wileyonlinelibrary.com/journal/jonm J Nurs Manag. 2018;26:86–93.
© 2017 John Wiley & Sons Ltd
Accepted: 18 June 2017
Maldistribution or scarcity of nurses? The devil is in the detail
Jitske M.C. Both-Nwabuwe MSc, Policy Advisor, Cordaan and PhD Student |
Maria T.M. Dijkstra PhD, Assistant Professor | Ab Klink PhD, Professor, CEO, Cooperatie
VGZ and Professor | Bianca Beersma PhD, Professor
Department of Organization Sciences, VU
University, Amsterdam, the Netherlands
Jitske M.C. Both-Nwabuwe, Department
of Organization Sciences, VU University,
Amsterdam, the Netherlands.
This study was conducted as part of a PhD in
Organizational Science and was financed by
Aims: The goal of this paper was to improve our understanding of nursing shortages
across the variety of health care sectors and how this may affect the agenda for ad-
dressing nursing shortages. A health care sector comprises a number of health care
services for one particular type of patient care, for example, the hospital care sector.
Background: Most Western countries are shifting health care services from hospital
care towards community and home care, thus increasing nursing workforce challenges
in home and community care. In order to implement appropriate policy responses to
nursing workforce challenges, we need to know if these challenges are caused by
maldistribution of nurses and/or the scarcity of nurses in general.
Evaluation: Focusing on the Netherlands, we reviewed articles based on data of a la-
bour market research programme and/or data from the Dutch Employed Persons’
Insurance Administration Agency. The data were analysed using a data synthesis
Key Issues: Nursing shortages are unevenly distributed across the various health care
sectors. Shortages of practical nurses are caused by maldistribution, with a long- term
projected surplus of practical nurses in hospitals and projected shortages in nursing/
convalescent homes and home care. Shortages of first- level registered nurses are
caused by general scarcity in the long term, mainly in hospitals and home care.
Conclusions: Nursing workforce challenges are caused by a maldistribution of nurses
and the scarcity of nurses in general. To implement appropriate policy responses to
nursing workforce challenges, integrated health care workforce planning is
Implications for Nursing Management: Integrated workforce planning models could
forecast the impact of health care transformation plans and guide national policy deci-
sions on transitioning programmes. Effective transitioning programmes are required to
address nursing shortages and to diminish maldistribution. In addition, increased re-
cruitment and retention as well as new models of care are required to address the
scarcity of nurses in general.
health care sectors, maldistribution, nursing shortages, scarcity