Nursing Staffing Crisis – From the Desk of Dr. Nettleton

11 Jan, 2024

Recently, M. Bridget Nettleton, PhD, RN, CNE joined the Davin Healthcare team in a role that draws upon her experience and knowledge. We asked if she could share some of her insights and opinions in a reoccurring blog, named From the Desk of Dr. Nettleton

For the first installment, we asked Dr. Nettleton to address the nursing staffing shortage that is currently impacting the country.

Just last month the American Nurses Association (ANA) called for the nursing staffing crisis to be declared a national emergency. If short and long-term solutions cannot be identified in response to the nursing staffing shortage, there will be long-term consequences for not only nurses and other health care practitioners, but also for healthcare systems, and the citizens of the United States who need these essential healthcare services. Currently, there are 4.2 million registered nurses in the United States representing the largest group of healthcare providers. Shortages in the nursing workforce must be addressed to prevent the crisis predicted by the ANA1.

Dr. Nettleton has over 40 years of experience not only in the field of nursing but as a nurse educator. She’s followed the growing crisis and has developed solutions that may be able to help.

I would suggest a national nursing staffing crisis already exists, and we need a multi-pronged approach to address it. First, let’s discuss solutions that can be offered at a Federal and national governmental level. While Medicare pays a share of the cost of educating residents through direct graduate medical education (DGME) payments, no such program exists to assist in nursing education. There is an indirect Medicare payment to hospitals considered “teaching hospitals” that provides for some funding for nursing programs affiliated with such institutions, but it covers minimal costs and is not applied to nursing programs without this hospital affiliation. I would suggest we need to see an increase in fiscal support of all levels of nursing programs (associate’s, bachelor’s, master’s, and doctorate), but most especially for pre-licensure nursing programs that create the pipeline for beginning nurse professionals.

There needs to be a call to action at the national level to reduce regulation (imposed primarily at the state level) to address current barriers to nurses practicing to their full potential. I would advocate for a national licensure compact for registered nurses to ease interstate practice. I have always been puzzled why we require all registered nurse (RN) candidates to pass the National Council Licensure Examination (NCLEX-RN) and then be restricted to specific states for practice. It would be the responsibility of the RN to become familiar with their state’s perspective Nurse Practice Act and to follow any state-specific regulations. All state-specific regulation needs to be minimized also.

Another solution to the nursing staffing crisis would be a nationally supported change in reimbursement procedures for nursing and allied health services. Nursing and allied health cost centers should be established so that the contributions of these health care practitioners can be realized and reimbursed accordingly.

There is no single solution to this significant problem and in a future blog, we will discuss the role of healthcare systems (practice) and nursing education programs (academia) in being part of the solution.

Throughout the next few months, Dr. Nettleton will continue to follow the situation and other developments in the healthcare field and check back with us to share her expert opinions, knowledge, and solutions.

1. American Nurses Association. (2021, September 1). Ana urges HHS to declare nurse staffing shortage a national crisis. American Nurses Association. Retrieved October 20, 2021, from

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