The world of nursing: what is the cause of the shortage? One of the few so-called eternal careers in the United States seems to have a taste of reality. . What was once a thriving career gradually began to struggle with a call to arms. Hospitals around the world are finding that the need for nurses is increasing as new nursing graduates decrease. Nursing schools are not able to produce enough new graduates to meet the need. Which requires adequate instructors with the necessary knowledge to train nursing students. Even with the rate of nurses earning a bachelor's or associate's degree each year, why do we have such a dire need for nurses? Have population and disease increased so quickly that our current nurses are unable to keep up? Many researchers have tried to understand what could be at the origin of this need. This need for nurses is vital to patient care and outcomes, but we still lack consensus. The question that has been asked since the 1980s without an answer. The medical environment has changed since the 1980s, positions and functions have changed. Each position contains specific tasks to assist with patient care and outcomes. Just like a pyramid, each position is ranked higher than the other. The doctors are on top and control patient care. They make their decisions based on the information provided to them by the nurses. The registered nurse (RN) is the next level and communicates between doctors and support staff. Support staff, the last level, assist patients individually. This position pyramid changes depending on the specialty or facility in which a person is employed and the patient's condition. One without the other is an impossible task...... middle of paper ...... staff but reduce hours, so staff are available when needed. Keeping staff available also reduces replacement cost. In an article by Kovner, Brewer, Greene, and Fairfield, "the estimated cost of replacing a registered nurse is 1.2 to 1.3 times the salary of a registered nurse, or between 40,000 and 65,000" (cited in Edwards , 2011). The recession is also affecting patients as well, with more and more people being laid off and having difficulty finding new positions. Fewer people are seeking medical care, especially when there is no insurance to help pay the bill. With all over-the-counter medications, patients rely on websites like WEB MD to diagnose and treat their symptoms. Ultimately, this will cause hospitals to make difficult decisions about how to stay afloat in a crumbling economy. How are new graduate nurses assigned? it would decrease.