The debate over nursing shortages in the United States is intensifying, with critics arguing that hospitals are adopting lean staffing models and utilizing gig workers to cut costs, rather than addressing a genuine lack of nurses. This approach, they contend, exacerbates workload issues for remaining staff.
Katie Wells, a senior fellow at the AI Now Institute, stated that hospitals are increasingly turning to apps to hire nurses on a gig basis. This practice, she explained, often allows healthcare facilities to bypass providing benefits to these workers. "Lean staffing has just become the norm," Wells told TIME.
The American Hospital Association (AHA) disputes this characterization, asserting that the issue is indeed a workforce shortage, not just lean staffing. The AHA projects these shortages will persist for over a decade. In a statement, the association noted that nurses face growing demands due to the increasing complexity of patient care, stringent regulatory requirements, and administrative burdens imposed by corporate insurers.
Rick Pollack, AHA's president and CEO, highlighted rising operational costs for hospitals. In 2025, hospital expenses increased by 7.5%, outpacing the growth in hospital prices. He also pointed out that hospitals are currently treating patients with more severe and complex conditions than in previous years, further straining resources and staff.
This divergence in perspective suggests that while licensed nurses may be available, the conditions and demands of bedside roles may be deterring them from taking on positions that have become increasingly challenging. The core of the issue may lie not in the total number of nurses, but in their willingness to fill roles that have become significantly more demanding.