Currently, there is a nursing shortage worldwide. There are many reasons for this shortage, including an aging population, many nurses approaching retirement age, rural areas struggling to employ enough nursing staff and the after-effects of the COVID-19 pandemic. These factors have increased the demand for nurses in the state of Missouri and across America. To mitigate this situation, new nursing students must train and enter the profession.
There are many reasons why people choose to enter the nursing profession. One reason is job security – the demand for nurses is consistently high and expected to grow. This means that numerous job opportunities are available, and the chances of finding employment as a nurse are very good. There is also variety in the settings that nurses can work in, such as hospitals, clinics, nursing homes, schools, and government agencies. This allows for a lot of flexibility in finding an appropriate work environment. There are many opportunities for career advancement, and nurses typically earn good salaries.
Career progress in nursing
The current nursing shortage does have a positive side as there are many career opportunities in nursing, and this is an ideal time to start on this career path. The healthcare sector is seen as recession-proof, potentially providing long-term job security. There are many choices for employment, particularly for nurses with bachelor’s degrees or higher, especially in states where demand is greatest.
As the nursing shortage increases, there will be many opportunities within the changing healthcare landscape. There are plenty of employment opportunities for anyone interested in being a nurse in Missouri. The number of nurses in this state has been projected to grow at more than double the national growth rate.
The 2022 Missouri Nursing Workforce Report
The 2022 Missouri Nursing Workforce Report provides insight into the current condition of nursing in Missouri and how nursing impacts healthcare needs. This comprehensive report on the nursing workforce includes information on age, gender, county distribution, employment settings, and more. The report was produced to support policymakers in healthcare, government, and education with the aim to improve access and quality of healthcare for Missourians. Reliable data is required to plan and assess healthcare. The information can be used to address nurse shortages and the uneven distribution of healthcare professionals.
The shortage of nurses is a concern, with many nurses approaching retirement. In Missouri, many nurses are aged 54 years or older. 10.1% of employed registered nurses are of retirement age (65 or over), and 19.2% are nearing retirement age (55-64). The percentage of nurses aged 55 or older in Worth County and Knox County, both rural counties, is 58%. These counties will need more nurses soon when nurses retire. Hospitals have 21% of nurses who are 55 years or older, but occupational health and schools of nursing have 50.3%.
The state of Missouri has a rate of 150 nurses per 10,000 residents. The distribution of nurses across the state reflects population density patterns and the location of medical facilities. As a result, the number and rate of nurses in rural areas is low compared to metropolitan and micropolitan areas. 86% of registered nurses (RNs) and advanced practice registered nurses (APRNs) work in metropolitan counties, with only 5.3% employed in rural counties. There are more licensed practical nurses (LPNs) in these areas, with 17.7% in micropolitan counties and 13.8% in rural counties. This is partly due to the number of nursing homes, assisted living, or extended care facilities in rural counties, where one-third of LPNs are employed. There is concern over the high number of nurses aged 55 and over and nearing retirement. Across counties, 22.7% of APRNs, 28.1% of LPNs, and 28.5% of RNs are in this group.
Like most of the country, Missouri faces challenges in rural areas with the demands for healthcare services. A greater number of nurses live in rural areas than work in them. Most employed nurses who live in Missouri work there. The low number of nurses employed in rural counties often corresponds to the low number of healthcare facilities, including hospitals and urgent care.
The Missouri State Board of Nursing has expanded the state’s nursing programs to allow more students to enter the nursing profession and reduce nursing vacancies. There has been a proposal to allow younger people to enter nursing so that new nurses can replace those leaving.
Focus on recruiting new nurses is essential. Higher education institutes can help by directing graduate nurses to hospitals with shortages. Universities and nursing schools can partner with community colleges in rural areas. They can support healthcare provision to underserved communities and provide more educational and employment opportunities to nursing students in the places where it is most needed. The overall goal in Missouri is to give everyone the healthcare they need, regardless of where they live.
An aging population
America has a larger population over 65 years old than ever before, comprised mainly of baby boomers (those born between 1946 and 1964). The increase in average life expectancy has been caused by better living conditions, proactive prevention of diseases, decreasing infant mortality rates, and more access to medication and healthcare services. The healthcare system is changing as the baby boomer generation is aging. The impact of this aging population on nursing will be considerable, and more nurses must be recruited to meet the demand and contribute to running the healthcare system.
