nursing articles 2023

Nurses Predict Nursing and Healthcare Trends for 2023

• Dramatic changes have swept through the healthcare industry since 2020. The pandemic highlighted significant gaps in healthcare and demonstrated that decision-making should not rely solely on public health experts.
• 2023 nursing healthcare trends will be led by the fallout of a momentous nursing shortage and growing technological changes.
• 2023 should also bring a renewed focus on nurses’ mental health, wearable medical devices, and a rise in virtual medicine.

Dramatic changes have swept through the healthcare system since 2020 when the World Health Organization announced the world was facing a pandemic. The pandemic highlighted many of the gaps in healthcare that affected certain populations. It also revealed the shortcomings of a decision-making chain that relied solely on public health experts.

The current nursing shortage, which began in 2012, has been made worse by the pandemic and the looming number of nurses reaching retirement age. In the face of these challenges, it’s important to prepare for upcoming changes to healthcare. Find out what nursing trends to expect in the year ahead.

10 Nursing Trends We Expect to See in 2023 and Beyond

As the baby boomer generation ages, the complexity of healthcare rises. All baby boomers will reach retirement age by 2030, including a large contingent of nurses.

Nursing and healthcare leaders expect to see the following 2023 nursing healthcare trends that will affect management and care delivery.

1. Job Growth Will Continue to Rise

Job growth is a function of supply and demand. According to the U.S. Bureau of Labor Statistics , the job growth rate for registered nurses through 2031 is 6%. This is as fast as the overall average for all occupations. However, the estimated growth rate for nurse practitioners (NPs) is 40%, much faster than average.

The supply of new nurses is impacted by a shortage of nursing faculty. According to the American Association of Colleges of Nursing , 91,938 qualified applicants were turned away from baccalaureate nursing programs in the 2021-2022 school year.

Schools cite an insufficient number of preceptors and clinical sites as the reason for denying admission. However, it’s the faculty shortage that most schools said was the top reason for not admitting qualified candidates.

The supply of nursing staff is also affected by the number of nurses who say they will quit by the end of 2022. According to one survey, 34% of nurses said they would quit their jobs by the end of the year, citing nurse burnout and a high-stress environment as reasons.

2. The Nursing Shortage Will Be a Top Priority

Rising demand for nursing staff to care for patients with more complex healthcare needs and a falling supply of nurses has contributed to the largest nursing shortage the U.S. has ever experienced. The shortage is expected to intensify through 2023.

Nursing programs and states are coming up with nursing shortage solutions . For example, nursing programs are addressing the nursing shortage by offering rolling admissions to accommodate more students. Other colleges are opening new programs.

Nursing programs are working to facilitate creative clinical opportunities and engage in public and private partnerships. These strategies offer students greater scheduling flexibility and more clinical opportunities. Several states are reviewing general nurse staffing requirements and increasing funding to healthcare institutions.

Some states are also investing in nursing education to increase the number of new nurses. Finally, others are evaluating increasing pay and establishing safer nurse-to-patient ratios .

3. Increased Funding Will Impact Staff

The nursing shortage will be a top priority for hospitals, government agencies, and nursing programs in 2023. In October 2022 , the U.S. Department of Labor announced $80 million in grants to increase the number of nursing faculty and support more nurses entering nursing programs.

Grants will be awarded to organizations that propose strategies to support underrepresented populations as they attend nursing programs. Successful grant applicants will propose programs that attract new nurses while building community partnerships.

4. Reliance on Travel Nursing and Per Diem Staff Will Continue

Healthcare institutions have relied on travel and per diem nurses to fill the gaps in staffing and ensure safe patient care. When the demand exploded during the pandemic, so did the hourly rates that hospitals were charged, which increased 213% from 2019-2022.

As travel nurse salaries rose, so did the number of nurses who quit their full-time employment to make more money traveling. This has put the current healthcare system in financial jeopardy and put patients’ lives at risk.

However, while strategies are in place to increase the number of new nurses, it will realistically take between 2-4 years for those nurses to reach the bedside. In the meantime, hospitals may continue to need travel nurses to fill the gaps, which may have a significant impact on each institution’s financial stability.

5. Renewed Focus on Nursing Mental Health

The growing nursing shortage has highlighted the critical need to pay greater attention to nurses’ mental health . Stress, fatigue, and burnout have taken a toll on nursing staff and are a primary driver in the mass exodus of nurses in 2022.

Although there are countless resources available for healthcare workers, healthcare institutions must do a better job of ensuring workers know these resources exist. They must also encourage staff to prioritize preventing nursing burnout.

Digital access to resources makes the process simple and easy. For example, virtual therapy is available to nurses, as are mobile apps for nurses that help users improve their sleep quality or guide them through meditation, exercise, journaling, or expressing gratitude. Each of these factors can help protect mental health and lower burnout rates.

Popular Nursing Programs

Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.

6. Increase in Patient Wearable Medical Devices

One of the 2023 nursing healthcare trends is the rising reliance on wearable medical devices, which are not limited to watches and Fitbits. Patients can also opt for implantable devices that monitor critical trends and send the data to the patient’s mobile device. The information is then wirelessly sent to their physician or monitoring company.

The global value of the wearable medical device market is expected to grow 19.1% through 2031, reaching an estimated $183.8 billion. However, the growth in the U.S. is even greater. In 2021 the market was worth $21.3 billion and is estimated to grow 28.1% from 2022-2030.

7. Integration of Primary Care and Behavioral Health

Medicare has begun prioritizing behavioral health and recorded telehealth visits have skyrocketed. This is likely to continue since telehealth services integrate well with behavioral health. They offer patients a unique and personalized approach.

The U.S. Health and Human Services Office reports the number of telebehavioral health visits rose by 3.090% from 2019-2020. Destigmatizing mental health and a greater understanding of how mental and physical health are intertwined should lead to a more holistic approach to primary care.

This is a burgeoning opportunity for nurse practitioner-led practices in states that support full-practice authority .

8. Continued Rise in Virtual Care

While most are familiar with telehealth virtual visits, there are expected shifts in the delivery of “virtual” care in 2023 that may include in-person visits. Several regulations increased the flexibility of Medicare reimbursement for telehealth visits, causing experts to estimate the evolution of telehealth may increase rapidly in 2023.

Revenue dictates innovation. Should this flexibility demonstrate better patient outcomes and lower Medicare costs, they could become a permanent part of Medicare reimbursement. Logistically, this move would integrate virtual visits with a higher level of in-home healthcare from skilled nurses and nurse practitioners.

The advancement and evolution of telehealth has the potential to improve healthcare and solve several industry challenges.

9. Increasing Number of NP-Led Practices

In states where nurse practitioners have full-practice authority, they may open their own practice. Currently, there are 26 states with full-practice authority , which means the NP can assess, diagnose, prescribe medication , and treat patients without physician oversight.

There are also several states that increase NP authority to full practice after they have met certain criteria, like the number of hours in practice. The growing number of NP-led practices has had a significant impact on patient satisfaction and patient outcomes.

Kevin Lee Smith, DNP, FNP, FAANP, is the chief nurse practitioner officer at The Good Clinic. He notes there is also a growing shortage of physicians, especially primary care physicians. One way to remedy the challenge of access to healthcare is to utilize nurse practitioners.

“What is unique about NPs is their patient education focus, experience, and holistic care approach. We want to leverage the nursing perspective that takes the whole person into account — the bio-psycho-social-spiritual being,” he says. “NPs are more inclined to take time with patients because that’s part of our education.”

10. Data and Privacy

Many are excited by the collection of patient data, citing improved access to patient information and a potential lower risk that patients will receive unnecessary prescriptions and imaging studies.

However, there is also the question of privacy that has not yet been adequately addressed. It isn’t unusual for large stores or credit card companies to announce that cardholder information was accessed by an outside source.

If your healthcare information can be hacked and released, it may be used to blackmail individuals or to make employment decisions based on the likelihood that a new employee would consistently use the company health plan and thus drive up costs.

Although the convenience of centralized healthcare data is enticing, in 2022, questions about privacy may first have to be addressed and answered before the majority are willing to release sensitive information.

Meet Our Contributor

Kevin Lee Smith, DNP, FNP, FAANP

Kevin Lee Smith is the chief nurse practitioner officer at The Good Clinic with previous experience helping to create the MinuteClinic model and providing early-stage informatics leadership at Zipnosis. Smith has also been an active primary care nurse practitioner and served in faculty positions at the University of Minnesota throughout his career.

Bacon B. (2022). 3 shifts in healthcare to expect from telehealth innovations in 2023.

https://medcitynews.com/2022/08/3-shifts-in-healthcare-to-expect-from-telehealth-innovations-in-2023/

Davis C. (2022). One-third of nurses plan to quit their jobs in 2022, thanks to high stress and burnout. https://www.healthleadersmedia.com/nursing/one-third-nurses-plan-quit-their-jobs-2022-thanks-high-stress-and-burnout

Hughes S. (2022). AHA voices support for the travel nursing agency transparency study act. https://www.aha.org/lettercomment/2022-06-06-aha-voices-support-travel-nursing-agency-transparency-study-act

Larson C. (2021). Medicare telehealth visits for behavioral health up over 3,000% says HHS.

https://bhbusiness.com/2021/12/03/medicare-telehealth-visits-for-behavioral-health-up-over-3000-says-hhs/

Kreimer S . (2022). Nursing shortage looms large and projected to intensify in next 18 months: report.

https://www.fiercehealthcare.com/providers/nursing-shortage-looms-large-and-projected-intensify-next-year-and-half-report

Krishna M. (2021). Equifax hack: 5 biggest credit card data breaches

https://www.investopedia.com/news/5-biggest-credit-card-data-hacks-history/

Musil S. (2016). Home Depot offers $19M to settle customers’ hacking lawsuit. https://www.cnet.com/news/privacy/home-depot-offers-19m-to-settle-customers-hacking-lawsuit/

Nursing faculty shortage. (2022). https://www.aacnnursing.org/news-information/fact-sheets/nursing-faculty-shortage

State practice environment. (2012-2022). https://www.aanp.org/advocacy/state/state-practice-environment

The 2021 American nursing shortage: A data study. (2021). https://www.usa.edu/blog/nursing-shortage/

U.S. Bureau of Labor Statistics, Occupational Handbook. (2022). Registered nurses. https://www.bls.gov/ooh/healthcare/registered-nurses.htm

U.S. Bureau of Labor Statistics, Occupational Handbook. (2022). Nurse anesthetists, nurse midwives, and nurse practitioners. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm

U.S. department of labor announces $80M funding opportunity to help train, expand, diversify, nursing workforce; address shortage of nurses. (2022). https://www.dol.gov/newsroom/releases/eta/eta20221003

Value of wearable medical devices market estimated at U.S. $183.8 Bn by 2031, TMR report. (2022).

https://www.globenewswire.com/en/news-release/2022/07/06/2475011/0/en/Value-of-Wearable-Medical-Devices-Market-Estimated-at-US-183-8-Bn-by-2031-TMR-Report.html

Wearable medical device market size, share & trends analysis report by type (diagnostic, therapeutic), by site (handheld, headband, strap, shoe sensors), by application, by region, and segment forecasts, 2022 – 2030. (2022). https://www.grandviewresearch.com/industry-analysis/wearable-medical-devices-market

Yang Y, et al. (2022). COVID-19’s impact on nursing shortages, the rise of travel nurses, and price gouging

https://www.healthaffairs.org/do/10.1377/forefront.20220125.695159/

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What Nurses Need to Know: The 2023 Healthcare Forecast

2023 is already shaping up to be an interesting year in the world of healthcare. Our faculty experts at the Johns Hopkins School of Nursing weigh in on some trends to expect in 2023 and beyond.

Global Health

Unprecedented disruptions caused by COVID-19, combined with economic, geopolitical and climate challenges place complex and interconnected threats on health and healthcare systems around the globe in 2023. 

The pandemic has exposed and exacerbated vast global disparities caused by income, age, race, sex and geography, but, at the same time, has accelerated innovation in science and technologies.

Key global health trends in 2023 include widening disparities in overall health and wellness and variable access to advanced therapies, worsening mental health, healthcare workforce shortages, supply chain issues, climate change related challenges and macroeconomic instability. Concurrent advances in information technology infrastructure and mobile computing power in many low and middle-income countries support rapidly developing applications of artificial intelligence (AI) might help to address challenges unique to the field of global health and accelerate achievement of the health-related sustainable development goals. 

Nurses can help to bridge the gap and inform the redesign of health care services available to vulnerable populations around the globe and improve access to quality care. However, there must be greater investment in nursing education, workforce conditions and leadership to maximize their important potential contributions ( World Health Organization Strategic Directions in Nursing and Midwifery 2021-25 ). Substantial dialog on health system reform, regulatory changes, care coordination, and health information technology is ongoing. It is key that nurses are actively engaged in these discussions and inform critical health policy decisions toward better health for all.   

– Dr. Nancy Reynolds PHD, MS, RN

Staffing Issues

It is no secret that there is a nursing shortage in the United States. Nurses are going on strike and leaving their positions at an alarming rate. Burnout is causing a lot of nurses to take a look at other opportunities to use their expertise elsewhere while those who remain are left to deal with the fallout.

The nursing shortage can still be felt on a weekly basis with announcements to fill deficits sent out regularly. Some nurses have expressed dissatisfaction with salary, feeling that it is not competitive. – Hope agen-davis msn, rn

In 2023 we may see an increase in salary expectations for nurses as more hospitals and healthcare facilities work in partnership with their staff to increase workplace satisfaction.

The Johns Hopkins School of Nursing launched the brand new Policy Honors program in late 2022. The goal of this program is for students to gain experience and foundational skills in policy analysis and advocacy to address the nation and world’s most critical health challenges.

11 students were chosen to participate in this two semester program where they will partner with a faculty expert to broaden their understanding of nursing’s role in policy. These students will gain the skills and confidence to connect with policymakers, effectively communicate policy proposals, and advocate for policies that improve health for communities around the country and world.

Nurses, who make up the most trusted profession, will start to lead more in the policy arena.  Nurses are trained to solve problems while thinking of the whole person, their strengths and needs. This fits well with changing policy in any arena – a health care setting, a business, or on Capitol Hill. Dean Sarah szanton phd, rn, faan

JHSON students will set the example by getting involved in policy planning, advocacy, and change.

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Nursing 2023: A New Emphasis on Nursing Strategy

Affiliation.

• 1 CommonSpirit Health, Chicago, Illinois.
• PMID: 37643227
• DOI: 10.1097/NAQ.0000000000000596

The COVID-19 pandemic has been blamed for multiple health system problems. Many of the current issues, including staffing shortages, while exacerbated by the epidemic, have plagued us for decades. Various reactionary solutions to nursing shortages have been implemented during periods of crises, only to be abandoned when shortages have become less acute. Root causes for the resulting chronic shortages of nursing care team members have not been widely addressed. Nurse leaders have a responsibility to current and future patients, communities, and caregivers to mitigate these while implementing solutions to the current acute crisis in staffing. This requires an organization's nursing enterprise to define a vision for a preferred future, a strategic plan, and specific tactics to address the current crisis while ensuring sustainability of solutions. This article shares a high-level example from one of the country's largest health care systems.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Nearly a third of nurses nationwide say they are likely to leave the profession

Jaclyn Diaz

Miriala Gonzalez, a registered nurse in Miami, carries a monkeypox vaccine. A new survey highlights major concerns from nurses nationwide regarding future staffing levels in hospitals. Joe Raedle/Getty Images hide caption

Miriala Gonzalez, a registered nurse in Miami, carries a monkeypox vaccine. A new survey highlights major concerns from nurses nationwide regarding future staffing levels in hospitals.

Close to a third of nurses nationwide say they are likely to leave the profession for another career due to the COVID-19 pandemic, a new survey from AMN Healthcare shows.

This level is up at least seven points since 2021. And the survey found that the ongoing shortage of nurses is likely to continue for years to come.

About 94% of nurses who responded to the AMN Healthcare survey said that there was a severe or moderate shortage of nurses in their area, with half saying the shortage was severe. And around 89% of registered nurses (RNs) said the nursing shortage is worse than five years ago.

The Indicator from Planet Money

The economics of america's nurse shortage.

Nurses aren't optimistic about the future, either. At least 80% of those surveyed expect that to get much worse in another five years, the report shows.

Unions representing nurses have long warned about the problem facing the profession, said National Nurses United President Deborah Burger and President of SEIU Healthcare 1199NW Jane Hopkins. Both women are also RNs.

"It's a critical moment in our time for nurses. The country needs nurses. We are very short and we are feeling very worried about the future of their work," Hopkins said.

Nurses, other healthcare workers and members of the Service Employees International Union rally for better staffing levels at West Hills Hospital on January 12, 2023 in West Hills, California. Araya Doheny/Getty Images for SEIU hide caption

Nurses, other healthcare workers and members of the Service Employees International Union rally for better staffing levels at West Hills Hospital on January 12, 2023 in West Hills, California.

The COVID-19 pandemic certainly exacerbated problems, but short staffing was an issue even before then, Burger and Hopkins said.

"The staffing crisis didn't just happen. It's been around for years. Unions have been sounding the alarm that organizations were putting profits before patients," Hopkins said. Employers "had cut staffing so bad, that there was no room for flexibility."

She said she hears from members that they rarely have time to eat lunch or use the bathroom during their shifts.

Low staffing has a dangerous trickle-down effect, Burger said. It leads to a heavier workload, more stress and burnout for the remaining staff, as well as a negative impact to patient care.

The AMN Healthcare survey findings indicated younger generations of nurses were also less satisfied with their jobs compared to their older counterparts.

Shots - Health News

The u.s. needs more nurses, but nursing schools don't have enough slots.

But even before the pandemic, the younger generation had signaled they were done with nursing, Hopkins said. "First and second year nurses were leaving the profession at a higher rate because it's not what they expected. This escalated during the pandemic," she said.

Across generations, a higher percentage of nurses also reported dealing with a greater deal of stress at their job than in previous years, the survey said. Four in five nurses experience high levels of stress at work — an increase of 16 points from 2021.

