Sebastian Junger's1 book, The Perfect Storm, chronicled the disastrous effects of a confluence of major storms in the northeastern Atlantic Ocean. Despite its overuse, the term, "the perfect storm" is an accurate descriptor for the global nursing shortage. A recent report by McKinsey and Company,2 based on surveys of nurses in 7 countries, paints a bleak picture, particularly for the United States, where the percentage of nurses considering leaving direct patient care rose 10 points in the year 2021, now at more than 20%. The US health system is anticipating a shortage of between 200 000 and 450 000 nurses by 2025. The factors driving this storm are a combination of pandemic fatigue, negative work environments including understaffing, the aging of the population demanding more direct nursing care, and the shortage of qualified nursing faculty that necessitates the turning away of nursing applicants. Elements of the McKinsey survey findings were surprising. Key priorities identified by nurses surveyed are workplace safety, flexibility so that better work-life balance is achievable, and healthier work environments; compensation, though important, was not at the top of the list. Nurses surveyed were clear that they need more recognition for their contributions to health care organizations, more open and effective lines of communication, and better support resources including ways to facilitate positive nurse-to-nurse connections.
Ask yourself-what needs to change in your clinical work environment? Heading into this perfect storm, are you willing to rock the boat, to steer it in a new direction, to cast your message so that managers and administrators, whether open to listening or not, hear from nurses exactly what needs to change? Will you set expectations that administrators become nurse advocates and managers serve as mentors? Such efforts will improve practice environments and have a positive cascading effect on care outcomes.
Remember the last scene in The Perfect Storm? The fishing boat is heading into a massive wave-the question is, can the crew guide the boat to ride over the top and get to calmer waters on the other side or will it succumb to the crashing water? It is up to all of us.
-Gloria F. Donnelly, PhD, RN, FAAN, FCPP
Editor in Chief
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