Fall is considered “conference season” in nursing. It is an incredibly busy time of the year, but it provides the opportunity to engage in meaningful conversations with nurses and nurse educators nationwide. 

Recent conversations with nurses across various settings have illuminated crucial and disturbing issues such as nurse staffing deficits, a shortage of nurse educators, workplace incivility, inadequate patient assessments, and subsequent poor patient outcomes. The nursing profession faces a multifaceted crisis with far-reaching implications for the health of our communities and nation. 

Last month, we highlighted troubling stories shared in our Facebook group about neglectful and sometimes harmful care provided by nurses and physicians. I promised some of you who sent me emails that we would highlight the solutions – and we will – but first, I want to clearly define the problems and our role in the solutions.

As nurse educators, we must acknowledge these challenges, explore their interconnections, and actively seek solutions that foster a more sustainable and supportive environment for current and future nurses.

Understanding the Nurse Shortage

The nurse shortage has been a persistent issue, exacerbated by an aging population, increased healthcare demands, and the ripple effects of the COVID-19 pandemic. Many nurses report feeling overwhelmed by their workloads, often compounded by staffing shortages. This leaves nurses unable to provide the quality of care patients deserve.

Conversations with frontline nurses made it clear that many are contemplating leaving the profession due to burnout and frustration. Several nurses strongly discouraged my intent to return to practice. This sentiment underscores the urgent need for systemic change that prioritizes nurse well-being alongside patient care.

The Crisis in Nursing Education

Parallel to the nursing shortage is the alarming decline in nurse educators. Many experienced nurses are retiring, and there are not enough qualified professionals to take their place. This shortage is particularly concerning given the increasing demand for nursing programs to produce new graduates who meet the increasingly complex needs of healthcare.

Nurse educators often face their own challenges, including limited resources, high workloads, and the pressure of preparing students for a rapidly changing healthcare landscape. Without adequate support, the quality of nursing education may suffer, leading to a cycle in which new nurses are ill-equipped to handle the complexities of patient care and, thus, widening the academic-practice gap.

Incivility in the Workplace

A significant theme emerging from discussions with nurses and presentations at recent nursing conferences is the prevalence of incivility in the workplace. Many nurses report experiences of bullying, undermining behaviors, and a lack of support from colleagues. This toxic environment affects nurse morale and compromises teamwork and collaboration — essential elements for providing safe patient care.

Incivility can lead to a culture of silence where nurses feel discouraged from speaking up about unsafe practices or advocating for their patients. Addressing this issue requires a commitment from leadership to foster a culture of respect and open communication, creating spaces where nurses feel valued and empowered to voice their concerns.

Addressing incivility also requires educators to intentionally address workplace realities with our students and develop the leadership skills necessary to advocate for our patients, ourselves, and the nursing profession.

Inadequate Patient Assessment

Inadequate patient assessment in practice compounds these challenges. Assessment is an essential, foundational skill on which we build all subsequent nursing reasoning, judgment, and intervention. How does a nurse provide competent care without assessment? He or she does not!

Some nurses express frustration over their limited ability to conduct thorough assessments due to time constraints and overwhelming patient loads. This often leads to missed or delayed diagnoses, severely impacting patient outcomes. They voiced a need for realistic staffing ratios that allow for meaningful patient interactions. 

Other nurses voiced that assessment is unnecessary depending on the diagnosis and use of assessment technology. Lack of assessment has become acceptable behavior!

A nurse’s assessment is where touch, empathy, and care are expressed. Without this critical human element, even robots could perform the basic tasks of our job.

A culture that prioritizes thorough assessments not only enhances patient safety but also instills a sense of professional fulfillment among nurses, reminding them of their critical role in patient care.

Poor Patient Outcomes

A shortage of nurses and educators, coupled with a hostile work environment and inadequate assessments, inevitably leads to compromised patient safety and quality of care. In our Facebook group, nurses shared poignant stories of patients who suffered due to nurse and system failures, highlighting the urgent need for reform.

Improving patient outcomes requires a comprehensive approach that addresses the root causes of these systemic issues. Critical steps include investing in nurse retention strategies, reforming nursing education programs, and implementing policies that foster a positive work environment. Moreover, establishing mentorship programs can help bridge the gap between seasoned nurses and new graduates, promoting knowledge transfer and reinforcing a culture of support.