Similarly, a higher level of nurses reported feeling emotionally drained from the 2021 survey — up at least 15% in two years (62% to 77%).

One source of that stress? Nurses are also experiencing an increasing level workplace violence in the hospitals, Burger said.

"Nurses don't feel safe in many of the hospitals around the country. And we've heard horrendous stories. That also gets tied back into short staffing," she said.

Nurses have been fighting for better working conditions

This discontent among staff has deeper implications for hospitals and other organizations across the country.

In January, around 7,000 nurses in New York went on strike over a contract dispute with hospitals in the city. The nurses were looking for higher wages and better working conditions. This strike forced several hospitals to divert patients elsewhere.

NYC nurses are on strike, but the problems they face are seen nationwide

For Health Care Workers, The Pandemic Is Fueling Renewed Interest In Unions

Vox reported in January that nurses and other healthcare workers have frequently gone on strike in recent years. In 2022, eight of the 25 work stoppages involving 1,000 or more workers in the U.S. were done by nurses.

National Nurses United has issued a number of its own reports and surveys about the current state of the profession, which have come to similar conclusions to the AMN survey. The union has lobbied Congress hard to pass legislation that address staffing ratios and improve workplace safety provisions .

The AMN Healthcare survey similarly recommended that health care providers create safer working environments and broader regulatory changes to make meaningful differences.

Burger was more direct.

"Stop studying it and start actually legislating. Congress knows that they need to do something," Burger said.

"It's concerning that there's a lot of hand wringing," she said, but nothing is being done.

2023 nursing trends and salary survey results

Some improvements, but challenges continue..

The more than 3,500 nurses who took part in the American Nurse Journal’s seventh annual Trends and Salary Survey helped paint a slightly more hopeful portrait of nursing in 2023 with regard to turnover rates, higher salaries, and personal safety. However, challenges still exist. For example, although a smaller percentage of nurse managers report more open positions in the past 12 months, they told us that recruiting to fill those vacancies has been harder this year than last. And most nurse managers say turnover increased in the past 12 months, though at a lower percentage than in 2022.

Job satisfaction (flat for nurse managers at 63% but up from 65% to 70% for clinical nurses) may play a role in the slight improvement in turnover. A contributing factor to the job satisfaction rise could be improved staffing levels, with 56% of clinical nurses reporting that staffing levels at their organization met patient needs at least 80% of the time— an increase from 49% the year before.

Most nurse managers and clinicians report that their workload has increased in the past year, but the percentage is lower than in 2022 (59% vs. 66%). The percentage who said their salary increased in the past 12 months fell 1.5%, but more nurses are moving into the top tiers of the salary range; however, this year’s cohort skewed toward longer-tenured nurses.

Trends and Salaries Interactive Results

2022 nursing trends and salary survey results

Safety from patient and visitor abuse remains a concern, but most nurses said that they believe their organization is working to help reduce workplace violence. Although verbal abuse from coworkers increased, bullying from managers declined slightly, and those reporting being physically assaulted by a coworker or manager fell into the single digits.

Nurse managers’ perspectives

Most nurse managers (57%) participating in the survey told us that they’ve noticed an increase in open positions in the last year, but that’s down from 63% in 2022 and 71% in 2021. Similarly, more than half (54%) report that turnover increased, down from 61% last year and 71% in 2021.

Most nurse managers said that they’re satisfied with their job and have positive relationships with coworkers. However, when we asked what about the future of nursing keeps them up at night, nurse managers voiced concern about staffing shortages, recruitment challenges, and the experience level of their staff. “It is getting harder and harder to find people that want to work in healthcare. Between staffing shortages and budget cuts, I fear for the safety of future nurses and patients,” said one respondent.

As salaries increase to attract nurses, some nurse managers expressed concern about the ability to compete. “Working for an academic medical center, we don’t pay as well as other private hospitals and cancer centers. We have lost many nurses and support positions to competitors and have also had many job offers for new candidates turned down due to pay,” one wrote. “It’s exhausting trying to continually make the claim that our institution needs to increase pay. They continue to hire and pay for nurse travelers, which costs a lot more than if they increased pay for current employees or new hires who want to work for us permanently.”

Other nurse managers expressed concern over the broader healthcare system, from the impact of health insurance on the quality of care and the patients they see. “I worry about the broader medical systems’ ability to care for patients without adequate primary and preventive care,” said one respondent. “My area of expertise is emergency nursing, and we see a system that is increasingly unable to care for patients with conditions that used to be routine. ICU capacity over 95% across our region seems to be common, and we are increasingly boarding and discharging patients from the ED.”

What’s on your mind?

When we asked clinical nurses and nurse managers what, other than staffing, are the most important issues facing the nursing profession, salary was mentioned most often.

Here’s what else they told us:

• Facilities would do well to bridge the pay gap between staff and travel nurses. I’d be thrilled to make more than half what most travelers make in my facility.
• The most important thing is to care for patients and to provide safe, high-quality medical care.
• The culture of “mean” nurses. There is a toxic underlying culture that if not nipped by the institution is very damaging to our future generations of nurses.
• Many nurses are not in the profession for the right reasons so the focus of leadership has shifted to making nurses happy instead of patient care and patient satisfaction.
• Patients not getting the care they need due to lack of insurance or increased prices of healthcare. Nursing feels more like working in an assembly line with focus on the number of patients being pushed through.
• Poor quality and short orientation for new nurses is another huge issue. Nurses are burnt out and don’t want to precept new grads. New grads have much less clinical experience than is appropriate due to the pandemic causing most students to lose invaluable hours of hands-on patient care learning.

What keeps nurse managers up at night

We also asked nurse managers what about the future workforce keeps them up at night.

Here’s a sampling of what they had to say:

• I worry about what mandated staffing ratios might do to population health and access to care. I understand why nurses think mandated staffing ratios is the answer to reducing burnout, but the short- and long-term implications on quality of care are extremely worrisome.
• Younger nurses aren’t seeing the big picture when it comes to their patients’ health. Many are purely task-focused.
• Keeping nurses at one site long enough to have a “seasoned” workforce again. New RNs job hop now.
• How am I going to accomplish everything that is needed without the staff I need?
• We won’t have enough nurses in the future to take care of us.
• The lack of experienced nurses still in the workforce available to train the next generation of nurses.
• Nurses unable to provide safe care due to staffing shortages then being punished for any failures when it’s too much for one person to reasonably take care of safely and adequately.

Clinical nurses’ perspectives

The percentage of clinical nurses who said that they’re somewhat or very satisfied with their current job increased from 64% to 71%. More of them expressed satisfaction with their salary (54% vs. 48%) and benefits (55% vs. 53%).

Salary remains an important factor in retaining and recruiting nurses, as more than three-quarters (76%) of the clinical nurse respondents chose salary as one of the most important aspects of nursing, up from 71% in 2022. Other key categories include flexible hours (56% vs. 51% in 2022) and providing patient care (54% vs. 55% in 2022).

Salary and job choices

Although roughly the same percentage of nurse managers and clinical nurses reported that their salaries increased within the past 12 months, these increases appear to be lifting more nurses into the highest tiers of the salary scale. The portion making less than $69,000 fell while those making $80,000 and above increased. However, more of the nurses responding to this year’s survey had 15 or more years of experience and fewer of them had less than 5 years.

These higher salaries may be why nearly three-quarters (73%) of respondents said they had no intention of seeking another job in the next 3 months. However, more said they could be swayed by an offer with a higher salary—68% vs. 56% last year. Those who did intend to leave their job cited dissatisfaction with the salary as one of their top reasons. In fact, when we asked nurses what, other than staffing, were the top two issues facing nursing, salary was mentioned most often.

Assault and bullying from patients and colleagues

A slightly smaller percentage of nurses reported witnessing bullying in the past 2 years compared to 2022 (61% vs. 66%). More than half said that they’d been verbally assaulted by a patient or a family member/visitor over the past 2 years, and 22% said they’d been physically assaulted. In both cases, most nurses reported the incidents, and overall, 64% of nurses said that their organization has been supportive in reducing workplace violence, roughly the same level as last year.

Coworker bullying saw an increase in 2023. Nearly 40% of respondents said that they’d been a victim of verbal bullying by a colleague, up from 35% in 2022. However, reported bullying by a manager was down slightly. Nurses reporting sexual harassment in the workplace went down slightly from the prior survey, dropping to 14% from 17%.

We asked nurses to tell us about their experience with workplace violence. Most of the more than 1,000 responses dealt with abuse and physical assaults by patients or their families. Many felt discouraged that this kind of patient behavior has become viewed as the norm.

“Nurses should not accept violence as just being part of the job,” said one. “Any assault on any hospital or healthcare worker should be reported to local police and prosecution should result, with the employer’s support.”

Many comments drew a distinction between patient behavior that’s due to mental conditions, such as dementia, and what they see as a broader willingness by patients and their families to act abusively toward healthcare workers.

“Violence among coworkers and healthcare workers towards each other has significantly decreased,” said one. “Violence towards healthcare workers from patients has increased significantly over the last 10 years.”

Nurses speak about workplace violence

• I see an increase in the way that patients are allowed to treat nurses, and it seems to be okay with the organization, and there are no re­percussions for the patients or their family members.
• My hospital is taking patient/family and coworker aggression more seriously. This is long overdue. Nurses are battered and nobody cares because “we signed up” for this job.
• If you wouldn’t tolerate the behavior toward your patient, it isn’t acceptable to happen to you!!
• Have seen a huge increase of verbally abusive patients. We refuse to treat them if they continue to behave this way.
• The idea of “it’s part of the job” is being addressed, but there is still a long way to go.
• I’m amazed by the idea that workplace violence is just part of the job for healthcare professionals. We have to stand up for ourselves and each other and state that violence will not be tolerated.
• My employer’s attitude is one of saying they have a total nontolerance policy, yet when someone actually is being harassed or bullied, the victim is made to feel as if they caused the issue.
• It has escalated. It’s why I left bedside nursing.
• In my previous job, it was expected for staff to have to deal with verbal and physical violence at times due to the population I served. At my new job it is not tolerated on all levels and [I] feel more supported at my current job.

Percentage who reported witnessing someone being bullied in the past 2 years:

A difficult job that most would choose again

Despite all of the challenges reflected in the survey results, most respondents rated their mental health as healthy or very healthy in this year’s survey, although a smaller percentage chose that top category compared to 2022. We also saw a small increase in the percentage who described their well-being as not mentally healthy. In the end, however, when asked if they would choose to be a nurse if they had to do it over again, 79% said yes, slightly lower than the 82% who gave that affirmation the year before.

Many nurses may feel inspired by the words of wisdom they’ve received over the years. We asked them to share the best of that advice, and more than 1,500 did. Here’s a sampling:

Be like a duck (swimming like crazy under the water, calm appearing on the surface).

As a nurse manager, the best advice I’ve received is to hold people accountable, even when it involves tough conversations.

Empower those you lead to be leaders so that they can function effectively when you are not in the building.

Find the specialty you love, then get an advanced degree in it and get certified in it.

Take the time required to do the task correctly no matter how far behind.

Save your back and take your breaks no matter what.

You’re the last person in line before a patient error is made or a patient is harmed. It is your responsibility to speak up.

You are competent before you are confident.

Diversity, equity, and inclusion at work

We asked survey respondents to tell us what steps their organizations are taking to improve diversity, equity, and inclusion (DEI). More than 1,500 of them responded. Many said DEI committees and staff positions have been created in their institutions, and others mentioned special training for staff, special events, and hiring initiatives. Others said nothing was being done, and many said their organizations were already very diverse, both in their staff makeup and their patient mix. Here are some of the more specific responses we received:

• Strong DEI program and history of recruiting and supporting a diverse population of students.
• The company I work for is inclusive. I am a lesbian and one of my PCTs is nonbinary. We feel very accepted and supported.
• Diversity and inclusion is one of our core values at my current institution. From groups within the workplace to celebrating and recognizing differences in a positive light, we work inclusivity into our daily practice with both our peers and patients.
• We have a DEI council, which helps with education and events for employees. We have three employee resource groups to support marginalized employees and gather staff input for patient services for the marginalized groups. Our health system was awarded grants to increase health services to the ZIP codes with the worst health disparities in the state by addressing social determinants of health.
• The absolute bare minimum. We have a couple policies related to DEI, but actively resist outward allyship.
• Spending too much money and time on telling adults how to be kind to others. We are in the nursing profession to care for others regardless of their ethnicity, race, sex, or who they identify as.
• Active recruitment with HBCUs [historically Black colleges and universities], hiring LPNs and other nontraditional students, DEI team on nursing recruitment calls.
• Enterprise-wide we have an effective structured tiered plan. My overall department of health and wellness for staff is very diverse, and we have scheduled time to educate all of us on programs, provide discussion and time to deepen our actions to build and sustain a diverse work environment. Our overall staff have been the target of verbal assault and threat from the community. Our local county government is supportive though our state legislature is very regressive.
• My hospital hired older new grads such as myself and is very diverse. On my floor, between all of us, we speak at least eight different languages.

If you had it to do all over again, would you still become a nurse?

To read more comments in response to this and the other open-ended questions, visit myamericannurse.com/trends-and-salary-results/ . We at American Nurse Journal thank you for what you do every day for your patients, students, colleagues, and general public.

David J. Gilmartin is a digital content editor at HealthCom Media in Doylestown, Pennsylvania. Cynthia Saver is president of CLS Development, Inc., and editor of Anatomy of Writing for Publication for Nurses, 4th Ed. Her blog, The Writing Mind, is available at myamericannurse.com/category/the-writing-mind .

American Nurse Journal. 2024; 19(1). Doi: 10.51256/ANJ012419

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Gilmartin DJ, Saver C. 2023 nursing trends and salary survey results. American Nurse Journal. 2024;19(1):19-25. doi:10.51256/anj012419 https://www.myamericannurse.com/2023-nursing-trends-and-salary-survey-results/

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Future of Nursing

How the nursing profession should adapt for a digital future, richard g booth.

1 Arthur Labatt Family School of Nursing, Western University, London, Canada

Gillian Strudwick

2 Centre for Addiction and Mental Health, Toronto, Canada

Susan McBride

3 School of Nursing, Texas Tech University Health Sciences Center, Lubbock, USA

Siobhán O’Connor

4 School of Health in Social Science, University of Edinburgh, Edinburgh, UK

Ana Laura Solano López

5 University of Costa Rica, San José, Costa Rica

Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues

Digital technologies increasingly affect nursing globally. Examples include the growing presence of artificial intelligence (AI) and robotic systems; society’s reliance on mobile, internet, and social media; and increasing dependence on telehealth and other virtual models of care, particularly in response to the covid-19 pandemic.

Despite substantial advances to date, challenges in nursing’s use of digital technology persist. A perennial concern is that nurses have generally not kept pace with rapid changes in digital technologies and their impact on society. This limits the potential benefits they bring to nursing practice and patient care. To respond to these challenges and prepare for the future, nursing must begin immediate transformation into a digitally enabled profession that can respond to the complex global challenges facing health systems and society.

Many exemplars show how digital technologies already bring benefit to nursing practice and education. 1 For instance, telehealth programs where nurses provide daily monitoring, coaching, and triage of patients with several chronic diseases have helped reduce emergency department admissions. 2 Mobile devices, in particular smartphones and health applications, are enabling nurses to offer remote advice on pain management to adolescent patients with cancer 3 4 and supplement aspects of nursing education by providing innovative pedagogical solutions for content delivery and remote learning opportunities. 5

The development and application to nursing of systems based on AI are still in their infancy. But preliminary evidence suggests virtual chatbots could play a part in streamlining communication with patients, and robots could increase the emotional and social support patients receive from nurses, while acknowledging inherent challenges such as data privacy, ethics, and cost effectiveness. 6

Challenges persist

Digital technologies may, however, be viewed as a distraction from, or an unwelcome intrusion into, the hands-on caring role and therapeutic relationships that nurses have with patients and families. 7 This purported incompatibility with traditional nursing ideals, such as compassionate care, may explain some nurses’ reluctance to adopt digital approaches to healthcare. 8 9 In addition, nursing’s history was as structurally subordinate to other healthcare disciplines, 10 and the profession is still cementing its relationship and leadership in health systems.

The specialty of nursing informatics has long advocated for the integration of technology to support the profession, but it has comparatively few practitioners globally. Nursing informaticians are predominantly based in the United States, where the discipline seems to have originated, but many other countries and regions are expanding their digital nursing workforce and involvement with informatics. 11 12

Slow progress in some areas has been due to a lack of leadership and investment that supports nurses to champion and lead digital health initiatives. Globally, uncertainty remains regarding the next steps the nursing profession should take to increase and optimize its use of digital technology. This challenge is exacerbated by the global diversity of the profession, including unequal access to resources such as technological infrastructure maturity and expertise. Huge differences exist among countries and regions of the world in terms of the digitalization of healthcare processes, access to internet connectivity, and transparency of health information processes.

Selected technologies: benefits and challenges

The nursing literature contains many analyses of digital technologies used to support or extend the profession, including practice (eg, hospital information systems, electronic health records, monitoring systems, decision support, telehealth); education (eg, e-Learning, virtual reality, serious games); and, rehabilitative and personalized healthcare approaches (eg, assistive devices sensors, ambient assisted living). 1 T able 1 summarizes the potential benefits, challenges, and implications of emerging innovations to practice.

Benefits, challenges, and implications of selected digital technologies in nursing

The table is not exhaustive, but the diversity of topics researched shows the profession recognizes the value and challenges of digital technologies. Given the evidence, for the profession to make further progress we recommend five areas for focused and immediate action. These recommendations should be qualified in light of regional context and professional background owing to global heterogeneity in nursing and the inclusion of digital technologies into healthcare.

