护士短缺的背后到底是什么？1,500名护士分享他们的故事

What’s Really Behind the Nursing Shortage? 1,500 Nurses Share Their Stories

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If the past two years have taught the world anything, it's that nurses are NOT okay. The truth is that despite the 7 pm cheers, the commercials thanking nurses for their dedication and selflessness, and the free food from major retailers – the overwhelming majority of nurses are burnt out, underpaid, overworked, and underappreciated.  

With millions of nurses worldwide, we wanted to truly understand the current state of nursing and give nurses a voice to share their thoughts, feelings, and apprehensions about the nursing profession. We surveyed nearly 1,500 nurses to find out how they felt about the past year and get to the real reasons behind the nursing shortage. The responses were heartbreaking, but not without hope.  

What We Found: Nurses Are Struggling

Nurses are struggling. Regardless of practice specialty, age, or state of practice – the answers were all the same. Nurses, NPs, and APRNs are all struggling and need help.  

Only 12% of the nurses surveyed are happy where they are and interestingly, 36% would like to stay in their current positions but changes would need to be made for that to happen. Nurses report wanting safe staffing, safer patient ratio assignments, and increased pay in order to stay in their current roles.  

Nurses didn’t hold back when discussing their feelings regarding the current state of nursing:  

• 87% feel burnt out 

• 84% are frustrated with administrators 

• 84% feel they are underpaid 

• 83% feel their mental health has suffered 

• 77% feel unsupported at work 

• 61% feel unappreciated 

• 60% have felt uncomfortable having to work outside of their comfort zone in the past year 

• 58% of nurses have felt frustrated with their patients 

• 58% of nurses have felt unsafe at work in the past year 

The numbers don’t lie. It’s astounding that a profession continually recognized for its compassion, strength, and resilience is suffering. And the suffering is universal.  

One nurse responded with the following, “I have been an RN for 34 years and in my specialty of nursing for 31 years and I am burned out.” 

What Is the Nursing Shortage and Why is it Happening?

You’ve likely heard about the nursing shortage, but what does that mean and why is it happening? 

According to the U.S. Bureau of Labor Statistics (BLS), the employment of registered nurses is projected to grow 9% from 2020 to 2030.  Approximately 194,500 openings for registered nurses are projected each year, on average, over the decade. However, this number was projected prior to the pandemic, and before the mass exodus of bedside clinical nurses. As a result, it’s likely substantially lower than what the real demand for nurses will look like.

The American Nurses Association (ANA) reports that the increased need for nurses spans beyond the current pandemic. In fact, they sent a letter to the U.S. Department of Health and Human Services (HHS) on September 1, 2021, urging the country to declare the current and unsustainable nurse staffing shortage to be a national crisis. 

The ANA attributes the needs for thousands of nurses to the following:  

• The Affordable Care Act made access to health care services possible for more people

• Increased focus “primary care, prevention, wellness, and chronic disease management” 

• Aging baby-boomer population

• Growing interest in community-based care

Why Are Nurses Really Leaving The Bedside? 

However, those stats don’t address some of the systemic issues nurses face every day, particularly in the midst of a pandemic. That’s why we asked nurses why they are really leaving the bedside.

What we heard is that, overwhelmingly, the number one reason nurses want to leave the bedside is because of unsafe staffing ratios. This leads to a never-ending cycle of shortages: nurses face unsafe staffing ratios so they decide to leave the bedside, this results in even fewer nurses available to care for patients, so the downward cycle continues.

Essentially, nurses are dealing with an increased workload with fewer resources. Typically, pre-covid ICU nurses would experience a 1:1 or 2:1 patient-to-nurse ratio. Now ICU nurses throughout the country are experiencing a 3:1 or 4:1 patient-to-nurse ratio which exacerbates staff burnout and unsafe nursing practices.  

One nurse reported, “With increased patient census, staffing ratios are very unsafe especially with high acuity patients. Having 4+ critically ill patients not only puts licenses at risk but the patients do not benefit at all. We’re just running around doing tasks, not providing adequate care.”

Unsafe Staffing Ratios Are Just Part of the Problem

While a big piece of the puzzle, unsafe staffing issues are, unfortunately, one part of a long list of issues plaguing nurses today. 

 Nurses are leaving the bedside because of issues like: 

• Inadequate staffing ratios 

• Not getting equal pay for equal experience 

• Not receiving hazard pay during a pandemic 

• Not having adequate back up 

• An inability to take breaks, sick days, or even turn down extra shifts 

To learn more about the nursing shortage and learn ways you can get involved, check out the full report here. 

