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News News April 18, 2018

Nurse Leaders Say Nurse Shortages Erode Patient Care and Staff Morale: New Survey

Nurse Leaders Say Nurse Shortages Erode Patient Care and Staff Morale

The nation’s growing shortage of nurses is undermining some of the most critical aspects of healthcare delivery -- patient satisfaction, care quality and staff morale, according to the results of a new survey of nurse leaders.

The survey, Worsening Shortages and Growing Consequences: CNO Survey on Nurse Supply and Demand, , measured the views of CNOs and other nurse executives on the magnitude and impact of nurse shortages that have impacted the healthcare industry over the last several years. Its results demonstrate growing concern that the nurse shortage will get worse in the next five years, and the impact on clinical environment will increase for patients and staff.

The survey of 233 nurse leaders was conducted by AMN HealthcareBE Smith, and The Center for the Advancement of Healthcare Professionals.

Major Recruitment Challenges

Nearly all CNO respondents acknowledged that their healthcare organizations are currently experiencing some level of nurse shortages, with 72% describing the shortages as moderate, significant, or severe. Only 7% said there is no shortage.

How would you describe the nursing shortage at your organization?

In addition, most felt that the shortages would gradually get worse over the next five years. Specifically, 28% of CNOs predicted a worsening in one year; 43% in two years; and 61% in five years.

How do you think the nursing shortage at yout organization will change in...

Survey respondents also noted that nursing recruitment has become very challenging. More than 80% of CNOs described difficulty in nurse recruitment at their organization as moderate, significant, or severe, with 41% describing it as significant or severe.

In identifying the determinants of nurse recruitment problems, CNOs said the two greatest challenges are the lack of access to high-quality talent (32%) and the location of their organization (37%).

Patient Care Concerns

More than one-third (34%) of CNOs surveyed said the nurse shortage has a considerable or great negative impact on patient care. The numbers go even higher when CNOs were asked about patient satisfaction, with 41% viewing shortages as greatly or considerably detrimental to how patients feel about their care.

These observations go hand in hand with studies showing a link between work environment and patient satisfaction. Understaffing can degrade the nurse work environment, and the quality of the work environment is significantly related to all patient satisfaction measures in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) (Kutney-Lee, 2009).

How do you feel staffing shortages in your organization are impacted

Nurse Morale Worries

Some of the highest levels of concern appeared when CNOs were asked how shortages might affect nurse morale. The vast majority, 61%, said shortages have a considerable or great negative impact on nurse morale.

Nurse morale problems are linked to many challenges facing healthcare organizations, including patient satisfaction and quality of care (McHugh, 2011).


The survey results depict a clear view from the front lines of healthcare: CNOs see nurse shortages as bad and getting worse, and they worry that they’re creating recruitment challenges while negatively affecting patient experience, patient care and staff morale.

Healthcare organizations may not be equipped to deal with the magnitude of the shortages, considering that their human resources recruitment expenditures are generally minimal. HR expenditures usually tally approximately 1% of operating budgets (Bloomberg BNA, 2016) and talent acquisition is only a fraction of that amount.

Outside healthcare sourcing experts, who possess great proficiency and sophisticated national search capabilities, may be needed to address worsening nurse shortages and the growing consequences they create.


Kutney-Lee A, McHugh M, Sloane D, Cimiotti J, Flynn L, Neff D, Aiken L. (2009) Nursing: a key to patient satisfaction. Health Aff (Millwood). 28(4):w669-77. doi: 10.1377/hlthaff.28.4.w669.

McHugh M, Kutney-Lee A, Cimiotti J, Sloane D, Aiken L. (2011). Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff (Millwood). 30(2):202-10.

Bloomberg BNA. HR Department Benchmarks and Analysis, 2015-2016 (2015). ISBN 978-1-63359-087-8. Arlington, VA