Most nurses say there’s not enough staffing, and many intend to leave

Hospitals around the country are dealing with a shortage of nurses, and a new survey suggests it could get worse.

Only 24% of nurses said they have adequate staffing more than 75% of the time, according to a new study released Thursday by the American Association of Critical-Care Nurses. In 2018, 39% of nurses said they had appropriate staffing the majority of the time.

Two out of three nurses (67%) said they intend to leave their current position within three years, compared with 54% in 2018. Among those who say they would leave their post, 36% of the respondents said they would leave within the next year.

The nursing group surveyed more than 9,000 nurses in 2021. The association typically does its survey of nursing work environments every five years, but opted to do another report two years early to gauge the effects of the COVID-19 pandemic.

Among the nurses who said they intend to leave their positions, nearly two-thirds (63%) said better pay and benefits could get them to reconsider. Just behind compensation, a strong majority (57%) said better staffing would get them to think about sticking around.

Hospital nurses have said they have been exhausted during the pandemic. Some nurses have left hospitals and health systems for jobs with travel agencies, and nurses at hospital and health systems said they have worked long hours without enough staffing. Many have said the pandemic and the stress have affected their mental health.

Some nurses have also said they don’t feel adequately supported by their employers, adding to their burnout. And some nurses have said they are doing too many other tasks that go beyond nursing duties, which is causing more stress and making it more difficult to focus on patients.

• Related story: ‘Return nurses to being nurses’ to address burnout

Many nurses said they don’t feel safe in the workplace. Only 47% of the nurses surveyed said they felt that their organization values their health and safety. That’s a big drop from the 2018 survey, where 68% of nurses shared that sentiment.

Nurses have said they are seeing more violence at the workplace. In a separate poll by National Nurses United in the spring, nearly half of hospital nurses said they’ve seen an increase in workplace violence. Several health groups have backed a bill that would give hospital employees greater protections and impose tougher penalties for those who attack hospital workers.

Nurses are feeling less satisfaction at their job. Only 40% of nurses said they were very satisfied with being a registered nurse, down from 62% in 2018, the AACN survey found.

Connie Barden, AACN’s chief clinical officer and a co-author of the study, said in a statement that the survey findings about the decline in the work environments aren’t surprising, but they are troubling nonetheless.

“Unchecked, this decline can cause permanent damage to nurse retention and the entire healthcare system,” Barden said in the statement.

• Related story: Should hospital nurses be working 12-hour shifts?

The association has developed six standards for establishing and sustaining healthy work environments, and the study indicated nurses said they feel more satisfied at hospitals that have adopted those measures.

Nurses at health systems that have adopted those standards were much less likely to say they would leave their position in the next year. Roughly a quarter (26%) of nurses whose employer had adopted the standards said they planned to leave within a year, while more than half (52%) of nurses at organizations without those standards said they would walk away.

Vicki Good, executive director of nursing for Mercy Springfield, Missouri, spoke with Chief Healthcare Executive in the spring about the crisis in the nursing profession. She’s also a former president of the American Association of Critical-Care Nurses board of directors.

When asked for the biggest problem facing the industry, Good said, “Nurses don’t want to work at the hospital bedside, and that’s where we need nurses the most.”

You can see an excerpt from Good’s discussion with Chief Healthcare Executive in this video.

The full study ("National Nurse Work Environments: October 2021 - A Status Report") can be found online at Critical Care Nurse.