There is little debate that healthcare is facing a potentially unprecedented nursing shortage. According to the Bureau of Labor Statistics’ Employment Projections 2014-2024, the total number of job openings for nurses due to growth and replacements will be 1.09 million by 2024.
One of the significant contributing factors to the future need for nurses is the impending retirement of baby boomers, who currently make up 40 percent of registered nurses in the United States. The loss of these nurses caring for patients will also see years of experience and expertise go by the wayside, leaving nursing with a significant knowledge gap.
Baby boomers (born between 1946-1964) dominated the nursing profession by 1981 as they entered the workforce in record numbers.
However, as more career opportunities for women became available, those in the next generation — Generation X (born between 1965-1981) — sought out other careers, leaving a lag of those entering the nursing profession. These events caused some concern, as a perceived gap in nurses became eminent.
Fortunately, the large national shortage has been stalled a bit by two significant factors — the Great Recession delayed many baby boomer’s retirements and the surge of millennials (born between 1982-2000) who have entered the nursing profession at unexpected rates.
Although the reasons for the large surge are not entirely clear, many speculate on the factors influencing millennials’ decision to enter nursing. One factor noted is that the generation came of age during economic uncertainty and instability, causing them to look for opportunities in the stable healthcare market. Other factors focus on millennials’ tendency to be drawn to meaningful work and growth opportunities, which makes nursing very appealing.
With a looming shortage, there has been much attention paid to filling these future open positions. Efforts have been made to increase nursing programs and to entice delayed retirement.
However, little attention has been paid to the looming experience gap that will accompany the shortage. As 1 million nurses leave the workforce between now and 2030, so will their accumulated years of nursing experience.
This realization has caused leaders to shift their focus from numbers to a concern about experience. With the modest number of Generation X nurses, the nursing workforce is not evenly distributed across the age spectrum, making the gap obvious.
With years of experience comes an arsenal of intuitive knowledge — that gut feeling from seeing the same phenomenon over the years, and the things the books or school cannot teach a new nurse.
Nursing researcher Dr. Peter Buerhaus noted, "policymakers should be concerned because experienced nurses are adept at recognizing complications and manipulating organizational cultures to get patients the care they need." He says the loss of this knowledge could "compromise quality and safety of care."
Although they do not suggest that nurses with fewer years of experience are less qualified to provide high-quality care, they acknowledge that with more experience, nurses are more likely to be able to effectively navigate the challenges both clinically and organizationally.
Authors Buerhaus, David Auerbach and Douglas Staiger offer four recommendations for nursing leaders to help close and manage the expertise gap:
- Gather and share information about impending retirements to reduce the negative impact on healthcare.
- Encourage delayed retirements to give less experienced nurses more time to learn from their more experienced counterparts.
- Implement succession planning and management training to prepare up-and-coming nurses to take the helm.
- Bring experienced and new nurses together in ways that will encourage the transfer of knowledge from one generation to the next.
One innovative approach to keeping experienced nurses close is through volunteer nurse programs. Riverside Methodist Hospital in Columbus, Ohio, initiated a volunteer nurse program in 2009.
This allows experienced nurses to give back to their profession and, ideally, continue to impart their wisdom and knowledge to the next generation of care givers. Often their roles are "softer" duties, such as assisting with meals or taking vital signs, but with their insights and experience, they can be valuable members of the team.
As it appears that the nursing shortage has been tapered some by entering millennials, it will be imperative for healthcare leaders to also recognize the other facets of the nursing shortage — the loss of knowledge, skills, experience and judgment that will depart as baby boomers’ retirements continue to ramp up.
