McKinsey Report: Nursing Shortage Will Become Dire by 2025

May 18, 2022
A new report from McKinsey predicts potentially dire nurse staffing issues in the next few years, as the nationwide nursing shortage could reach 450,000, or 20 percent, by as early as 2025

A new report from the McKinsey consulting and advisory firm paints a dire portrait of the situation around nurse care in the U.S. healthcare system in the next several years. Indeed, if the firm’s experts are proven correct, the healthcare system could experience a shortage of between 200,000 and 450,000 nurses by as soon as 2025, representing a shortage of between 10 and 20 percent of the nurses needed to care for all the patients in the system.

The report, entitled “Assessing the impact of COVID-19 on the nursing workforce,” was published on May 11 and posted to the McKinsey website. Its authors are Gretchen Berlin, R.N., a senior partner in McKinsey’s Washington, D.C. office; Meredith Lapointe, a partner in the San Francisco office; Mhoire Murphy, a partner in the Boston office; and Joanna Wexler, a consultant in the New York office.

The report’s authors write that “COVID-19 has altered many US nurses’ career plans. Over the past two years, McKinsey has found that nurses consistently, and increasingly, report planning to leave the workforce at higher rates compared with the past decade. In our latest McKinsey survey, 29 percent of responding RNs in the United States indicated they were likely to leave their current role in direct patient care, with many respondents noting their intent to leave the workforce entirely. Even as COVID-19 cases fluctuate, US healthcare providers are still experiencing the workforce and operational challenges exacerbated by the pandemic. Patient demand is expected to rise, given the growing and aging population of the United States. Without addressing this potentially wider divide between patient demand and the clinical workforce, with a specific focus on nurses, the US health sector could face substantial repercussions. For example, as of February 2022, 90 percent of McKinsey COVID-19 Hospital Insights Survey respondents said workforce shortages were a barrier to increasing elective surgery volume, up 11 percentage points from July 2021.”

Indeed, the report’s authors write, “If no actions are taken, there will likely be more patients in the United States who will need care than nurses available to deliver it. By 2025,” they write, “we estimate the United States may have a gap of between 200,000 to 450,000 nurses available for direct patient care, equating to a 10 to 20 percent gap. To meet this demand, the United States would need to more than double the number of new graduates entering and staying in the nursing workforce every year for the next three years straight. While we do not directly address rapid evolutions in healthcare productivity in this article, we acknowledge it may affect the nursing shortage. These may include evolution in allocation of care team members to ensure constrained nurse time is focused on things they are uniquely qualified for (for example, medication administration or physical assessment), technology-enabled productivity tools, or alternative sites of care settings for patients to receive care. These advances may have a substantial impact in the long term, but our experience suggests these measures may have limited impact over the next three years.”

A whole cluster of challenges is involved, and the report’s authors state that “There is no one-size-fits-all solution to the workforce challenges that are likely to persist over the short and medium term. However, respondents from the McKinsey Frontline Workforce Survey in March 2022 who had left direct patient care said a more manageable workload, increased total compensation, ability to take time off, and being more valued by an organization would be the most important factors they would consider when evaluating a return.”

But they offer four broad ideas to consider. First, they say, more people need to be attracted to the nursing profession. In that regard, they write, “Casting nursing as an attractive and exciting career opportunity could help more people understand how they could thrive in the profession. Making the value proposition and pathways for a nursing career more visible and clear for high school students and midcareer joiners may also help. That may start with educational institutions promoting a traditional nursing path (to aide, LPN, or RN), as well as encouraging allied health professionals (such as technicians) to consider nursing. It could also require institutions to identify and train new sources of talent (for example, from adjacent industries and from international programs).”

Second, they acknowledge a huge gap in nursing education, notig that “[T]here are not enough spots in nursing schools and there are not enough educators, clinical rotation spots, or mentors for the next generation of nurses. To increase the number of spots, higher education institutions could increase resources and healthcare providers could find ways to support training while still often managing their own staff shortages. Regulators also may consider additional flexibility in how to accredit programs and on streamlining timely licensure processes.”

Third, the authors believe that innovative new arrangements will have to be created. For example, “Academic institutions could consider partnering with healthcare providers to identify and address skill gaps and to connect potential candidates with employers. For instance, an employer collaborative of Cleveland Clinic, MetroHealth, and University Hospitals in Ohio partnered with Cuyahoga Community College as part of the Workforce Connect Healthcare Sector Partnership (HSP). The partnership’s goal is to hire 100 entry-level full-time workers by June 2022.”

Finally, they write that, “To maximize nurses’ time and energy, providers could prioritize innovating their care delivery models. They may learn from other industries. Airlines, for example, have been moving toward a customer-centric model where seamless integration of data and flight options has nearly eliminated the need for staff to spend time on simple tasks related to flight bookings and communications. In a healthcare setting, sensitive healthcare information and interpretation are often analyzed via digital platforms that only require clinician intervention in extreme circumstances. Internationally, providers have launched innovations such as self-dialysis, which can enable patients to perform their own dialysis in dialysis centers or at home and allow clinicians to remotely follow up with low-risk patients.”

And, in that regard, the authors note that “Healthcare providers could begin by using more analytics to find greater effectiveness and efficiency in workforce planning and deployment. Predictive analytics may allow healthcare providers to ensure optimal resourcing, while AI-enabled workforce planning may help match talent with expected needs.”

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