In a survey of 232 chief nursing officers (CNOs) by AMN Healthcare, the vast majority said they’re experiencing at least a moderate shortage of nurses at their organizations—and 61 percent expected it would only get worse in the next five years.

Most CNOs responding to the survey—72 percent—said the current shortage of nurses was either moderate, significant or severe. Twenty-one percent said they were experiencing a slight shortage, and only 7 percent reported no shortage at all. Some 28 percent expect the shortage to get worse within one year, but that percentage climbs in the medium-term, with 43 percent saying it will get worse in two years and 61 percent saying it will worsen in five years.

With a shortage of available nursing talent comes recruitment issues. More than 80 percent said it’s at least moderately difficult to recruit nurses for available positions.

"Nurse leaders are increasingly concerned about worsening nurse shortages and their impact on patient and staff satisfaction, as well as nurse recruitment," AMN’s chief clinical officer, Marcia Faller, said in a statement. “This survey also suggests that finding effective solutions to this situation may be beyond the capabilities of most healthcare organizations. They are going to need help, especially as nurse shortages get worse.”

What’s hurting recruitment isn’t problems organizations can fix internally, like culture or compensation. Larger factors like location (37 percent) and access to talent (32 percent) are proving most problematic. Overcoming such obstacles may require “a level of workforce sourcing expertise and capacity that few healthcare organizations possess,” with AMN recommending systems start by dedicating more money to human resources.

When asked to approximate the nurse vacancy rate in their organizations, 40 percent of CNOs placed it between 5 and 11 percent. A quarter (25 percent) placed it at between 12 and 20 percent, and another 7 percent said more than 20 percent of the nursing positions were vacant. Twenty-eight percent pegged it at less than 5 percent.

More vacancies can lead to lower morale and high turnover among staff and snowball from there, affecting quality of care, patient satisfaction and the finances of hospitals and health systems. More than 40 percent of CNOs said shortages have a considerable or great negative impact on patient satisfaction and 34 percent said the same for its impact on patient care.

There have been signs that increased interest among millennials in becoming registered nurses or advanced clinicians could help alleviate some of the shortage. However, the rate of entry among these younger RNs appeared to have plateaued around 2013, while the rate of baby boomer nurses retiring has continued to accelerate.