The Nursing Shortage: What Can Nurse Educators Do?

developing nursing students with resilienceby Susan Sportsman, PhD, RN, ANEF, FAAN

The Problem

Approximately 100,000 Registered Nurses and 34,000 Licensed Practical/Vocational Nurses have left the workforce in the last two years as a result of stress, burnout, and retirement. These findings from the 2022 National Nursing Workforce Survey are quite alarming. However, additional findings paint an even more disturbing picture. Another 610,388 nurses reported an “intent to leave” the workforce by 2027. An additional 188,962 RNs younger than forty reported similar intentions to leave nursing. Altogether, about one-fifth of RNs nationally are projected to leave the workforce by 2027 (Smiley, Allgeyer,2023).

Why are these nurses, particularly those under forty, planning to leave?  The incredible stress and trauma of the COVID-19 Pandemic is a leading cause. During these two plus years, nurses were pushed to the brink in an already complex and stressful environment. Sixty-two percent of the sample reported an increase in their workload during the pandemic. A quarter to one-half of all nurses responding to the survey reported “feeling used up and at the end of their rope.”  These issues were most pronounced with nurses having less than ten years of experience (Smiley, Allgeyer, 2023).

Moving forward, we may think that the nurses’ workload will improve as COVID-19 wanes. Yet the healthcare delivery system is likely to remain chaotic for the foreseeable future. In addition, data from research reported by Joi (2022) suggests that the annual probability of extreme epidemics occurring could increase threefold in the coming decades. The probability of a pandemic similar to Covid-19 is about 2% in any given year. Since much of the world is still reeling from the shock of COVID-19, additional extreme medical conditions that further tax health care workers must be considered possible. The researchers in Joi’s (2022) report emphasized the urgency to develop plans for rapid response to disease outbreaks, building capacity for pandemic surveillance, strengthening health systems, and increasing research to understand why large outbreaks are becoming more common.

Recommendations for Improvement

The crisis of the current nursing shortage is being addressed by many groups. For example, Beal (2022), in Beckers Hospital Review reports on the recommendations of a 2022 Nursing Staffing Think Tank, sponsored by the American Association of Critical Care Nurses, the American Nurses Association, the American Organization of Nurse Leaders, Healthcare Financial Managers Association, and Institute for Healthcare Improvement. The recommendations included six priorities for hospitals to address the shortage:

·       Healthy workplace

·       Diversity, equity, and inclusion

·       Work schedule flexibility

·       Stress injury continuum

·       Innovative care delivery models

·       Total compensation packages, which include paid time off for self-care (Beal, 2022).

Federal, state, and local policy changes, such as financial assistance to increase the number of nurse educators available to teach more students have also been widely recommended. Despite the hope that policy changes designed to improve the work environment for nurses may reduce the nursing shortage, nurse educators must also prepare new graduates for a stressful workplace. Developing nursing students who have sufficient resilience to move through challenging times without significant burnout is a responsibility that nurse educators are in a position to assume.

Characteristics of Resiliency

Healthcare is unlikely to be significantly less stressful for health professionals going forward. However, developing resiliency can be an antidote to negative stress. The American Psychology Association defines resilience as the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demand. The ways in which individuals view and engage with the world, the availability and quality of social resources, and the ability to apply specific coping solutions increases the individual’s resiliency to stress and burnout. Psychological research has demonstrated that developing resilience can be cultivated and practiced (

What Can Nurse Educators Do?

Nurse educators are in a unique position to provide opportunities for students to develop resilience as they move through the nursing curriculum. Nursing school is often described by students as “very stressful”. Developing skills to become more resilient to the stress will aid them during their nursing education and prepare them for the healthcare environment they will experience as they move into practice. It is not uncommon in a nursing curriculum to include a section on stress management (perhaps in Introduction to Nursing or in Mental Health Concepts) but often, this content focuses on helping clients reduce stress. Faculty may informally work with students who are having stress related issues. However, to prepare students for the stress they will likely encounter following graduation, we must be intentional about integrating concepts to build resilience for the nurse throughout the curriculum. While we hope our new graduates will not enter the workforce in such an extremely stressful environment as has occurred in the last 2-3 years, we must prepare them for any eventuality.

Below is an evaluation tool that nurse educators can use to evaluate the extent to which teaching-learning activities designed to develop resilient nurses is well integrated throughout the curriculum. In addition, faculty can use the tool to evaluate how well a specific course addresses resilience building.

Building Resiliency Tool


Approximately one-fifth of RNs nationally are projected to leave the profession by 2027. This trend must be interrupted to reduce the nursing shortage and improve healthcare in this country.

Most nursing curricula in the US address stress reduction strategies at least once. However, the potential and real exodus of nurses, including young nurses who would have been tomorrows’ leaders, must be stopped. We should amplify our efforts to consistently reinforce the development of the students’ resilience throughout their course of study. I hope the Building Resiliency Tool will provide new teaching-learning ideas to consistently present students with opportunities to build resilience.

Best wishes for a successful Fall term!




AHRQ (2023) Burnout in primary care. Assessing and addressing it in your practice. Agency for Healthcare Research and Quality. Accessed 2023.

ANA (2023) Healthy Workplace and Practice and Advocacy. American Nurses Association.  Accessed 2023.

Beal, N. (2022) 6 Strategies to address nursing shortages in the next eighteen months. Beckers’ Hospital Review. May.  Accessed 2023.

Joi, P. (2022) New Study Suggests Risk of Extreme pandemics like COVID-19. Gavi, Vaccines Work. September 5th. Accessed 2023.

NCSBN (2023) NCSBN Projects Significant Nursing Workforce Shortages. National Council of State Boards of Nursing Research Project. Press Release. 4/13. Accessed 2023.

National Academy of Medicine (2023) Valid and reliable survey instruments to measure burnout, wellbeing, and other work-related dimensions. Accessed 2023.

Ong, J., Lim, W., Doshi, K., Zhou, M., Sng, B., Tam, L. Org, S. (2021) An evaluation of the performance of 5 Burnout Screening Tools. Journal of Clinical Medicine. November, 10(21) 4386. Accessed 2023.

APA. (2023) Resilience. American Psychological Association. Accessed 2023.



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