Nursing Workforce

The nursing workforce constitutes the largest segment of most healthcare systems and underpins patient safety, care quality and service continuity. Supply is determined by the capacity of education programmes, retention of experienced practitioners and patterns of in- and out-migration, while demand derives from population ageing, growing chronic disease burdens and evolving care models. Chronic imbalances lead to shortages in acute, community and long-term care settings, with rural and deprived areas most affected by maldistribution. Key drivers of turnover include excessive workloads, limited decision latitude and poor organisational support. Conversely, protective factors encompass transformational leadership, peer cohesion and opportunities for professional development. The global trend towards person-centred and team-based care amplifies the need for a resilient, adaptable nursing cohort with advanced clinical and coordination skills. Technological innovations and shifting payment models further reshape role expectations, calling for continuous curriculum renewal and workplace redesign. Sustaining a fit-for-purpose workforce therefore demands integrated strategies: expanding training pipelines, optimising deployment to high-need zones, enhancing practice environments and embedding career pathways that foster both clinical excellence and leadership capacity.

Research from Nature Portfolio

A large European cross-sector survey of physicians and nurses revealed that turnover intentions vary by role, with nearly 14% of nurses considering leaving the profession and 9% leaving their employing hospital. Analysis based on the Job Demands–Resources model identified depersonalisation and job dissatisfaction as direct determinants of intent to leave, while work engagement mitigated departure risk. The study underscores that targeting job satisfaction and promoting positive work climates can reduce attrition pressure among nursing staff.

Research from all publishers

A systematic review of hospital nursing shortages highlighted multifactorial barriers to workforce stability, including inflexible policies, insufficient training capacity and organisational constraints such as inadequate staffing ratios and weak managerial support. The authors called for policy reform to address recruitment, retention and resource allocation in tandem.

An integrative review of reviews applied the Job Demands–Resources framework to nursing, identifying work overload, lack of formal recognition and work–life conflict as primary demands, and transformational leadership, autonomy and collegial support as key resources. Evidence indicated that strengthening job resources can buffer the negative impact of high demands on burnout and turnover intention.

A longitudinal study of registered nurses developed an age-moderated mediation model demonstrating that emotional, quantitative and physical job demands increase perceived effort, whereas quality leadership, developmental opportunities and social support enhance the meaning of work. Burnout emerged as a mediator between these factors and turnover intentions, with effort–reward and work–life imbalances exerting the strongest influence, particularly among younger and older nurse cohorts.

Nursing Workforce publication trend

The graph below shows the total number of articles in nursing workforce across all publications each year (not limited to Nature Index journals).

Technical terms

Turnover intention: The cognitive likelihood that an individual plans to leave their current position or profession.

Burnout: A work-related syndrome characterised by emotional exhaustion, depersonalisation and reduced personal accomplishment.

Depersonalisation: A component of burnout involving a detached or indifferent response towards recipients of one’s care.

Job Demands–Resources (JD-R) model: A conceptual framework positing that job demands deplete energy and job resources foster motivation and wellbeing.

Work engagement: A positive, fulfilling, work-related state marked by vigour, dedication and absorption in one’s role.

References

1. Workforce and Excellence in Nursing Care: Challenges for Leaders and Professionals.
2. The Key Job Demands and Resources of Nursing Staff: An Integrative Review of Reviews. Frontiers in Psychology (2020).
3. Impact of Job Demands and Resources on Nurses’ Burnout and Occupational Turnover Intention Towards an Age-Moderated Mediation Model for the Nursing Profession. International Journal of Environmental Research and Public Health (2019).
4. A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open (2022).
5. Intention to leave, depersonalisation and job satisfaction in physicians and nurses: a cross-sectional study in Europe. Scientific Reports (2024).
6. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Human Resources for Health (2006).
7. Simulating future supply of and requirements for human resources for health in high-income OECD countries. Human Resources for Health (2016).