Why the Current Approach to Solving the Nursing Shortage Is Missing the Mark – And What Needs to Change

As someone who frequently listens to startup pitches, I’ve noticed a common theme when it comes to solving the nursing shortage in hospitals and healthcare organizations. Most startups propose scheduling systems designed to improve nurse work-life balance or tweak how shifts are distributed. It all sounds great on paper. But let me be clear: while well-intentioned, these solutions barely scratch the surface of the real issue.

The reality is that the nursing shortage is far more complex than just improving shift schedules. Startups are attempting to solve a deep-rooted, systemic problem with surface-level fixes. And that simply won’t work. The nursing shortage is a multifaceted challenge driven by factors like burnout, career advancement, and the pressures of private equity in healthcare. Without addressing these root causes, no scheduling system, no matter how well-designed, will fix the problem.

Let me break it down.

The Real Reasons Behind the Nursing Shortage

The shortage in nursing is not just about overbooked schedules; it runs deeper:

1. The Private Equity Impact: In recent years, private equity firms have made a significant push into healthcare. The result? Nurses are expected to do more with less—fewer staff, higher patient ratios, and limited resources. This isn’t just about shifts; it’s about the overwhelming expectations placed on nurses. Until we address this demand for increased productivity with decreased support, nurses will continue to leave the field.

2. Burnout: The word "burnout" is thrown around a lot, but for nurses, it's not just a buzzword—it's a reality. Nurses are physically and emotionally exhausted. They work long hours, face high-stress environments, and often don’t have the time or support needed to recharge. Burnout isn’t just about needing a better schedule; it's about fundamentally rethinking how we support nurses in their day-to-day work.

3. Career Advancement: Nursing is a profession with growth potential, but that also means many nurses leave the bedside to move into administrative roles, promotions, or even entrepreneurship. While it’s great that nurses have opportunities to advance, it leaves a gap in the workforce. We simply don’t have enough new nurses coming in to replace those who are leaving.

If we want to solve this problem, we need to think bigger.

Current Solutions Don’t Address the Root of the Problem

I’m empathetic to the entrepreneurs trying to solve this issue—many of them are incredibly passionate about improving healthcare. But focusing on nurse schedules alone won’t cut it. Improving work-life balance is important, but it's a Band-Aid on a much bigger wound.

What many of these startups fail to realize is that nurses aren’t just leaving because of bad schedules. They’re leaving because they’re overwhelmed, burnt out, and unsupported. If we want to keep nurses at the bedside, we need solutions that go beyond shift preferences. We need systems that actually reduce the burden on nurses.

One big issue I see in some of these scheduling solutions is that they inadvertently promote bias and inequality. For example, giving more desirable shifts to a select group of nurses may seem fair, but it can create resentment and lead to more nurses leaving the profession. We need solutions that lift everyone up, not just a few, and you can't give every nurse an optimal schedule. Who would work the graveyard shift?

So, what does a real solution look like? It needs to address several key areas:

1. Automate Routine Tasks: One of the biggest opportunities is developing full-time equivalent (FTE) innovations—technology that can automate some of the routine tasks nurses handle. These tasks take nurses away from the bedside, from administrative paperwork to routine patient monitoring. Startups should focus on creating tools that free up nurses’ time so they can focus on what really matters: patient care.

2. Support Systems for Mental Health and Burnout: Solutions that provide better mental health support for nurses are critical. We need more programs focusing on nurses well-being, helping them manage stress and prevent burnout before it starts.

3. Address the Private Equity Influence: This is a tough but essential one. We need healthcare models that push back against private equity’s drive for higher productivity with fewer resources. Whether through advocacy, policy change, or rethinking how care is delivered, startups can’t ignore this pressure. Solving the nurse shortage means addressing the systemic factors that make the profession untenable for so many.

4. Equal Opportunities for All Nurses: The solution must also ensure that all nurses have the same opportunities for advancement, training, and the best shifts without passion or prejudice. Any tool that promotes bias in shift assignments is destined to fail.

A Tech-Driven Approach

If you’re an entrepreneur, now is the time to think bigger. AI, machine learning, and automation are your friends here. There’s a huge opportunity to develop AI-driven systems that can predict nurse workloads, redistribute tasks, and even provide real-time support for nurses. Imagine a tool that could analyze nurse workloads and automatically assign specific tasks to technology, allowing nurses to focus on more critical care needs.

For example, here’s a basic approach for an AI-assisted staffing model in Python:

```python

import pandas as pd

import numpy as np

# Sample nurse data with current hours worked and tasks

nurses = pd.DataFrame({

'nurse_id': [1, 2, 3, 4],

'hours_worked': [30, 35, 28, 32],

'tasks': [12, 15, 10, 14]

})

# Set the ideal working hours and max number of tasks a nurse should handle

ideal_hours = 32

max_tasks = 12

# Calculate workload factor: A measure of how much a nurse is over/under the ideal workload

nurses['workload_factor'] = (nurses['hours_worked'] / ideal_hours) + (nurses['tasks'] / max_tasks)

# Assign additional support to nurses based on workload factor

def assign_support(row):

if row['workload_factor'] > 2:

return 'High Support Needed'

elif row['workload_factor'] > 1.5:

return 'Moderate Support Needed'

else:

return 'Low Support Needed'

nurses['support_level'] = nurses.apply(assign_support, axis=1)

# Print final assignment

print(nurses[['nurse_id', 'workload_factor', 'support_level']])

```

This simple model calculates the workload factor for each nurse and assigns a level of support based on their current load. This model can be expanded and refined to include real-time data and machine learning algorithms that predict future nurse workloads and automatically allocate resources where needed.

Here's the thing . . .,

Startups and entrepreneurs: if you genuinely want to solve the nursing shortage, it’s time to go beyond scheduling solutions. Nurses need more than just better shifts—they need systemic change that reduces their workload, supports their mental health, and creates a more equitable work environment.

The solutions we imagine often miss the real issues. The ultimate solution requires rethinking how we approach staffing, making full use of technology to support nurses in meaningful ways, and addressing the deeper, systemic factors driving nurses out of the profession. Until we do that, we’ll keep seeing the same results: overworked nurses, burnout, and a growing shortage that no scheduling system can solve.

Let me know your thoughts. What novel approaches are needed to solve the nursing crisis? Comment on this article and share it with your nursing friends.