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The Critical State of Nursing Shortages in the Midwest

News about the nursing shortage has been circulating for decades. With COVID-19’s impact, there is renewed attention on this issue — particularly in the Midwest region, where the shortage has grown to problematic levels.

In fact, reports have referenced a drop from the recommended 1:1 nurse-to-patient ratio in ICUs to a shocking 1:4 — attributed, in part, to the COVID-19 pandemic.

What Is Causing the Shortage?

Reasons for the nursing shortage are varied, but they are typically grouped into the following breakdown:

  • An aging Baby Boomer population
  • Prolonged average lifespan due to medical/scientific advancements
  • Greater access to care, thanks to the Affordable Care Act and expanded Medicaid programs
  • Fewer resources to train/educate up-and-coming nurse candidates
  • A nurse population nearing retirement (both in practice and in faculty roles)
  • Burnout among nurses in the field as facilities are understaffed

All of these factors come together to create a deficit in supply versus demand.

How Bad Is It?

As the saying goes, “numbers don’t lie.” Nurse Journal reports that nationally, there were 3,956,080 active nurses in 2018. Putting that figure against the 2019 U.S. population of 328,055,000 amounts to only 12.06 nurses per 1,000 individuals on a national scale. Digging deeper into the data, it’s apparent that Illinois ranks as the most “in need,” when comparing the nurse to individual ratio in all of the other Midwest states:

  • Illinois: 12.42
  • Nebraska: 12.93
  • Michigan: 13.77
  • South Dakota: 14.12
  • Iowa: 14.64
  • Kansas: 14.73
  • Indiana: 14.99
  • Missouri: 15.14
  • Wisconsin: 15.2
  • Ohio: 15.74
  • Minnesota: 15.78
  • North Dakota: 16.4

The Illinois division of the American Nurses Association also recognizes the growing need for nurses. A study by the Illinois Nursing Workforce Center revealed that 27% of the 182,951 registered nurses (RNs) in the state in 2019 are expected to retire within five years. That means the state needs to replace 9,879 nurses each year just to maintain current staffing levels.

What’s even more troubling is that only approximately 7,000 newly licensed RNs graduate each year in Illinois, meaning there is a shortage of 2,879 on top of the already-dire scenario the state is facing. If nothing changes, Illinois could see a compounding shortfall of 14,395 professionals by 2025.

Where Are Nurses Needed?

With the shortage impacting the entire healthcare system, RNs are needed in several roles and settings, including:

  • Hospitals — acute, chronic and critical care
  • Clinics — from pediatric to geriatric care
  • Nursing homes and long-term care facilities
  • Veterans’ homes
  • Rehabilitation centers
  • Mental health centers
  • Travel nursing

One of the greatest needs is in education. With fewer nurse educators in faculty positions, there is a diminishing opportunity for individuals to even pursue a career.

The American Association of Colleges of Nursing (AACN) released a report, 2019-2020 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, stating that “U.S. nursing schools turned away 80,407 qualified applications from baccalaureate and graduate nursing programs in 2019 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.”

What Will Improve the Shortage?

At this point, the healthcare industry needs an “all hands on deck” approach to addressing — and fix — the nursing shortage. While some help may come in the form of legislative action (for example, safe staffing laws), hospitals and other healthcare facilities must own their role in:

  • promoting a healthy work environment
  • encouraging more nurse representation among key decision-makers
  • allowing RNs to have a stronger voice as a part of the healthcare community

Nurses must also do their part. Multiple organizations — from global to local — have joined in the push to have more RNs earn their Bachelor of Science in Nursing (BSN) degree. BSN-prepared nurses not only deliver a higher level of patient care, but they are also often compensated well for their expertise.

BSN-prepared nurses also have greater opportunities for expansion into other, higher-paying specialties or sub-specialties. They are more likely to secure leadership or faculty positions — increasing the opportunity to bring about much-needed change from within the field. Ultimately, this all leads to greater job satisfaction and improved retention across the profession.

What Is the Salary Potential for BSN-Prepared Nurses?

Nurse Journal highlights the notable salary benefit of earning a BSN when compared to an RN diploma or certificate or an associate degree (ADN). Taken from PayScale’s current data on average national salary, as of May 2021, the following represent current salaries for nurses with different levels of education:

  • RN diploma/certificate: $65,690
  • ADN: $70,700
  • BSN: $86,520

Of course, salary ranges depend on additional factors, such as geographical location and level of experience. Nurses in the Midwest may make less than highly populated coastal areas such as New York City, Los Angeles and Miami — largely because of the high cost of living in those areas. Yet, a lower cost of living in Midwest communities allows for a more comfortable lifestyle.

Looking Toward the Future

It’s easy to feel overwhelmed by the seriousness of the nursing shortage. However, advanced degree programs also present immense opportunities for nurses who are either just entering the field or leveling up their education.

Learn more about University of Illinois-Chicago’s Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) online program.


American Nurses Association Illinois: Nurse Staffing: How COVID-19 Highlighted an Issue That Always Existed

University of Minnesota/Center for Infectious Disease Research and Policy (CIDRAP): COVID-Related Nursing Shortages Hit Hospitals Nationwide

Illinois Nursing Workforce Center: Registered Nurse Workforce Survey Report 2018

The Center Square: Illinois Long-Term Care Facilities Facing Worker Shortages

American Association of Colleges of Nursing: Nursing Faculty Shortage

Nurse Journal:

RN Diploma vs. ADN vs. BSN Degree: What’s the Difference?

The U.S. Nursing Shortage: A State-by-State Breakdown

National Center for Biotechnology Information: Nursing Shortage

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