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A National Crisis and What It Means
Introduction
Nursing is the largest healthcare profession in the United States, with 4.2 million active registered nurse (RN) licenses and 944,813 active licenses for licensed practical nurses (LPN). Nurses are omnipresent within hospitals, offering around-the-clock care and guiding individuals through their most vulnerable moments from birth to death. Outside of the hospital, nurses often work behind the scenes but remain present in virtually all aspects of everyday life. Despite all this, the nursing workforce has been experiencing its longest shortage in U.S. history. And when many factors driving the existing nursing shortage collided with the COVID-19 pandemic, concern for the future of the nursing workforce began to garner increased national attention.
Currently, the demand for nurses has outpaced the available and projected supply of nurses. Failure to alleviate the nursing shortage threatens to render the American people vulnerable and without access to medical care. This seemingly impossible scenario has already started to play out in various parts of the country, where hospitals have had to temporarily or permanently discontinue services due to nursing shortages. Because nurses play a vital role in safeguarding the public, it is imperative that meaningful change occur before the nursing shortage's devastating effects become more widespread.
Various levels of scope of nursing practice exist, and nurses are present in a variety of settings worldwide. Although many of the topics covered in this article are shared experiences by nurses and healthcare workers across the globe, this article will focus predominately on nurses, without distinction in scope or setting, unless otherwise indicated.
A Historical Review
Nursing shortages have occurred throughout history for various reasons. In the mid-1930s, an increase in demand due to changes in healthcare delivery necessitated a larger nursing workforce. This was closely followed by the relocation of approximately 25% of the available civilian nurse population to the war effort in World War II. Recognizing the nation's vital need for nurses, Congress passed the Bolton Act in 1943.
Under the Bolton Act, the U.S. Cadet Nurse Corps (CNC) was established, and federal funding enabled women to train as nurses for military and civilian roles. The creation of categories of nurses to address supply and demand issues ran concurrent with the creation of the...