What The Nursing Crisis Can Teach Any Industry About Employee Satisfaction

Nurses face low pay, long hours, and little recognition. What an industry in crisis can teach us about building a better workplace.

What The Nursing Crisis Can Teach Any Industry About Employee Satisfaction
[U.S. Navy Photo: Mass Communication Specialist 2nd Class John O'Neill Herrera/Released]

Not enough pay, long hours, an unmanageable workload, not enough staff, and lack of support from management. These frustrations are common among many workers, regardless of their industry or job level. They form the root cause of why so many U.S. workers are disengaged.


Last year, less than a third of workers reported being engaged in their jobs. The majority (51%) said they weren’t engaged, and nearly a quarter (17.5%) said they were “actively disengaged,” according to Gallup’s 2014 “State of the Global Workplace” report. A previous report indicated that this can cost our economy up to $350 billion per year in lost productivity.

But the fact that these complaints are coming from a large pool of the nation’s registered nurses makes the potential impact greater than just a bottom line concern.

A new report from AMN Healthcare and its Center for the Advancement of Healthcare Professionals indicates that a third of nearly 9,000 nurses surveyed earlier this year say they want to quit. Couple this with 62% of registered nurses over age 54 who say they are considering retirement within the next three years, and it’s no wonder that Marcia Faller, RN, PhD, chief clinical officer at AMN Healthcare, said, “The harm to the health-care industry goes beyond the numbers.”

Faller says the survey data confirms anecdotal intelligence about this particular segment of the industry. Of the repercussions, she said, “The loss of this intellectual asset may be acutely felt in terms of quality of care and patient satisfaction.”


This impending crisis can teach us a lot about how to manage any workplace to keep existing workers engaged and attract new talent.

Day-To-Day Drag

The health-care industry as a whole got high marks in TINYpulse’s 2015 rankings of sectors with the most satisfied workers. While there are many factors that contribute to overall satisfaction on the job, it helps when the worker is content with their career choice.

The AMN Healthcare survey found that a large majority of registered nurses (85%) say they are satisfied with their overall career choice. The problems begin with they’re asked to rate the day-to-day aspects of their work. These nurses said the time spent with patients–a major driver to pursue this career–isn’t adequate.


Some respondents reported that the sheer volume of documentation required makes them feel like they are nursing a computer rather than a patient. This is exacerbated by facilities that are consistently understaffed. Employers in any industry should take note that research from Zeynep Ton of MIT’s Sloan School of Management found that cutting staff to meet certain budget metrics is linked to job dissatisfaction and turnover–which has the opposite effect on the bottom line over time.

Wages Don’t Measure Up

According to the survey, inadequate compensation was the nurses’ number one concern. They reported that the pay rates are too low, and when they do receive raises, they are minimal. Many said they are not compensated for working overtime.

Although women represent nearly 80% of the health-care workforce in the U.S., according to the Bureau of Labor Statistics, and 90% of nurses are female, the gender wage gap is alive and well in this sector.

A recent study published in the Journal of the American Medical Association that focused on pay data from nearly 300,000 registered nurses found that male nurses earn $5,100 more on average than their female counterparts who hold similar positions. The same study found that this wage gap had remained unchanged since 1988.


Anne Ladky executive director of Women Employed told Fast Company in a previous interview that the disparity is a consequence of persistent unconscious bias, “That men are simply more capable, that women with children are less committed to their work, and so on,” she explained.

As for the minimal raises and lack of overtime pay, Ladky points out that women in professions like nursing often assume that compensation policies are more rigid than they really are, so they don’t ask for more money. “Negotiation is always possible—and necessary,” she argued.

The Pipeline Problem

Not having enough qualified women to apply for jobs has long been the complaint of hiring managers who can’t seem to diversify their employee pools. Ellen Pao, who recently brought a notable gender discrimination case against her employer, believes this isn’t an issue, as plenty of women graduate with STEM degrees. The bigger problem is that they don’t stay in these careers because of bias and harassment, among other factors.

For nurses, the pipeline problem is reaching a crisis point. More than half of RNs are over the age of 50, according to the AMN Healthcare survey, and their institutional knowledge and mentoring expertise are invaluable to quality health care.

Photo: Ververidis Vasilis via Shutterstock

On the flip side, the survey also shows very strong interest in furthering their education, especially among younger RNs. Health-care experts say this is necessary to making improvements in the profession.


An additional challenge is the number of teachers available to instruct this new generation of nursing students. A 2014 survey conducted through the American Association of Colleges of Nursing (AACN) found that 56% of U.S. nursing schools had vacant full-time faculty positions. The AACN found that U.S. nursing schools turned away nearly 69,000 qualified applicants in 2014, partly because of a shortage of faculty.

Management Woes

According to a global poll of nearly 2,000 participants from Monster, nearly half of American workers (48%) never feel appreciated at work. Another of the top causes of dissatisfaction among survey respondents was the lack of support from management as a major cause of dissatisfaction.

They cited that managers and administrators don’t demonstrate loyalty to the nursing staff and don’t take action to address challenges that nurses face in their daily work. Additionally, nurses say many managers and administrators don’t listen to staff and make unreasonable demands on them. This may be why nearly a quarter (21%) of nurses surveyed say now that the economy has improved, they will move to part-time work.

Recognizing good work and supporting employees with regular feedback and resources to meet their goals can go a long way to improving the overall culture of satisfaction in any workplace.

As Gallup research shows: “When employees feel that their company cares and encourages them to make the most of their strengths, they are more likely to respond with increased discretionary effort, a stronger work ethic, and more enthusiasm and commitment.”


About the author

Lydia Dishman is a reporter writing about the intersection of tech, leadership, and innovation. She is a regular contributor to Fast Company and has written for CBS Moneywatch, Fortune, The Guardian, Popular Science, and the New York Times, among others.