A critical examination of the U.S. nursing shortage: contributing factors, public policy implications.

BACKGROUND. Despite short-lived periods of adequacy in nurse availability, the nursing shortage has endured. In order to better understand the myriad factors that influence the current shortage of nurses, as well as possible solutions, this project addresses the influence of social factors and government policy on nurse staffing inadequacy. When the government intervenes in a philosophically free-market economy, the assumption is that a problem, such as the current nursing shortage, could not be solved without such intervention. PURPOSE. Nursing care arguably falls into the realm of protecting the common good, and therefore requires government oversight. We provide a critical analysis of policy intervention efforts into the nursing shortage debate by examining the passage of legislation, the provision of educational assistance, and the establishment of minimum staffing requirements and minimum quality standards for reimbursement, which all impact nursing supply and demand. RESULTS. Arguments supporting and opposing policy intervention in general, and its impact on the overall provision of nursing care in the United States, were examined. Without policy incentive to place financial value on the quality of care provided by nurses, a simple increase in the number of available nurses is unlikely to solve the current problem. IMPLICATIONS. Important considerations that should be factored into policy creation include measurement and compensation for quality care, the nature of recruitment efforts of new nurses, and the complex nature of a nursing work.