Reform nursing education

We must urgently create educational opportunities at undergraduate and graduate levels in informatics, digital health, co-design, implementation science, and data science. 39 These should include opportunities to work with and learn from computing, engineering, and other interdisciplinary colleagues. For instance, nursing will need a critical mass of practitioners who understand how to use data science to inform the creation of nursing knowledge to support practice. 40 These practitioners will also need savviness and courage to lead the development of new models of patient care enabled by digital technologies. 41 42

Determining how, where, and why technology like AI should be used to support practice is of immediate interest and a growing competency requirement in health sciences and informatics education. 43 Nursing education should evolve its competencies and curriculums proactively for the increasing use of digital technologies in all areas of practice 39 while incorporating novel pedagogical approaches—for example, immersive technologies such as virtual and augmented reality—to deliver aspects of simulation based education. 44 45

Recently, the American Association of Colleges of Nursing released core competencies for nursing education, explicitly identifying informatics, social media, and emergent technologies and their impact on decision making and quality as critical to professional practice. 46

Build nursing leadership in digital health

All levels of nursing leadership must advocate more actively for, and invest resources in, a profession that is both complemented and extended by digital technology. The profession needs to evolve its use of digital technology by continuing to champion and support nurses to become knowledgeable in, and generate new scientific knowledge on, data analytics, virtual models of care, and the co-design of digital solutions with patients, differences across contexts and regions permitting.

Advancement of leadership competencies in existing informatics technologies, such as clinical decision support systems, electronic health records, and mobile technologies, is also essential: these kinds of systems will undoubtedly come with increasing levels of AI functionality. Possessing a critical mass of nursing leaders who understand the intended and unintended consequences as well as opportunities of these kinds of technologies is vital to ensure the quality and safety of nursing.

The increasing presence and recognition of the importance of chief nursing informatics officers is a step in the right direction. 47 Further, providing opportunities for nurses of all specialties to contribute to the development and implementation of digital health policies, locally and nationally, could increase future use of digital technologies in nursing.

Investigate artificial intelligence in nursing practice

The influence of AI on human decision making and labor are areas in need of immediate inquiry to support nursing practice for the next decade and beyond. AI technologies could provide the profession with huge benefits in data analytics and advanced clinical decision support.

Although many of the purported potential benefits of AI (eg, improved patient outcomes, streamlined workflow, improved efficiency) have yet to be fully shown in nursing research, 6 it is inevitable that AI technologies will be used more regularly to support and extend nurses’ cognitive, decision making, and potentially labor functions. 15

These opportunities bring new and dynamic practice considerations for nursing and interprofessional expertise. One example relates to the potential automation of inequity and injustice within systems and decision support tools containing AI 48 49 : self-evolving algorithms in systems sometimes unintentionally reinforce systemic inequities found in society.

Increased use of AI also brings novel policy, regulatory, legal, and ethical implications to the fore. The nursing profession must examine its role, processes, and knowledge against emerging ethical frameworks that explore the opportunities and risks that AI and similar innovations bring, while advocating for patient involvement in AI development and application. Floridi and colleagues offer tenets regarding AI development and the ethical considerations in using such innovations in their call to develop AI technology that “secures people’s trust, serves the public interest, and strengthens shared social responsibility.” 50 They also advocate that as guiding principles, AI should be used to enhance human agency, increase societal capacities, cultivate societal cohesion, and enable human self-realization, with an emphasis on instilling and reinforcing human dignity. 50 Further research, funding, and thought leadership in this domain are needed to help support the development of new practice policy, regulatory frameworks, and ethical guidelines to guide nursing practice.

Re-envision nurse-patient relationships

The profession must reframe how nurses interact with and care for patients in a digital world. The sheer variety of “do-it-yourself” health and wellness applications (eg, personalized genetic testing services, virtual mental health support), mobile and social media applications (eg, mHealth, wearables, online communities of practice) and other virtual healthcare (eg, telemedicine, virtual consultations) options available to consumers is impressive.

All this may seem antithetical toward the traditionally espoused nursing role—therapeutic relationships in physical interactions—but patients are increasingly empowered, connected to the internet, and demanding personalized or self-management healthcare models that fit their busy and varied lifestyles.

To maximize its impact on patient care, the profession should continue to develop virtual care modalities that exploit internet and mobile technology, drawing on its experiences with telehealth and remote models of care. 51 These care models might also be extended through virtual or augmented reality technologies or integrated with assisted living or “smart home” systems, 52 and potentially other precision and personalized healthcare solutions that leverage genomic and other biometric data.

Care approaches, interpretations of privacy, and technological interoperability functionalities should be co-designed among the interprofessional healthcare team, patients, and carers 53 and available where patients want them, ideally in both physical and digital realms. Deeper discussions and scientific research regarding access, cost, electronic resource use or wastage, and equity implications of the increasing digitalization of nurse-patient relationships will also need to be thoroughly explored.

Embrace digital practice

The profession requires a cultural shift. Its membership and leadership must demand the evolution of digital systems better to meet contemporary and emerging needs.

Too often, technology to support nursing is poorly configured, resourced, or not upgraded to respond to practice and societal trends. Nurses still commonly use practice systems that are lacking basic usability (eg, contributing to alert fatigue, reinforcing disruptive workflow processes) or generate added documentation burdens because of poor configuration and optimization. 54

There is huge variation globally in access to, integration of, and sustainability of digital technology. 55 56 57 Solutions vary and are context specific. Renewed awareness of digital technology’s use brought about by the covid-19 pandemic offers an impetus for change that nurses should embrace.

Tasks undertaken by nurses that do not add enough value to patient care present opportunities for partial or full divestment, 58 and may be better integrated into future technology enabled processes or delivered by other care providers.

The profession should revisit cultural interpretations of how technology such as drones, robots, and other AI enabled systems can be considered complementary to nursing practice and process, rather than as competition or adversaries. Collaboration with technology developers, providers, and patients will be essential to ensure success.

Although some outdated nursing activities and processes made redundant or less relevant will likely be missed by some in the profession, digital technology provides opportunities to support new models of care and approaches to nursing practice. We must not allow cultural and historical interpretations of nursing to upend or impede progress.

How nursing can stay relevant

Nurses entering the profession today will undoubtedly witness substantive disruption and change from digital technology by the time they are mid-career. 59 Without immediate action, the nursing profession stands to miss a remarkable opportunity to generate new roles, knowledge, and relationships within future health systems and societies saturated by digital technologies.

Nursing will continue to offer value and importance to healthcare systems in the coming decades. However, the profession must consider its role, knowledge, and relationships with technologies and patients to remain relevant in digitally enabled societies and healthcare systems and continue to provide compassionate care in a digital world. Without proactive strategic self-reflection, planning, and action, nursing will fail to control its trajectory across the chasm separating the past, present, and future of practice.

Key recommendations

• Nursing must accelerate the transformation to a digitally enabled profession by investing in informatics education, research, and practice
• Nurses should upskill in data science and other digital health topics to ensure emerging technologies such as AI are developed appropriately and safe for nursing practice and patient care
• Nursing must invest in and lead digital health developments and collaborate with others to develop and deliver digital tools that patients and the public need
• Nurses should champion informatics across all areas of professional practice, create leadership opportunities in digital health, and inform health policy in this area

Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

Provenance and peer review: Commissioned; not externally peer reviewed.

This article is part of a series commissioned by The BMJ for the World Innovation Summit for Health (WISH). The BMJ peer reviewed, edited, and made the decision to publish. The series, including open access fees, is funded by WISH.

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Calling It Quits

Nurses Are Burned Out. Can Hospitals Change in Time to Keep Them?

The pandemic has pushed already stressed nurses away from a demanding field. Does the job need to be rethought?

• Share full article

By Bradford Pearson

Bradford Pearson found subjects for this article from an online request from The Times asking readers, including nurses, for their quitting stories.

Calling It Quits is a series about the current culture of quitting.

One morning, in fall 2020, Francesca Camacho drove away from her 12-hour night shift as a critical care nurse at Rush University Medical Center in Chicago and tried to merge onto the highway. The day’s work, in her words, was “just very terrible.” This wasn’t uncommon at the time: The Cook County area was experiencing the highest levels of Covid hospitalization it had ever experienced, surpassed only by the Omicron variant wave the following year.

She was on the phone with her parents, a ritual she’d developed as a way to decompress after a shift, when she noticed what appeared to be a teenage driver in front of her.

“I remember thinking, What is this girl doing that justifies her not letting me in?” Ms. Camacho, now 27, recalled. “And I just felt this surge of rage.” She hung up the phone and screamed and cried for the rest of the drive home.

The next day, she asked her co-workers if anything similar had ever happened to them; they all said yes. Lunchtime therapy sessions with fellow nurses turned into professional therapy sessions. “It really was feelings of anger that I felt, and I think very deep underneath that was just terrible sadness about what I was seeing and what we were all going through,” she said recently.

Last August, she quit her job. She is now a first-year law student at Boston University and plans to use her law degree to advocate changes in the medical field.

Burnout has always been a part of nursing, an effect of long working hours in physically and often emotionally taxing environments. The Covid pandemic exacerbated those factors and added some of its own: understaffing, a rise in violence and hostility toward health care workers over masking mandates and an increase in deaths, particularly in the early months of the pandemic. In a study from the American Nurses Foundation , released last month, 57 percent of 12,581 surveyed nurses said they had felt “exhausted” over the past two weeks, and 43 percent said they felt “burned out.” Just 20 percent said they felt valued. (Those numbers were largely consistent throughout the pandemic.)

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• OJIN Homepage
• Table of Contents
• Volume 28 - 2023
• Number 2: May 2023
• Special Topic: Nursing Now
• Telehealth and Remote Patient Monitoring

Telehealth and Remote Patient Monitoring Innovations in Nursing Practice: State of the Science

ORCID ID: https://orcid.org/0000-0002-8874-6610

Mary Anne Schultz is Professor and Informaticist in the Department of Nursing at the California State University, San Bernardino. She is a former Department Chair and Associate Dean who is now a Consultant specializing in Precision Health. She holds a gubernatorial appointment (California, Newsom) to the state’s Advisory to Advance Precision Medicine and she chairs a workgroup of a CMS-sponsored committee on Post-Acute Care Interoperability (PACIO) under the CARIN Initiative. She holds numerous awards for scholarship and writing in data science and informatics. Correspondence concerning this article can be sent via email or mailed to Dr. Mary Anne Schultz, Department of Nursing, California State University, San Bernardino, CA 92407.

• Figures/Tables

Thrust forward by the COVID-19 crisis, with accompanying consumer and legislative pressure, telehealth has now become part of the standard of care. Telehealth and an adjunct tool, Remote Patient Monitoring, use the latest technological advancements to improve both access to and the quality of care. When used together, a powerful venue for a data-rich patient-provider encounter transpires. The method for this state of the science article included review of recent academic and gray literature to identify the breadth and depth of nurse-led innovations using these tools. Results of this rapid review of literature indicate that innovations reported in the gray literature surpass those in the academic literature in both volume and scope. Each article discussed is illustrative of the Nursing Now Challenge Global Solution Initiative (NNCGSI) which is designed to facilitate nurse-led large-scale change. The discussion asserts that nursing innovations in telehealth and RPM are understudied in the peer-reviewed literature. In conclusion, findings of this rapid review suggest that the state of the telehealth and RPM scientific literature is in its infancy.

Key Words : Telehealth, remote patient monitoring, artificial intelligence, gray literature, data analytics, informatics, nursing practice, Nursing Now

The use of telehealth and its popular companion tool, remote-patient monitoring (RPM), have been on the rise for a decade... The use of telehealth and its popular companion tool, remote-patient monitoring (RPM), has been on the rise for a decade ( Lurie & Carr, 2018 ) and have surged significantly during the COVID-19 crisis. Conceived in an attempt to extend the reach of providers and improve continuity of care, telehealth has come into de facto use during COVID-19. It is defined by the California Department of Health Care Services (DHCS) as a

…mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health while the patient is at the originating site and the provider is at the distant site” ( DHCS, 2022 , para. 2).

Telehealth has been redefined as part of routine care, not a novelty or a matter of convenience ( Halamka & Cerrato, 2020 ). Yet, its use is without formalized best practices, especially when nursing interventions are considered.

The Nursing Now Challenge Global Solutions Initiative (NNCGSI) aimed to facilitate opportunities for nurses and midwives to advance novel nurse-led solutions to common global health challenges... For purposes of this review, RPM is defined as patient data collection and transmission outside of the customary environment of care, usually asynchronously and through technology as practices that aid clinical decision-making and care management ( AMA, 2021 ). This state-of-the-science article will assist readers to understand a) the breadth and scope of nurse-led innovative telehealth and RPM projects and b) the best practices evolving from them. The Nursing Now Challenge Global Solutions Initiative (NNCGSI) aimed to facilitate opportunities for nurses and midwives to advance novel nurse-led solutions to common global health challenges ( Nursing Now Challenge, 2021a ). Each article chosen for review is consistent with the Nursing Now initiative commitment to advance the digital global health agenda ( Nursing Now Challenge, 2021b ).

The use of telehealth and adjunct tools such as RPM has exhibited a steep rise due to a variety of factors such as pressure from consumers and legislators as well as the COVID-19 crisis. The incentive for many healthcare stakeholders (e.g., providers, patients, payors) to move toward remote models of care is quite strong from resource consumption, infectious disease, and safety points of view ( Mobbs et al., 2020 ). Prior to this predicament, relatively little evidence on either use or effectiveness of these modalities existed; only now are some trends emerging. According to Bestsennyy et al. ( 2022 ), telehealth is now used nearly forty times more often when compared to a comparable period in 2019. As this technology evolves, its promise is found in the large quantity of data flowing, a multitude encompassed in the term “Big Data.” These data, when fully deployed, will lead to highly-individualized care based on one person’s unique data ( Brem et al., 2020 ). The COVID-19 pandemic has significantly accelerated the use of telehealth and thus is one factor in the state of the science; however, this review considered articles published both before and after this eventful period.

As this technology evolves, its promise is found in the large quantity of data flowing... As with most emergent care processes, exploring the scientific literature to describe practices is an important first step. Gray literature, which is professional literature that has not gone through a peer review process, is also included for a more balanced view of evidence ( Paez, 2017 ). Much of the literature on telehealth and RPM has only relatively recently entered nursing and healthcare. A traditional literature review, coupled with a thoughtful examination of selected gray literature, will allow the entire horizon of the selected innovations to be seen, such as the scope of projects; sources of funding; and potential roles for nurses (e.g., data collectors, data scientists, subject matter experts, design thinkers). The review was conducted using the following research question: What is the state of the science in telehealth and RPM in the context of nursing innovations?

A rapid review of the telehealth and RPM literature (Cumulative Index of Nursing and Allied Health Literature [CINAHL], PubMed, ABI Inform, ProQuest & selected gray literature) was conducted for the years 2017-2021 in order to describe evolving practices in this rapidly growing digital care space. A rapid review is defined as, “a form of knowledge synthesis in which components of the systematic review process are simplified or omitted to produce information in a timely manner” ( Tricco et al., 2015, p.2 ). This type of review is useful when a traditional review (e.g., a systematic or meta analysis review) would deprive the audience of timely and relevant research to be quickly applied to practice ( Haby et al., 2016 ). A rapid review, then, is especially appropriate in light of how the COVID crisis triggered a huge increase in demand for wearables of all kinds, including smart watches, smart bands, and finger rings ( Umair et al., 2021 ).

Articles were screened for description of nursing innovations in telehealth that involved RPM... The rapid search strategy and screening steps used to produce this non-exhaustive rapid review mirrors that of Douthit et al. ( 2022 ) and are elaborated below. Search terms for each data base were formed after consultation with a biomedical library science specialist and a nurse informaticist (see Table 1 ). The gray literature from the following societies and/or websites was purposively hand-searched for specific nurse-driven innovations: Health Information Management Systems Society (HIMSS); the American Nurses Association (ANA); Johnson & Johnson; Society of Nurse Scientists, Innovators, Entrepreneurs and Leaders (SONSIEL); and the American Organization of Nurse Leaders (AONL). A title/abstract review of the scientific and literature was then performed using the Zotero web application. Articles were screened for description of nursing innovations in telehealth that involved RPM and were produced from 2017-2021. Then, the investigator reviewed full-text articles for relevance of each scientific contribution; the results of this review are summarized below.

Table 1. Main Search Strategy, Telehealth & Remote Patient Monitoring Innovations, 2017-present

The search was delimited to English-language publications, those involving human subjects, and those for which a full-text article or complete report was available. Exclusion criteria included: non-English language reports, projects partially reported, and articles or reports not contained in either a peer-reviewed source or a vetted competition (e.g., Johnson & Johnson Quick Fire Challenge). Lastly, the Joanna Briggs Institute (JBI) Critical Appraisal Tools ( 2017 ) were used to appraise the quality (i.e., low, moderate, high) of each article from the traditional literature. This set of formal appraisal criteria, found at https://jbi.global/critical-appraisal-tools , was used because JBI is the recognized global leader in assessing the credibility and trustworthiness of the evidence-basis for healthcare.

Search Strategy Results Upon completion of the search of scientific literature, 917 citations were retrieved from the combined inquiries of CINAHL, PubMed, ABI Inform and ProQuest Dissertations and Theses: Humanities and Social Sciences. One more article was identified incidentally for a total of 918. After 13 duplicates were merged and filters for English language, human subjects and research articles were applied, 255 citations remained. A title/abstract screen was performed to select the final 33 relevant articles for full review to partition the digital nurse innovations that involved both telehealth and RPM. After full review of these 33 peer-reviewed articles, five scientific articles remained for final inclusion in this rapid review, as shown in the PRISMA diagram (see Figure 1 ).

Figure. Search Strategy

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Data extraction, reported in Table 2 , lists these descriptors for each study: a description of the innovation, study design, conceptual model, sample, sampling strategy, setting, data analysis or analytics techniques, concept deployed, quality of the research and the role of the nurse-author(s).

Table 2. Descriptors of Reported Innovation Studies, Scholarly Literature

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For the gray literature, each site was searched for “telehealth remote patient monitoring.” This mechanical search yielded hundreds of results at four of the five sites and dozens at the remaining site (SONSIEL). Additionally, a close examination of select columns or functions in each site, for example, “Health and Wellness” and “Innovation” for the Johnson & Johnson site, was conducted using a title/abstract approach. No article or content fitting the criteria for this rapid review was found; however, many items offered a context for this study.

