The nursing workforce is under significant strain amid an ongoing shortage and concerns about burnout. To understand how nurse leaders are responding, we recently surveyed nursing leaders about their top concerns for the RN workforce. We asked 242 nursing leaders to rank a list of issues and rate their level of agreement that each issue was a concern in their market. We then had them select their five most pressing concerns and their five least pressing concerns. Check out the complete list of issues, as prioritized by nurse leaders.

The biggest thing that stood out to us was that nurse leaders are laser-focused on the urgent demands of today.

The top five concerns of nursing leaders were:

1. Market shortage of qualified RN candidates
2. Abuse directed at RNs (i.e., physical/emotional/verbal)
3. Continuing increases in RN labor costs (compensation, agency, etc.)
4. Unresolved RN burnout
5. Undergraduate academic pipeline not keeping up with projected RN demand

The concerns of nurse leaders show that they are keenly aware of the high levels of competition that increase the difficulties of recruiting RNs to work in acute care. They also clearly understand the struggles acute care RNs are facing in the post-COVID world and why many RNs are choosing to leave acute care nursing.

It makes sense that nurse leaders feel a need to focus on building daily stability into the clinical enterprise (filling vacancies quickly, reducing reliance on travel nursing, and mitigating burnout). The top concerns clearly show that nurse leaders are doing everything they can to keep hospitals fully staffed and ensure that patients are receiving the highest quality care amid nursing shortages.

However, this means nurse leaders have very limited bandwidth to focus on system-level changes that may lead to longer-term solutions. Nurse leaders are aware of and concerned about priorities we believe can have long-term impacts on the RN workforce — they just aren’t the top issues right now. Hospitals and health systems need to support their nurse leaders in addressing the urgent concerns listed above while also giving them the tools and support to shift some of their focus to these lower-priority concerns. The best way to do this is to give nursing leaders the freedom to implement innovative ways to best use and support their nurses.