Despite All This, Nurses Still Have Hope

70% of nurses still think that nursing is a great career and 64% still think that new nurses should join the profession. 

“If you’re a student considering becoming a nurse, please know that you are not walking into a doomed profession. You will never meet anyone who is more determined, more resourceful, or more ready to jump in and lend a helping hand than a nurse." 

--– Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org

If you’re a nurse, you know that nursing isn’t just a profession, it’s a calling. It’s devastating to see that so many nurses are suffering in their quest to heal and give care, but it’s heartening to know they are not without hope. 

What Nurses Need Now 

If you’re a nurse, know that your job is simply to put yourself first. If we want to solve the nursing shortage (and we do!), it can't happen without nurses recognizing that they are NOT the problem. 

"The problem is not with nurses or nursing; the problem is that nurses have been so busy taking care of others that no one has taken care of them. And we’re here to change that--and by entering the nursing profession, you will be part of the solution too”

 – Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org 

The truth is nurses need a lot more to be incentivized to stay practicing clinically at the bedside. Nurses reported needing:  

• Higher pay 

• Safe nurse-to-patient ratios 

• Hazard pay 

• REAL mental health resources 

• Adequate staff support 

• Support programs for new nurses

4 Ways to Support Nurses and Take Action

While we may not be able to make this change at an individual level, collectively, we can amplify the voice of nurses and shed some light on the issues that they are facing every day. Together, we have the power to create meaningful, lasting change for current and future nurses.  Here's how to get involved: 

1. Sign the Pledge

Sign the pledge seen below and encourage your friends & colleagues to do the same. While you’re at it, print it out and post it in your break room. 

2. Spread the Word 

Change can’t happen unless we get the word out about what’s really going on. Share what you’ve heard and what you’ve experienced, and encourage others to do the same. 

3. Contact Your Elected Officials 

It’s time for elected officials to stand up for nurses. Write them a letter. Call their office. Demand change for nurses. Click here to get the contact information for your local and state Officials. 

全文翻译（仅供参考）

如果说过去的两年教会了世界什么，那就是护士并不好过。事实是，尽管有晚上7点的欢呼声，感谢护士的奉献和无私精神的广告，以及主要零售商提供的免费食物--绝大多数的护士被烧毁了，报酬不足，工作过度，而且不受重视。 

全世界有数以百万计的护士，我们希望真正了解护理工作的现状，让护士们有机会分享他们对护理职业的想法、感受和忧虑。我们调查了近1500名护士，了解他们对过去一年的感受，并了解护士短缺背后的真正原因。他们的回答令人心碎，但并非没有希望。 

我们的发现。护士们在挣扎

护士们正在挣扎。无论其执业专业、年龄或执业状态如何，答案都是一样的。护士、非执业护士和APRN都在挣扎，需要帮助。 

只有12%的受访护士对自己所处的位置感到满意，有趣的是，36%的人希望留在目前的岗位上，但要实现这一目标，需要做出改变。护士们报告说，他们希望有安全的人员配置，更安全的病人比例分配，以及增加工资，以便留在他们目前的岗位上。 

护士们在讨论他们对护理工作现状的感受时，并没有隐瞒。 

87%的人感到疲惫不堪 

84%的人对行政人员感到失望 

84%的人认为他们的工资很低 

83%的人认为他们的心理健康受到影响 

77%的人觉得在工作中没有得到支持 

61%的人感到不被赏识 

60%的人感到不舒服，在过去的一年里，他们不得不在自己的舒适区之外工作。

58%的护士对他们的病人感到沮丧 

58%的护士在过去一年中感到工作不安全 

这些数字并没有说谎。令人震惊的是，一个因其同情心、力量和复原力而被不断认可的职业正在遭受痛苦。而且这种痛苦是普遍的。 

一位护士回答说："我做了34年的护士，在我的专业护理领域做了31年，我已经筋疲力尽了。" 

什么是护士短缺，为什么会出现这种情况？

你可能听说过护士短缺，但这意味着什么，为什么会发生？

根据美国劳工统计局（BLS）的数据，从2020年到2030年，注册护士的就业率预计将增长9%。预计在这十年中，平均每年约有194,500个注册护士的职位空缺。然而，这个数字是在大流行之前，以及在床边临床护士大规模出走之前预测的。因此，它可能大大低于对护士的实际需求。

