Biggest issue I've seen (from outside looking in) is the traveling nursing program. Why work for $30 an hour when you can get 2-7x more.
From what I've read local nurses are signing up to be travel nurses then getting hired by the local hospital because the local hospital can't find nurses willing to work for the going rates.
If the hospital is willing to contract with travel companies they should also be willing to just pay more.
I'm considering getting my RN and becoming a travel nurse once my kids are gone so I can see the country and make serious bank.
I'm sure there are lots of other issues as well but it always comes down to money.