Shortage of professional nursing practice: a reframing of the shortage problem.

A fundamental restructuring of how hospitals use nurses is needed and this solution will in the long run be more effective in solving the shortage problem than is the effort simply to add more nurses into the existing system.

Abstract

The nursing shortage is discussed in terms of supply, demand, and wages, and the current situation is compared with previous nursing shortages. Reasons for the shortage are examined and reframing the problem from a shortage of nurses to a shortage of professional nursing practice is suggested as a strategic first step in solving the problems of nurse staffing in acute care general hospitals. Four kinds of shortage situations are identified; only one kind, vacancy, results from vacant positions. The other three types, transient, position, and scheduling, are the result of administrative decisions regarding the use of nursing personnel. A fundamental restructuring of how hospitals use nurses is needed, and this solution will in the long run be more effective in solving the shortage problem than is the effort simply to add more nurses into the existing system.