Historical and contemporary perspectives on nursing workforce satisfaction

In 1928, the Committee on the Grading of Nursing Schools published “Nurses, Patients, and Pocketbooks,” which surveyed nurses and revealed widespread dissatisfaction with working conditions, pay, and hours, despite a strong commitment to patient care. Nearly 100 years later, the 2024 National Nursing Workforce Survey by the National Council of State Boards of Nursing echoes similar concerns on a much larger scale. The COVID-19 pandemic further intensified these issues, accelerating retirements and increasing the demand for complex care. These pressures have continued to erode job satisfaction and exacerbate the ongoing nursing shortage. Nurse dissatisfaction is not a new phenomenon but a persistent, systemic issue with serious implications for workforce retention and patient care quality. By tracing the historical continuity of these challenges, the urgent need for structural reforms in nursing leadership, policy, and practice are highlighted. The aim of this work is to explore how nursing satisfaction has evolved over the past century, describe persistent challenges, and offer implications for nursing leadership and policy.