Nurses are the largest group of health care professionals and the backbone of every hospital. Hospital leaders that proactively address nursing trends will be at an advantage, while those who ignore nurses’ concerns may struggle in an increasingly competitive landscape.
The three nursing trends you can’t afford to ignore in 2024 are:
1. Continued exodus of experienced nurses
In 2020, the median age of Registered Nurses was 52 years and more than 20% of nurses said they expected to retire by 2025. The COVID-19 pandemic and its associated stresses accelerated that timeline. Approximately 100,000 RNs — most of them with years of experience — left the nursing workforce over the past two years, and another 610,388 reported an intent to leave by 2027, according to a 2023 study published in the Journal of Nursing Regulation. Most troubling: experienced nurses are more likely than their less experienced peers to step away from nursing, either via retirement or a career change.
As a result, “there currently aren’t enough experienced nurses available at the bedside to provide quality care to people who need it,” according to a 2023 article published by Wolters-Kluwer. That’s a problem because nurse experience contributes to patient safety. New and inexperienced nurses are more likely to make mistakes and less likely to pick up on subtle clinical signs that may indicate an impending problem. Inexperienced nurses also sometimes omit key aspects of nursing care, which can lead to adverse outcomes.
Hospitals will need to make a concentrated effort to retain experienced nurses. They should also invest in preceptor programs that pair experienced nurses with newer nurses. Creative staffing can be used to bridge the experience gap. Experienced nurses who struggle with the physical demands of clinical nursing may be willing to work as resource nurses who advise lesser-experienced nurses. Clinical resource nurses can review nurses’ plan of care, help them plan priorities, and troubleshoot situations as they arise.
2. Calls for safe staffing
There were at least 27 healthcare labor strikes in the United States in 2023, most directly related to staffing concerns. According to a Nursing CE Central report, nurses at Saint Louis University Hospital in Missouri “held their first-ever strike in protest against the hospitals’ refusal to address safe staffing concerns.” The hospital has had a 30% RN vacancy rate since early 2022.
Striking nurses in California, Illinois, New Jersey and elsewhere have also highlighted “unsafe patient loads” and “chronic understaffing,” while pointing to research which shows that patients of overburdened nurses are more likely to experience adverse outcomes, including healthcare-associated infections (HAIs), death, and increased length of stay. In many states, lawmakers have introduced legislation that would mandate minimum staffing ratios for nursing; federal lawmakers have also proposed minimum staffing ratios, and the American Nurses Association “supports enforceable ratios as an essential approach to achieving appropriate nurse staffing.”
The Leapfrog Group is drawing attention to the issue as well. The Leapfrog Hospital Survey now asks hospitals to report Total Nursing Care Hours per Patient Day and RN Hours per Patient Day, despite objections from some hospitals and healthcare leaders, because evidence has repeatedly shown that “Nursing care is a core element to ensuring safe patient care in hospitals.”
Patients, nurses, and patient advocates demand safe staffing. In 2024 and beyond, hospitals should be prepared to explain their nurse staffing decisions – and should make those decisions with patient safety in mind.
3. Push for nursing reimbursement
In April 2023, a group of nurses, healthcare executives, policy experts, and academics launched the Commission for Nursing Reimbursement. The Commission was a “response to the nationwide concerns of nursing staffing shortages and will be working to change the way that Medicare reimburses health care systems for the valuable care that nurses do,” according to the About Us section of the Commission website.
Since then, group members and others have published numerous articles and editorials pointing out that nursing care is bundled into the room rate at hospitals and nursing homes. Because hospitals do not receive direct reimbursement for nursing care, “Nurses are viewed by health care facilities as overhead, rather than generators of revenue,” according to a STAT News article written by Rebecca Love, RN, MSN, a founder of the Commission for Nurse Reimbursement.
The Commission is working with nursing organizations and other healthcare groups to explore alternative reimbursement models, and plans to eventually “propose a solution to Congress.” Group members hope that changing the reimbursement model will spur hospital investment in safe staffing. Expect additional conversations about nurse reimbursement in 2024.
The exodus of experienced nurses from healthcare, calls for safe staffing, and push for nursing reimbursement are intertwined. Nurses want to provide excellent, safe patient care. They need tools and resources to help them thrive in fast-paced, challenging environments. Learn how the SwipeSense Nursing Insights application can support nursing staff and increase patient safety.