Health systems are under mounting pressure from nurse shortages, rising care demands and escalating burnout. That is why WHO/Europe has today issued the Region’s first-ever policy brief setting out concrete actions to address the crisis. At its core, the brief defines safe nurse staffing as having the right number and mix of appropriately educated and supported nurses to deliver safe care. Evidence consistently shows that when there are too few nurses without the right skill set, risks to patients rise, and so do stress, injury and mental ill-health among staff.
In 2022, WHO/Europe warned that health-care workforce shortages were a “ticking timebomb”, with new Region-wide estimates pointing to an expected shortage of nearly 1 million health workers by 2030. Further evidence from several European Union (EU) Member States has underscored how deteriorating working conditions and rising mental health pressures are accelerating nurse burnout, attrition and shortages – with direct consequences for patient safety.
“Nurses account for more than half – 56% – of the health workforce, the majority of whom are women. Safe nurse staffing is therefore not a luxury or administrative detail,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “It is a safety-critical investment – for patients and for the entire health system. If we are serious about patient safety in our health systems, we need to take concrete steps to adequately staff and support our workforce. The EU already faces a serious shortage of nurses; we simply cannot afford to drive them out of the profession.”
“Nurses are the backbone of our health systems, yet they are among those most affected by workforce shortages and high job strain,” said Dr Sandra Gallina, Director-General for Health and Food Safety, European Commission. “Across the EU, we are facing a shortage of health professionals and nurses, who suffer from heavy workloads and mental health pressures, and the interest in nursing careers is declining. The Commission supports Member States in addressing this challenge through EU4Health initiatives such as Nursing Action, Joint Action HEROES, training projects and support to address mental health issues. Other funding instruments such as Erasmus+, the Recovery and Resilience Facility and Cohesion Policy funds complement these efforts.”
Making the case for safe nurse staffing
Too often, nurse staffing decisions are made under pressure, without adequate data, mental health and well-being support, financial investment or long-term planning. WHO/Europe’s new brief equips policy-makers with a clear, practical framework to change that.
Drawing on global evidence and concrete examples from the 21 countries participating in the EU-funded Nursing Action project, the brief sets out how investing in safe nurse staffing delivers measurable gains, including lower patient mortality, improved quality of care, stronger workforce well-being and better overall health system performance.
From strategy to the bedside: a connected approach
The brief stresses that safe nurse staffing spans everything from national-level workforce planning to day-to-day decisions in hospitals and community care settings.
- Strategic safe nurse staffing means making the right long-term decisions about how and how many nurses are trained, but also how they are funded, and how the workforce is distributed and sustained.
- Operational safe nurse staffing means ensuring the right nurses are in the right place each day, responding to patient needs and the realities of care on the ground. Crucially, the brief makes clear that these measures cannot function in isolation. Strategic and operational measures are mutually reinforcing, and both are essential to achieving safe, sustainable staffing.
“We have evidence showing the negative impacts of unsafe staffing on the mental health and well-being of all health-care professionals, including nurses. These effects cannot be ignored,” said Margrieta Langins, Policy Advisor for Nursing and Midwifery at WHO/Europe. “This new brief now offers an opportunity to take concrete action to ensure that we protect and promote the mental well-being of the millions of nurses across our region.”
Eight policy actions
The brief identifies 8 priority policy actions to support effective implementation across Member States:
- Treat nursing as safety-critical
Safe staffing is inseparable from patient safety and staff well-being. Health systems must protect nurses from harm – including burnout and poor mental health – if they want patients to be safe. - Manage system complexity
Staffing is shaped by multiple factors including funding, digital technology, teamwork and increasingly complex patient needs. There is no single quick fix. - Build shared, long-term commitment
Lasting reform requires governments, employers, regulators, unions and educators to work together – and stay the course. - Use smarter data systems
Countries need reliable, interoperable staffing and workload data that support decisions without overburdening staff. Stronger national data also strengthens Region-wide evidence. - Strengthen monitoring and accountability
Clear standards, relevant regulation and transparent reporting are essential to ensure safe staffing. - Invest wisely
Funding matters – but so do the rules and incentives that ensure safe staffing becomes a standard and widespread practice. - Ensure high-quality education and training
Responsive education and continuous professional development enable nurses to meet real-world clinical demands and actively contribute to staffing decisions. - Empower nurse leadership
Strong, supported nurse leadership, with real professional autonomy, is critical to translating evidence into safe, context-specific staffing decisions.
Note to editors
The brief comes as part of the Nursing Action project, a 3-year initiative launched in 2024, led by WHO/Europe and funded by the European Commission under the EU4Health programme. Working with 21 EU Member States, the project supports the development and implementation of evidence-based strategies to recruit and retain nurses, improve working conditions and strengthen the nursing workforce across the European Region.