Review of Search Results

Study Selection and Review, Scientific Literature A single reviewer performed each step in the process illustrated in Figure 1. For the full-text review, the record was reviewed in its entirety for relevance to the definitions of this rapid review. Articles were eliminated if they reported use of telehealth without RPM or the converse. Each of the five articles remaining for full review is summarized below with uniform descriptors of each in Table 2 .

Article 1 . The first article reviewed described an attempt to compare traditional obstetric care to an alternative bundled-care triad of virtual (phone and online) visits, RPM, and an online community (OB Nest). Butler-Tobah et al. ( 2019 ) conducted a randomized controlled trial in a single obstetric center of the Mayo Clinic that served over 2,400 pregnancies during 2014-2015. A registered nurse (RN) served as data collector, data manager, online discussion facilitator, triage nurse, and/or co-author. As anticipated, the OB Nest group experienced significantly fewer antenatal visits, yet had significantly longer encounters when those visits occurred. The arm of the sample (n = 134) who received usual care (UC) experienced significantly higher stress and lower self-reported satisfaction scores for the care experience when compared to their OB Nest counterparts (n = 133, p < 0.001). Quality of care, including communication and decision-making, was not significantly different upon comparison of both arms of the sample (p = 0.69, p = 0.12, respectively).

...the OB Nest group experienced significantly fewer antenatal visits, yet had significantly longer encounters when those visits occurred. This study ( Butler-Tobah et al., 2019 ) added to the relatively few randomized controlled trials that incorporate both telehealth visits and RPM as well as an online community experience as an intervention purportedly related to satisfaction, stress, or quality of care. The authors reported no difference in care quality between the two arms of the study. They recommended future testing of each component of the OB Nest bundle because this study only compared the bundled whole to UC. This study was assigned a high rating using the JBI Critical Appraisal Tool for systematic reviews.

Article 2 . The second study ( Guzman-Clark et al., 2020 ) was a retrospective program evaluation designed to gauge adherence to a Home Telehealth (HT) program within the Department of Veteran’s Affairs (VA). Program adherence was measured at one-, three-, six- and 12-months post-enrollment in the system-wide follow-up program for those diagnosed with heart failure. General estimating equations, with facility as a covariate, were used to isolate determinants of success (adherence) in a sample of 3,449 mostly white, male, older subjects. Using the Andersen Behavioral Model, a framework studying relationships between person, environment, and health behaviors, the variable of most interest was daily HT technology use. This technology that involved web browsers, interactive voice response, and in-home messaging devices (with and without peripherals for RPM) deployed disease management protocols, educational information and disease management tips via interaction with providers. During a study period in 2014 (January through June), this program continuance variable was operationally reported as Weekly Percent Adherence (i.e., number of days/week the individual patient logged in for use of the system).

...the variable of most interest was daily HT technology use. Variables significantly associated with higher weekly adherence were lower percent service connection, higher ejection fraction, no prior hospitalizations, and previous sustained use of the patient portal, My HealtheVet (all at p < 0.5 level). This is the first national study within the veteran population aimed at discovering covariates of adherence to the use of HT technology for heart failure management and monitoring. A major recommendation was to target subgroups such as those with depression, those of younger age, and those who are non-white, to determine if there is improved adherence. The study was assigned a high rating with use of the JBI Critical Appraisal Tool.

Article 3 . The third article reviewed was a study designed to predict harbingers of home telehealth discontinuance and determine time to discontinuance in a sample of veterans with heart failure. Guzman-Clark and colleagues ( 2021 ) reported that older and sicker patients had a higher risk of cessation. This was the first national study of its kind; it was preceded by a similar study that sampled a medically heterogeneous population with respect to only one activity, polypharmacy use, and in only one facility. The VA Home Telehealth Program, underway since the early 2000s, uses disease management protocols for specific diseases (e.g., heart failure, chronic obstructive lung disease, diabetes).

The authors attributed the cessation or diminution of use of this technological vehicle to complexity... This program includes daily questions and education via telehealth technology, remote monitoring of health status and vital signs; these, in turn, drive care coordination and interventions. High health service use patients (e.g., frequent Emergency Department visitors) are targeted for this program which is equipped with secure hardware and software in the patients’ homes that guide them through daily reports of symptoms, remote monitoring of vital signs, in-home secure messaging and triage by a Care Coordinator or RN. Significant associated variables for the outcome of interest, attrition from the program, were advanced age, Caucasian race, and sicker patients with higher probability of readmission (p < 0.05). The study was assigned a high rating with use of the JBI Critical Appraisal Tool.

Article 4 . The fourth article described an attempt to dissect factors associated with successes and failures of technology-supported programs ( Greenhalgh et al., 2018 ). These investigators conducted a synthesis of the literature while simultaneously testing theories identified on a sample of six case studies. This partial report of their larger action research study of four clinical services (including a nurse-led heart failure service) indicated that there was strong support from clinicians and senior management for synchronous video consultation (a form of virtual-space-based strategy), but implementing such a program was logistically challenging, labor-intensive, and slow. At the end of the study period, use of video consultation for the antenatal diabetes service was discontinued and the same venue for the community heart failure service was paused. The authors attributed the cessation or diminution of use of this technological vehicle to complexity, especially as the study RNs reported profound fatigue for the heart failure group and a consequent decline in cognitive ability and/or mental health. This study, assigned a low rating using the JBI Critical Appraisal Tool, appears to be a collection of six separate case reports as opposed to a case series, per se.

...the Virtual Hospital provided care to approximately 2/3 of the system’s COVID-positive population of 2,229 patients during the study period. Article 5 . The remaining article ( Sitammagari et al., 2020 ) describes response of one large organization to the rapid advancement of COVID-19 in March of 2020. The Atrium Health created a Virtual Hospital, the Atrium Health hospital at home (AH-HaH) that paralleled, in every way, the traditional brick and mortar hospital. Staffed by physicians, advanced practice nurses and others, the Virtual Hospital provided care to approximately 2/3 of the system’s COVID-positive population of 2,229 patients during the study period of March 23, 2020 to May 7, 2020. A rapid-response team of representatives of every type of provider and other professional or technical support or administrative staff persons united to design digital eligibility assessments; patient-and provider-facing information systems; health information technology integration; and workflows that mirrored that of traditional inpatient care ( Sittammagari et al., 2020 ).

...the virtual hospital program, launched in only two weeks, successfully and safely kept most patients in their home... Funded completely by the Atrium Health system, the Virtual Hospital consisted of a “first floor” for the (lower level) Virtual Observation Unit (VOU) and the “second floor” for the Virtual Acute-Care-Unit (VACU). Screening processes, staff structure, hospital-at-home interventions and aspects of the proactive telemonitoring software (GetWellNetwork, Inc.) communicating with “virtual providers” are discussed in this descriptive study ( Sitammagari et al., 2020 ). The only hard measures reported were descriptive statistics for the 1,293 VOU patients and the 183 VACU patients, illness progression (i.e., transfer, admission to traditional hospital, death), and length of stay by unit. Nonetheless, an important finding remains: the virtual hospital program, launched in only two weeks, successfully and safely kept most patients in their homes, with only 3% of VOU patients and 13% of VACU patients requiring traditional hospitalization. The Atrium Health achievement is memorable in that it built a scalable platform for the electronic health record (EHR) that mandated a data-informed patient eligibility milestone in mere weeks. This study, assigned a high rating using the JBI Critical Appraisal Tool, could represent one of the best-ever design thinking projects in recent healthcare history.

...each of these five studies constituted original research and used a variety of forms of telehealth... In sum, each of these five studies constituted original research and used a variety of forms of telehealth, including two-way audiovisual communication and at least some aspect(s) of RPM. Except for the study by the Butler-Tobah group ( 2019 ), which involved obstetric patients, all others reported on an exclusively adult or primarily adult population yet shared no other structural commonalities. As each of the studies represents research in its earliest stage (e.g., descriptive or case analysis), no mention of best practices appeared.

Article/Content Selection and Review, Society/Gray Literature Website content, meeting proceedings, and innovation pages for each of the following nursing and healthcare societies were examined for nurse-led inventions in telehealth and RPM. These societies were selected because they each exhibit a commitment in their activities, calls for abstracts, meeting themes, or modern approaches to data-based care improvements. Each contains the language of healthcare “innovation” in their mission, vision, and values. Though no content items or full articles were retrieved that contribute to the state of the science, many items at each site contribute to a panoramic view of the state of practices related to rapidly-emerging scientific findings.

Health Information Management Systems Society and American Organization of Nurse Leaders. The HIMSS site has many governmental and quasi-governmental reports on issues such as digital workflow, interoperability, and rapid expansion of digital care or strategic planning for telehealth and RPM. The AONL site contains relevant tertiary articles (e.g., news briefs) and legislative or regulatory short pieces; it also has quality improvement articles on very recent repurposing of technology, such as telehealth within a hospital ward or intensive care unit or single-function reports like remote ventilator monitoring. Topical and educational articles abound at these and at all sites examined.

Johnson & Johnson and Society of Nurse Scientists, Innovators, Entrepreneurs and Leaders . The most promising and relevant material is found at the sites for Johnson & Johnson. Their website included projects in common with SONSIEL as well as launch projects from the ANA membership reported at their society site. Johnson & Johnson supports the work of nurses in a number of important ways, including the NursesHack4Health Hackathons and the Quick Fire Challenge Series. Each venue is designed to give voice to nurse innovations at their earliest stage of idea inception. NursesHack4Health Hackathons, a crowdsourcing opportunity to spin ideas into a viable business plan with the technological and mentoring support of SONSIEL and Microsoft, yielded such efforts as Project Flourish, a limited RPM project designed to connect minimal patient data to a provider in a rural population with little or no technologic literacy or present-day devices.

Each venue is designed to give voice to nurse innovations at their earliest stage of idea inception. The Quick Fire Challenge Series enables individual nurses and small nursing teams to move from idea generation to a testing stage with small grants for new devices, new uses for existing devices and/or treatment protocols. Projects such as the Care Station, a low-cost telehealth enabled tablet, allowed a qualified nurse to remotely screen for COVID-19 at the entrances of homeless shelters. Projects such as these, while meaningful, are not completed studies, are often in the proposal formation stage, and are usually communicated through partial results with a full article at scale or funding pending. They serve as valuable resources for ecologically-valid hypotheses or theses.

American Nurses Association . ANA offers incentives, awards, and recognitions such as the NursePitch™ Contest and the ANA Innovation Award powered by Beckton, Dickinson, and Company. The latter venue highlights, celebrates, and rewards nurse-led innovations (e.g., cash prizes, incubator opportunities) for individuals and small teams with the aim of sponsoring such ideas through translational research phases including prototyping, testing, and product implementation. A prominent award-winning product, iN, is a wall-mounted device placed directly behind the patient bed that uses computer vision to monitor prodromal activities predictive (through custom algorithms) of patient injury and aggregates data from the EHR and other devices. The Pitch Contest offers small-scale entrepreneurial projects the opportunity to be “pitched” to judges in a 5-minute rapid-fire format with competitors responding to queries on costs, uses, re-deployment potential, and target markets. Each takes place in a yearly event with the competition phase open to the entire global nursing public.

The paucity of such studies is likely a reflection of the rapidity with which these nursing practices evolved... Overall, nursing innovations in telehealth and RPM are understudied in the peer-reviewed literature. The paucity of such studies is likely a reflection of the rapidity with which these nursing practices evolved as well as a lack of capacity in new research and analytics methodologies suitable to their exploration. As the number of vetted standards for structured information exchange in healthcare grows and guidelines for proper use of available Big Data are translated to practice ( Weigel et al., 2020 ), it is anticipated that many more nursing innovations will develop, as evidenced in numerous reports of start-up efforts in the gray literature.

Of the five studies reported, three used a conceptual framework ( Guzman-Clark et al., 2020 ; Guzman-Clark et al., 2021 ; Greenhalgh et al, 2018 ) and only one ( Butler-Tobah et al., 2019 ) used primary patient data. The remaining studies used secondary data from individual patient records or a hospital system/subsystem. All research reports used traditional biomedical statistics for analysis and not a more sophisticated means of pattern identification or other analytics available through artificial intelligence/machine learning (AI/ML). All but one study ( Greenhalgh et al., 2018 ) reported the contribution of the nurse in a coordinating role; two studies ( Guzman-Clark et al., 2020 ; Guzman-Clark et al., 2021 ) reported that a professional nurse led the study.

One promising change on the horizon includes development of Nursing Innovation Centers. The descriptive nature of the most promising current research leads naturally to a need for replication in different populations, health systems, and countries. Outcomes explored in the select studies included: adherence, attrition, satisfaction, program discontinuance, and appropriateness of virtual hospital care. As awareness and acceptance of telehealth and RPM evolves ( Weigel et al., 2020 ) and, hopefully, data science becomes increasingly utilized within our ranks ( Schultz et al., 2021 ), the large data sets now available will be more fully deployed using AI/ML to explore phenomena of interest to nursing and beyond. One promising change on the horizon includes development of Nursing Innovation Centers ( Albert, 2018 ). Dedicated to invention and improvement within the healthcare environment, some see the novel practices and infrastructures in these environments as more conducive to testing and diffusion of innovation in practice and research than in traditional research settings, such as academic medical centers.

Each of the well-known organizations and sites provides inspiration for researchers to invent new practices or improve existing ones, most notably patient monitoring. Technology improves patient surveillance or monitoring, a long-term function of the nurse advocate, by extending nurses’ reach to check physiologic and environmental factors. Additional time points for data establish trends (e.g., blood sugar or blood pressure readings) which are transmitted in real time and conjoin in exceptionally large data bases from which clinicians and researchers can predict an emergent clinical condition or the need for an urgent treatment change.

Only recently has nursing research begun to move toward the advanced analytics necessary to identify and organize data patterns in these vast data sets... Only recently has nursing research begun to move toward the advanced analytics necessary to identify and organize data patterns in these vast data sets to improve care. These technological advances coincide with biologic discoveries in genomics and the environment that have resulted in exponential change in possibilities for care improvement through data science. The steep rise in the use of data science methods for actual predictive capabilities within these large data sets has accelerated the innovations reported by major provider websites. This is in stark contrast to the academic literature, which relies on traditional scientific methods and biostatistics to explore phenomena of interest to nursing and healthcare at a much slower rate and limited scope.

Findings of this rapid review suggest that the state of the telehealth and RPM scientific literature is in its infancy. Big Data use is new to healthcare, so actionable insights from such data mining are only evolving now. Few nurses have trained as Data Scientists so most do not possess the expertise in data analytics necessary to wrestle with the plethora of data yielded. This gap in applied statistic and methodologies versus advanced analytic training presents barriers to the full realization of a rapidly growing body of practice and opportunities in telehealth and RPM. Recommendations are twofold: more nurses must be prepared as Data Scientists and existing nurse researchers must add to their repertoire through interprofessional work with methodologists and scientists prepared in AI/ML.

Findings of this rapid review suggest that the state of the telehealth and RPM scientific literature is in its infancy. As healthcare organizations worldwide begin to examine their Analytics Maturity to derive the maximum utility from this data tsunami ( Carvalho et al., 2019 ), it could be that these types of studies will soon join the already exponential exploration of healthcare data through AI/ML published in journals of computer science and medicine. The gray literature portends the permanence of telehealth and RPM in the global healthcare landscape, thus identifying new fertile ground for nursing research in this space. The Nursing Now Challenge espouses a commitment to person-centered care ( Nursing Now, 2021b ) making it poised to continue its considerable influence on nurse-led innovative care based on individual patient and/or consumer health data.

Acknowledgement: I have no known conflict of interest to disclose.

Mary Anne Schultz, PhD, MBA, MSN, RN, FAAN Email: [email protected] ORCID ID: https://orcid.org/0000-0002-8874-6610

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May 04, 2023

DOI : 10.3912/OJIN.Vol28No02ST01

https://doi.org/10.3912/OJIN.Vol28No02ST01

Citation: Schultz, M.A., (May 4, 2023) "Telehealth and Remote Patient Monitoring Innovations in Nursing Practice: State of the Science" OJIN: The Online Journal of Issues in Nursing Vol. 28, No. 2, ST Manuscript 1.

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24 Nursing Trends We Expect to See in 2024

Updated January 18, 2024.

We've put together a list of top nursing issues and trends that we expect to see in 2024 and beyond based on the latest data and insights from American Nurse Today, the Association of American Medical Colleges (AAMC), the American Association of Nurse Practitioners (AANP), and other sources.

The medical field, particularly nursing, is still experiencing the long-term effects of the COVID-19 pandemic. As the current field of nurses becomes more educated, they have an opportunity to take on expanded roles and fill a drastic need in the years to come. Read on to learn what to expect in the ever-changing world of nursing in 2024.

Why It's Important to Stay Ahead of Nursing Trends and Issues

Why should health care professionals stay abreast of future trends in nursing? By monitoring nursing issues and trends, nurses can:

• Become better advocates for patient safety, comfort and care
• Apply cutting-edge technologies to optimize efficiency and improve outcomes
• Safeguard their own mental health and well-being
• Collaborate with other nurses, doctors and specialists more ably
• Seize opportunities for nurse leadership, including heightened responsibility and more competitive pay

These are just a few of the many benefits of keeping up with future trends in nursing. Here are some of the top nursing trends for the coming year.

1. Online Education Programs Will Continue to Increase in Popularity

In 2010, the Institute of Medicine (IOM) appointed the Committee on the Future of Nursing to put together recommendations for an action-oriented response to some of the challenges nurses are facing.

One of its key recommendations was to increase the percentage of workers holding a Bachelor of Science in Nursing (BSN) degree from 50% to 80% by 2020. In 2018, New York became the first state to pass a law requiring nurses to earn a BSN within ten years of becoming licensed. Many other states have plans to adopt similar legislation.

In light of these changes, the motivation for nurses to pursue higher education is stronger than ever. Online nursing degree programs provide a way for nurses to obtain a degree while continuing to work full time, opening the door to higher education without sacrificing work-related responsibilities or family obligations.

We predict the popularity of online Master of Science in Nursing (MSN) to Family Nurse Practitioner (FNP) and online Post-Master's FNP Certificate programs to increase in 2024 as virtual education evolves from a pandemic necessity to a mainstay for career advancement.

