Nursing Shortage and Its Ethical and Cultural Factors


Nursing shortage is a major problem for different countries worldwide. Most developed economies have a rapidly aging population that will require increased attention in a few years. Nurses would also reduce significantly in these countries leading to a domino effect where fewer trainers will result in limited education capacity. Countries must incorporate immigrants and expatriates nursing staff to avoid the impending shortage. However, this is difficult because people are less inclined to work far from home. The problem is worse in societies with racial discrimination as the rising demand for nurses makes countries desperate for workers. Hospitals and other medical institutions opt to entice nursing personnel using tuition fees and other perks that would justify moving to new countries for these experts. Monetary, political, and power structures should focus on developing a hospitable environment for expatriates and immigrants as they are the best solution to avoid nursing shortage.

Introduction: Ethical Perspective of Inquiry

Nursing shortage has led to higher costs in the healthcare industry. Hospitals have boosted their spending in the US, incurring billions of dollars to recruit and retain nurses. In this case, they are offering higher salaries, repaying student loans, and signing bonuses to deal with a rising nursing shortage within the country. It is vital to note US society’s transition as baby boomers reach retirement age. These individuals require consistent and constant healthcare services. It is crucial to determine how do money, power, and control matters relate to the issue and its treatment? Further understanding the question: Which cultures or societies are most affected by the issue? Why?

How Do Money, Power, and Control Matters Relate to The Issue and Its Treatment?

While hospitals have experienced nursing shortages in the past, the current problem is more challenging to deal with. The agency determines that registered nurses’ openings will rise by more than one million by 2024 (MacDonald, 2017). Ron Moore, the former Charleston Area Medical Center’s chief nursing officer, and vice president claims he has not seen a more dire situation since his integration into the field 40 years ago. Ron’s former employer reimburses nurses’ tuition if they stay with the institution for two years. Therefore, medical institutions are using more revenues to attract nurses.

Political issues have increased the potential for nursing shortages immensely. The current political position in the US has resulted in significant delays in providing visas. This problem is continually compounded by rising nationalistic politicians that fuel resentment toward expatriates. As a result, the US is currently facing issues concerning proposed legislation integrating 8,000 international nurses into the country’s economy (MacDonald, 2017). The US would boost its nursing personnel and alleviate shortages. However, current anti-immigration policies protected by politicians have reduced the public’s faith in the government to protect them. Political division has accelerated nursing shortages across the US.

Furthermore, some hospitals are using travel nurses to reduce staffing shortages. For instance, healthcare institutions accrued costs reaching $4.8 billion in 2017 as payment for traveling nurses. These costs have skewed effects on hospitals in rural areas, such as J.W. Ruby Memorial Hospital in West Virginia, which incurred more than $10 million in 2017 in its hiring strategy (MacDonald, 2017). The hospital provided a $10,000 signing bonus and free accommodation for nurses living 60 miles away from the institution. Additionally, the hospital offers college tuition for these individuals’ family members to promote nurse retention (MacDonald, 2017). Many hospitals use J.W. Ruby Memorial Hospital’s design to prepare for a likely nursing shortage. In this way, many institutions have chosen to develop a succession plan while hoping existing nurses opt for delayed retirement if they can reduce their working hours and adopt new roles.

Employee job satisfaction is a significant consideration for nurses working in different countries and depends on working conditions such as organizational atmosphere and culture (Faramarzpour et al., 2021). Hospitals further consider the ethical environment’s effects on decision-making and a nurse’s communication with patients and their families. These institutions should connect job satisfaction with nurses’ positive emotions when determining their working situation. They must note the ethical climate’s role in ensuring employees have a positive working environment regardless of their demographic. In this way, ethical working situations are necessary to eliminate the medical staff shortage in different countries (Faramarzpour et al., 2021). Nursing is a tedious role that takes its toll on a person’s body and mind; a nurse is unlikely to move to a country with discriminatory practices.

Nursing involves complex work and poses a significant health risk to individuals in the field. This hard work further determines the extent to which the nursing field faces shortages in current societies. Boosting a person’s living and working conditions significantly increases adherence to ethics and limit the potential of developing psychological stress and injury (Tei-Tominaga & Nakanishi, 2018). An ethical environment would eliminate risks and improve the working conditions for employees. This would contribute to a significant reduction in nursing shortages. Personnel turnover and an unfavorable working environment can boost this figure and mandate employees to necessitate compensation from their medical institution (Tei-Tominaga & Nakanishi, 2018). Therefore, higher compensation results from incurring significant health risks for nursing employees.

