The Problem

Nurses are the largest group of health care professionals providing direct patient care in hospitals and are strongly linked to the quality of care patients receive. However, an estimated 118,000 hospital nursing positions are currently unfilled with a projected shortage of over 1 million nurses by the year 2020. Health Care’s Human Crisis: The American Nursing Shortage concluded that the current shortage is more serious and likely to be more persistent than previous shortages. Factors include:

• A nursing faculty shortage that led U.S. nursing schools to turn away 41,683 qualified applicants from baccalaureate and graduate nursing programs in 2005.
• Inadequate hospital work environments which cause nurses to leave their jobs.
• An aging nursing workforce, coupled with an aging patient population which will increase the demand for nurses.
• Men and minorities are underrepresented in the field.

What We’ve Supported

RWJF has invested over $150 million in nursing programs over the past 30 years. We support programs that address critical issues related to the nursing shortage and the nursing profession, while consistently focusing on improving the quality of patient care. Key goals of our programs include:

Building the nursing field and profession. Early nursing programs such as the School Health Services Program and Primary Care Training for Emergency Nurses helped to establish the nurse practitioner as a highly valued health care professional who provided care in settings such as public schools and hospital emergency rooms. The Nurse Faculty Fellowship Program followed, training 99 nurse fellows who became leaders in nurse practitioner education. Later, Colleagues in Caring filled a critical gap by developing a collaborative approach for addressing nursing workforce and educational issues including data collection and analysis to inform policy-makers and the streamlining of the nursing education system.

Improving academic nursing. The Teaching Nursing Home Program resulted in improvements in patient care and professional growth of both faculty and nursing home staff. The Clinical Nurse Scholars Program educated postdoctoral nurse educators in clinical practice and the Ladders in Nursing Careers Program provided assistance to entry and midlevel hospital staff to obtain the education for entry and advancement in the nursing field.

Attracting and retaining high-quality nursing staff by improving hospital working conditions. Strengthening Hospital Nursing addressed the nursing shortage through innovations to use nursing resources efficiently while improving patient care. From this stems our recent approach to making hospitals better, safer places for patients and staff: 

Improving the organization of work and use of information technology as accomplished inTransforming Care at the Bedside, which empowers front-line nurses and staff to identify problems in their units and provides the resources and freedom to propose and test solutions.

Examining the physical design of hospitals as demonstrated in The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity, an analysis of more than 600 studies that show the link between hospital design features and patient and staff satisfaction and outcomes.

Changing hospital leadership and culture as described in Cultural Transformation in Health Care, a white paper about the complex nature of organizational culture and its role in health care organizations. We have also funded researchers to follow a group of newly licensed nurses over time to gain insights into their experiences in the first few years of nursing.

• Building leadership and partnerships to broadly address nursing issues.

  • Leadership at all levels is a key theme among our programs. Developing leadership skills through training was originally addressed through the Clinical Nurse Scholars Program and then through the Executive Nurse Fellows Program, which currently offers high-level leadership training, mentoring and opportunities for networking.
  • Although partnerships are embedded in all of our programs, we developed Partners Investing in Nursing’s Future to engage new partners to invest in nursing issues by providing support to local foundations to advance nursing workforce solutions in their own communities. Our National Nurse Funders Collaborative includes approximately 90 organizations nationwide to assist in engaging new funding partners so nursing issues across the spectrum may be addressed with organizations nationwide.

RWJF’s Work Today

RWJF continues to support nursing programs with current funding efforts dedicated to improving the quality of patient care and building a strong capable health care workforce. We have a strong commitment to furthering the evidence base for the link between nursing and quality, as demonstrated in our research program, the Interdisciplinary Nursing Quality Research Initiative. We are also interested in developing programs to address the nursing faculty shortage, create nursing school curriculums on quality and safety, and develop a national nursing advocacy center.