Introduction
In most countries, the shortage of nurses is a perennial problem although nurses are a
critical link in providing direct patient care. There are currently 29 million nurses and midwives
globally with an estimated demand for one million additional nurses in 2020. Moreover, it is
projected that 11 million additional nurses are needed to curb any future shortages even though
employment opportunities for nurses will steadily grow to 15% by 2026, the fastest of any
profession in the world. A lack of professional educators, inequitable distribution in the
workforce and high employee turnover have been cited as some of the reasons to the shortages.
Aging urban populations and an aging nursing workforce have also put pressure on healthcare
facilities further compounding the problem (Haddad, et al., 2021) .
Challenges facing nursing profession
Many studies in the past have shown a causal relationship between work stress among
nurses and the nursing shortage. In Sri Lanka for instance, the nursing shortage has increased the
workload on nurses thereby directly diminishing the quality of healthcare. (Hellerawa &
Chamaru, 2015) . It has also been evident that nurses suffer burnout and often opt to leave the
profession with a turnover rate of 37%. Majority of nurses are female and often they cut back
from the profession when balancing their career and family. In the midst of the covid-19
pandemic, the nursing profession has seen a decline in mental health among nurses as the
physical and mental toll of their career weighs on their well-being.
England in recent years has experienced a demand for geriatric nurse, or gerontological
nurses. In most European countries, nurses that offer general adult health services form the
largest group of nurses due to a fall in the availability of nurse education spaces. Furthermore,
quality and safety issues and inadequate staffing levels are crippling the capacity of nurses to
deliver quality healthcare services (Halter, et al., 2017) . Job dissatisfaction, stress and leadership
issues have been cited as a direct causes of high turnover and job dissatisfaction among nurses.
On the other hand, mental health professionals are leaving their jobs because of unfair treatment,
incivility and unsafe work environments.
Limited opportunities for career growth opportunities, inappropriate skill matching and
unequal patient-staff ratios impact stress levels as nurses feel unappreciated and disempowered.
Improving nursing retention is a pillar to improving the quality of healthcare and maintaining a
healthy workforce that is responsive to changing healthcare needs. The Global Financial Crisis
and Covid-19 lockdown saw an increased uptake of nursing as a profession in many parts of the
world. On the backdrop of the looming nursing shortage, there is raising concern that a great
workforce of nurses may leave their jobs once the economy improves. Studies in New Zealand
show that 36% of nurses had returned to their professions in the last 5 years due to financial need
and 22.1% intend to leave which will result in a 22.6% loss of the nursing workforce (Moloney,
et al., 2018) .
Work-life balance today for nurses today is a significant barrier to the retention of
registered nurse in the workforce and the quality of care they deliver. The average age of a
registered nurse in Texas is 44 years old, signaling a rapidly aging nursing workforce. In
addition, nurses in managerial positions cited that hospital management has not made provisions
to accommodate nurse over the age of 55. According to gender, females dominate the nursing
workforce at 91% stressing a need to train more men to supplement the dwindling workforce of
adult care givers and mental health care givers. When it comes to pay raises, most nurses deem
them inconsequential and inadequate with regard to their workload. Although many expect
increased education will result with pay raises, it is often not the case for nurses. Salary increases
for nurses usually plateau in spite of more experience or tenure ( Reineck & Furino, 2006) .
Since nurses are responsible for people’s lives they need to perform a perfect job by
completing tasks accurately and correctly. Due to the delicate nature of handling patients, a study
by (Abdollahzadeh, et al., 2017) found out that improving the skills and knowledge of nurses
prevents incivility. Poor communication skills when handling patients also presented a challenge
to nurses in communicating healthcare messages to patients. Mismanagement of hospitals also
shows a lack of leadership skills and officials