Healthcare systems across the world are facing another pandemic. It’s not the COVID-19 pandemic, but something equally alarming: the pandemic of the massive exodus among healthcare professionals, particularly nurses. The COVID-19 crisis both highlighted and compounded the challenges faced by nurses, pushing them to the brink of physical, emotional, and psychological exhaustion. Exhaustion has led to extraordinary dissatisfaction and burnout, with many in the nursing workforce planning to leave their employer or the nursing profession entirely.
In this exodus dubbed "The Great Resignation," "The Great Attrition," and "The Big Quit," the large number of healthcare workers, including nurses, who have left or intend to leave is high. The 2022 COVID-19 Impact Assessment Survey, conducted by the American Nurses Foundation and the American Nurses Association, revealed that 52% of nurses intended to or were considering leaving their current position, primarily due to insufficient staffing and poor working conditions that impact their health and the quality of care they are providing. The Clinician of the Future Report published by Elsevier Health in 2022 had similar findings, revealing that up to 47% of U.S. healthcare workers had planned to leave their positions in the next two to three years. The data is further substantiated by the preliminary quit rates reflected on the U.S. Bureau of Labor Statistics website, which show 1.6 million people had left their healthcare jobs in the last quarter of 2022.
The increasing number of nurses intending to leave not just the workforce but also the nursing profession is alarming in the present global and national nursing shortage. In 2021, the International Council of Nurses estimated a future shortage of up to 13 million nurses globally, while in 2022, the U.S. Bureau of Labor Statistics’ Employment Projections 2021–2031 forecasted a shortage of more than 200,000 nurses annually through 2031. These figures are a call to action for healthcare leaders and organizations to address this growing crisis.
So, what has been done to mitigate the Great Resignation? The healthcare industry across the globe has incorporated various strategies with the primary aim of alleviating the exodus of nurses. One approach includes giving signing bonuses to attract more nurses to join organizations. Organizations utilized temporary staffing through agencies, leveraged travel nurses, and increased the number of administrative support staff to help with non-clinical tasks in the patient care units. Some organizations invested in technology to help automate manual workflows, decrease administrative burden, and increase time spent on hands-on patient care (Delatore, 2022). The healthcare industry continues to grapple with the best solutions to alleviate staffing strains and retention.
The availability of professional learning and development opportunities is one proposed strategy aligned with nurse-identified factors promoting re-engagement and increasing intention to stay in the field. Professional development is essential to the lifelong learning strategies built into nursing practice, and it may be enticing to nurses who wish to enhance their careers in their present practice areas, move into other specialties, or take on leadership positions. Some nurses may decide to change their careers to pursue jobs that are more in line with their own ideas of meaningful employment, as opposed to quitting nursing altogether (Nowell, 2022). This strategy is well supported by studies conducted by Armstrong-Stassen (2005) and Hall and colleagues (2011), which identified educational support as a highly important retention strategy for nurses.
Several studies revealed that supporting healthcare workers' professional education and career advancement are important factors that reduce turnover retention (Challinor et al., 2022; Poon et al., 2022). Another study conducted by Zhu and colleagues (2021) showed that a limited organizational structure offering few opportunities for new knowledge and skills acquisition and support for career development are among the primary reasons why nurses encounter career plateaus and eventually decide to leave their jobs.
Therefore, being more intentional in providing career advancement and training opportunities to nurses may aid in alleviating the effects of the Great Resignation. By providing alternative nurses with career paths and professional development opportunities that nurture their interests and professional growth, they might find meaning in what they can do beyond the bedside. This will hopefully motivate them to stay in the nursing field, thereby mitigating the effects of the Great Resignation. Retaining and repurposing the cumulative years of experience and expertise possessed by these nurses will be beneficial to the next generation of nurses.
So, the next call to action is: how can we assist nurses in finding the right field of specialization and help them reroute their professional development journey?
Dr. Tariga dove deeper into the Great Resignation and how NPDs can address it in his webinar. View the recording here.
Please note that editorials are opinion writings. This piece expresses the opinions of the author and has not been subjected to peer review. The author has no affiliations to declare.
References:
American Nurses Foundation. (2022, March). COVID-19 Two-Year Impact Assessment Survey. https://www.nursingworld.org/~4a2260/contentassets/872ebb13c63f44f6b11a1bd0c74907c9/covid-19-two-year-impact-assessment-written-report-final.pdf
Armstrong-Stassen, M. (2005). Human resource management strategies and the retention of older RNs. Nursing Leadership (Toronto, Ont.), 18(1), 50-64.
Bureau of Labor Statistics, U.S. Department of Labor. (2023, January). Occupational Outlook Handbook, Registered Nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm.
Challinor, J. M., Alqudimat, M. R., Teixeira, T. O., & Oldenmenger, W. H. (2020). Oncology nursing workforce: Challenges, solutions, and future strategies. The Lancet Oncology, 21(12), e564-e574. https://doi.org/10.1016/s1470-2045(20)30605-7
Delatore, M. (2022, June). Why nurses are joining the great resignation and what can be done. CoverMyMeds Insights. https://insights.covermymeds.com/healthcare-technology/care-teams/why-nurses-are-joining-the-great-resignation-and-what-can-be-done
Elsevier Health. (2022, March). Clinician of the future report 2022. https://www.elsevier.com/__data/assets/pdf_file/0004/1242490/Clinician-of-the-future-report-online.pdf.
Hall, L. M., Lalonde, M., Dales, L., Peterson, J., & Cripps, L. (2011). Strategies for retaining midcareer nurses. JONA: The Journal of Nursing Administration, 41(12), 531-537.
International Council of Nurses Policy Brief. (2021). The global nursing shortage and nurse retention. Retrieved from: https://www.icn.ch/sites/default/files/inline-files/ICN%20Policy%20Brief_Nurse%20Shortage%20and%20Retention.pdf
Nowell, L. (2022, July). Helping nurses shift from the great resignation to the great reimagination. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15403
Poon, Y. R., Lin, Y. P., Griffiths, P., Yong, K. K., Seah, B., & Liaw, S. Y. (2022). A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: A systematic review with future directions. Human Resources for Health, 20(1). https://doi.org/10.1186/s12960-022-00764-7
U.S. Bureau of Labor Statistics. (2023, January). Quits levels and rates by industry and region, seasonally adjusted. https://www.bls.gov/news.release/jolts.t04.htm#jolts_table4.f.p.
Zhu, H., Xu, C., Jiang, H., & Li, M. (2021). A qualitative study on the experiences and attributions for resigned nurses with career plateau. International Journal of Nursing Sciences, 8(3), 325-331. https://doi.org/10.1016/j.ijnss.2021.05.006
Jose Arnold Tariga, PhD, MSN, MN, RN, CPHQ, CNE, NPD-BC