Nursing shortage predicted to impact an ageing world

In recent years, some governments have focused their attention on the allocation of resources for their ageing population. Yet little attention has been paid to the labour force who will care for them.


There are 57 countries identified by the World Health Organization (2010) to be in a crisis relative to their health care work force. In the coming decades, the redistribution of the population toward older adults will reduce the relative size of the working population to the non-working older adult population, and also increase the need for workers to provide healthcare services to the ageing population.


More specifically, the supply of nurses needed to provide healthcare will become insufficient to provide care to an ageing population. In virtually all countries, nurses make up the largest group of health care providers. Their services are essential to the provision of safe and effective care for older adults.  


In Canada, in 2014, the supply of regulated nurses declined by 0.3% over the previous year (CIHI, 2015).  According to one report on the nursing workforce in sub-Saharan Africa, there is a shortfall of more than 600,000 nurses in relation to the estimated number needed to scale up priority interventions, as recommended by the Commission on Macroeconomics and Health (2005).  


A RN4CAST project (Filkins 2011) funded by the European Commission predicted a similar shortage of 600,000 nurses across Europe by 2020.


Even less discussed is what the impact of lost knowledge that these nurses have gained through their years of experience and will take with them could have on the care of older adults, their significant others, and healthcare organizations.  


The nursing shortage occurring around the world is creating a crisis in terms of adverse impacts on the health and well-being of older populations.

The nursing shortage presents challenges for policy makers at all levels of government in both high and low income countries.  


Inadequate human resources planning and management, the ageing nursing workforce, internal and external migration, and high attrition (due to poor work environments, low professional satisfaction, low social status, and inadequate salary levels) are some of the factors driving the nursing shortage.  


A UN report highlighted the need for partners to “work together to address critical shortages of health workers at all levels,” providing coordinated and coherent support to help countries develop and implement national health plans that include strategies to train, retain, and deploy health workers (United Nations Secretary General, 2010).


Strengthening the nursing workforce will lead to enhanced access to preventive, curative, and rehabilitative care; and will contribute to improved health status for older adults.  


There is no one action that will resolve the nursing crisis.  It requires advocacy, leadership, and a sustained political and financial commitment by individual countries and the global community.  The issues are complex and the solutions must be multi-faceted.  Sharing of knowledge, research, and networking are essential to an effective response.  


The IFA can provide assistance to strengthening the nursing workforce as it relates to older adults through its’ Global Connection lens.  The upcoming IFA 2018 Conference will generate lively discussions while bringing to the forefront strategies to address the challenges of preparing the global health care workforce, not just my own discipline of nursing, to provide quality health care to older adults.


Article by Sandra P. Hirst RN, PhD, GNC(C), Vice President, North America, IFA. This article appeared on the International Federation on Ageing website.


8 April 2017.