The Real Issues Driving the Nursing Crisis
MIT Sloan Management Review|Winter 2024
Our analysis of nurses' employer reviews reveals the true source of burnout and why nurses are leaving the field. Here's how health care leaders can improve nurse job satisfaction to fight a looming nursing shortage.
Donald Sull and Charles Sull
The Real Issues Driving the Nursing Crisis

HEALTH CARE LEADERS FACE A DAUNTING SET OF CHALLENGES — rising costs, the transition to digital health, and shifting payment models, to name just a few. But according to a recent survey from the American College of Healthcare Executives, the No. 1 problem hospital CEOs face is staff shortages and burnout.¹ Ninety percent of the CEOs surveyed cited nursing shortages as a particularly acute pain point.

In 2021, the total number of registered nurses working in the U.S. dropped by the largest amount in 40 years, with younger nurses leading the exodus.² By 2025, the U.S. health care system could suffer a shortfall of up to 450,000 nurses, or 20% fewer than the nursing workforce required for patient care.³

High levels of job dissatisfaction and burnout are driving nurses from the profession. The COVID-19 pandemic placed tremendous pressure on all health care workers, but dissatisfaction and burnout among nurses have not improved since the pandemic ended. And by some measures, it might be getting worse: In 2021, nearly two-thirds of registered nurses would have encouraged others to become a nurse, but only half said they would recommend nursing as a profession two years later.⁴

One of the richest sources of insight on dissatisfaction among nurses is how they describe their job, in their own words, on employment sites like Indeed and Glassdoor. This information is voluminous but difficult to synthesize because most of it takes the form of unstructured free text. To understand the challenges nurses face, we analyzed how 150,000 of them had described their employers in Glassdoor reviews since the beginning of the pandemic. (See

This story is from the Winter 2024 edition of MIT Sloan Management Review.

Start your 7-day Magzter GOLD free trial to access thousands of curated premium stories, and 9,000+ magazines and newspapers.

This story is from the Winter 2024 edition of MIT Sloan Management Review.

Start your 7-day Magzter GOLD free trial to access thousands of curated premium stories, and 9,000+ magazines and newspapers.

MORE STORIES FROM MIT SLOAN MANAGEMENT REVIEWView All
Ask Sanyin: How Do You Build for an Unpredictable Future?
MIT Sloan Management Review

Ask Sanyin: How Do You Build for an Unpredictable Future?

While the pandemic was a wild ride of uncertainty for me and many of my peers in leadership, it feels like we never regained our footing.

time-read
2 mins  |
Winter 2025
What You Still Can't Say at Work
MIT Sloan Management Review

What You Still Can't Say at Work

Most people know what can’t be said in their organization. But leaders can apply these techniques to break through the unwritten rules that make people self-censor.

time-read
7 mins  |
Winter 2025
Make Character Count in Hiring and Promoting
MIT Sloan Management Review

Make Character Count in Hiring and Promoting

Most managers focus on competencies when evaluating candidates but it’s character that will transform the DNA of the organization. Here’s how to assess it.

time-read
10+ mins  |
Winter 2025
Why Influence Is a Two-Way Street
MIT Sloan Management Review

Why Influence Is a Two-Way Street

Managers achieve better outcomes when they prioritize collaborative decision-making over powers of persuasion.

time-read
10 mins  |
Winter 2025
Know Your Data to Harness Federated Machine Learning
MIT Sloan Management Review

Know Your Data to Harness Federated Machine Learning

A collaborative approach to training AI models can yield better results, but it requires finding partners with data that complements your own.

time-read
9 mins  |
Winter 2025
How Integrating DEI Into Strategy Lifts Performance
MIT Sloan Management Review

How Integrating DEI Into Strategy Lifts Performance

Incorporating diversity, equity, and inclusion practices into core business planning can provide a competitive edge.

time-read
9 mins  |
Winter 2025
The Myth of the Sustainable Consumer
MIT Sloan Management Review

The Myth of the Sustainable Consumer

Companies that understand the different kinds of consumers for sustainable products can market to them more effectively.

time-read
10+ mins  |
Winter 2025
A Practical Guide to Gaining Value From LLMs
MIT Sloan Management Review

A Practical Guide to Gaining Value From LLMs

Getting a return from generative AI investments requires a systematic approach to analyzing appropriate use cases.

time-read
10+ mins  |
Winter 2025
Improve Workflows by Managing Bottlenecks
MIT Sloan Management Review

Improve Workflows by Managing Bottlenecks

Understand whether process or resource constraints are stalling work.

time-read
10+ mins  |
Winter 2025
Craft Schedules That Work for Everyone
MIT Sloan Management Review

Craft Schedules That Work for Everyone

Business leaders can improve retention and business performance with schedules that make sense for workers’ lives.

time-read
10+ mins  |
Winter 2025