2. The Shortage of Primary Care Physicians Will Create an Even Greater Demand for Family Nurse Practitioners

Recent research from the AAMC found that the United States could face a shortage of up to 48,000 primary care physicians by 2034 due in part to a growing aging population.

Without enough primary care physicians to care for the population, the demand for family nurse practitioners (FNPs) will be high, especially in those states where they have full practice authority. In November 2023, AANP reported that the United States had 385,000 licensed nurse practitioners (LNPs). We expect this number to continue to grow.

Another factor in the increasing demand for FNPs is rural hospital closings, which significantly impact health care. Between 2010 and 2021, a total of 136 of all rural hospitals closed their doors , according to the American Hospital Association (AHA). This is undoubtedly one of the most significant nursing trends of the last several years.

About 14% of the U.S. population, or 46 million people, live in rural areas and already find it challenging to obtain health care, according to the AHA. Another issue impacting residents in these areas is the insufficiency of doctors . FNPs can perform checkups, physicals, etc. for patients who might otherwise be stuck waiting long periods of time for an appointment with a doctor.

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3. a greater number of states will grant nurse practitioners full practice authority.

As a further response to the primary care physician shortage, more states are likely to grant nurse practitioners (NPs) the authority to practice independently. Currently, about 30 states and U.S. territories grant NPs full practice authority, while other states require collaborative agreements with supervising physicians or have practice restrictions.

Given the pressing need for primary care providers and the fact that both the National Academy of Medicine (NAM) and the National Council of State Boards of Nursing (NCSBN) recommend that states provide NPs full practice authority, the remaining states face increasing pressure to follow suit.

Learn how COVID-19 has impacted NP practice authority.

4. We Will See Significant Job Growth for Nurses in 2024

The numbers are clear: In the U.S. and globally, the shortage of registered nurses (RNs) is expected to intensify as baby boomers age, the need for care providers grows and health care workers deal with the long-term effects of COVID-19.

The nursing shortage intensified due to the COVID-19 pandemic as hospitals and other health care environments struggled under unprecedented patient loads.

The U.S. Bureau of Labor Statistics (BLS) projects registered nursing to be a fast-growing profession through 2032. The BLS expects it to grow by 6%; an estimated 177,400 new RN jobs will be added by 2032 .

This demand stems from the United States having an aging population. By 2030, the U.S. Census Bureau states that 21% of the population will be of retirement age. By 2034, there will be more people over age 65 than those under 18. It's expected that there will be a 48,000-plus shortage of primary care physicians by 2034, with many of today's doctors retiring. An aging population will need access to medical professionals, and FNPs are equipped to help fill this void

The lack of nurse educators is another issue. An AACN report explains that "U.S. nursing schools turned away 91,938 qualified applications from baccalaureate and graduate nursing programs in 2021 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors and budget constraints."

5. Salaries for Registered Nurses Will Stay Steady or Increase

Despite COVID-19's negative impacts on inflation and hospital finances, nurses surveyed by the American Nurse Journal report that they've continued to receive salary increases. The rise in nurses' salaries is especially true for FNPs, whose median annual pay in 2022 was $121,610, according to the BLS . Medical facilities are also using other incentives to entice nurses. Many facilities are offering bonuses to both recruit and retain nurses.

6. More States Will Join the Enhanced Nurse Licensure Compact, Making It Easier for Nurses to Move Across State Lines

The enhanced Nurse Licensure Compact (eNLC) was officially implemented on January 19, 2018. The compact, coordinated by NCSBN, makes it substantially easier for travel nurses to work across state lines.

In 2023, Washington and Rhode Island became the latest states to sign the compact's provisions into law, bringing the total number of states and territories that have enacted and implemented the eNLC to 41.

7. Telehealth and Chatbot Services Are Making It Easier for Patients to Access Care

The coronavirus pandemic accelerated the demand for virtual health care. A 2022 U.S. Department of Health and Human Services (HHS) report found that 22% of respondents had telehealth appointments in the previous month. That's why we predict telehealth and chatbot services will continue to be the norm in some aspects of the nurse's role in 2024. This is among the clearest and most consequential future trends in nursing.

With telehealth technology, patients can manage certain aspects of their own health care by accessing an online portal to see their test results, schedule appointments and request prescription refills. Virtual appointments enable them to see their nurse or doctor via live video feed.

Similarly, chatbots can assist patients with things like booking appointments and reminding them to take certain medications. For example, the health care chatbot Florence monitors patients' health, gives patients instructions and reminders for taking pills, and helps patients find specialists in their area.

Telehealth has faced some legislative restrictions regarding Medicare payments in the past. As the rules related to payments and other regulations are eased, barriers to its growth will be lessened.

The relaxation of rules around reimbursement for telehealth visits in the wake of COVID-19 has shown health care providers and patients alike how well the systems can work.

Besides working for patients with minor complaints, telehealth visits are a boon for nurses, therapists and providers who can use the technology to manage patients with mobility challenges and who are at especially high risk if exposed to the coronavirus.

Read our blog to learn more about how FNPs use telehealth today.

8. Virtual Technology Will Also Help Practitioners

Virtual technology has already assisted nurses with many tasks and will continue to do so into 2024. Virtual assistants can help nurses make data-informed decisions about treatments and medications. It can also help improve health outcomes by reminding patients to take medication, automating prescription refills, and handling billing and insurance, which can free up time for nurses.

Virtual reality (VR) can also provide many opportunities for working nurses and nurse education simulations. Practitioners have recently begun to use VR for chronic pain management in patients, which has been linked to higher quality of life and fewer visits to the hospital . These emerging examples are just some of the potential opportunities for VR to assist nurses in 2024.

9. Bilingual Nurses Will Be More Valued

The U.S. population is becoming increasingly diverse. The U.S. Census Bureau reported that at least 350 languages are spoken in American homes as of 2023.

Next to English, Spanish is the most widely spoken language in the United States. An estimated 42 million U.S. residents, approximately 13% of the population , speak Spanish at home — more than twice as many as in 1990.

Bilingualism is becoming increasingly valued as a skill for nurses to have. Nurses who speak a second language, especially Spanish, may be more attractive to employers than monolingual nurses in 2024.

10. More Nurses Will Choose to Specialize

Nurses today are expected to specialize, a nursing trend likely to continue into 2024 and beyond.

Nursing is a career with greater demand at higher levels of practice than entry-level ones. Nurses who choose to specialize find that they're in higher demand and that they can command higher salaries .

The BLS reports that RNs had a median annual salary of $81,220 in 2022, with projected job growth of 6% between 2022 and 2032. However, NPs will enjoy even brighter prospects for employment and salary. According to the BLS, they earned a median annual wage of $121,610 in 2022, and their employment is projected to grow by 45% between 2022 and 2032.

From family health to psychiatry, nurses can choose to focus their careers on many advanced specialties in 2024.

11. More Focus Will Be Placed on Holistic Care

Holistic care is a method for treating the whole patient. Holistic nurses recognize each patient's unique physical, mental, emotional, spiritual and environmental strengths and weaknesses.

The global body of evidence about the benefits of holistic care is growing, placing it at the center of future trends in nursing.

A 2020 study of patients in Hong Kong found that those who received holistic care intervention reported better outcomes than patients who received routine care.

Increasingly, U.S. hospitals and other health care facilities are emphasizing integrative and holistic health in their delivery models. At Carson-Newman University, our online MSN-FNP and online Post-Master's FNP Certificate programs focus on holistic care.

12. Nurses With Technological Skills Will Be in High Demand

Technology is ever-present in the modern world of health care, and the pace of reliance on technology only increased with the COVID-19 pandemic. Nurses today use a wide range of technologically driven approaches to increase efficiency, including electronic health records (EHRs) to track health history and smart beds to optimize patient positioning.

Nurses' use of mobile devices is also rising. A Zebra Technologies study, the Future of Healthcare 2022 Hospital Vision Study, predicted that the percentage of bedside nurses who used mobile devices in their practice would increase from 65% in 2017 to 97% in 2022. The same study showed that mobile technology can improve cost savings, care quality and patient safety.

Technology in nursing is here to stay, and nurses will need to become confident and comfortable with it at an increasing pace.

13. The Field of Health Informatics Will Become More Mainstream

In response to the influx of health care technology, a new field has arisen: health informatics. This growing specialization uses data collected by information technology (IT) systems to create a more collaborative environment between patients and their various health care providers.

One survey by the Healthcare Information and Management Systems Society (HIMSS) found that respondents reported a direct positive impact on the quality of care patients received as a result of the work of informatics nurses. With a high average salary and a very good job outlook, this specialization should attract even more interest in 2024.

14. Patients Will Continue to Become More Educated

In the era of smart devices, people are constantly consuming more information, including health-related information. Nurses can now expect to see patients who've already researched their conditions or symptoms online and may have an understanding of which medications might be right for them based on pharmaceutical advertisements they've seen.

Nurses in 2024, especially NPs, must be prepared to serve a more educated patient population by listening to patients' views about their health condition and synthesizing this information with their own professional knowledge and expertise.

15. We'll See an Increase in Cost-Effective Urgent Care Clinics

The lines between the retail and health care industries are blurring. Retail health clinic services offered by major players, such as Walgreens and CVS, provide alternative channels for the provision of primary care. They're majorly disrupting the health care landscape.

Future Market Insights (FMI) estimates an annual growth rate of 9.6% in the global market for retail clinics through 2028. Researchers point to patient accessibility and affordability in explaining this growth.

This is good news for NPs, as many NPs have already opted to open up their own clinics within such retail locations.

16. Nursing Faculty Positions Will Become More Attractive

The demand for RNs may be growing, but paradoxically, many institutes of higher education have been forced to turn away qualified applicants due to an ongoing nursing faculty shortage.

According to an AACN report on enrollment and graduations in baccalaureate and graduate programs in nursing, U.S. nursing schools had to turn away 78,191 qualified applicants from baccalaureate and graduate nursing programs in 2022. AACN identifies budget and faculty constraints as factors contributing to the shortage.

In response to this crisis, many initiatives are underway to make nursing faculty positions more attractive to qualified nurses. One example of such an initiative is the Jonas Nurse Leaders Scholar Program , which provides financial support to more than 1,400 scholars in all 50 states to expand the pipeline of future nursing faculty.

17. The Demand for Geriatric Specialists Will Continue to Rise

America is aging, and that can't help but affect nursing issues and trends. The Congressional Budget Office (CBO) calculates that by 2060, 23% of the U.S. population will be 65 or older. In the coming years, more geriatric nurses will be required to deal with an aging and ailing population of baby boomers. New nurses entering the field in 2024 may wish to be at the forefront of this highly sought-after specialty by becoming certified in geriatric care management.

18. More Awareness Will Be Given to Common Issues Faced by Nurses

According to a 2023 McKinsey & Co. report , 31% of nurses are considering leaving their jobs. The reasons for this potential exodus are exemplified in a 2021 AMN Healthcare survey of RNs :

• High levels of stress at work
• Concerns about work-life balance
• Difficulty recovering from the emotional toll of work
• Impact of work on physical health

There's some good news to counter this nursing trend. AMN Healthcare found that 64% of nurses were likely to encourage others to join the profession, and 66% were likely to stay with their current employers. They believed in the work they were doing and its value to the world.

The awareness of nursing issues increased in 2022 and 2023. More organizations, such as the American Psychiatric Nurses Association (APNA), emphasize the importance of self-care to guard nurses against the effects of job-related stressors. As health care facilities work to retain nursing staff, more resources will be devoted to nurses' well-being and job satisfaction.

Read our blog on how to practice self-care as a nurse during COVID-19.

19. Nurses Will Continue to Retire Later

While the U.S. faces a nursing shortage, older nurses are delaying retirement. The number of nurses 65 and over increased from 14.6% in 2017 to 19% in 2021. That's according to the 2020 National Nursing Workforce Study conducted by NCSBN and the National Forum of State Nursing Workforce Centers.

Amid the coronavirus pandemic, some retired nurses started working again. In March 2020, HHS urged states to relicense retired health care workers for quick reentry into the workforce.

The trend toward later retirement is expected to continue in 2024 and beyond. What does this mean for new nurses entering the field? There will be many job opportunities as new nurses work alongside experienced colleagues.

20. Nurses Will Help Uphold Health Care Cybersecurity

With the increasing adoption of digital technologies in health care , such as multi-cloud infrastructure and telehealth, the risk of cyber threats also rises. Health care facilities will need to develop and implement strategies to mitigate potential cyberattacks that could compromise confidential information.

Because they upkeep patient records and serve as points of communication between patients and other health care professionals, organizations and nursing leaders should train nurses on essential cybersecurity issues and safeguards, making it an essential 2024 nursing trend. They should also maintain compliance with Health Insurance Portability and Accountability Act (HIPAA) standards and review their current protocols to ensure they have robust defense measures.

21. Automation Will Free Nurses to Tackle More Complex Challenges

Nurses carry out repetitive tasks each day in service of their patients. These tasks can be physically demanding and monotonous when completed hundreds of times per shift. Robots and other automation tools are increasingly used to handle basic jobs in clinical settings.

Moxi is a self-operating robot that delivers medical supplies to exam rooms in several Texas hospitals. Henry Ford Health System deploys Xenex LightStrike robots to disinfect surfaces with ultraviolet-C (UV-C) after exams and in-patient stays. Brigham and Women's Hospital uses Boston Dynamics robots to measure the vitals of COVID-19 patients.

The future of nursing will see robots increasingly involved in diagnostics and procedures. In 2024, nurses may share the halls with robot colleagues that ease their workload. Additionally, nurses will increasingly turn to machine learning and artificial intelligence (AI) to help automate mundane and repeatable tasks, freeing more time for direct patient care.

22. There Will Be a Growing Role for Nurses in Health Equity Efforts

The Centers for Disease Control and Prevention (CDC) defines the term " health equity " as "everyone has a fair and just opportunity to attain their highest level of health." Millions of patients face inequities due to one or more social determinants of health, including the following:

• Housing insecurity
• Lack of access to healthy food
• Racial discrimination
• Poor air and water quality

Nurses encounter the consequences of these determinants in their daily work. Social and economic inequalities were magnified by the COVID-19 pandemic, leaving front-line health workers to find solutions for their patients. 

The NAM sees opportunities for health equity innovations by nurses. In its report The Future of Nursing 2020-2030, the NAM advocates for health care providers to "incorporate nursing expertise in designing, generating, analyzing, and applying data" into health equity programs. Nursing professionals will have opportunities to improve conditions for patients in 2024 and beyond.

23. Support for Nurses' Mental Health Will Grow

Given the physical and emotional demands of the nursing profession, burnout is a significant risk. The rate of nurses leaving the profession bears this out and makes rising mental health awareness another key nursing trend for 2024 and beyond.

Nurse leaders can advocate for their own mental well-being and that of their team members in many ways. Examples are as follows:

• Investing in AI and other tools to help nurses bear their workload
• Promoting more flexible scheduling, including ample time off
• Providing on-site support and counseling options for nurses to opt into

The bottom line: Successful nurses will need to be mindful of their own mental health concerns, in 2024 and into the future.

24. Preventative Care Will Be Prioritized

Nurses and other health care professionals will continue to prioritize preventative measures in holistic care in 2024. This involves addressing potential health issues before they arise. Preventative measures include: 

• Performing risk assessments
• Providing health education and community outreach
• Administering vaccinations 
• Encouraging screenings and other early detection tests
• Facilitating chronic disease management

With effective prevention, patients can mitigate the risk of developing a serious or chronic illness before it happens, avoiding extra health care visits and decreasing the likelihood of chronic pain and discomfort. 

Stay Ahead of Nursing Trends

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Why become an FNP student at Carson-Newman? Our FNP students benefit from these distinctive Carson-Newman advantages:

• Online coursework with no mandatory login times, so you can continue working full time or part time as you study
• Small-sized classrooms to accommodate your learning needs
• Ongoing clinical placement services, so you can focus on your studies and maintain a work-study-life balance
• A dedicated student success advisor who'll support you from start to finish

NP was ranked No. 1 in Best Health Care Jobs by U.S. News & World Report in 2022. As an NP, you'll empower your career as a holistic leader in primary care.

Learn more about our online MSN-FNP or online Post-Master's FNP Certificate programs.

What’s Really Behind the Nursing Shortage? 1,500 Nurses Share Their Stories

• Survey Results
• What Is the Nursing Shortage?
• Reasons Nurses Quit
• Hope For the Future
• What Nurses Need Now
• How to Take Action

Winner of the Gold Award for the Digital Health Awards, Best Media/Publications Article, Spring 2022

Update 10/10/2022

The findings of  Nurse.org's 2021 State of Nursing Survey revealed some harsh truths about the profession but also spoke to the strength, perseverance, and passion that nurses have for their work. Nurse.org has relaunched the State of Nursing survey in 2022 with the aim to capture a complete picture of the true state of the profession - from how nurses feel about work, how nurses are being treated, how nurses feel about the future of nursing, nurse's mental wellbeing and what nurses think needs to change within the profession. Take the survey now (it takes less than 10 minutes.)

>> Take Nurse.org's NEW 2022 "State of Nursing Survey" and let your voice be heard about issues in nursing that matter most. 

January 26, 2022

If the past two years have taught the world anything, it's that nurses are NOT okay. The truth is that despite the 7 pm cheers, the commercials thanking nurses for their dedication and selflessness, and the free food from major retailers – the overwhelming majority of nurses are burnt out, underpaid, overworked, and underappreciated.  

With millions of nurses worldwide, Nurse.org wanted to truly understand the current state of nursing and give nurses a voice to share their thoughts, feelings, and apprehensions about the nursing profession. We surveyed nearly 1,500 nurses to find out how they felt about the past year and get to the real reasons behind the nursing shortage . The responses were heartbreaking, but not without hope.  

What We Found: Nurses Are Struggling

Nurses are struggling. Regardless of practice specialty, age, or state of practice – the answers were all the same. Nurses, NPs, and APRNs are all struggling and need help.  

Only 12% of the nurses surveyed are happy where they are and interestingly, 36% would like to stay in their current positions but changes would need to be made for that to happen. Nurses report wanting safe staffing, safer patient ratio assignments, and increased pay in order to stay in their current roles.  

