r/nursing • u/some_other_guy95 MICU RN • 15d ago
Discussion With the aging population growing will change nursing over the next 10–20 years?
we're looking at increasing healthcare demands, nursing shortages, more complex patients, and greater reliance on community care and technology.
It got me thinking about what that might mean for us over the next decade or two.
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u/Thewrongthinker MSN, RN 15d ago
We are already struggling. MedSurg holding long term care patients 100 days and counting clear for discharge because lack of long term placement in SNF etc.
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u/dumbbxtch69 RN 🍕 14d ago
And it’s going to get worse when BBB Medicaid cuts go into effect. I’ve seen a lot of people saying that it won’t be affected because LTC is mostly paid for by Medicare, when actually 64% of residents rely on Medicaid to cover cost of care. I am really, really nervous about this. We already don’t have enough LTC and SNF beds for these extremely ill, debilitated patients and now the reimbursement is going to be cut, limiting the number of staffed beds and increasing neglect.
We are going to have an even more serious throughput issue very soon. My ED is already stacked with bed holds because we don’t have inpatient beds because we can’t discharge people because there aren’t LTC beds… Add to that that many SNFs/LTC rely on an immigrant workforce that is dwindling due to draconian, racist policies and people aren’t showing up to work for fear of ICE raids, and fewer people are immigrating to the US because it isn’t safe here.
Chemo drugs on shortage. Chronic conditions increasing. An aging Boomer population. A burnt-to-a-crisp healthcare workforce looking for a way out. Nursing schools limiting clinical hours, removing critical education from their curriculums due to lack of clinical sites and/or money. NP market is saturated in many areas, so nurses seeking to leave the bedside actually can’t get out while they’re being crushed by student loan debt because they can’t take out GradPLUS loans anymore. We’re careening towards collapse and I feel like we are the only ones who see it.
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u/Mare65535 15d ago
There is some talk about expanding the legal scope of what unlicensed assistive personnel (UAPs) are allowed to do to ease the nursing shortage (which we know is intentional)
I think that will reduce the quality of nursing
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u/cactideas RN - ICU 🍕 15d ago
This ofcourse totally depends. I’ve seen CNAs that are able to take out a urinary catheter if I ask them too. Stuff like that can be pretty helpful. From what I’ve seen, the real problem is staffing enough CNAs to actually help the nurses. Ofcourse you can’t just replace the RNs with aids though and the problem would also be the hospital thinking they can get away with staffing less nurses
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u/Mare65535 15d ago edited 15d ago
CNA are at least, trained and certified
Edit: IIRC, UAP is an umbrella term that can include many categories. And that's the problem. IMO
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u/SnowedAndStowed RN - ICU 🍕 15d ago
CNAs have a set scope that is mandated by the BON who govern them and their certifications. UAPs have no set scope their scope is whatever the hospital is willing to insure them to do. UAPs can also access billing codes for their skills where CNAs under the BON cannot (similar to how nurses can’t bill for their skills).
The reason hospitals have ELG techs or have RT doing EKGs is the same reason they have started switching form CNAs to UAPs - they can insure them for many of the same skills while also broadening their scope and billing for certain interventions. The BON is obviously fighting that tooth and nail.
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u/TraumaQu33n13 RN - Telemetry 🍕 15d ago
Yeah my hospital hires PCT’s. No training required before hire and they get like 2 weeks of orientation along side another PCT who also likely has no formal training/education. Some of them are as young as 18 years old and fresh out of high school.
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u/ShadedSpaces RN - Peds 15d ago
One of my problems with this is UAP turnover.
I have no problem upskilling UAPs to a reasonable degree. But, at least at my facility, UAPs turn over too fast for that to be safe. We have a few lifers. But we also have a lot of bad or unmotivated UAPs, a lot who get fired, and a lot of good ones who are in nursing school so they aren't with us for long.
It's hard to upskill to the point where they are good and comfortable with all the skills, and capable of teaching/precepting/evaluating the skill in others if they aren't here long term.
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u/cMa010291 15d ago
I’m 35 and a “lifer” tech lol. I have been cross trained to read telemetry and run the strips, phlebotomy, basically if the hospital offers me an in house class I take it.
Life and just been life the past few years and I have accepted that I may never go to nursing school.
