Hospitals, MedCity Influencers

Solving the nursing crisis starts with psychological safety

When thinking about gratitude for nurses who have carried our nation over the last two-plus years, it’s going to take a lot more than a pizza party during Nurses Month to show them we care.

If you’ve turned on the evening news, read a newspaper headline, or skimmed TikTok on your phone, you know that the nursing crisis is being felt everywhere. It’s easy to think that all hope is lost, but it’s actually one of the best times to be a nurse.

Despite the current strain on our nation’s healthcare system and the immense stress of navigating high acuity patients amidst an ever-worsening labor shortage, people are listening.

Today, most people recognize that the pandemic exacerbated longstanding problems within the nursing profession, and reports now show we will need as many as 13 million new registered nurses (RNs) by 2030 to address the current global shortage. As baby boomers retire early, other generations are following suit, with many leaving the nursing workforce altogether or pursuing roles away from the bedside due to burnout and a sense of being under-appreciated.

Additionally, and perhaps most tragically, nursing hasn’t always been a safe profession. Beyond a lack of personal protective equipment seen at the beginning of the pandemic, it’s not uncommon for the very patients we are working to protect to lash out in violence against us. There are few protections in place or opportunities to react.

A recent survey of nursing leaders points to top priorities in driving change for the nursing profession, namely ensuring adequate, competent, staffing at the bedside, strengthening talent pipelines, and fostering resiliency within the nursing workforce. With the spotlight on us today, we have an opportunity to fix these foundational problems alongside those resulting from or exacerbated by the pandemic, so that nurses feel supported, validated, and – most importantly – safe.

Ensuring sufficient staffing at the bedside

When nurse staffing is discussed, often the conversation centers on nurse-to-patient ratios. While this is important, more attention must be focused on providing an adequate number of competent nurses at the bedside to perform care and it must take into account the patient acuity and severity of illness. The solution includes practical training as well as the clinical experience and knowledge of how to tailor care for everyone based on individual situations and needs. If nurses don’t trust that the people working beside them are capable of delivering safe and consistent patient care, they will continue to resign out of fear of being blamed for errors or worse, losing their own license.

Staffing appropriately also means utilizing resources more efficiently. If we want nurses to feel more empowered to deliver the best care they can, we need to give them more resources. Simple, but powerful changes, such as supporting nurses to work at the top of their licenses and scope of practice, and to voice their preferences for when they work and for how long, would go a long way. As it stands now, nurse staffing can be incredibly inflexible and might easily push people into a different way of working by simply quitting.

Expanding the nursing pipeline

We need to act now to ensure there are enough nurses to fill the growing number of open positions anticipated in the coming years. Partnerships between healthcare organizations and nursing schools are vital to prepare nursing students for clinical practice upon graduation. This includes modifying nursing school curriculums to reflect the reality of practice today, development of nurse residency programs, where graduate nurses receive more oversight and educational opportunities to refine their skills and clinical judgement than they would have in a typical orientation program. The more exposure future nurses have during their education to the reality of their clinical role, the better prepared they will be to enter the workforce – and the more likely these new nurses are to stay in the field long-term.

Telehealth nursing is also creating opportunities for inclusivity and flexibility. People who require special accommodations or have disabilities can join the profession and work in settings without the physical tasks required in a direct patient-care setting. It’s also inviting retirees back into the workforce, with added schedule and location flexibility. And, telehealth can be a platform for virtual coaching between seasoned mentors and less experienced nurses.

People who are considering a second career also represent a recruitment opportunity for the nursing workforce. For those with a bachelor’s degree, moving into a career in nursing can take as little as 18 months of additional education and training – meaning we can get more nurses to the bedside more efficiently.

Foster respect and resiliency in today’s workforce

One of the reasons we’re experiencing such a monumental nursing shortage is a result of unprecedented churn across the industry. Even the nurses choosing to stay in the field are moving away from bedside positions. Nurses can’t do more. Instead, leadership must institute changes that enable them to work more efficiently. This should include redesigning care models and equipping nurses with the right resources, technology, data, and partnerships. Equally important, gratitude goes a long way, too.

When thinking about gratitude for nurses who have carried our nation over the last two-plus years, it’s going to take a lot more than a pizza party during Nurses Month to show them we care. These efforts must be rooted in authentic respect for their role at the bedside as well as a deep understanding of their needs, helping them feel safe, heard, and valued across all aspects of their life-work journey.

To protect their nurses, hospitals are beginning to implement new guidelines on patient behavior to make clear what is expected and what behaviors won’t be tolerated. They are also investing in mental health and wellness resources that offer nurses support and critical time to recharge. They are actively listening to nurses who speak up in situations that aren’t safe and enacting change. For the nursing profession to thrive, it’s going to take hard work on the part of healthcare institutions, academia, and individual nurses.

Our profession was built by nurses who were willing to take risks, challenge the status quo, and advance their clinical practice for the betterment of patients. Moving forward, nurses – and their leaders – must continue to be courageous.

Nurses now have more visibility and a louder voice to influence and drive transformation. Navigating the challenges ahead will take grit and innovation, but the reward is a more satisfied, appreciated, and resilient workforce ready and willing to support patients in their time of greatest need.

Photo: asiseei, Getty Images,


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Anne Dabrow Woods and Nanne Finis

Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN has been a practicing nurse and nurse leader for over 38 years, and a critical care nurse practitioner for over two decades and is the Chief Nurse of Wolters Kluwer, Health, Learning, Research and Practice.

Nanne Finis, RN, MS, has been a practicing nurse and nurse leader for over 40 years and is committed to creating more meaningful and connected work experiences for all as the Chief Nurse Executive at UKG.

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