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The Nursing Shortage: Bearing the Burn Out
• Vickie Miranda
(University of Massachusetts Dartmouth)

Nursing is the largest of all health care professions. So why are nurses
burned out? Why are more and more nurses leaving this profession? A very
simple answer, with a very complex solution. Nursing shortages are becoming
more common across the country. The decline in nursing staff has had many
detrimental effects on this “caring profession”. Not only are nurses
burdened by physical and mental stress, but there is a potential risk for
the deterioration of quality patient care.
The growing nursing shortage has prevented some hospitals from keeping full
staffing levels, and many have asked nurses to work longer shifts or float
to other units during their shifts to make up the difference (Connolly,
2001). Understaffing is causing organizations to mandate nurses to work over
time and to work under unsafe conditions. For example, nurses who are
physically drained from working extra long hours are forced to pick up extra
patient assignments. Further, adding to the burn out. It is not uncommon
for medical surgical nurses to have 9-12 patient assignments or a 30-40
patient assignment for those nurses who work in a nursing home. The
understaffing crisis has lead to additional problems, such as recruitment
and retention issues, as well as the improper placement of unspecialized or
inexperienced nurses.
Nurses don’t want to be nurses or “bear the burn out” any longer. The
average age of RNs is 44 years. Approximately 50 percent of nurses are
entering their 50s, and many will leave the workforce within the next 10
years. As of 1996, only 9 percent of nurses were under the age of 30
(Stewart, 1998).
According to a survey of more than 7,000 nurses conducted by the ANA, 75% of
nurses identified inadequate staffing as the cause of declining care. An
alarming 40% would not even recommend their professions to their children
and friends. Some expressed that they would not feel comfortable having
their family members cared for at their own place of employment. If most
nurses share this opinion, then it’s understandable why the retention and
recruitment rates, as well as, student enrollment in nursing schools are
declining (Peterson, 2001).
The shortages of nurses cause a rise in the demand for nurses in specialized
areas. The supply of nurses does not meet the demand in terms of preparation
of desired level of skill. Competence and experience are two key elements
for nurses to possess when being placed in specialty areas, such as the
emergency room, intensive care units, and maternity units. Although it is
completely individualistic, some nurses may not be ready to handle that
specific role. “Competence requires practice and specific experience”. New
nurses are not receiving an adequate orientation period with a preceptor,
which is needed, in order to gain enough experience and level of competency
for working on their own.
Efforts are being made to improve patient care and alleviate the nursing
shortage. Safe staffing bills must be advocated and passed in order to
ensure safe and quality care for patients. It is important to work toward
the adoption of a safe staffing bill that will provide a legal framework for
safe staffing in all areas of the organization. Passing a safe staffing
bill, establishing mentoring programs to facilitate the transition for new
nurses, and dramatically increasing staffing development efforts within
institutions to transition nurses into specialized areas of practice will
alleviate the burn out experienced by most nurses. Staff development and
professional education will assist the nurse in gaining competence in the
setting of their choice and interests. Providing quality care and
maintaining quality of life for all patients is a nurse’s number one goal.
How much burn out does a nurse have to bear in order to achieve this goal?

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