Top 10 Issues in Nursing for Facilities

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Written by Katherine Zheng, PhD, BSN Content Writer, IntelyCare
Two nurses have a jovial conversation with a physician.

Nursing is undoubtedly a challenging profession, evidenced by the high turnover rates and ongoing shortages affecting the industry. It’s no secret that nurses are often tasked to provide quality care without always having the proper resources needed to do so. While some of these workforce challenges have been present for decades, there are also new problems arising alongside the demand for patient care. But, what exactly are the current, top 10 issues in nursing and how can they be prevented?

As a facility leader, it’s important to stay up-to-date on nursing trends so that you can better support your staff and patients. To help keep you informed, we’ll walk through current challenges in nursing and solutions that may help mitigate these issues at the facility-level.

The Top 10 Issues in Nursing

Nurses face a range of challenges in their daily work — many of which overlap or are directly driven by one another. This is why it’s important for facility leaders to take comprehensive measures to support their staff. Below we’ll cover 10 of the most current issues in nursing, discuss how they relate to each other, and provide tips on how you can address them at your facility.

1. Short Staffing

Short staffing remains one of the top issues in nursing, affecting the healthcare industry nationwide. Experts project that the nursing shortage will continue through 2030, leaving facilities pressed with the continuous challenge of hiring and retaining qualified nurses. Inadequate staffing not only compromises quality of care, but it can also leave nurses feeling more burned out and inclined to leave their jobs over time.

What facility leaders can do to address this:

  • Utilize diverse staffing methods, such as float pool, per-diem, or travel nurses.
  • Work with a staffing partner that can help identify and address short- and long-term staffing issues at your facility.
  • Prioritize recruitment and retention efforts.

2. Nurse Turnover

One reason why many facilities are consistently understaffed is high turnover. The national turnover rate among nurses ranges between 8% to 37%, depending on the type of specialty. With such a large volume of nurses leaving their roles, this can cause remaining staff to be stretched thin while increasing hiring costs for facilities.

What facility leaders can do to address this:

  • Implement retention programs that support the wellbeing of nurses beyond offering competitive pay.
  • Provide mentorship and career advancement opportunities that incentivize nurses to grow in their current roles.
  • Promote a healthy work environment built on trust, collaboration, and respect.

3. Unmanageable Workloads

Both short-staffing and turnover can lead to unmanageable workloads, which also remains one of the top 10 issues in nursing. When nurses are tasked to care for too many patients at a time, this can lead to fatigue, burnout, and job dissatisfaction. Poor nurse-to-patient ratios also compromise safety and care, increasing the risk of medical errors and decreasing the amount of attention that each patient receives.

What facility leaders can do to address this:

  • Regularly assess and anticipate staffing needs to get ahead of gaps.
  • Identify ways to improve workflow processes, such as from updating paper charting methods to electronic health record (EHR) systems.
  • Reduce non-clinical tasks that add to nursing workloads and stress.

4. Unsafe Work Environments

Nurses encounter environmental work hazards on a daily basis. When coupled with a lack of institutional support, this can compromise their personal safety. From exposure to infectious diseases to the physical demands of patient care, nurses are highly susceptible to experiencing work-related illness or injury. In fact, over 78,000 cases of work-related injury or illness led nurses to take a day off in just one year alone.

What facility leaders can do to address this:

  • Provide resources and training to support compliance with standard precautions.
  • Conduct ergonomic evaluations and adopt devices that help alleviate physical strain.
  • Regularly survey staff to identify and minimize environmental risks that are currently impacting nurses.

5. Workplace Violence

Beyond the risk of illness and injury from daily care tasks, healthcare workers are also five times more likely to be victims of workplace violence than any other type of worker. Nurses in particular can face verbal abuse or physical assaults from patients and visitors, and they may even experience acts of horizontal violence from their own colleagues.

What facility leaders can do to address this:

  • Provide comprehensive de-escalation training to help staff remain safe in high-risk situations with patients.
  • Promote a collegial, transparent, and collaborative work culture to prevent horizontal violence between staff.
  • Implement better security measures, such as a multidisciplinary safety response team that’s trained to help staff in dangerous situations.

6. Burnout

Burnout consistently makes the list of the top 10 issues in nursing. It’s common for nurses to feel high levels of burnout as a result of unmanageable workloads and poor working conditions. More than one-third of nurses in the U.S. experience burnout during their careers, which is also a primary reason why many leave their jobs or the profession altogether.

What facility leaders can do to address this:

  • Implement and enforce policies that support adequate nurse-to-patient ratios.
  • Provide comprehensive mental health support and employee assistance programs.
  • Let nurses have more control over their schedules to promote better work-life balance.

7. Poor Work Culture

Much of the burnout and stress that nurses experience also stem from a poor work culture. A lack of communication, respect, and collaboration can leave nurses feeling like they’re not emotionally or socially supported in the workplace. This can negatively impact their mental health and hinder their ability to provide quality care.

What facility leaders can do to address this:

  • Implement a zero-tolerance policy for bullying, incivility, and harassment.
  • Educate and train staff members on how to build a more inclusive, collegial environment.
  • Promote a transparent culture where staff are encouraged to talk to their leaders about work-related concerns.

8. Moral Distress

Moral distress occurs when nurses want to take the best course of action for a patient, but they’re unable to do so because of resource constraints. This is one of the top ethical issues in nursing, since nurses are forced to provide care that doesn’t align with their values. This also often leaves nurses feeling guilty and frustrated, since they have no choice but to compromise standards of care.

What facility leaders can do to address this:

  • Create an ethics committee trained to help and guide nurses through moral dilemmas.
  • Enact shared governance so that nurses have a say in shaping facility-level policies.
  • Provide institutional resources, such as a trained ethicist, who can help nurses find their voice and talk through their feelings after facing ethical dilemmas.

9. Lack of Development Opportunities

It can be difficult for nurses to think about career development while they’re juggling heavy patient loads and stressful schedules. However, a lack of professional growth can contribute to job dissatisfaction and turnover intention, since nurses may feel like there is no upward mobility in their roles.

What facility leaders can do to address this:

  • Maintain adequate staffing levels so nurses have more time to participate in professional development.
  • Create programs, such as clinical ladders, for nurses who want to develop their careers on the floor.
  • Invest in workshops, training, and courses for nurses who wish to develop new skills or expand their clinical knowledge.

10. Poor Management

As leadership is fundamental to shaping the culture and workflow of a unit, many of the other top 10 issues in nursing are inevitably driven by inadequate management. This is an issue that can affect the morale, productivity, and overall job satisfaction of nurses. As such, facilities must also address current issues in nursing management and provide adequate resources to support higher-level roles.

What facility leaders can do to address this:

  • Support the work-life balance of nurse leaders by providing comprehensive benefits.
  • Fund conferences, professional memberships, and leadership training for nurse managers and leaders.
  • Invest in staffing solutions that take the scheduling burden off of nurse managers, allowing them to focus more on team-building efforts.

Learn More Ways to Cultivate a Healthier Workforce

Ready to tackle these top 10 issues in nursing, but need some more help getting started? IntelyCare’s team of experts provides dozens of other tips and strategies to help you translate these recommendations into practice — all at no cost to you.

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