Nursing understaffing at the center of the World Health Organization’s “Nursing Action” project

Nursing understaffing has emerged as one of the most critical challenges facing health systems globally and across the European Region. Nurses constitute the largest professional group within healthcare organizations and provide the vast majority of direct patient care. Adequate nurse staffing is essential not only for patient safety and quality of care, but also for the physical and mental well-being of nurses, the effective functioning of healthcare organizations, and the long-term sustainability of health systems. In recent years, and particularly following the COVID-19 pandemic, nursing shortages have intensified, revealing structural vulnerabilities that demand coordinated international action. The causes of nursing understaffing are multifactorial and interconnected. Key drivers include workforce ageing and retirements, poor working conditions, high levels of occupational stress and burnout, low salaries, limited career development opportunities, and insufficient educational capacity. Migration of nurses to higher-income countries has further exacerbated shortages, while the pandemic has contributed to increased attrition through illness, mortality, and resignations. At the s