Nursing Trends for 2023

While maintaining a commitment to delivering stellar patient care, nurses face continuing challenges, which they will face head-on in 2023.

"The past few years have had an incredible impact on acute and critical care nurses," said Beth Wathen, MSN, RN, CCRN-K, 2021-22 president of the American Association of Critical-Care Nurses (AACN) board of directors.

"The pandemic amplified long-standing staffing challenges and eroded nurse well-being and the health of our work environments. As we look to 2023 and beyond, it's essential as a profession that we carry forward our lessons learned and use them to build on our roots, strengthen our profession and lead in the needed transformation of healthcare."

The COVID-19 pandemic created unprecedented stress on the nursing industry and healthcare in general. And as nurses enter 2023, they are caring for patients with COVID, influenza, and respiratory syncytial virus. The multiple respiratory viruses are straining the healthcare system. Busy outpatient and inpatient settings are occurring at the same time the nursing industry is facing a shortage of nurses.

"The nurse staffing shortage has been a growing concern in 2022," said Jennifer Schmitz, MSN, EMT-P, CEN, CPEN, CNML, FNP-C, NE-BC, president of the Emergency Nurses Association (ENA)."

Twenty-nine percent of emergency nurses surveyed by the American Nurse Foundation earlier this year said that they planned to leave their job, with one of the reasons being insufficient staffing...Nursing can be an extremely rewarding profession, but when short-staffed, nurses can be easily burned out and leave sooner than they may have otherwise."

Future Nursing Trends

Nurses will likely continue to leave patient care in 2023, further exacerbating the staffing crisis for hospitals and the nursing industry.

"We have a shortage of front-line nursing staff and nursing faculty teaching new nurses entering the field," said Nancy Mimm, DNP, lead faculty in Master of Science in Nursing and Public Health at Harrisburg University of Science and Technology in Pennsylvania.

"Healthcare facilities, including offices and post-acute care, are experiencing nursing shortages due to the large number of nurses leaving the field either through retirement or moving out of nursing altogether."

In addition to dealing with a shrinking workforce, future nursing trends show that demand for care remains high, especially with the nation's aging population. Additional trends in nursing include a focus on nurses' mental and physical health, violence prevention, greater use of telehealth, and continued reliance on travel nurses and contingent staffing.

Creative solutions to address nursing shortage

The Bureau of Labor Statistics predicts a six percent increase in registered nurse jobs by 2031, with an average of 203,200 job openings each year as current RNs leave the profession. Major changes will likely happen in 2023 to reverse the nursing trend of skilled clinicians leaving patient care.

"We have a workforce that is in dire need of something different, bold and creative, something that our current system does not allow for," said Katherine Virkstis, vice president of clinical advisory services at Get Well in Bethesda, Maryland. Those might include shortening the work week without a decrease in compensation or investing in virtual care tools that allow hybrid work options."

Elizabeth Speakman, EdD, RN, ANEF, FNAP, FAAN, senior associate dean of nursing at the University of Delaware, School of Nursing in Newark, reported that admission and enrollments have not declined,

"People still want to be a nurse," Speakman said.

"The number of people entering the nursing workforce is increasing, but it is not keeping pace with the need," added Maryann Alexander, PhD, RN, FAAN, chief officer, nursing regulation at the National Council of State Boards of Nursing in Chicago. "Additionally, the number of advanced practice registered nurses is increasing."

"That could be a potential reason we are short the number of RNs," Alexander said. "We need more RNs and people in the pipeline."

Speakman and Alexander reported that academia and hospitals are working together to solve the nursing shortage.

"Chief nurse executives in the clinical setting and deans of nursing are working together to find solutions, to work as a concerted effort to come up with strategies to reduce the nursing shortage," Speakman said. "It remains a high priority for everyone."

Federal support for nurse faculty

"We are seeing a drop in the number of faculty," Alexander said. "The vacancy rate has decreased most significantly since we have been collecting the data."

That limits how many candidates can be educated as nurses.

"Recognizing a need to educate more nurses, the U.S. Department of Labor announced an $80 million funding opportunity to support the Nursing Expansion Grant Program. The funds will help train additional nurse faculty, who in turn will educate more nurses.

Focus on healthy work environments

"I am hopeful that 2023 will be the year where hospitals and health systems finally realize that implementing the AACN Healthy Work Environment Standards is no longer optional," said Amanda Bettencourt, PhD, APRN, CCRN-K, ACCNS-P, 2022-23 president of the AACN board of directors.

"The evidence-based way to reverse the trend of nurses leaving acute and critical care nursing is to make the environments we practice in supportive of our best work. Appropriate staffing is the foundation, but we also need good communication and true collaboration, we need nurses legitimately at decision-making tables and authentic leaders."

"Meaningful recognition means valuing our unique contribution and compensating us for it. Now is the time -- making healthy work environments a right and not a privilege is long overdue."

Work environments also are a focus for ENA and other nursing organizations.

Reductions in workplace violence

Nurses often leave the field after experiencing workplace violence. Alexander reported that violence is increasing, which is a difficult nursing trend that needs to be addressed.

Nurses working in the emergency department (ED) often bear the brunt of patient and visitor violence, but assaults are by no means limited to that setting.

"Studies have shown that ED staff, including nurses, experience a violent event once every two months," Schmitz said. "Any workplace violence should be unacceptable, and unfortunately, [it has] become part of the job for many ED nurses. One of the ENA priorities is to raise awareness about workplace violence through advocacy efforts including the No Silence on ED Violence campaign and to support legislation at the federal level to help reduce violence against healthcare workers."

Virkstis expects "leaders will double down on a commitment to workplace safety in 2023."

Staffing models that include contingent nurses

Hospitals especially continue to rely on travel nurses and per diem staff to fill vacancies. AMN Healthcare, which includes American Mobile, reported significant year-over-year growth in their travel nursing business for the third quarter of 2022.

"In addition to agency nurses, many hospitals are creating in-house per diem pools to offer more flexibility to nursing staff," Mimm said.

Focus on nurses' well-being

Nursing has always been emotionally taxing, but during the pandemic, some nurses became surrogate loved ones of dying patients. They may have been the only ones in the room as a patient passed from this life, something Speakman describes as "mentally exhausting."

"Additionally, the pandemic killed folks who would have not typically died, as a nurse finding rhyme or reason was simply impossible, it challenged all that we knew. It made us look at our own mortality -- all while being physically drained from working long hours as our colleagues themselves became sick and the nursing shortage expanded," Speakman explained.

"Now, nurses are encouraged to speak up when they need help," Speakman added.

"I am happy to move forward to 2023, hoping nursing continues to heal and become a more resilient workforce," Mimm said.

Speakman reported that "clinical environments are creating spaces for nurses to be able to have respite, verbalize the need for a break, or talk about traumas that have affected them."

New opportunities for virtual nursing care

Nursing and other healthcare providers will need to see an increased use of technology and artificial intelligence," Mimm said.

Alexander indicated that "while virtual nursing began in the intensive care units, such as the eICUs, it is moving to other units. In some cases, older nurses are tending to patient education, discharge planning, and other tasks that do not require hands-on care, as well as mentoring less experienced nurses."

"It allows nurses who have retired or maybe would have retired or cannot stand the physical rigors of working at the bedside to participate in care," Alexander said.

"The challenges of nursing 2023 are not all gloom and doom," Alexander concluded. It's a call for action. We need to think differently, be more innovative, and have national conversations; and we need to be working together."

Related: 10 Key Nursing Trends in 2022

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