Hospitals face a catch-22 amid nurse shortages

Hospitals have spent years working to ease nurse shortages; however, they are now facing a catch-22 in the nursing workforce.

More experienced nurses are retiring in waves, and nurses with a few years of experience are pursuing non-bedside roles such as leadership. But hospitals still need nurses at the bedside. 

“We still need strong engagement at the bedside,” Timothy Carrigan, PhD, RN, regional chief nursing officer of Illinois and Indiana at Livonia, Mich.-based Trinity Health, told Becker’s. “Some would say the pendulum has swung too far toward advanced education, and we’re exploring ways — like virtual nursing — to keep experienced nurses connected to bedside care without requiring the same physical demands.”

However, systems want to support nurses in their career advancements. This often includes helping them get master’s and doctorate degrees, which not only open new career pathways but bring a higher level of clinical care to patients.

“Work-life balance is important to younger nurses. Many prefer 12-hour shifts, which give them more days off to pursue other interests, often further education. It’s a win-win: many nurses return to us as NPs or CNSs, or as educators,” Carolyn Santora, MSN, RN, CNO and chief regulatory officer at Stony Brook (N.Y.) University Hospital, told Becker’s. “While this trajectory sometimes contributes to bedside nurse shortages, it also fills important roles that support public health and hospital operations. Advanced nursing practice has become vital in meeting today’s healthcare needs.”

Professional development is also a vital part of many retention programs.

“Career growth plans keep people in the system,” Tim Plante, MSN, RN, CNO of the central region of Chicago-based CommonSpirit Health, told Becker’s. “For too long, nursing didn’t focus on that. If we identify nurses’ goals early — whether leadership, advanced practice or education — we can support them with tuition reimbursement and mentorship. That not only helps them grow, it keeps talent within the organization rather than losing it when they’re ready for the next step.”

In years past, a bachelor’s degree in nursing was considered the end goal for most nurses, but now, many new graduates see it as the starting point, Ms. Santora said. 

The number of students in master’s-level nursing programs has increased 4.8% and the number of students in Doctor of Nursing Practice programs grew by 2%. DNP programs are offered at 439 nursing schools across the nation and have grown from 70 students in 2003 to 42,767 students in 2024.

Hospital leaders report seeing a corresponding interest in the degrees and roles nurses are pursuing. The most in-demand roles nurses want are certified registered nurse anesthetist and nurse practitioner for family or behavioral health. 

The most popular degrees nurses are pursuing are Master of Science in Nursing, Master of Business Administration, or Master of Hospital Administration for those looking to go into leadership roles, and Doctor of Nursing Practice and a doctorate in nursing, or PhD, for those wanting to pursue research- or clinical-focused roles. 

“We’ve also launched targeted cohort programs with local universities — like a master’s in nursing education — to fill immediate workforce gaps,” Susan Reeves, EdD, RN, system chief nurse executive at Lebanon, N.H.-based Dartmouth Health, told Becker’s.

Systems are providing a number of benefits to support nurses getting a higher degree. These include online learning, tuition reimbursement, loan forgiveness and accommodating schedules. Some nursing schools also provide tuition subsidies for nurses who participate in clinical teaching, Helen Staples-Evans, DNP, RN, senior vice president of patient care services and chief nursing officer at Loma Linda (Calif.) University Health Hospitals, told Becker’s. 

“Additionally, many current nurse leaders are enrolling in DNP programs, particularly those with a focus on administration,” she added.

But how to keep experienced nurses at the bedside as more new nurses enter the workforce is still a challenge systems are trying to resolve.

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