'Crisis' looms as 800,000 more nurses plan to exit workforce by 2027: study

The critical nursing shortage in the United States is going to get worse — much worse — according to results of a comprehensive National Council of State Boards of Nursing and National Forum of State Nursing Workforce Centers study released April 13.

About 800,000 nurses say they intend to leave the workforce by 2027, according to the study. To put this number in perspective, consider that approximately 100,000 nurses left the workforce during the pandemic — a fact that has already sounded alarm bells throughout U.S. healthcare. Combined, these numbers equate to one-fifth of the 4.5 million nurses in the workforce today. 

"While we anticipated there would be a loss in the number of nurses in the workforce due to the pandemic, we did not expect to see data that clearly indicates we are headed towards a national health care crisis," Maryann Alexander, PhD, RN, chief officer of nursing regulation at the NCSBN, told Becker's. 

"Most disconcerting and apart from any other data collected, our study indicates that of the 800,000 nurses with an intent to leave the workforce in the next five years, 24 percent of them are new, younger nurses," she said. "This is dramatically different from past surveys that have indicated that 'nurses with an intent to leave in the next five years' were of or nearing retirement age."

The NCSBN is officially calling for "significant action." 

The nursing workforce shortage will be "threatening the national health care system at large if solutions are not enacted," according to the study. Further, findings uncover "alarming data points which have far reaching implications … for patient populations."

There is also evidence that suggests decreased practice and assessment proficiency for new nurses. This fact, coupled with the dwindling nursing support staff, has pushed the NCSBN to call for "significant action to foster a more resilient and safe U.S. nursing workforce moving forward."

"The data is clear: the future of nursing and of the U.S. health care ecosystem is at an urgent crossroads," said Dr. Alexander. "The pandemic has stressed nurses to leave the workforce and has expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately."

The NCSBN pointed out that "disruptions in prelicensure nursing programs have also raised concerns about the supply and clinical preparedness of new nurse graduates."

"There is an urgent opportunity today for healthcare systems, policymakers, regulators and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future," Dr. Alexander said.

She presented the study findings April 13 at the National Press Club in Washington, D.C. This study examines a subset of the 2022 National Nursing Workforce Survey for analysis and provides population-based estimates. This is the largest national study that includes all levels of nursing practice (RNs, LPNs and APRNs) and includes data from over 300,000 nurses.

Key findings of the study:

Here's a breakdown of the study's main finding that one-fifth of 4.5 million nurses employed in the profession today say they intend to leave the workforce in the next four years. (Again, this statistic includes the 100,000 nurses who left the profession in the past two years.) 

  • A total of 610,388 RNs reported an "intent to leave" the nursing workforce by 2027, citing stress and burnout as the main drivers.This number also includes retirement-related attrition.
  • These same challenges were most cited by another 188,962 RNs younger than 40 who also said they intended to leave the profession by 2027. In fact, there already has been a 3.3 percent decline in this age group of nurses in the past two years.
  • More than 33,800 licensed practical/vocational nurses have already left the profession due to pandemic burn out.   

A look at behavior

In addition to collecting data about the shrinking nursing workforce, the NCSBN study included questions that reveal information about how pandemic-induced stress in the workplace has affected nurses' professional and personal characteristics.

The study reveals more than demographic information. "It gives us true insight into the emotional and mental stress that nurses have endured and are still experiencing since COVID. It outlines specific reasons for their distress and thus provides an initial roadmap for addressing the issues," Dr. Alexander said.

Since the start of the pandemic: Workload increased for 62 percent of the survey respondents. One-quarter to half of nurses surveyed reported "feeling emotionally drained" (50.8 percent), "used up" (56.4 percent), fatigued (49.7 percent), burned out (45.1 percent), or at the end of the rope "a few times a week" or "every day" (29.4 percent).

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