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Top Four Challenges for Today’s Nurse Administrators

It’s clear that health care is undergoing huge changes and growth, and will continue to do so for the foreseeable future. Nurses are at the forefront of this transformation. Nurse administrators hold much of the responsibility for responding to challenges and integrating new solutions to ensure that patient care is efficient and supports positive outcomes. Below are a few of the main challenges nurse administrators have to face today.

1. A Multi-Generational Workforce
Today’s nursing workforce spans several generations. Nurse administrators have to manage nurses who have different attitudes, work habits, and communication styles. Nurse administrators have to learn how to identify generational differences, make sure nurses of different generations are able to communicate clearly about expectations and habits, and minimize conflicts.

The range of ages and experience among nurses is an asset, but only if nurse administrators can remove the obstacles to collaboration and learning among nursing team members. For example, younger nurses can learn from older nurses’ years of experience dealing with potential problems and issues, while older nurses may learn newer and more efficient ways of caring for patients from younger nurses.

Nurses with strong interpersonal and leadership skills can build opportunities and environments in which nurses from different generations feel supported about their abilities and empowered to grow and learn.

2. The Business of Health Care
The increasing costs of medical care and the corporatization of health care have transformed the industry. Nurse administrators are often tasked with providing care and trying to ensure positive patient outcomes with limited resources, such as less time available to spend with each patient and dwindling budgets.

Nurse administrators must create realistic strategies and plans for effective patient care maximizing the resources available, both equipment and employees. Skills in budgeting, information technology, organizational leadership, and human resources are vital elements in their toolbox.

3. Ethics
As medicine and technology advance, humans have to contend with their ethical implications. Nurse administrators need to have an understanding of ethical principles, be aware of available resources related to ethics, study how to apply them in practice, and learn how to communicate them to the nursing staff, patients, and patients’ families.

Given their direct experience at the bedside, nurse administrators play a pivotal role in ethics consultation, education, and policy development and review. They move back and forth between policy and practice: they communicate information and experience from the practice side, presenting those findings to ethics review boards and/or helping incorporate them into ethics policies, and then communicate those policies and create strategies for putting them into practice.

4. More Competition for Nursing Talent
Nursing is facing pressure from several fronts. According to data compiled by the American Association of Colleges of Nursing,1

  • 55 percent of the RN workforce in the United States is age 50 or older, pointing to a potential flood of retirements in the next several years.
  • Nursing schools and programs are facing a faculty shortage and have had to turn away thousands of qualified applicants for baccalaureate and graduate nursing programs.
  • The U.S. population is aging, indicating a need for more nurses to care for the elderly, a population with significant health care requirements.
  • Stress from having to care for larger numbers of patients due to financial or staffing shortages is driving more nurses out of the profession.

In addition, the Affordable Care Act has provided more people with access to health insurance, resulting in a greater demand for health care services.

Nurse administrators may have to deal with managing nursing shortages in their own departments or facilities, as well as having to spend significant time and effort recruiting, interviewing, and courting a shrinking pool of qualified nurses.

Considering the many hats nurse administrators wear today, it’s clear why so many of them choose or are required to earn a nursing degree, such as a Master of Science in Nursing. The responsibilities of nurse administrators run all across the spectrum, from business to technology to leadership. A graduate degree in nursing provides invaluable insights and skills that can be difficult to pick up on the job and ensures they are prepared to take on the challenges of nursing practice and health care in the 21st century.

1American Association of Colleges of Nursing, Nursing Shortage Fact Sheet,