美国护士协会（ANA）报告说，对护士需求的增加超出了目前的大流行病。事实上，他们于2021年9月1日致函美国卫生与公众服务部（HHS），敦促国家宣布目前不可持续的护士人手短缺为国家危机。

全美护士协会将对数千名护士的需求归结为以下几点。 

平价医疗法案使更多的人有可能获得医疗服务

更加注重 "初级保健、预防、健康和慢性病管理" 

婴儿潮人口的老龄化

对社区护理的兴趣越来越大

为什么护士真的离开了床边？

然而，这些统计数字并没有解决护士每天面临的一些系统性问题，特别是在大流行病中。这就是为什么我们问护士为什么他们真的要离开床边。

我们听到的是，绝大多数情况下，护士想离开床边的首要原因是不安全的人员配置比例。这导致了一个永无止境的短缺循环：护士面临不安全的人员配置比例，所以他们决定离开床边，这导致可用来护理病人的护士更少，所以下降的循环继续。

从本质上讲，护士们正在用更少的资源处理更多的工作量。通常情况下，癌症前的ICU护士会经历1：1或2：1的病人与护士的比例。现在，全国的ICU护士正经历着3:1或4:1的病人与护士的比例，这加剧了工作人员的倦怠和不安全的护理行为。 

一位护士报告说："随着病人数量的增加，人员配置比例非常不安全，特别是对高危病人。有4个以上的危重病人，不仅使执照处于危险之中，而且病人根本就没有受益。我们只是跑来跑去做任务，而不是提供足够的护理。"

不安全的人员配置比例只是问题的一部分

虽然不安全的人员配置问题是难题的一大块，但不幸的是，它只是困扰当今护士的一长串问题中的一部分。

 护士们离开床边是因为以下问题。

人员配置比例不足 

同等经验不能得到同等报酬 

在大流行病期间没有得到危险津贴 

没有足够的后备力量 

无法享受休息、病假，甚至无法拒绝额外的班次 

想了解更多关于护士短缺的情况，并学习如何参与其中，请点击这里查看报告全文。

尽管这样，护士们仍然有希望

70%的护士仍然认为护理是一个伟大的职业，64%的护士仍然认为新护士应该加入这个行业。

"如果你是一个考虑成为护士的学生，请知道你并没有走进一个注定失败的职业。你永远不会遇到比护士更有决心、更有办法、更愿意跳进去伸出援手的人"。

---爱丽丝-本杰明护士，MSN，APRN，ACNS-BC，FNP-C，CCRN，CEN，CV-BC，Nurse.org的首席护理官和通讯员

如果你是一名护士，你知道护理不仅仅是一种职业，更是一种召唤。看到这么多护士在寻求治疗和提供护理的过程中遭受痛苦，令人痛心，但知道他们并非没有希望，令人振奋。

护士们现在需要什么 

如果你是一名护士，要知道你的工作只是把自己放在第一位。如果我们想解决护士短缺的问题（我们确实如此！），如果护士不认识到他们不是问题所在，就不可能实现。

"问题不在于护士或护理工作；问题在于护士一直忙于照顾别人，而没有人照顾他们。我们在这里要改变这种状况--进入护理行业，你也将成为解决方案的一部分"

 - 爱丽丝-本杰明护士，MSN，APRN，ACNS-BC，FNP-C，CCRN，CEN，CV-BC，Nurse.org的首席护理官和通讯员 

事实上，护士需要更多的激励措施来保持在床边的临床实践。护士们报告说需要  

更高的薪酬 

安全的护士与病人的比例 

危险津贴 

真正的心理健康资源 

充足的员工支持 

对新护士的支持计划

支持护士和采取行动的4种方法

虽然我们可能无法在个人层面上做出这种改变，但集体而言，我们可以放大护士的声音，对他们每天所面临的问题进行一些说明。我们一起有能力为现在和未来的护士创造有意义的、持久的变化。以下是参与的方式。

1. 签署承诺书

签署下面的承诺书，并鼓励你的朋友和同事也这样做。当你在做的时候，把它打印出来，贴在你的休息室里。

2. 2.传播信息 

除非我们把真正发生的事情说出来，否则变化不可能发生。分享你所听到的和你所经历的，并鼓励其他人也这样做。

3. 联系你的领导 

是时候让领导为护士站出来了。给他们写一封信。给他们的办公室打电话。要求为护士做出改变。

THE

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