The president of the American Samoa nursing leaders council says attracting Pacific islanders into nursing is one of their major challenges.
Toaga Seumalo, who is also the director of nursing at LBJ Hospital, just been re- elected to another term as president of the council.
Mrs Seumalo says the council is committed to addressing problems such as the recruitment and retention of staff.
She says some measures have been put in place to ease pressure.
"We do have a programme at the college that really helped our local government address the nursing shortage because we don't have to move off island to go to school, we are here and working at the same time, and at least that's a positive impact to us and to the other islands' jurisdictions."