Nurses didn’t hold back when discussing their feelings regarding the current state of nursing:  

• 87% feel burnt out 
• 84% are frustrated with administrators 
• 84% feel they are underpaid 
• 83% feel their mental health has suffered 
• 77% feel unsupported at work 
• 61% feel unappreciated 
• 60% have felt uncomfortable having to work outside of their comfort zone in the past year 
• 58% of nurses have felt frustrated with their patients 
• 58% of nurses have felt unsafe at work in the past year 

The numbers don’t lie. It’s astounding that a profession continually recognized for its compassion, strength, and resilience is suffering . And the suffering is universal.  

One nurse responded with the following, “I have been an RN for 34 years and in my specialty of nursing for 31 years and I am burned out.” 

What Is the Nursing Shortage and Why is it Happening?

You’ve likely heard about the nursing shortage, but what does that mean and why is it happening? 

According to the U.S. Bureau of Labor Statistics (BLS) , the employment of registered nurses is projected to grow 9% from 2020 to 2030.  Approximately 194,500 openings for registered nurses are projected each year, on average, over the decade. However, this number was projected prior to the pandemic, and before the mass exodus of bedside clinical nurses. As a result, it’s likely substantially lower than what the real demand for nurses will look like.

The American Nurses Association (ANA) reports that the increased need for nurses spans beyond the current pandemic. In fact, they sent a letter to the U.S. Department of Health and Human Services (HHS) on September 1, 2021, urging the country to declare the current and unsustainable nurse staffing shortage to be a national crisis. 

The ANA attributes the needs for thousands of nurses to the following:  

• The Affordable Care Act made access to health care services possible for more people
• Increased focus “primary care, prevention, wellness, and chronic disease management” 
• Aging baby-boomer population
• Growing interest in community-based care

Why Are Nurses Really Leaving The Bedside? 

However, those stats don’t address some of the systemic issues nurses face every day, particularly in the midst of a pandemic. That’s why we asked nurses why they are really leaving the bedside.

What we heard is that, overwhelmingly, the number one reason nurses want to leave the bedside is because of unsafe staffing ratios. This leads to a never-ending cycle of shortages: nurses face unsafe staffing ratios so they decide to leave the bedside, this results in even fewer nurses available to care for patients, so the downward cycle continues.

Essentially, nurses are dealing with an increased workload with fewer resources. Typically, pre-covid ICU nurses would experience a 1:1 or 2:1 patient-to-nurse ratio. Now ICU nurses throughout the country are experiencing a 3:1 or 4:1 patient-to-nurse ratio which exacerbates staff burnout and unsafe nursing practices.  

One nurse reported, “With increased patient census, staffing ratios are very unsafe especially with high acuity patients. Having 4+ critically ill patients not only puts licenses at risk but the patients do not benefit at all. We’re just running around doing tasks, not providing adequate care.”

Unsafe Staffing Ratios Are Just Part of the Problem

While a big piece of the puzzle, unsafe staffing issues are, unfortunately, one part of a long list of issues plaguing nurses today. 

 Nurses are leaving the bedside because of issues like: 

• Inadequate staffing ratios 
• Not getting equal pay for equal experience 
• Not receiving hazard pay during a pandemic 
• Not having adequate back up 
• An inability to take breaks, sick days, or even turn down extra shifts 

To learn more about the nursing shortage and learn ways you can get involved, check out the full report here . 

Despite All This, Nurses Still Have Hope

70% of nurses still think that nursing is a great career and 64% still think that new nurses should join the profession. 

“If you’re a student considering becoming a nurse, please know that you are not walking into a doomed profession. You will never meet anyone who is more determined, more resourceful, or more ready to jump in and lend a helping hand than a nurse." 

--– Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org

If you’re a nurse, you know that nursing isn’t just a profession, it’s a calling. It’s devastating to see that so many nurses are suffering in their quest to heal and give care, but it’s heartening to know they are not without hope. 

What Nurses Need Now 

If you’re a nurse, know that your job is simply to put yourself first. If we want to solve the nursing shortage (and we do!), it can't happen without nurses recognizing that they are NOT the problem. 

"The problem is not with nurses or nursing; the problem is that nurses have been so busy taking care of others that no one has taken care of them. And we’re here to change that--and by entering the nursing profession, you will be part of the solution too”

 – Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org 

The truth is nurses need a lot more to be incentivized to stay practicing clinically at the bedside. Nurses reported needing:  

• Higher pay 
• Safe nurse-to-patient ratios 
• Hazard pay 
• REAL mental health resources 
• Adequate staff support 
• Support programs for new nurses

4 Ways to Support Nurses and Take Action

While we may not be able to make this change at an individual level, collectively, we can amplify the voice of nurses and shed some light on the issues that they are facing every day. Together, we have the power to create meaningful, lasting change for current and future nurses.  Here's how to get involved: 

1. Sign the Pledge

Sign the pledge seen below and encourage your friends & colleagues to do the same. While you’re at it, print it out and post it in your break room. 

2. Spread the Word 

Change can’t happen unless we get the word out about what’s really going on. Share what you’ve heard and what you’ve experienced, and encourage others to do the same. 

3. Contact Your Elected Officials 

It’s time for elected officials to stand up for nurses. Write them a letter. Call their office. Demand change for nurses. Click here to get the contact information for your local and state Officials. 

4. Download and Share the Report

Get even more in-depth insights into what’s going on with the state of nursing and the issues that nurses face today, click here to download the full State of Nursing report or read about the best and worst specialties for nurses during COVID . 

“If you are a current nurse considering leaving the profession, be assured that you are not alone in your struggles. If all you’ve had the energy for is keeping your head down and getting through your shifts, sleeping, and getting up to do it all over again, know that you are doing enough. It’s not your responsibility to solve the nursing shortage.” 

– Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org 

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

By clicking “Join Now”, you agree to receive email newsletters and special offers from Nurse.org. We will not sell or distribute your email address to any third party, and you may unsubscribe at any time by using the unsubscribe link, found at the bottom of every email.

Nearly Half of RN Vacancies in 2023 Were Agency Staffing Positions: Three Takeaways for Employers

It’s a complex, multifaceted problem that no magic bullet will solve — but more visibility into the data behind hiring and salaries for RNs may help. Here’s a look at how.

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If you feel like nursing is in crisis right now, you’re not alone.

In fact, a biannual survey of US nurses by AMN Healthcare released last year highlights just how dire things are, especially in hospitals: among nurses who work in hospitals, just 15 percent plan to stay in their current role this year. The other 85 percent plan to look for work elsewhere, including in per-diem roles or as travel nurses.

Shifting the Payer Landscape with Health Tech

A new eBook from HLTH and MedCity News captures how health insurers and their partners are using health tech to improve the patient experience.

This resonated with me in part because we just published a roundup of labor market data, featuring details on who’s hiring where, for what positions, and at what wages. The data showed that, in 2023, there were 3.1 million job listings for RNs. That number seemed too high: the US only employs about three million nurses. We dug deeper and found that 44 percent of those postings – nearly half – were for agency roles.

To us, this suggests a vicious circle: hospitals (and other employers) are struggling to retain nurses, so they turn to agencies to fill the gaps; those agencies offer short-term relief for a high price tag, leaving less money to pay full-time staff. Those staff then burn out and look for higher-paying work – often at agencies.

Obviously, this is a complex, multifaceted problem. No magic bullet will solve it. But more visibility into the data behind hiring and salaries for RNs may help. Here’s a look at how.

1. Wage data can chip away at the nursing crisis

Are GLP-1 Drugs Here to Stay?

We recently spoke with Nicole Bulochnik, senior vice president of drug strategy for Abarca, about what payers need to consider as demand for this group of weight-loss drugs remains high.

It’s an oversimplification to suggest that, if you simply paid RNs more, the labor crisis would be solved. But it’s also true that wages play a role in the larger picture.

For example: when hiring, it’s standard practice to consider wages being paid by direct competitors (i.e., other care providers in your geographic area), but it’s less common to consider all “talent competition” – that is, competition for RNs from employers that don’t provide the same services as you.

When comparing agency employers vs. non-agencies, the salary question becomes significant: the median annual salary in 2023 for non-agency RNs was $92,102; for agency roles, it was $112,778.

And agencies aren’t the only talent competitor hospitals need to consider. Educational institutions – even those in different parts of the country – may be competing for the same RNs. An influx of federal funding for nursing educators and a population that’s comfortable with remote learning means you may now be competing for labor with a university four states over.

Other possible talent competitors: insurance companies, which employ RNs in all kinds of roles and senior living and skilled nursing facilities. Work in these contexts may be lower-stress or more flexible than hospital work and often at least as well paid.

Thus hospitals struggling to retain nurses must consider the full universe of their talent competition when setting RN wages. Even if you’re not immediately able to offer higher wages, knowing exactly what you’re up against will make it easier to predict turnover.

Further, knowing exactly what talent competitors are offering (including wages and benefits) may give you leeway to expand non-salary benefits to attract and retain top talent.

2. Non-salary strategies can help attract and retain talent

As I mentioned, there’s more to the picture than salaries. In the AMN study, nurses also cited extreme workplace stress and fears of getting sick at work as reasons they were considering leaving their current role.

The report also included case studies of organizations that have found ways to address those concerns. Three pilot programs are worth highlighting:

• Task reallocation . One pilot found that 40 percent of RNs’ tasks could be safely reassigned to other workers – presumably those with less expertise who command lower wages.
• Virtual care supplementation . Another pilot wove more virtual care into everyday tasks: real-time digital patient communication, remote patient monitoring, leaning on off-site specialists for imaging review, and more. This eased the burden on in-person nurses and provided them opportunities to work partially remote schedules.
• Additional staffing coordinators : Yet another pilot involved working with a specialized staff coordination team (in addition to nurse managers tasked with daily scheduling). This group reviewed daily needs and assigned members of a flex team as needed.

All of these strategies enable more efficient allocation of resources, which both eases the burden on RNs and may free up resources that can be used to set more competitive wages. Such efforts might also prove valuable should states pass staffing ratio laws currently being considered.

3. Communication about wages can ease labor woes

Another empowering figure we found in our end-of-year labor data analysis: job listings that include salary information get filled faster than those that don’t. For RN job listings in particular, jobs with salary data filled 31 percent – or 10 days – faster, on average.

Over the course of a year, this difference could be substantive, as it would mean fewer periods of under-staffing, which would mean both less burden on remaining staff and less need for expensive agency supplementation.

Already, five states mandate salary data in job listings , and more are considering such legislation. The advantage of upfront salary communication is clear today, but it may diminish as the practice becomes more common.

Still, it’s an immediate opportunity for employers not already including salary data in job postings: add that information, and expect a shorter hiring process.

Better nursing retention improves everyone’s life

Hospital CEOs and nurses may be the ones feeling the nursing labor shortage most acutely today, but if it continues, it will impact everyone in the country, as we’re all participants in the healthcare system.

I’m under no illusion that the problem we face can be resolved by using data more strategically in the hiring process, but I also recognize the urgency here and believe we need to pull every lever available to address the underlying problems. To that end, better access to and utilization of labor market data can and should be part of the solution.

Photo: Wavebreakmedia, Getty Images

Michael Woodrow

Michael Woodrow is the president of Aspen Technology Labs , a recruitment technology and data services company headquartered in Aspen, CO. The company’s flagship product line, WebSpiderMount, is a suite of jobs data management products. It includes job scraping, business intelligence, wage benchmarking, and access to over 9 million real-time job listings from over 150,000 companies globally. With more than 25 years of experience in recruiting and recruitment technology, Michael brings a wealth of knowledge that helps customers better understand the labor market. He also serves on several industry and nonprofit boards, including TATech.

This post appears through the  MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers.  Click here to find out how .

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• Open access
• Published: 21 June 2024

Professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia

• Sentayehu Admasu Saliya 1 ,
• Taye Mezgebu Ashine 1 ,
• Asnakech Zekiwos Heliso 1 ,
• Getachew Ossabo Babore 1 ,
• Bethelhem Birhanu 1 &
• Awoke Girma Hailu 1  

BMC Nursing volume  23 , Article number:  417 ( 2024 ) Cite this article

108 Accesses

Metrics details

Professional quality of life is a crucial aspect of healthcare professionals’ well-being and job satisfaction. Job satisfaction, on the other hand, encompasses fulfillment of desired needs within the work environment, happiness or gratifying emotional response towards working conditions, and job values or equity. Existing literature tends to address job satisfaction and professional quality of life separately, overlooking their interconnectedness, especially within the unique context of Ethiopia. This study aimed to assess nurses’ professional quality of life and job satisfaction.

A descriptive cross-sectional study was conducted from September 1–30 2023 among 420 nurses using a structured questionnaire. The study participants were recruited by simple random sampling. Multiple linear regressions were used to identify factors associated with outcome variables.

The study involved 420 nurses, with 407 completing the questionnaire, yielding a 96.68% response rate. The findings revealed varying levels of professional quality of life. Specifically, 258 participants (63.4%) exhibited low compassion satisfaction, while 271 (66.6%) and 266 (65.4%) experienced average levels of burnout and secondary traumatic stress, respectively. Job satisfaction was moderate to high for 55% of the participants. As the finding of this study indicates, there is a positive correlation between compassion satisfaction and job satisfaction in nursing. The study also identified predictors for job satisfaction, compassion satisfaction, and compassion fatigue, such as marital status, education, and experience.

The majority of participants reported a medium level of compassion satisfaction, with a significant proportion experiencing moderate to high levels of compassion fatigue. Although more than half of the participants had moderate to high job satisfaction, there were still low levels of satisfaction. The study recommends developing targeted training programs, implementing workplace policies, and designing initiatives to enhance education, experience, and compassion satisfaction.

Peer Review reports

Introduction

The standard of patient care and the well-being of healthcare professionals are significantly impacted by professional quality of life and job satisfaction in the nursing profession [ 1 ].

A nurse’s job-related satisfaction is impacted by both their favorable and detrimental daily work experiences [ 2 ]. Compassion Satisfaction is a positive aspect of professional quality of life, whereas Compassion Fatigue is a negative aspect. Two factors contribute to compassion fatigue. Burnout, which includes tiredness, frustration, rage, and despair that are usually connected to one’s job, is the first element. The second element is secondary trauma stress, which is an uncomfortable feeling brought on by fear and trauma at work [ 3 ].

In the nursing field, job satisfaction was characterized by three aspects: the ability to meet needs in the workplace, happiness or a positive emotional reaction to working conditions, and employment equity or values [ 4 ].

In the nursing context, these two elements are intricately interrelated, as the emotional demands and stressors inherent in the profession directly impact the overall job satisfaction of nurses [ 5 ]. The emotional toll of empathetic caregiving can have a significant impact on a nurse’s general well-being. Excessive compassion fatigue can have negative effects on one’s physical and mental health, while high levels of compassion satisfaction are linked to job satisfaction and general well-being [ 6 ].

Burnout, compassion fatigue, and workload pressures are among the key contributors to diminished professional quality of life and job satisfaction in nursing [ 7 ]. The study from the United States indicates compassion satisfaction is positively correlated with job satisfaction [ 8 ]. Studies have indicated that individuals who provide support to others who have had traumatic stressors may be more susceptible to negative symptoms of depression, burnout, and post-traumatic stress disorder [ 9 , 10 , 11 , 12 ]. On the other hand high level of job satisfaction has a positive effect on a high level of professional quality [ 13 ]. Job satisfaction is crucial to prevent burnout. It is defined as a “syndrome resulting from chronic workplace stress that was not properly addressed” [ 14 ].

In Ethiopia, the national pooled prevalence of job satisfaction among health professionals is 46.17% [ 15 ], However, there is a significant variation in job satisfaction levels across different regions of the country. For instance, the study conducted in the Amhara region reported a high level of job satisfaction among health professionals, with a mean score of 57.5 [ 16 ] On the other hand, a cross-sectional study in the Oromia region found that only 16.5% of health professionals were satisfied with their jobs.

In contrast, studies have reported moderate levels of compassion fatigue among health professionals in Ethiopia [ 17 ]. Similarly, a study conducted in South Africa, Turkey Saudi Arabia, and the United States reported moderate levels of compassion fatigue among healthcare providers [ 10 , 11 , 18 , 19 ]. Studies from Latvia indicate there was a positive correlation between compassion fatigue and secondary traumatic stress [ 20 ].

Achieving the best possible patient outcomes depends on nursing practitioners who feel satisfied with their work [ 1 ]. A significant positive relationship was observed between compassion satisfaction and clinical competence [ 21 ]. Nurses with higher levels of compassion satisfaction and lower levels of compassion fatigue and secondary traumatic stress tend to have higher levels of clinical competencies [ 22 ].

Altruism and the satisfaction that comes from being able to help others might be seen as the positive sides of helping. The degree of the painful content that the caregiver is exposed to such as direct contact with victims exacerbates the negative impacts of caregiving, especially when the exposure is ugly and explicit. Burnout, depression, increased substance use, and symptoms of posttraumatic stress disorder are possible effects [ 9 ].

Despite the abundance of individual studies on job satisfaction [ 15 , 16 , 23 , 24 ] and professional quality of life [ 17 , 25 ] in various occupational sectors in Ethiopia, there is a lack of comprehensive exploration that consolidates these two critical dimensions into a single study.

The existing body of literature tends to address job satisfaction and professional quality of life separately, overlooking the interconnectedness between these facets, especially within the unique context of Ethiopia, especially in nursing. This gap highlights the need for a comprehensive investigation that not only identifies the distinct contributors to job satisfaction and professional quality of life but also explores their synergies and interdependencies within the Ethiopian work environment. A study was conducted to assess professional quality of life and job satisfaction among nurses working in tertiary hospitals in central Ethiopia.

Objective To assess nurses’ professional quality of life and level of job satisfaction among nurses working at tertiary hospitals in central Ethiopia in 2023.

Study design and period

The institution-based cross-sectional was conducted from September 1–30, 2023.