By 2030, one in five Americans will be of retirement age, and this will mean a major increase in the demand for nurses. The aging population will mean more demand for doctors, nurses, and other healthcare workers who specialize in caring for older adults. Nurses with knowledge, skills, and experience in home and hospice health, gerontologic nursing, and long-term care will be sought after. Nurses specializing in chronic conditions, such as diabetes, will be in high demand.
Some changes due to aging are common, such as high blood pressure, a weakened immune system, muscle weakness, or a minor decline in hearing and vision. However, some health problems are not seen as part of the normal aging process. Chronic conditions affecting kidney function, causing cognitive impairment, or negatively affecting the quality of life must be treated with geriatric medicine.
Older adults are more likely to develop age-related diseases. Issues such as ischemic heart disease, urinary incontinence, vascular dementia, cardiovascular disease, multiple sclerosis, and other diseases are much more common among older adults. The most common chronic diseases experienced by older adults are:
- Chronic kidney disease
- Osteoporosis
- Stroke
- Diabetes
- Dementia, Alzheimer’s, and Parkinson’s
- Cancer
- Arthritis
- Chronic obstructive pulmonary disease
With the aging population and increased chronic health conditions, more nurses will be needed to provide healthcare, including long-term care or other geriatric nursing environments.
Nursing in rural areas
Throughout the US, rural areas struggle to meet the demand for healthcare services. The population can have more healthcare needs in these areas than in urban areas. Rural populations tend to have more chronic illnesses, so there is more demand. There are more elderly residents who usually require more care. Rural residents are generally poorer and may avoid seeking care because of the cost. Maintaining the healthcare workforce is crucial in providing access to quality healthcare in rural areas. Rural healthcare facilities must have enough staff to meet community needs. The COVID-19 pandemic has exacerbated shortages, leading to high turnover and staff burnout.
Geographical disparities are the main reason why there are nursing shortages in rural counties. Nursing graduates who have attended college in urban areas often stay in those areas when looking for work.
It can be difficult to attract nurses to work in rural areas if they are not already from there. To address this, hospitals and health organizations are looking for strategies to recruit and retain nurses who will suit working in a rural environment. Residents in these areas are typically underserved, and rural nursing can be rewarding to nurses who want to provide individualized care to people who need it.
If nurses do their residency in rural areas, they may find it rewarding to live and work in a rural community. This can be a way to attract more nurses to the rural areas. Rural health stakeholders are also looking at how they can attract nurses who already have ties to rural communities. Distance learning can allow more rural residents to pursue nursing training while still living in their community.
Rural counties in Missouri have lower numbers of nurses per number of residents compared to metropolitan and micropolitan counties. There are a high number of older nurses working in rural counties. Rural nurses have close connections with their communities and often work with a lot of independence and autonomy. The patient population ranges from infants to older people, and nurses have a depth of clinical skills and wide experience. These nurses work with a wider scope of illness and injury, and the wealth of skills they develop makes promotion quite accessible. Nurses often make home visits – rural nursing is about bringing healthcare to the people.
The COVID-19 pandemic
The COVID-19 pandemic put a huge strain on healthcare systems. While the public lauded nurses for their work at this time, it will take health services time to recover from the repercussions. Due to the pandemic, there were numerous early retirements. Elective surgeries were stopped, and patients avoided going to hospitals. As a result, many hospitals put their employees on furlough, and many nurses decided to retire who would not have done so otherwise.
Numerous nursing students decided to take a gap year and delay entry into college until the pandemic was over. This affected the number of students starting nursing programs. Universities had to quickly change how they delivered programs and introduced online learning. Universities reported that many of their students did not have suitable environments for distance learning, with some having problems getting access to the Internet.
For those looking to pursue a career as a nurse, studying for a Bachelor of Science in Nursing (BSN) or an accelerated BSN (ABSN) will mean that you have a respected qualification that employers demand. Rockhurst University offers a BSN, which is the preferred degree for nurses in the US. There is also an ABSN for students with bachelor’s degrees in other fields. Once you have completed one of these nurse practitioner programs, Missouri is a great place to work – you can read more about how to become a nurse in Missouri on Rockhurst University’s blog.
