In a First Opinion essay for STAT, nurse and health policy researcher Lynne S. Moronski argues that the global nursing shortage is being addressed with the wrong solutions. Governments focus on producing more nurses through expanded enrollment, accelerated training, and cross-border recruitment, but ignore whether the systems those nurses enter can sustain them. Moronski calls this "pouring water into a bucket with a hole in it," citing burnout, chronic understaffing, and high turnover as consistent predictors of workforce loss that are rarely measured with the same rigor as supply.
The essay is rooted in a personal tragedy: Moronski's 21-year-old daughter, who had intellectual and developmental disabilities, died within 48 hours of moving into a New Jersey group home after caregivers accidentally gave her too much medicine. Those caregivers were not nurses but direct support professionals — part of a largely invisible workforce that handles complex medication and care tasks with inconsistent training, low wages, and high turnover. Moronski notes that proposed legislation in New Jersey, still pending, would require a nurse or certified medication aide to administer medications in such settings.
Moronski, an associate fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania, says the solution is to fix the workplace, not just the pipeline. That means measuring whether new nurses receive structured transition support such as mentorship and residencies, tracking retention and turnover, and integrating direct support professionals into workforce planning with standardized training and sustainable wages. Without these changes, she argues, no amount of nurse supply will stabilize care delivery.