Which Cultures or Societies Are Most Affected by The Issue? Why?

Employers rarely pay attention to how their new worker will adapt to the new environment or the support offered that play a role in determining whether they will stay or quit work (Pressley et al., 2022). As these workers leave their homes and attachment to the native culture, they must adapt to varying societies with foreign cultures. Acceptance and support play a prominent role in integrating these people seamlessly into society (Pressley et al., 2022). Discrimination and racism are major barriers to expatriate nurses adapting to a different place and affect a person’s decision to stay or leave work.

Most developed countries have few childbirths, and a large aging population as the baby boomer generation gradually joins the list of people that need constant healthcare services. For instance, the United States is experiencing a novel problem as it elicits a higher population of people over 65 years old than ever. The last of this generation will have retired by 2029, raising the number of people 65 years or older by 73% (Haddad et al., 2022). This number is consistently rising in such countries as the US had 41 million in 2011 and 71 million retirees in 2019 (Haddad et al., 2022). As the country undergoes a shift, it will have a greater need for healthcare services. It is prudent to note the elderly frequently experience more than one morbidity and diagnosis, which necessitate ongoing treatment. Better living standards and treatment processes mean such countries have a population that survives longer, necessitating higher health services use. Various terminal disease processes have gained treatment as time progresses. Caring for individuals with such long-term ailments would strain nurses.

Furthermore, the nursing population exhibits a similar trend as the workforce is part of society and aging. The US currently estimates the number of registered nurses over 50 years at one million (Haddad et al., 2022). This would leave the United States in a predicament as almost one-third of its nursing workforce is set to retire within the next ten to fifteen years. These values account for nurse faculty, an issue that would elicit its unique problem as the country would have fewer resources to train nurses. An aging nurse population in faculties limits countries’ potential enrolments and reduces the nurses’ number that a particular nursing school can produce (Haddad et al., 2022). A limited and decreased faculty would shrink the number of students across the country while simultaneously lowering the overall quality of programs and classes.

Finally, it is prudent to consider that an increased number of patients would induce constant nurse burnout. Various nurses graduate and join the workforce for a certain period before determining the nursing profession is not what they sought and quit to work in other industries. Some individuals may work for a certain period and experience severe burnout where they leave the nursing profession. Turnover rates have been rising steadily for years, though recent statistics indicate that this trend is leveling off (Haddad et al., 2022). It is prudent to assume the rising cost in hospitals to retain nurses plays a part in this changing position. Nonetheless, this is a problem, as indicated in the earlier section.


Nursing research indicates that ethics and culture are vital to dealing with increasing nursing shortages. The ethical climate in the medical institution reduces risks to employees’ physical and mental health and contributes to increased job satisfaction. The cultural aspect is becoming increasingly important as employers attract nurses from other countries. Such employees need support in adapting to new cultural conditions. However, they face discrimination, which becomes a significant barrier to retention. Money, politics, and power determine a medical institution’s capacity to attract and retain nursing staff. It is essential to consider the aging population affects nurses’ population significantly as they would have more retirees to deal with and a smaller staff. Expatriation and respect for other people’s cultures are essential to deal with the impending nursing shortage crisis.


Faramarzpour, M., Farokhzadian, J., Tirgari, B., Shahrbabaki, P. M., Borhani, F., & Rafati, F. (2021). Nurses’ perceptions of hospital ethical climate and their job satisfaction. Ethics, Medicine and Public Health, 18, 1-8.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing Shortage. StatPearls Publishing LLC.

MacDonald, I. (2017). The financial impact of the nationwide nursing shortage: Hospitals pay billions to recruit and retain nurses. Fierce Healthcare.

Pressley, C., Newton, D., Garside, J., Simkhada, P., & Simkhada, B. (2022). Global migration and factors that support acculturation and retention of international nurses: A systematic review. International Journal of Nursing Studies Advances, 4, 1-16.

Tei-Tominaga, M., & Nakanishi, M. (2018). The influence of supportive and ethical work environments on work-related accidents, injuries, and severe psychological distress among hospital nurses. International Journal of Environmental Research and Public Health, 15(2), 1-13.

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