The study was carried out in tertiary-level hospitals in central, Ethiopia. The region is organized into 6 zones and three special woredas on an administrative level. In the region, there are 3 tertiary-level hospitals; Wolikite University Hospital, Wachemo University Hospital, and Worabe Hospital. About 539 nurses were working in those hospitals. Worabe Hospital is located 172 km south of Ethiopia’s capital city, Addis Ababa, in Worabe, a town. There are 112 nurses in the hospital at Worabe Hospital. Wachemo University Hospital Referral is in Hossaena town, 232 km south of Addis Ababa, Ethiopia’s capital city. There are 287 nurses in total at the Wachemo University Hospital. Wolikite University Hospital is located 158 km from Addis Ababa, Ethiopia’s capital. There are 140 nurses in total at the Wolikite University Hospital.

The source population was all nurses working at tertiary level hospitals of central Ethiopia and the study population was all sampled nurses who were working at tertiary level hospitals in central Ethiopia, 2023.

Eligibility criteria

All nurses who were working at tertiary-level hospitals in central Ethiopia, in 2023 were included in the study and nurses who were sick, unable to respond, and on annual leave were excluded from the study.

Sample size determination

The sample size was calculated using a single population proportion calculation that takes into account the following factors: 95% confidence interval, 46.68% proportion [ 26 ], and a margin of error of 5%.

\(N = (1.96)2 * \frac{{0.4801(1 - .0.4801)}}{{0.05 * 0.05}}\) = 382 a total of 420 is obtained by adding a 10% non-response rate.

Sampling technique

The total sample size was proportionally distributed based on the number of nurses working in each academic tertiary hospital as shown in the figure below (Fig.  1 ).

Sampling procedure to select study participants from tertiary level Hospitals in central, Ethiopia 2023

Ni = proportional sample size for each hospital.

Nh = total number of nurses in each hospital.

Nt = overall number of nurses in the hospital.

N = estimated sample size.

Then, the sampling frame was prepared for each hospital by having lists of nurses from the hospital’s human resource management. Finally, nurses of each hospital were selected by a simple random sampling technique using a computer-generated random number from the sampling frame.

Data collection tool and procedure

Data were collected using pre-tested, structured, and self-administered questionnaires which were adopted from previous Ethiopian studies [ 24 , 27 , 28 ]. The questionnaire was written in English and then translated into Amharic, with questions retranslated back into English for consistency. The questionnaire was divided into socio-demographic, Minnesota Satisfaction scale, and professional quality of life scale.

A pre-test was conducted in Hawassa University’s Comprehensive Specialized Hospital two weeks before the actual data collection time on 10%(42 nurses) of the sample size.

The Minnesota Satisfaction Questionnaire (MSQ) short form was used to assess job satisfaction [ 29 , 30 , 31 ]. Twenty questions were rated on a 5-point Likert scale, with 1 signifying severely dissatisfied and 5 denoting very satisfied. Negative items were reversed to positive before summing. The measuring items on nurses’ job satisfaction were achievement, advancement, work itself, recognition, growth at work, organization policy, relationship with colleagues and supervisor, payment, and working conditions. The overall score of the questionnaire ranges from 20 to 100 so the score ranges of 20–47, 48–76, and 77–100 indicate a low, moderate, and high level of job satisfaction, respectively [ 32 ].

The reliability test in the previous study revealed that the tool for the subscale was reliable, with a Cronbach’s alpha score of 0.83 [ 14 ], in this study reliability test value was acceptable with Cronbach’s alpha of 0.891. The mean score was calculated after checking the normality of the distribution.

The professional quality of life scale contains 30 items and the scale has 3 sub-scales [ 33 ]: Compassion satisfaction, secondary traumatic stress, and burnout scale. The secondary traumatic stress subscale and burnout subscale measure compassion fatigue. The scale was measured using a point Likert scale (5 = very often to 1 = never) [ 34 ]. The higher the score of compassion satisfaction, the higher the compassion satisfaction, the higher the score of compassion fatigue, and the higher the risk of compassion fatigue.

Dependent and independent variables of the study

Dependent variable.

Job Satisfaction.

Professional quality of life.

Independent variables

Socio-demographic factors.

Educational level

marital status

work experience

Operational definition

• Job satisfaction

The questionnaire’s total score ranges from 20 to 100, with scores in the three categories of 20–47, 48–76, and 77–100, representing low, moderate, and high levels of job satisfaction, respectively [ 32 ].

A score of 22 or less indicated a low degree of burnout, a score between 23 and 41 indicated an intermediate level of burnout, and a score of 42 or above indicated a severe level of burnout [ 35 ].

Secondary traumatic stress

A score of 22 or a low level; a score between 23 and 41 an average level, and a score of 42 or more indicated a high level of Secondary traumatic stress [ 35 ].

• Compassion satisfaction

A score of 22 or less low level, a between 22 and 41 is an average level, and a score of 42 or more indicates a high level of Compassion satisfaction [ 35 ].

Data management and analysis

After the data were checked for consistency and completeness, data were entered into EpiData version 4.6 and exported to SPSS (Statistical Package for Social Sciences) version 26 for analysis. Tables, graphs, and charts were used to interpret and show the results. Those that were associated with outcome variables in bivariate analysis at P  values of 0.25 or lower were included in the multivariable linear regression model. We then performed tests for multicollinearity, including variance inflation factor reports and condition number tests because of the potentially high overlap between the explanatory variables; for example, age and work experience, and gender and profession. Age and years of work experience variables were highly collinear and age was removed from explanatory variables. We report regression coefficients for these models. Variables with estimated coefficients that had P  values ≤ 0.05 were considered statistically significant associated factors in this study.

Ethical consideration

Ethical clearance was obtained from the Wachemo University College of Medicine and Health Science, with reference number IRB/172/16. Written informed consent was approved by the Wachemo University College of Medicine and Health Science Institutional Review Board. Written informed consent was obtained from all study participants. To protect participants from risks, the study did not record participants’ names, identification numbers, and names of health facilities where he or she worked.

Socio-demographic data

The questionnaires were distributed to the 420 sampled nurses working in tertiary-level hospitals. Four hundred-seven (407) nurses returned the questionnaires, indicating a 96.9% response rate. The participants were between 20 and 41 years old, with a mean age of 30.85 and an SD of 6.39. The respondents predominantly were between the ages of 25 to 29 years. The majority of 220 (54.1%) respondents were female. In terms of marital status, 204 (50.1%) study participants were single. Most respondents, 298 (73.2%), had a BSc degree in nursing. The majority of study participants 248 (60.9%) had less than five years of work experience. The average monthly income of respondents was 888.43, with a minimum of 5000 and a maximum income of 13,000 Ethiopian Birr (Table  1 ).

• Professional quality of life

The mean compassion satisfaction score among study participants was found to be 26.34 ± 9.38, with a minimum score of 10.00 and a maximum score of 47.00 [ 1 ]. On the other hand, the mean compassion fatigue score was significantly higher at 55.26 ± 18.80, with a minimum score of 20.00 and a maximum score of 93.00.

The results suggest that the average mean score of compassion satisfaction was lower than the mean score of compassion fatigue, indicating that most of the study participants experienced lower compassion satisfaction. This finding is concerning, as compassion satisfaction is an essential factor in maintaining the well-being and mental health of healthcare providers see (Table  2 ).

The findings of our study indicate that 258 (63.4%%) of the participants were found to have low levels of compassion satisfaction. Our study finding indicates the level of burnout and secondary traumatic stress is mainly average with 271(66.6%) and 266(65.4) respectively as shown in Table  3 .

The statement “I am pleased with how I can keep up with helping techniques and protocols” had the highest agreement level in the study, with 153 responses (37.6%) indicating often and 127 responses (31.2%) indicating sometimes. The statement “I get satisfaction from being able to help people” has the lowest agreement level in the study, with 116 responses (28.5%) indicating Sometimes and 98 responses (24.1%) indicating Often. The statement “I feel invigorated after working with those I help” has the highest disagreement level in the study, with 153 responses (37.6%) indicating often and 71 responses (17.4%) indicating “never.” The statement “I believe I can make a difference through my work” had the lowest disagreement level in the study, with 85 responses (20.9%) indicating often and 2 responses (0.5%) indicating always as shown in (Table  4 ).

• Compassion fatigue

The statement “I avoid certain activities or situations because they remind me of frightening experiences of the people I help” had the highest agreement level in the study, with 114 responses (28.0%) indicating often and 122 responses (30.0%) indicating sometimes. The statement “I feel as though I am experiencing the trauma of someone I have helped” has the lowest agreement level in the study, with 136 responses (33.4%) indicating often and 70 responses (17.2%) indicating never. The highest level of disagreement in the study was The statement “I feel depressed because of the traumatic experiences of the people” has the highest disagreement level, with 152 responses (37.3%) indicating Sometimes and 56 responses (13.8%) indicating Often. “The statement with the lowest agreement levels in the study was, “I think that I might have been affected by the traumatic stress of those I help.” has the lowest disagreement level, with 53 responses (13.0%) indicating often and 2 responses (0.5%) indicating always as shown in (Table  5 ).

The statement “I feel trapped by my job as a helper” has the highest agreement level in the study, with 132 responses (32.4%) indicating “Sometimes” and 98 responses (24.1%) indicating Often. The statement “I am the person I always wanted to be” had the lowest agreement level, with 152 responses (37.3%) indicating often and 43 responses (10.6%) indicating always. The highest disagreement levels in the study were The statement “I feel overwhelmed because my case workload seems endless” has the highest disagreement level, with 127 responses (31.2%) indicating often and 1 response (0.2%) indicating always. lowest disagreement levels, the statement “I feel happy” has the lowest disagreement level, with 152 responses (37.3%) indicating Sometimes and 56 responses (13.8%) indicating Often as shown in (Table  6 ).

The study found that the overall mean score for job satisfaction among healthcare providers was 27.46 ± 9.86. This score falls within the moderate range of job satisfaction, indicating that healthcare providers in the study reported a moderate level of satisfaction with their jobs.

Furthermore, the study found that 55% of healthcare providers reported a moderate to high level of job satisfaction. There is still room for improvement, as the overall mean score for job satisfaction falls within the moderate range.

as shown in (Fig.  2 ).

level of job satisfaction of nurses working at tertiary level hospitals in central Ethiopia, 2023

Job satisfaction various conditions revealed that the nurses working in academic tertiary hospitals were satisfied with five factors: satisfaction in achievement (0.73449), advancement (1.4263 (0.69797), autonomy (1.6454 (0.69723), the recognition they get for good work (2.7232 (1.06691), leadership and organizational policy (2.2973 (0.96494), salary and working conditions (2.0511 (0.75966) and relationship (3.2973 (0.98667)) (Table  2 ). According to the mean score of each, the nurses working in academic tertiary hospitals were dissatisfied with the remaining fifteen factors. The highest level of dissatisfaction was reported for the opportunity for training or education at 1.36 (0.503). This was followed by a house allowance of 1.53 (0.749), hazard allowance for nurses of 1.93 (0.259), availability of resources and supplies of 2.17 (0.800), feeling about the job itself of 2.85 (1.319), and Salary (3.20 ± 1.535), respectively as shown in the (Table  7 ).

Correlation between compassion fatigue and job satisfaction

The finding of our study indicates compassion satisfaction and job satisfaction are strongly correlated, with a Pearson’s correlation coefficient of 0.762 and a p -value of 0.001. This indicates that there is a significant relationship between compassion satisfaction and job satisfaction among the nurses in the study. This strong correlation signifies a meaningful and significant relationship between compassion satisfaction and job satisfaction within the study cohort. This finding underscores the interconnectedness of these two factors and highlights the importance of addressing both compassion satisfaction and job satisfaction to enhance the overall well-being and job performance of nurses. as shown in the (Table  8 ).

Multiple linear regression analysis for compassion satisfaction and compassion fatigue

For Compassion fatigue, the results showed that marital status had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.127, indicating that participants who were not married had higher levels of compassion fatigue. The educational level also had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.269, indicating that participants with lower levels of education had higher levels of compassion fatigue. For compassion satisfaction, the results showed that marital status had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.132, indicating that participants who were not married had lower levels of compassion satisfaction. educational level also had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.244 and a, indicating that participants with lower levels of education had lower levels of compassion satisfaction as shown in (Table  9 ).

Multiple linear regression analysis job satisfaction

The results showed that educational level had a positive relationship with the outcome variable, with a standardized beta coefficient of 0.088 and a t-value of 2.712, indicating that participants with higher levels of education had higher levels of job satisfaction. Experience in a year had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.094 and a t-value of -2.740, indicating that participants with more years of experience had lower levels of job satisfaction as shown in (Table  10 ).

This study was conducted to assess levels of professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia.

The finding of our study indicates that 64.1%% of the participants were found to have moderate to high levels of compassion satisfaction. Only 0.7% of the study participants have a high level of compassion satisfaction. This is lower than the study from China oncology nurses [ 36 ], 668, Guangzhou, Guangdong, China, 78% [ 37 ], a study from Nepal [ 38 ] with, a moderate level of compassion satisfaction is 71.3%, and a high-level compassion satisfaction 28.3%, Saudi Arabia, in which high of compassion satisfaction is 17.7% [ 35 ], a study from Thailand 75.3% [ 39 ], Northwest Ethiopia especially those on the high level of compassion satisfaction aspect in this study is 32.7% [ 27 ].

The discrepancies in studies can be attributed to various factors, including differences in sample size, for example, sample size from China oncology nurses [ 36 ], sample size 668, Guangzhou, Guangdong, China, its sample size 337 [ 37 ], and the specific population of nurses being studied.

This study indicated level of compassion fatigue is 124(30.5%), 275(67.6%), 5(0.5%) low, moderate and high level satisfaction respectively. Concerning components like burnout and secondary traumatic stress those who have moderate to high levels of burnout and secondary traumatic stress are 67%0.2,66.9% respectively.

The finding is consistent with a study from China on component burnout 63% and lower on secondary traumatic stress 76% component [ 37 ]. A similar study from a China frontline nurse in Wuhan [ 40 ] was higher than a study from Saud Arabia [ 35 ] in which the compassion fatigue level was 18% and burnout level 15%. Lower than the study from Nepal in which the level of compassion fatigue was moderate at 77% high level of 3.5% [ 38 ], a study from Uganda reported 49.11% high levels, 29.62% reported average levels, and 21.27% low levels of compassion fatigue [ 41 ]. Studies from oncology nurses also reported a high level of compassion fatigue and a low level of compassion satisfaction [ 34 ].

In our study, nurses working in central Ethiopia, have a moderate to high level of job satisfaction is 55%. This finding is consistent with other studies in Ethiopia like; a study from Jimma Ethiopia, with overall job satisfaction of [ 28 ], Bahir Dar Ethiopia [ 24 ], Ethiopia [ 42 ], and Ethiopian national pooled prevalence of job satisfaction [ 43 ], and lower than study from USA 2018 national sample survey of registered nurses, which 88.7% either extremely or moderately satisfied. Reasons for low level could be poor job conditions and limited resources [ 44 ], limited opportunities for career development, a combination of financial and non-financial incentives, and lack of motivation through incentives such as bonuses, house allowances, and salary increments [ 45 ].

The finding of our study indicates compassion satisfaction and job satisfaction are strongly correlated, with a Pearson’s correlation coefficient of 0.762 and a p -value of 0.001. This indicates that there is a significant relationship between compassion satisfaction and job satisfaction among nurses. This finding is in line with a study from the USA [ 8 ]. High levels of compassion satisfaction and job satisfaction can contribute to the overall well-being of nurses. Nurses’ satisfaction directly impacts the quality of care they provide to patients.

In this study, marital status had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.127 and a t-value of -2.779, indicating that participants who were not married had higher levels of compassion fatigue. The educational level also had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.269 and a t-value of -5.573, indicating that participants with lower levels of education had higher levels of compassion fatigue. This finding is consistent with a study from Turkey that found that being single or divorced and not having children were related to the highest levels of burnout in nurses [ 46 ].

The finding of our study indicates; that marital status and educational level were predictor variables for both compassion satisfaction and compassion fatigue.

This finding suggests that being married may serve as a protective factor against the development of compassion fatigue. This could be due to various reasons. For example, married individuals may have access to emotional support from their partners, which can help them cope with the emotional demands of their work. They may also have a stronger support system in general, including family and friends, which can contribute to their overall well-being and resilience. On the other hand, the negative relationship between educational level and compassion fatigue suggests that individuals with lower levels of education may be more susceptible to experiencing compassion fatigue. This could be attributed to several factors. For instance, individuals with lower levels of education may have limited access to resources and support systems that can help them cope with the emotional demands of their work. They may also have fewer opportunities for professional development and self-care, which can contribute to higher levels of emotional exhaustion.

For Compassion satisfaction, the results showed that marital status had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.132 and a t-value of -2.887, indicating that participants who were not married had lower levels of compassion satisfaction. educational level also had a negative relationship with the outcome variable, with a standardized beta coefficient of − 0.244 and a t-value of -5.043, indicating that participants with lower levels of education had lower levels of compassion satisfaction. This finding is consistent with systematic review and meta-analysis of oncology nurses [ 34 ].

The finding from our study indicates; that educational level has a positive relationship with nurses’ job satisfaction, with a standardized beta coefficient of 0.88. which indicates that participants with a higher level of education status had increased satisfaction with their jobs. On the other hand; experience in a year has a negative relationship with job satisfaction, with a standardized coefficient of -0.094 and a a t-value of -2.74. the finding was in line with study from Ethiopia [ 47 ] and Slovenia [ 34 ].

A study on the impact of broadcasting mistake management culture found that organizations that prioritize the quality of work life (QWL) of their personnel, which can include factors like educational opportunities, tend to have higher job satisfaction levels [ 48 ]. Another study on nursing home residents found that having more choice and control over relocation was associated with higher psychological well-being, which can be related to job satisfaction [ 49 ].

