Where Have All the Nurses Gone? Part III

by Kate Rowley, MBA

by Kate Rowley, MBA

What Do We Do?

The ultimate solution to the global nursing shortage does not have a single answer and it is most certainly not a quick fix.  By attacking the cause of the shortage with a multi-pronged, practical, and sustainable approach, we can begin to make significant progress towards increasing the number of nurses and, ultimately, creating a stronger global health system.

solve the problem

Create Incentives

First, health care providers and educational institutions in all nations can get creative with incentives to make nursing a more attractive field.  For existing nurses, this could mean healthcare coverage plans, company performance incentives, customer feedback incentives, 401K contributions, etc.  Some companies have even used land usage agreements as an incentive, allowing nurses to cultivate land owned by the facility for farming as an additional revenue stream for their families.  For potential nurses, the incentive of “guaranteed” employment can be a powerful motivator.  Creating relationships between educational institutions and health systems can also be mutually beneficial.  Particularly in private systems, an offer of employment after successful graduation can have tremendous allure for students.

Offer Education and Career Development Opportunities

Second, career development opportunities can motivate both potential and existing nurses.  These can be creative education solutions, such as short seminars, continuing education classes, on-the-job training, rewards of education for outstanding performance, access to online education platforms, etc.   Encouraging educational reform through supporting an enhanced local nursing school curriculum is a perfect example.  An updated curriculum can begin to impact students and graduates in less than a year.  Career development can be encouraged from several fronts – government bodies, private institutions, educational systems, nursing associations, etc.

Create a Healthcare Team

Third, creating a health care team has proven to be a mutually beneficial system for all members of a health care system.  Providing administrators, doctors, nurses, and allied health professionals a voice in decisionmaking fosters respect, understanding, and reinforces how valuable each position is to patient care.  Nurses are a valuable member of the health care team and make tremendous contributions to the field of health care.  By acknowledging this, it shows appreciation which can bolster loyalty and retention, strengthens self-worth, and increases workplace engagement.  This type of organizational change can be achieved by any nation, and it will benefit those with the greatest human capital needs the most.

Improve Working Conditions

Fourth, improving the working climate can have immense impacts on the health care system.  Offering different shift hours or flexible work plans allows for a better work-life balance, particularly for those who provide family care, which, in turn, makes nursing a more attractive field.  Allowing nurses decision-making abilities and ownership of tasks empowers them [1] and, in turn, reduces burnout, fosters ethical behavior, and increases employee satisfaction.  A team atmosphere will also cultivate a better work climate.  This type of solution can be implemented in public and private sectors, and can be encouraged by government policies.

Recruit Nurses Locally

Lastly, targeted nurse recruitment can stimulate the nursing field, particularly in rural areas.  Basically, supporting educating local individuals to meet local needs.  Research shows lower attrition rates if the selection of personnel for a particular site are persons from the local geographic area.  Many NGOs use this tactic to sustain their programs by providing additional education, better health insurance or benefits, and higher compensation than comparable local  positions.  This approach, when used for nursing professionals, elevates nursing’s  reputation in the community.

ANI Logo

The American Nursing Institute Approach

The American Nursing Institute (ANI) was developed by Global Health Services Network (GHSN) to specifically address the global nursing shortage and to elevate the skill level of nurses throughout the world.  The ANI program provides programs to enhance the skill level of existing nurses, train faculty and to provide academic nursing programs.  The approach is unique as North American faculty are place in country with the specific goal of teaching students, training faculty and updating the curriculum.  This approach builds capacity quickly and “train the trainer”.


As the global nursing shortage becomes more acute and gains greater recognition, the interest in improved working conditions and improved educational programs will increase.  We must provide realistic alternatives to shifting a limited number of nurses from one market to another.  Everyone will benefit from encouraging and promoting the nursing profession today in all nations. We must encourage the next generation of nurses, because in a world without nurses, who will provide care?

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