How a Learning Culture Can Shore Up Hospitals Against Risks of Nursing Shortage
By Gigi Acevedo-Parker
The nursing shortage is at crisis levels, forcing actions by providers that promise worrisome safety and quality consequences for their organizations and the communities they serve.
The persistent shortage of registered nurses is expected to tally up to 193,000 open jobs annually through 2032. Combined with other factors, like lack of demand for some services and anticipated Medicaid funding cuts, many providers have closed departments and curtailed services.
Obstetrics departments and related services are among the first to go. Intermountain Health, for example, closed its Grand Junction, Colo. birth center in March 2025, while Los Robles Regional Medical Center in Thousand Oaks, Calif., closed its pediatrics unit in July. But other services are also being hit: Northwest Community Hospital (Arlington Heights, Ill.) eliminated in-patient behavioral health services, while Yale New Haven (Conn.) Health ended a visiting nurse program serving low-income mothers.
Causes of the shortfall are well-known and much discussed: Burnout, when work is intense, demanding and sometimes dangerous. Flagging pay and benefits, in some cases. An aging nurse population with fewer trained replacements available.
Meanwhile, the shortage of all medical professionals continues to affect healthcare quality in the U.S. We spend almost twice as much on healthcare as comparable nations, yet our health outcome quality measures are deteriorating. Premature death rates are higher. Post-operative complications are more common. Rates of medication and treatment errors are higher.
There’s no single or quick fix. But the sector is ramping up initiatives to help relieve the pressure. A critical focal point is education. But related efforts must be thoroughly weighed to counter the downside risks.
The good and bad of accelerated nursing programs
The emphasis on nursing education in the context of today’s conditions is to make it more accessible, more flexible, more affordable and quicker to complete—in as little as 15 months. In 2024, U.S. schools offered 330 accelerated baccalaureate (ABSN) and 104 entry-level masters programs in nursing, with 20 ABSN and 16 masters being planned.
It stands to provide more warm bodies. But provider organizations must anticipate and manage the risk of new workers, fresh out of accelerated programs, who were able to pass their educational requirements and even have a license. But it’s unlikely they have the experience to provide skilled patient care, from decision-making and assessments to effective treatment options.
And without that seasoning, insufficient nursing has been shown to create many safety risks, like mistreatment, errors and delayed care. New nurses, for example, are involved in over half of medical errors. Another study showed care by nurses with limited experience increased in-hospital mortality risk by a factor of 1.05 for patients with comorbidities.
The need for learning culture
There is no single way, of course, to manage all the risks of the shortage of healthcare professionals. What all new healthcare practitioners—not just nurses—need is a supportive environment built on a foundation of learning and teamwork.
Over the long term, making learning a key underpinning of the organization’s values pays off any number of ways, making it more competitive and resilient and less vulnerable to risk. A learning culture is important for creating a quality employee experience that enhances recruitment and retention and ultimately optimizes quality patient care. Employees are more engaged in this type of environment because it reinforces their sense of value.
Here are three considerations for making this shift:
- Ramp up training. Offset the risk of less-skilled/less-experienced healthcare workers asked to provide higher-skill care by providing more in-house, continuous training opportunities. This improves their understanding of how to do the work better, safer, more effectively, and efficiently, and will also create more staff satisfaction.
- Vary the training. It’s not just consistent basic training that’s important. Additional training (for professional staff of all skill levels) on big care risks in the hospital environment have tremendous value. Refreshers on avoiding medication errors and vigilance about medication administration’s “five rights” are essential. So is remedial training on hospital-acquired infections. Protocols for managing the risk of workplace violence is another area of focus.
- Team up. A team approach, led by the most experienced leaders on the nursing staff, is key to a successful learning and working environment. This takes strong management and collaborative support. Mentorships should also be encouraged.
A nurse I know of is just now retiring from direct care at the age of 85. She has continued to do one or two 12-hour shifts during the week, not just because she loves patient care but because she loves her team. She feels her knowledge and skills remain relevant because her employer’s learning environment keeps her on top of new equipment and new methodologies.
It’s a smart organization that creates the sort of environment where health professionals who are physically and mentally able and want to work are equipped with the support they need to do so.
Gigi Acevedo-Parker is National Practice Leader – Clinical Risk Management, for global insurance brokerage Hub International.