In 2023, the American Hospital Association warned that the United States could face a shortage of up to half a million nurses by 2025. The same scenario applied to my home country, Nigeria, where there has been a consistent exodus of nurses from the country as they seek better opportunities abroad. The only difference is that Nigeria’s nurses’ shortage had been many more years in the making, and even patients could glaringly observe the dearth of human resources each passing year. With Nigeria already grappling with an alarmingly high patient-to-nurse ratio, this migration of skilled professionals is deeply troubling.
Having worked in both Nigeria and the US, both having vastly different economies and circumstances yet now facing similar challenges, I’ve witnessed firsthand the stark differences in their healthcare systems. Despite these differences, both are grappling with the same challenge: a nursing workforce pushed to its limits.Moreover, both countries strategically reflect the broader realities of healthcare in developing and developed nations.
What is the reality in Nigeria and developing countries?
There are many factors that have contributed to the nursing crisis in Nigeria. The first is the chronic underfunding that healthcare gets, which has long been a crisis. Nurses often work long hours in under-resourced facilities, lacking basic supplies, consistent salaries, or institutional support. Therefore, for many, emigrating isn’t just about ambition, it is more about survival and making the most of their training and career.
This trend has intensified. According to HealthNika, the National Association of Nigeria Nurses and Midwives reported that as of January 2024, over 15,000 Nigerian nurses had left to work abroad.
This brain drain is crippling Nigeria’s healthcare system, especially in rural communities where a single nurse might care for hundreds of people. Emergency rooms are overwhelmed, clinics are understaffed, and preventable deathsare tragically common.
A different struggle in U.S. and developed countries
In the U.S., the nursing crisis has taken on a different dimension. The onslaught of the COVID-19 pandemic pushed many American nurses to the edge. Despite better pay and advanced infrastructure, burnout, emotional fatigue and unreasonable workloads have driven over 100,000 nurses to leave the profession in the post-pandemic era.
To fill the gaps, hospitals have increasingly turned to international recruitment, including from Nigeria. No doubt this offers opportunities for many but it also raises serious ethical concerns: is it right to recruit from nations already struggling to meet basic healthcare needs and are experiencing mass emigration of professionals?
Nursing crisis is global not isolated
These parallel crises aren’t unrelated, they’re part of a larger, systemic issue. When Nigerian nurses emigrate to meet foreign demands, it solves one problem but deepens another. This interconnectedness highlights a sobering reality: healthcare is global, and so are its inequities. In the foreign lands, indigenous practitioners quit their jobs, switch careers and create more gaps for outsiders to fill.
The World Health Organisation has long advocated for ethical recruitment. When high-income countries siphon talent from under-resourced nations without investing in those systems, they perpetuate the very disparities they claim to combat.
What needs to change?
For Nigeria, urgent investment in the nursing profession is critical. That means fair wages, better working conditions, and opportunities for professional growth. Nurses must also be included in policy-making spaces as they deserve a say in shaping the future of healthcare.
In the United States, the solution lies not just in hiring more nurses but also in keeping them. Addressing burnout, promoting diversity and inclusion, and ensuring access to mental health resources are essential. Ethical recruitment should become the norm and not the exception.
On a global level, we need collaborative solutions such as nurse exchange programme, bi-national training initiatives, and regional workforce development strategies that can provide more sustainable paths forward. The expertise is there, what is needed is political and institutional will.
Looking ahead
Having lived and worked in both Nigeria and the U.S., I’ve seen the strain and I’ve experienced the shared opportunity. The global nursing shortage is a wake-up call; it is a chance to reimagine how we value care, and those who provide it.
If Nigeria, the U.S., and the international community commit to ethical collaboration and bold investment in nursing, I believe we can transform this shared crisis into a collective success.
It cannot be overemphasised that the future of healthcare depends on how we care for the caregivers.
Temitope Ogunkoya, a licensed Registered Nurse (RN), a certified Clinical Nurse Leader (CNL) and a Master of Science in Nursing (MSN), writes from the United States.
