Legislative Solutions to Address Tennessee's Nursing Workforce Shortage Crisis
Overview
This advocacy letter addresses Tennessee Governor Bill Lee regarding the critical nursing workforce shortage affecting healthcare quality across the state. The author presents evidence of the crisis's impact, including HCA Healthcare's $2.4 billion expenditure on contract labor, and proposes three legislative interventions: increased state funding for nursing schools, a state nurse loan forgiveness program, and addressing equity disparities in nursing recruitment and retention.
What this essay covers
- Opening statement establishing credibility as healthcare professional and context of crisis
- Evidence presentation: financial impact, national shortage projections, mortality data, demographic decline in nursing profession
- Equity analysis addressing disproportionate impact on rural and minority communities
- Personal professional experience demonstrating workforce challenges and cost implications
- Three proposed legislative interventions for addressing the shortage
Preview
To,
Honorable Bill Lee
Governor of Tennessee
Tennessee State Capitol
600 Dr. Martin Luther King Jr. Blvd.
Nashville, TN 37243
Dear Governor Lee,
I am writing to you as a health care professional with an interest in the health of our communities in Tennessee and the sustainability of our health care system. I want to encourage your administration to act urgently on legislation and funding to tackle the nursing workforce shortage, which is having a devastating impact on the quality of care provided to Tennesseans across all counties in our state. HCA Healthcare, which is based here in Nashville and operates dozens of health care facilities across Tennessee, spent roughly $2.4 billion on contract labor in 2022 alone due almost entirely to a shortage of permanent nursing positions (HCA Healthcare, 2023). This is money that could be used for increasing access to care for the people who live in your district.
The effects of this under-supply are immediate and long-term. The 2022 National Nursing Workforce Survey reports that around 100,000 registered nurses resigned during the COVID-19 pandemic and that we are on track for a national shortage of up to 450,000 nurses by 2025 (Smiley et al., 2023). In Tennessee, this is a crisis that disproportionately affects rural areas and the elderly, poor, and uninsured who rely on publicly available hospital services. One study published in BMJ Quality and Safety showed that hospital units with the lowest nurse staffing ratios had the highest rates of 30-day death and preventable harm (Lasater et al., 2021).