Challenges in nursing practice

College professor teaching anatomy class to nursing or medical students

Nursing challenges have existed since the field began. From social disparities faced by the first nurses to modern-day staff shortages, challenges in nursing continue to evolve.

Today, nurses have gained respect as the most trusted roles in society and maintain the top ethics rating in the U.S., according to a 2022 Gallup poll. Though difficult, nursing is rewarding work that impacts countless lives.

In the following article, we’ll discuss past and present challenges in nursing. We’ll dive into the origin of nursing, then discuss how challenges in the field have progressed with the introduction of modern medicine, technology and more rigorous standards of education.

We’ll also take a look at how one can navigate daily challenges in nursing while delivering quality patient care.

Challenges in Nursing: In the Beginning

Professional nursing started with Florence Nightingale, a visionary who saw beyond the social norms of her time.

In the mid-1800s, the act of nursing consisted of women taking care of family members in their homes, and establishing nursing as a legitimate profession was a challenge. However, Nightingale saw the value of extending this type of care beyond the home, which would serve as an opportunity for both women and the profession to gain notice.

During the Crimean War, the British government assigned Nightingale and her small band of nurses to one of their military hospitals. They sanitized walls, let fresh air in, prepared healthy food and dispensed medicine. Not only were these changes made, Florence also used the scientific methods of observation and data analysis to determine their effects. In a matter of weeks, death rates dropped and countless soldiers regained health.

Challenges in Nursing: 20th Century

In the 20th century, nursing care became more common in public facilities than in homes. However, the quality of care was inconsistent and depended on the hospital.

As time went on, more standards were put into place to combat these inconsistencies and nursing challenges. Hospitals began providing their own training schools for nurses. This required nurses to learn on the job rather than at a university.

Inadvertently, this led to gender segregation in the field and promoted the stereotype that nursing was “women’s work.” These challenges in nursing were the norm until the latter half of the 20th century.

With the evolution of technology and industrialization, the nursing profession began to expand beyond hospital walls. In 1965 the American Nurses Association (ANA) released a position statement calling for nursing education to move to the higher educational setting in an attempt to professionalize the role. Programs in community colleges, technical colleges and universities replaced hospital training programs.

By the 1970s, universities also started offering doctoral programs, with a focus on science and research.

Challenges in Nursing: Today 

Problems in nursing have changed over time, but the career itself is still a rewarding path for those who are motivated to serve others. Today, nursing is a vast and varied field, with a multitude of opportunities for those considering it as a career.

Advanced degree programs, such as Master of Science in Nursing (MSN) programs, have expanded the offerings and reach for modern-day nurses, equipping them with the skills they need to meet evolving challenges.

Nurses work hard to ensure that patients receive quality care. To avoid burnout, it’s important to be aware of today’s nursing challenges and understand their impact. This will help you find ways to cope and use self-care.

Long Hours 

Long hours have been one of many consistent challenges for nurses. They typically have demanding schedules because nursing is a 24/7, round-the-clock job. These long hours can also mean working overtime, several 12-hour shifts in a row or being on-call. Because nurses’ schedules are demanding, working over 40 hours a week is not uncommon.

Over time, this can leave nurses feeling drained. Stress and exhaustion (both mental and physical) can present secondary challenges in nursing, leading to the potential for costly medical mistakes.


Nurses are on their feet most of the time. Nursing duties can be physically demanding, as in the case of helping to lift patients (from a wheelchair to a bed, for instance, or from the bed to the bathroom).

They do have access to equipment that can make these physical aspects less strenuous, such as slide sheets or mechanical lifts. However, nurses experience a high rate of work-related injuries — one of the most chronic being back injuries. Shoulder injuries and leg pain are also common ailments.

Safety on the Job

Nurses face additional challenges through workplace hazards in a hospital or clinical environment. Because nurses work with sick people, their risk of exposure to someone with an infectious illness is much higher than that of the general population.

The risk of exposure to and contraction of infectious diseases is one of the most serious challenges of nursing. A necessary measure to combat this challenge is for nurses to turn to preventative and self-care. 

Workplace Violence 

Workplace violence and bullying are serious issues, and the nursing field is not immune to these challenges. The American Nurses Association (ANA) defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient.”

This is one of the more dangerous challenges nurses face, and it’s a prominent concern. According to a 2022 survey crafted by the healthcare performance company Press Ganey, more than two nursing personnel were assaulted every hour during Q2 of 2022. 


According to a 2022 analysis conducted by McKinsey & Company, the United States may experience a registered nursing (RN) shortage of between 200,000 and 450,000 by 2025 without industry and government intervention. 

A continued shortage of nurses is an ongoing challenge. This contributes to nurses being stretched thin and overworked. For a nurse who takes the care of patients seriously, it can be frustrating to not have enough time to devote to each individual patient or interact compassionately with their families. 

Technological Advancements

Technological advancements have impacted the healthcare profession in positive and exciting ways, but technology has also created one of the newest challenges in nursing.

Technology moves at a very fast pace, and new advances can have an immediate impact on the way nurses work, requiring nurses to continually learn new skills. New software or equipment can seem overwhelming, especially if one doesn’t have a natural aptitude for technology.

Patient Death 

Due to the nature of the job, nurses in certain clinical settings can be exposed to dying patients. Their death can evoke a wide range of emotions, such as sadness, compassion and helplessness. 

It’s important for nurses to develop strong coping strategies that can help them prevent compassion fatigue from overwhelming them in the wake of patient death. Doing so can help them focus on delivering consistent care to every patient they encounter.