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The ongoing nursing shortage poses a threat to the healthcare system at large, which is at “urgent crossroads,” according to a study published Thursday by the National Council of State Boards of Nursing.

Since the start of the pandemic, according to the group, 100,000 RNs have left the nursing profession, and by 2027, almost 900,000 more RNs are expected to leave the workforce. Licensed practical/vocational nurses, who generally work in long-term care settings, have lost 33,811 of their peers since the beginning of the pandemic, according to the research.

The study analyzed a subset of the 2022 National Nursing Workforce Study and included 29,472 registered nurses and 24,061 LPNs/LVNs across 45 states. Reported trends represent population-based estimates.

“The data is clear: The future of nursing and of the US healthcare ecosystem is at an urgent crossroads,” Maryann Alexander, PhD, chief officer of nursing regulation at NCSBN, said in a statement. “The pandemic has stressed nurses to leave the workforce and has expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately.

Stress and burnout have driven an exodus of nurses during the COVID-19 pandemic, according to the study results. Sixty-two percent of the nurses sampled noted an increase in their workload during the pandemic. One fourth to one half of nurses reported feeling emotionally drained (50.8%), used up (56.4%), fatigued (49.7%), burned out (45.1%) or at the end of the rope (29.4%) “a few times a week” or “every day.” The effects of burnout were more pronounced among workers with 10 or fewer years of experience. 

Not only have RNs left in great numbers, Alexander said, but stress and burnout have “expedited an intent to leave in the near future, which will become a greater crisis and threaten patient populations if solutions are not enacted immediately.”

Some contributing factors existed before the pandemic, the researchers noted. They said, however, that current data “has identified unprecedented levels of stress and burnout among the key factors driving high rates of projected turnover.”

The projections are not impossible to change, according to the authors, who said that policymakers could influence the fate of the profession.

“There is an urgent opportunity today for healthcare systems, policymakers, regulators and academic leaders to coalesce and enact solutions that will spur positive systemic evolution to address these challenges and maximize patient protection in care into the future,” Alexander said.