By 2020, the Hawai’i State Center for Nursing projects a shortage of
approximately 2,670 registered nurses in Hawai’i. Nationwide, the Health
Resources and Services Administration (HRSA) estimates indicate there will be a
shortage of more than 1 million registered nurses by 2020. 6 The broad set of
complex and interwoven factors driving the shortage are impacting healthcare at
a micro and macro level. These drivers include:
• An aging population that will require more RN managed/guided care 5,7-9
• An aging nursing workforce that will find it difficult to meet the physical
demands of employment 10-12
• An inadequate supply pipeline of new nurses created by a lack of adequate
nursing faculty to educate new nurses, fewer women choosing nursing as a
career, and salary inequities 13
• A poor image of nursing as a professional career option, particularly for men 14-
17
• Difficulty retaining nurses in work environments perceived as unattractive and
unsupportive 18-20
Trends indicate demand as well as supply factors contributing to the RN shortage
will deepen as the baby boom generation consumes greater portions of
healthcare services and the aging nursing workforce retires from the profession.
A number of recommendations are presented for consideration.
1. Promote and support the integration of nurse education and practice
Nursing is a practice based profession. Programs that integrate education and
practice may be the tipping point to generating new resources, improving
education and addressing the myriad of quality and patient safety issues in the
work environment.
2. Link educational opportunities and resources across the State of Hawai’i
A regional educational linkage integrated to the practice community offers
providers greater opportunity for innovation. Simulation learning, shared
information technology, a single uniform curriculum and shared faculty are some
of the conceptual ideas proposed to revolutionize nursing in Hawai’i.
3. New graduate nurse residency programs
There is a growing body of evidence demonstrating that new nurses are not
competent to work independently immediately after graduation. Evidence
suggests new nurses that participate in residency programs after graduation
transition into their professional role with less negative impact, are happier in
their role, and are more likely to be retained by the facility.
4. Develop strategies that promote the retention of mature nurses
Create a system to develop and apply evidence based criteria for best practices
focused on the retention of our aging nursing population. Strategies could include
shortened working hours, adaptation of the work environment, and assignment to
less physically demanding positions. |