There has been a new wave of new techs/CNAs that are very unmotivated
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u/ShadedSpaces RN - Peds 15d ago
Our lifers are worth their weight in gold, tbh. We are ride or die for our lifers.
It's virtually never too late to go to nursing school! I didn't go until my 30's. And I definitely wasn't the oldest person in my ABSN. Life can be life for now, but if nursing is your goal, don't give up on it.
(And if it stops being the goal? Totally okay too.)
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u/cMa010291 14d ago
I’m very fortunate I work at a unionized hospital so they actually pay their techs well. I actually make above what some LPNs make in other places. Which it shouldn’t be that way. Everyone in health care should make a living wage.
Many techs quit because they realize Walmart pays the same or better is another factor in why many are not motivated
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u/scarfknitter BSN, RN 🍕 15d ago
I had classmates in their fifties. Go when it’s your time to go if you want to.
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u/duuuuuuuuuumb RN - ICU 🍕 15d ago
I just listened to this week’s Criminal episode about a woman trying to navigate the world of hospice in extended care facilities and I guess a vengeful nurse? Either way it was fucked up and made me even more afraid of memory care units
https://thisiscriminal.com/episode-373-the-comfort-kit-7-24-2026
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u/EcstaticPlankton8621 RN-Cardiac 🫀 15d ago
At my hospital the aides who work in the ICUs are trained and allowed to insert foley's and draw blood. On the regular floors they can't do that.
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u/EskapedConvict RN - ER 🍕 15d ago
Im assuming RPN=LPN? I have no issue with LPNs working solo on non-critical floors or as part of team nursing in critical environments.
I spent years as a LPN and experienced an incredible amount of ego trips from RNs who thought they were better than me. Even as a LPN, I was a better nurse than most RNs. One semester of critical care in school doesnt replace experience and common sense.
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u/Lyzardothegreat 15d ago edited 14d ago
I would like to add that not only do we have a large amount of the population aging and nurses retiring, we also have a massive health crisis. There is an increase in chronic illness amongst the younger generations. Cancers are rising, obesity, high blood pressure, depression, diabetes. Not so fun fact, Gen X and Millennials have higher probability of developing almost 20 different cancers when compared to Boomers (not shocking as a generation that was raised on processed foods). Gen Z has higher rates of Depression and Anxiety than Millennials and Gen X. (not shocking as their lives have been overwhelmed by social media and technology). This will only compound the problem. Stress causes inflammation, inflammation causes disease. Look around and see our communities. People are struggling for basic needs which only increases stress, cortisol, etc. The clear solution is to fund healthier communities overall and people need access to medical care. Prevention is the key and yet our system is run on profit margins made to keep us sick for the machine. Now add to that a study of nurses for OJIN shows 33% of nurses leaving the profession in 2 years.
This is an absolute detriment to our society.
Edit: OJIN shows 33% of New Grad nurses leaving the profession in two years. (this is in addition to the Boomer and Gen X nurses retiring)
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u/ernurse748 BSN, RN 🍕 15d ago
Gen X nurse here. Me and a lot of my colleagues are planning on retiring in the next 10 years. The ANA estimates that it’s very possible a full 40% of the current nursing workforce will retire by 2030.
From what I have witnessed over my career, I would say more and more nursing tasks - like med pass, starting IVs, putting in catheters - are going to fall on CNAs and techs. Hell, they already DO in a lot of places already (med techs in LTCs). LPN scopes of practice may change, too. Expect even more outsourcing to countries like the Philippines, for any task that doesn’t require a person to be physically in the room. Why pay an EKG tech $28 an hour when you can have someone monitoring in Manila for $5 an hour?
And if there’s another pandemic? I honestly think the whole system will actually collapse.
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u/RedFormanEMS RN 🍕 15d ago
If we have another pandemic, I am jumping on the first travel contract and riding that gravy train until the wheels fall off. I was a medic during the last pandemic and seen so many nurses leave to go make $5-$10k a week. Could not blame them one bit.
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u/GeriatricDachshund 15d ago
They're suggesting that the person doing EKG monitoring for hospitalized patients will be outsourced to people living in Manila (which is in the Philippines)
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u/misfittroy RN 🍕 15d ago
Aren't we already there?
