One question that continues to haunt the nursing profession is, "Will there be another big nursing shortage?" Although an impending nursing shortage would mean job security for those still working and entering the profession, there could be consequences with patient care if the needs can not be met.

According to most projections, the United States will need at least 500,000 nurses by 2022. However, when taking into account retirement and attrition of staff, that number quickly escalates to 1.5 million nurses that will be needed nationally.

The need for nurses is not only an American problem. A World Health Organization report in 2010 described a growing need for nurses around the globe. The need is present in all countries — rich or poor. For example, India was projecting a need for more than 2.4 million nurses to meet the needs of their population.

So what is causing this great need, and how will it be met?

Lagging retirements

During the last recession, many nurses of retirement age deferred their retirements as the economy became unstable. While unemployment rates rose, nursing remained one of the most recession-proof jobs, forcing many to stay in the work force. Certainly, retirement of a work force is a normal progression, however, the bulk of nurses of retirement age is grossly disproportionate.

Title VIII funding, often referred to as the Nurse Training Act of 1968, created funding to educate nurses to meet an impending shortage in the 1970s. The funding increased profoundly over the next 10 years, creating a significant increase of nurses during that surplus time.

However, this funding was quickly decreased, and the number of nurses entering the workforce slowed in response. This created what is referred to as a "Title VIII cohort" of nurses who were born between 1951-1959 — all just now coming into retirement.

So, as the economy stabilizes, it is estimated that this group of approximately 500,000 will be applying for retirement in the next few years, creating a huge void.

Increase in healthcare needs

Healthcare is currently experiencing an unprecedented influx of patients. Between 2007-2009, the baby boomer generation began retiring and aging into the Medicare program. It is estimated that each year 2-3 million will age into Medicare.

With the passing of the Affordable Care Act, millions of previously uninsured Americans now have increased access to healthcare services. This influx, coupled with advancements in medical technology allowing people to survive longer with chronic illnesses, will continue to tax the need for nurses and the healthcare community at large.

These factors are creating a significantly high projected job outlook. According to the Bureau of Labor Statistics, the job outlook for registered nurses is growing at a rate of 19 percent, much higher that than the national average.

Educational crisis

Unfortunately, despite many willing students, the ability to provide adequate training spots for potential nurses is also rising to a critical level. According to a recent report by the American Association of Colleges of Nursing, schools turned away more than 60,000 qualified applicants from enrollment due to issues such as insufficient faculty and limited clinical sites.

The aging of faculty members is similar to the problems encountered in the healthcare sector — they are retiring. The Bureau of Labor Statistics projects a job growth rate of at least 35 percent for nursing instructors. With many retiring and an increased need to train more nurses, it is estimated that there will be a need of 34,200 nursing faculty by 2022.

Although most go into education based on a love of teaching, the salary will need to become more competitive to attract qualified instructors. The average annual salary of a nursing instructor in 2012 was about $68,000. In comparison, the average national nursing salary is about $67,000.

Considering the increased requirements of advanced education to teach, the salaries need to become more comparable and competitive with other nurses with advanced degrees. For example, the national average for a nurse practitioner is about $90,000. Strictly from a personal economic decision, it makes little sense to return to school, incur added debt for little increase in your salary.

Therefore, the need for nursing faculty will continue to be significant contributing factor to the impending nursing shortage.

Bright future

For those entering the nursing work force, the availability of jobs in the future is great. However, for those left working, the need will place added strain on limited resources and potentially affected patient care.

However, with awareness of the impending need, actions have historically been taken, and the needs have been met. Hopefully, the same will be true for this projected shortage as well.