The heavy workload of hospital nurses is a major problem for the American health care system. Nurses are experiencing higher workloads than ever before due to four main reasons: (1) increased demand for nurses, (2) inadequate supply of nurses, (3) reduced staffing and increased overtime, and (4) reduction in patient length of stay.
First, the demand for nurses is increasing as a result of population aging. Between 2000 and 2020, the United States population is expected to grow by 18 percent (31 million), but the over-65 population, with more health care needs, is expected to grow by 54 percent (19 million).1, 2 Second, the supply of nurses is not adequate to meet the current demand, and the shortage is projected to grow more severe as future demand increases and nursing schools are not able to keep up with the increasing educational demand.3, 4 When a nursing shortage occurs, the workload increases for those who remain on the job.5 Third, in response to increasing health care costs since the 1990s, hospitals reduced their nursing staffs and implemented mandatory overtime policies to meet unexpectedly high demands, which significantly increased nursing workloads. Fourth, increasing cost pressure forced health care organizations to reduce patient length of stay. As a result, hospital nurses today take care of patients who are sicker than in the past; therefore, their work is more intensive.6