Conclusion and recommendations

The study aimed to assess the levels of professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia. The majority of participants reported a medium level of compassion satisfaction, with a significant proportion experiencing moderate to high levels of compassion fatigue. Although more than half of the participants had moderate to high job satisfaction, there were still low levels of satisfaction. The study also identified predictors for compassion satisfaction and compassion fatigue, such as marital status, education, and experience, providing valuable insights into factors influencing professionals’ well-being. The strong correlation between compassion satisfaction and job satisfaction underscores the interconnectedness of these factors in nursing. Addressing the factors that contribute to satisfaction is essential for promoting the well-being of nurses and ensuring high-quality patient care. The study recommends developing targeted training programs, implementing workplace policies, and designing initiatives to enhance education, experience, and compassion satisfaction.

Strength and limitation

The results of this study provide fresh knowledge and reflect the state of nurse professional quality of life and job satisfaction in tertiary hospitals of central Ethiopia. The sample was taken randomly, which nearly represented the population under the study. However, this study employed a cross-sectional study design and it was not possible to ascertain the temporal relationships between the outcome and explanatory variables.

Data availability

The dataset used and analyzed during the current study will be available from the corresponding author upon reasonable request.

Abbreviations

Compassion Satisfaction

Compassion Fatigue

Professional Quality of Life

Adjusted OD Ratio

Confidence Interval

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Acknowledgements

We would like to say thanks to the supervisors, data collectors, and our study participants for their valuable input. We also would like to give our greatest thanks to Wachemo University, College of Medicine and Health Science, School of Nursing, for providing an opportunity to carry out this study.

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Sentayehu Admasu Saliya, Taye Mezgebu Ashine, Asnakech Zekiwos Heliso, Getachew Ossabo Babore, Bethelhem Birhanu & Awoke Girma Hailu

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Conceptualization: Sentayehu Admasu SaliyaData curation: Sentayehu Admasu Saliya, and Taye Mezgebu Ashine Formal analysis: Sentayehu Admasu Saliya, Taye Mezgebu Ashine, and Asnakech Zekiwos HelisoFunding acquisition: Getachew Ossabo Babore, Bethelhem Birhanu, and Awoke Girma HailuInvestigation: Sentayehu Admasu SaliyaMethodology: Sentayehu Admasu Saliya, Taye Mezgebu Ashine, Asnakech Zekiwos Heliso, Getachew Ossabo Babore, Bethelhem Birhanu, and Awoke Girma HailuValidation: Sentayehu Admasu Saliya, Taye Mezgebu Ashine, Asnakech Zekiwos Heliso, Getachew Ossabo Babore, Bethelhem Birhanu, and Awoke Girma Hailu Visualization Sentayehu Admasu Saliya, Taye Mezgebu Ashine, Asnakech Zekiwos Heliso, Getachew Ossabo Babore, Bethelhem Birhanu, and Awoke Girma HailuWriting – original draft: Sentayehu Admasu SaliyaWriting – review & editing: Sentayehu Admasu Saliya, Taye Mezgebu Ashine, Asnakech Zekiwos Heliso, Getachew Ossabo Babore, Bethelhem Birhanu, and Awoke Girma Hailu.

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Ethical clearance was obtained from the Wachemo University College of Medicine and Health Science, with reference number IRB/172/16. In Ethiopia, we did not ask the National Research Ethics Review Committee (NRERC) to obtain ethical approval/waiver for the following two reasons: (a) This study had no significant risks on study participants as approved by Wachemo University College of Medicine and Health Science, with reference number IRB/172/16; (b) NRERC is primarily focused on providing ethical decisions for clinical trials involving new drugs, experimental research, and studies that require human biological specimens/samples. Instead of NRERC ethical approval, the human resources for health experts at Wachemo.

The University Institutional Review Board (IRB) of the College of Medicine and Health Science reviewed the study protocol and granted permission to conduct the study. Written informed consent was approved by the Wachemo University College of Medicine and Health Science Institutional Review Board. Written informed consent was obtained from all study participants.

To protect participants from risks, the study did not record participants’ names, identification numbers, and names of health facilities where he or she worked. Data were also entered into a computer with unique randomly generated ID numbers given for each study participant. All methods were carried out following relevant guidelines and regulations.

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Saliya, S.A., Ashine, T.M., Heliso, A.Z. et al. Professional quality of life and job satisfaction among nurses working at tertiary hospitals in central Ethiopia. BMC Nurs 23 , 417 (2024). https://doi.org/10.1186/s12912-024-02101-w

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Grace Hall’s journey from National Guard to nursing school

Cincinnatus scholarship empowers military member to pursue uc nursing dreams.

As a dedicated member of the Army National Guard while balancing classes at the University of Cincinnati, Grace Hall has navigated a challenging but rewarding path toward her ultimate goal — a nursing degree.

Her journey, marked by military service and academic excellence, reflects her unwavering commitment to making a difference in the medical field. But it didn’t come easy.

Juggling classes at UC while simultaneously mastering military drill maneuvers with the local National Guard became a balancing act of innovative time management strategies she says wouldn’t have been possible if she hadn’t received the gift of funding.

Hall received the prestigious Cincinnatus Scholarship upon entering UC, which she says played a pivotal role in her academic journey. “Even with the National Guard covering my tuition, the Cincinnatus Scholarship was vital for helping with additional expenses like books, room and board,” Hall explained. “This scholarship was particularly encouraging because I couldn’t receive FAFSA funding due to my parents' salaries.”

The Cincinnatus Scholarship is the cornerstone scholarship program for UC, providing more than $22 million in renewable funding to the brightest and most promising incoming first-year students, including out-of-state students, in all academic disciplines.

Putting what I learn in the classroom into actual practice through co-op and clinical experiences has been my favorite part of nursing school at UC, and is key in better preparing us all for the work force. The Cincinnatus Scholarship allows me to further apply myself in my education, making my National Guard service and academic success possible.

Grace Hall UC nursing student and Army National Guard specialist

Perseverance pays off

Hard for Hall to hold back her excitement after her nursing white coat ceremony. Photo provided

Soon after completing basic training at Fort Jackson, South Carolina, Hall entered her first year at UC in the fall of 2020.

Originally from Greenfield, Indiana, Hall chose UC because of the prestige of the College of Nursing and its close locale during the pandemic when the introduction to university life was unique for most students around the country.

Throughout the academic year, Hall continued her military drills locally in Hamilton, Ohio, while attending mostly online classes.

Between summers spent in out-of-state military training, then continuing drill exercises locally in Lebanon, Ohio, during the academic year, Hall’s dedication paid off by consistently earning a 3.96 GPA and a spot on the Dean’s list each semester.

Radio checks were one of Hall's many duties during her Army National Guard deployment in the Middle East. Photo provided

Hall’s commitment to the National Guard ultimately led to taking a break from her coursework during her third academic year to deploy with her unit overseas in the Middle East where she performed her job in a hostile environment for over nine months. 

Despite these challenges, Hall’s passion for nursing remained steadfast, deeply influenced by her mother, an emergency room nurse for over 20 years.

“Watching my mom as a nurse showed me how rewarding collective accomplishments can be,” Hall shared. “I did an internship at a local hospital during my senior year of high school, and even as a volunteer, I felt a strong connection to my patients. When COVID-19 struck, I felt honored to work in such a critical setting, which affirmed my calling to nursing.”

Balancing act

Surrounded by fellow nursing students during her clinical practice is a highlight of Hall's (front, second from left) nursing program at UC. Photo provided

“The financial support from the Cincinnatus Scholarship allowed me to excel in my National Guard training while fully immersing myself in my education,” Hall declares, describing her clinical experiences as the highlight of her nursing program.

Hall’s ability to balance her training in the National Guard with her academic responsibilities became a testament to her resilience. Using her time wisely during drilling exercise downtime, Hall stayed on top of her nursing studies by making and memorizing flashcards. “Because I had no Wi-Fi on the training base, the flashcards were easy to read and memorize.”

Beyond her academic and military commitments, Hall has been an active participant in UC’s community. She continues to serve as an executive member of CleanUp Cincy and has been a campus coach for UC’s Transition and Access Pathways program since 2021, helping new students transition into university life.

After assisting at Cincinnati Children’s Hospital Emergency Department as a patient care advocate during the summer of 2022, Hall looks forward to her nursing co-op this summer at the University of Cincinnati Medical Center's ICU float pool, providing her with even more invaluable clinical experience.

“Putting what we learn in the classroom into actual practice through co-op and clinical experiences has been my favorite part of nursing school at UC, and is key in preparing us all for the work force,” Hall beams proudly. “The Cincinnatus Scholarship allows me to further apply myself in my education, making my National Guard service and academic success possible.”

Because of Hall’s earlier deployment in the Middle East, her UC graduation has been delayed until spring of 2025, where she will earn her Bachelor of Science in nursing.

Hall was excited to take her first helicopter ride during her deployment in the Middle East and now looks forward to serving as an active-duty nurse in the Army after graduation. Photo provided

Looking ahead, Hall plans to re-enlist in the U.S. Army as an active-duty nurse. She aspires to continue her service, potentially in Germany, and is considering further training to become a nurse practitioner.

Reflecting on her journey, Hall expressed profound gratitude for the opportunities afforded by her experiences at UC. “This scholarship has helped me overcome financial hurdles, allowing me to focus on my studies and passion for nursing,” Hall boasts proudly. “I am excited to continue my career in the Army and look forward to making a significant impact through my work.”

Hall’s story is a powerful example of dedication, resilience and the transformative power of education and support, underscoring the profound impact of collegiate funding like Cincinnatus on students' lives.

Featured image at top: Grace Hall in UC's College of Nursing. Photo/UC Alumni Association

With its focus on innovation and impact,  Next, Now: The Campaign for Cincinnati  is where ambition meets action. At the University of Cincinnati and UC Health, we’re driven by next; thinking bolder and dreaming bigger to create the tomorrow we envision, today. Learn more at  nextnow.uc.edu .

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As a dedicated member of the Army National Guard while balancing classes at the University of Cincinnati, Grace Hall has navigated a challenging but rewarding path toward her ultimate goal — a nursing degree. Her journey, marked by military service and academic excellence, reflects her unwavering commitment to making a difference in the medical field.

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What Are The Fastest-Growing Jobs Of 2024?

Updated: Feb 23, 2024, 8:28am

The current job market might be turbulent at best, but there are still several career paths with strong projected growth trends through 2024 and beyond. In response to fluctuating job markets, job seekers are prioritizing high-growth careers and recession-proof jobs , upskilling to maintain a competitive edge.

Fortunately, some of the fastest-growing jobs in 2024 also offer stability and long-term potential. Whether you’re looking to switch jobs or you’re just launching your career, it’s worth considering these in-demand fields.

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Forbes Advisor’s education editors are committed to producing unbiased rankings and informative articles covering online colleges, tech bootcamps and career paths. Our ranking methodologies use data from the National Center for Education Statistics , education providers, and reputable educational and professional organizations. An advisory board of educators and other subject matter experts reviews and verifies our content to bring you trustworthy, up-to-date information. Advertisers do not influence our rankings or editorial content.

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Fastest-Growing Careers of 2024

We’ve listed eight of the fastest-growing careers of 2024 below, but this list is far from exhaustive. According to the Bureau of Labor Statistics (BLS), other jobs slated for high growth rates include taxi drivers, home health and personal care aides, actuaries, epidemiologists, veterinary support occupations and physical therapist assistants.

Jobs with the highest projected growth rates from 2022 to 2032 include nurse practitioners, data scientists, wind turbine service technicians and physician assistants.

Below are some of the fastest-growing careers in the health, tech and trade sectors.

Fastest-Growing Health Careers

Nurse practitioners.

Growth Rate (2022–32): +38% Median Pay: $125,900 per year Education Requirements: Master’s degree in nursing Career Overview: Nurse practitioners’ responsibilities vary widely depending on their state of licensure, but in general, nurse practitioners provide primary and urgent care services to a diverse array of patients. They work in various medical settings including hospitals, physicians’ offices and clinics.

Nurse practitioners may work independently, but frequent collaboration with physicians is often necessary to ensure patients’ health and wellness. Most states allow nurse practitioners to prescribe medications, diagnose conditions and order medical tests. Some nurse practitioners specialize in areas such as geriatric health, pediatrics or mental health.

Check out our guide on how to become a nurse practitioner .

Medical and Health Services Managers

Growth Rate (2022–32): +28% Median Pay: $104,830 per year Education Requirements: Bachelor’s degree in healthcare administration or a related field Career Overview: Medical and health services managers are responsible for planning, directing and coordinating healthcare providers’ business activities. They usually manage an entire facility, a clinical area or department or a physician group medical practice.

Medical and health service managers wear many hats. Overall, they play a crucial role in ensuring their facilities run smoothly and efficiently. It’s up to these professionals to set departmental goals and objectives and ensure that their staff meets those goals. They also make sure their facilities are up to date with codes and regulations.

These managers recruit and supervise staff, manage facility finances, create work schedules, prepare and monitor budgets and stay in close contact with medical staff and department heads.

Physician Assistants

Growth Rate (2022–32): +78% Median Pay: $126,010 per year Education Requirements: Master’s degree Career Overview: Physician assistants support physicians in examining, diagnosing and treating patients in a variety of healthcare settings, including primary care and family medicine, emergency medicine and psychiatry. Some physician assistants make house calls or visit patients in nursing homes.

Under the supervision of a physician, physician assistants are responsible for educating and counseling patients and their families, prescribing medication, assessing and recording a patient’s healing progress and researching various treatments.

Fastest-Growing Tech Careers

Data scientists.

Growth Rate (2022–32): +35% Median Pay: $103,500 per year Education Requirements: Bachelor’s degree Career Overview: Data scientists extract insights and knowledge from large, complex data sets. They leverage that data to make intelligent, informed decisions to help organizations improve their performance and achieve their goals.

Conducting surveys or scraping the web to collect data is a key component of a data scientist’s job. From there, data scientists clean and classify raw data, using machine learning and data visualization software to demonstrate their findings. It’s paramount that data scientists know how to communicate their findings effectively and in a way that’s accessible to a general audience.

While only a bachelor’s is required to enter the field, these professionals may hold master’s degrees in data science . Some gain discipline-specific training by building on prior academic experience with a data science bootcamp .

Information Security Analysts

Growth Rate (2021-31): +35% Median Pay: $102,600 per year Education Requirements: Bachelor’s degree in cybersecurity or a related field Career Overview: Information security analysts are responsible for ensuring the safety and security of an organization’s sensitive information and computer systems. They rigorously monitor networks for security breaches and investigate any attacks that may occur.

Information security analysts use software like firewalls and data encryption programs to safeguard sensitive assets. They are also responsible for documenting metrics and reporting attempted attacks. Information security analysts recommend security enhancements to management or senior IT staff, and they help other employees gain their footing with new security products and procedures.

Cybersecurity analysts are a type of information security analyst. For more information, check out our guides on information security vs. cybersecurity and how to become a cybersecurity analyst .

Software Developers

Growth Rate (2022-32): +25% Median Pay: $124,200 per year Education Requirements: Bachelor’s degree in computer science or a related field Career Overview: Software developers design and develop software applications to meet a variety of user needs. These professionals may participate in all stages of the development process, from research and ideation to creating models, overseeing development teams, documenting progress, testing and quality assurance. After a product launches, software developers help maintain its functionality through upgrades and bug fixes.

Often working in the computer systems design and software publishing industries, software developers frequently collaborate with clients, programmers, engineers and other professionals such as user experience designers. They also work in sectors such as finance and manufacturing and may create applications for consumer use or proprietary programs tailored to an organization’s internal needs.

Fastest-Growing Trade Careers

Wind turbine service technicians.

Growth Rate (2022–32): +45% Median Pay: $57,320 per year Education Requirements: Professional certificate Career Overview: Also known as wind techs, wind turbine service technicians install, maintain and repair wind turbines. The bulk of their work centers around maintaining wind turbines that have already been built, though these professionals may occasionally install new turbines when needed.

Wind techs inspect the exterior and physical integrity of wind turbines. They test and troubleshoot electrical, mechanical and hydraulic components and systems. They’re also responsible for replacing worn or malfunctioning equipment or components, collecting turbine data and servicing underground transmission systems.

Wind techs must be comfortable working outdoors, in confined spaces and at significant heights.

Solar Photovoltaic Installers

Growth Rate (2022–32): +22% Median Pay: $45,230 per year Education Requirements: High school diploma or equivalent Career Overview: Career Overview: Solar photovoltaic installers assemble, install and maintain photovoltaic (PV) systems that convert sunlight into energy. These systems might be needed in commercial, industrial or residential settings. Some are installed on rooftops; others sprawl on the ground.

Solar photovoltaic installers plan out PV system configurations based on site conditions and their customers’ needs. Once a PV system is installed, the technicians hook it up to the electrical system and apply weather sealant to the equipment exposed to the elements. PV installers then test the system to ensure everything works properly.

Sometimes, installers connect the PV system to the grid, but in other cases, electricians are called in. Solar photovoltaic installers must be comfortable using a variety of power tools on the job, such as drills, wrenches, saws and screwdrivers.

Frequently Asked Questions (FAQs) About the Fastest-Growing Careers

What is the fastest-growing occupation.

Wind turbine service technicians claim the title as the fastest-growing occupation over the decade. The BLS estimates an average growth rate of 45% between 2022 and 2032, which is significantly faster than the national average across other occupations.

What are the five careers that are the fastest-growing?

The five fastest-growing careers are wind turbine service technicians, nurse practitioners, data scientists, statisticians and information security analysts.

What is the number one job that pays the most?

According to the BLS, several types of physicians and surgeons—such as cardiologists, oral and maxillofacial surgeons, radiologists and emergency medicine physicians—were tied for the highest-paid jobs in the U.S. as of 2022. All of these high-earning medical professionals make median annual salaries exceeding $239,000 per year.

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Cecilia is a freelance writer, content marketing strategist and author covering education, technology and energy. She is a current contributor to the Forbes Advisor education vertical and holds a summa cum laude journalism degree from California Polytechnic State University, San Luis Obispo.

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AIIMS BSc Nursing results 2024: Result declared at aiimsexams.ac.in

The aiims bsc nursing 2024 results have been posted on aiimsexams.ac.in by aiims delhi. on june 8 and 9, the aiims bsc nursing exam 2024 was held for female candidates.

AIIMS BSc Nursing results 2024

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First Published: Jun 19 2024 | 3:09 PM IST

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