to leave. Organizations can also utilize the Think Tank’s worksheet, a gap analysis tool they can use to evaluate and implement these recommendations, as well as monitor potential gaps that need to be addressed.

We invite you to share the work you are doing inside your organizations to address the unique needs of your workforce and communities and encourage you to submit your work for publishing in Texas Nursing.

OVERVIEW OF THE PRIORITY TOPICS AND RECOMMENDATIONS (2022).

Healthy Work Environment

• Elevate clinician psychological and physical safety to equal importance with patient safety through federal regulation.

• Specialty nursing organizations should investigate evidence related to scope of practice and minimum safe staffing levels for patients in their specialty.

Diversity, Equity and Inclusion (DEI)

Implement Inclusive Excellence, a change-focused iterative planning process whereby there is a deliberate integration of DEI ideals into leadership practices, daily operations, strategic planning, decision making, resource allocation and priorities.

Work Schedule Flexibility

• Build a flexible workforce with flexible scheduling, flexible shifts and flexible roles.

Stress Injury Continuum

• Address burnout, moral distress, and compassion fatigue as barriers to nurse retention.

• Incorporate well-being of nurses as an organizational value.

Innovative Care Delivery Models

• Implement tribrid care delivery models that offer a holistic approach with three components, including onsite care delivery, IT integration of patient monitoring equipment, and ambulatory access and virtual/remote care delivery. This approach will improve access, patient and staff experience, and resource management, with continuous measurement for improvement and adjustment for sustainability and support.

Total Compensation

• Develop an organization-wide formalized and customizable total compensation program for nurses that is stratified based on market intelligence, generational needs and an innovative and transparent pay philosophy that is inclusive of benefits such as paid time off for self-care and wellness and wealth planning for all generations.

We have made the decision to focus on these themes in 2024 for our annual conference, “Gaining Traction: Nurses Driving Change,” and as the sub-themes of the 2024 issues of our quarterly publication, Texas Nursing Magazine. We invite you to share the work you are doing inside your organizations to address the unique needs of your workforce and communities and encourage you to submit your work for publishing in Texas Nursing. Together we can share best practices and implement these priority topics and recommendations to improve the practice of nursing across the State of Texas.

REFERENCES

Haines, J. (2022). The state of the nation’s nursing shortage. https://www.usnews.com/news/healthnews/articles/2022-11-01/the-state-of-the-nationsnursing-shortage.

McKinsey and Company (2023). Nursing in 2023: How hospitals are confronting shortages. https://www. mckinsey.com/industries/healthcare/our-insights/ nursing-in-2023.

Partners for Nurse Staffing Think Tank. (2022). https:// www.nursingworld.org/practice-policy/nurse-staffing/ nurse-staffing-think-tank/.