Below, we discuss these degrees in more detail.
Bachelor of Science in Nursing (BSN)
This is a four-year undergraduate degree program that prepares students to become RNs. It consists of two years of preliminary courses and general education followed by two years of nursing classes and clinical rotations. There is the opportunity to practice in specialist areas and develop the knowledge and critical thinking skills required for managerial roles. Many healthcare facilities have started to require RNs to have a BSN degree. The BSN is a highly respected qualification because it provides more advanced nursing preparation and education.
Online BSN programs offer a convenient and flexible route to becoming a nurse. The courses completed online can be less expensive and take less time than programs run in a traditional classroom setting. Online nursing schools allow for enrollment in the most affordable school without relocating. Having a BSN is also a requirement for specialization in the Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), Clinical Nurse Specialist (CNS), and Nurse Practitioner (NP).
The BSN has prerequisite course requirements, such as introductory biology, chemistry, anatomy, and physiology classes. The BSN curriculum consists of various nursing courses, including Assessment of health and illness, research in nursing, community health nursing, and leadership and Management.
Students also gain practical experience through clinical rotations in various healthcare settings, such as clinics, hospitals, and nursing homes. They work with patients, other healthcare professionals, and clinical mentors. Placement opportunities include oncology, ICU, coronary care, operating rooms, district nursing, medical and surgical wards, integrated community teams, and GP practice nursing.
BSN programs focus on the student’s development, ability to think critically, and leadership skills. There is emphasis placed on the importance of evidence-based practice, patient safety, quality improvement, cultural sensitivity, and diversity. Graduates of the program are eligible to take the NCLEX-RN to become licensed RN. BSN graduates can work in various healthcare settings, such as clinics, hospitals, schools, nursing homes, and government agencies. They can continue their education and pursue advanced practice roles such as NP.
Accelerated Bachelor of Science in Nursing (ABSN)
This program is for those with a bachelor’s degree in another subject who want to train as a nurse. The ABSN is shorter than the BSN, lasting 12 to 18 months, in contrast to the traditional four years. The course includes nursing subjects shortened to adapt to the faster pace of the program. Many accelerated programs require applicants to have already completed some studies, such as statistics and microbiology.
There are online ABSN programs that can be preferable for those who work or have other responsibilities and want to enter the nursing profession, as coursework can be completed online. Online programs take a similar length of time as classroom-based programs to complete (between 11 and 18 months). Students will have to attend clinical settings and some campus meetings.
The entrance exam covers math, science, English, and reading. Resources are available to help students prepare. Accelerated programs often require core prerequisite courses. The subjects tend to be physiology, microbiology, chemistry, and anatomy. The accelerated program concentrates on science-based subjects. There is work experience in healthcare settings such as hospitals or nursing homes and practical teaching in laboratories.
Many accelerated programs require several core prerequisite courses. Common subjects include microbiology, statistics, anatomy, and physiology. Students must earn a minimum grade of C in these courses, and the school can require that they were taken within the last five to 10 years.
Below is an example of the courses studied in the accelerated program:
- Family health, clinical, and community health.
- Pharmacology, mental health, surgical, geriatric, and clinical.
- Foundations of clinical nursing, research, laboratory, and pathophysiology.
- Leadership, advanced clinical, and ethics.
This program is more intensive than the traditional BSN program. This makes it only suitable for some students. It requires commitment and effective time management. The BSN provides opportunities for higher pay, promotion, and training for specialist work. The teaching and practical experience should prepare students to pass the NCLEX-RN and become an RN.
Conclusion
The shortage of nurses has been caused by many factors, including the aging population, the number of nurses approaching retirement, the struggle to employ enough nurses in rural areas and the consequences of the COVID-19 pandemic. States such as Missouri are working to ensure that they have more nurses by training more students and improving nurse numbers in rural counties. There are numerous opportunities for nurses, such as promotion and specialization. Students who complete the BSN or ABSN can have a rewarding and successful career ahead of them.