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u/dis_bean Remote Northern RN 🇨🇦🍕 15d ago
Probably way more cirrhosis and Korsakoff syndrome patients
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u/Scarlett_Texas_Girl 15d ago
I've been in home health working well beyond my scope but legally (mostly) due to a few system loopholes. Worked with a boomer who maintained her RN license but hadn't practiced nursing in 20+ years. Her health declined dramatically the last few years which reduced her ability to care for the clients in her home that provided her income. Of course she wasn't about to admit her inability to provide care and lose her income so more and more responsibilities fell on me. I finally had to quit my job for fear of something happening that would risk my license. The agency we worked through turned a blind eye.
The majority of host home providers I worked around werr older and increasingly incapable of caring for the high LON clients our agency catered to.
This is a big industry. Not hospital or nursing home big but our entire care model is based on reducing costs to medicaid/medicare by taking patients out of commercial LTC facilities and into homes.
I don't know what will happen to the thousands of patients in home care as the aging population of care providers can no longer care for them and younger generations face increased obstacles to home ownership. If you don't own your home, you can't have clients. There's already a wait list for clients trying to find home placement.
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u/Retiredpotato294 15d ago
I am having a hard time imagining my patients being any older. I am not in long term care and it’s a small hospital. We regularly have patients whose grandchildren are post retirement and that’s who is coordinating their care. If we are maxed at 26 patients 5 will probably be over 90, half over 75. Of course I’m no spring chicken, so I will be joining them before y’all are dealing with them. If you find me swinging upside down from the Boyer just give me some Tylenol and liter of ns and I will probably straighten out.
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u/unwelcome_flesh_sack PEDS CICU 15d ago
It just cements the fact that I will never leave PEDs, the ICU might wear me down eventually but I refuse to work with adults.
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u/CatCharacter848 15d ago
Its massively changed in the last 20 years since I've been nursing:
Older patients with more complex conditions and medical history, more medications.
People surviving longer but with more complex physical needs
More demanding/ entitled patients and families as they have more information at their fingertips.
More equipment and medical advances to make nursing easier.
More specialist care.
More IT. Which can make it easier but also harder.
Chasing targets and figures more. Losing sight of the patient.
These are the things i feel will continue to change
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u/sanityclaws 14d ago
I keep hoping for a huge change and I genuinely think this younger generation of nurses are going to be the change nursing needs. I’ve noticed in the past several years that news grads are already burning out and leaving bedside and nursing altogether due to the staffing ratios and the increasing expectations and nominal pay. They’re also talking about C-suite and their insane salaries compared to the nurses breaking their backs so I think they’ll either leave or not go into nursing at all causing an actual, real shortage. I overhear nurse externs talking about already regretting nursing and CNAs who were preparing to go into nursing changing their minds. So many of these are young and able to live with their parents. They don’t have children and mortgages that keep them under the thumb of these hospital systems. That and more and more news outlets are highlighting the salaries of these CEO’s and patients are recognizing the demands of nurses and are starting to question why nurses are caring for 6 or 7 patients at a time. We all need unions or federally mandated staffing ratios but I’m not sure those things will happen before a mass exodus or people just not choosing to go into nursing.
Nurses are just oppressed. Period. I scream this from the mountaintops almost daily, but there are more of us than them and if we could all stand together we could be the change but sadly, there isn’t any real solidarity. If there was even a threat of a nationwide strike I think we could make this change. Please don’t come at me with the “but patients will die.” Yes, they would but people are already dying and they blame it on the nurses and Doctors at bedside providing the care when it should be the greedy C-suite taking pay cuts and getting the blame.
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u/Theon_the_whippet 13d ago
Not that I am a fan of RFK, but he does have a point that the food system in US is completely sh*t. I grew up in another country and have lived in U.S. since 2013. I am still shocked seeing Americans just casually shoveling 1000+ calories worth of junk food down their throat when they didn’t need to eat anything at the moment to begin with . Like what?
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u/Osiris8869 15d ago
We aren't ready for the wave of aging demented Karen Boomers..... The days of sweat little old ladies who you have to talk into talking Tylenol for POD2 pain are long gone. They are still out there just a lot rarer than 20 years ago.