A trust with around 500 nursing vacancies has admitted it is having difficulty recruiting and said it is considering filling some roles with other staff.
The number of vacant nursing posts is likely to grow, Julie Smith, chief nurse at the University Hospitals of Leicester Trust, said.
She told the Health Service Journal (HSJ) the priority is to ensure patients get the "right care" as she suggested options could include having a different ratio of registered nurses on some wards.
Ms Smith said: "We have got a scenario where we have 500 vacancies and that is likely to grow."
She added: "We have to make sure patients get the right care. Some of my nurses are doing tasks they don't need to do, they are cleaning bed spaces and giving out cups of tea, things other people can be trained to do.
"It might be that we replace a nurse with a pharmacist or a physio, I don't know yet. It depends on the level of care and the type of wards they are on.
"When we know what the boundaries for the nursing associates' scope of practice will be, it may be that on some of our wards, we do say we can have a different ratio of registered nurses."
The trust said any ideas are still at the "concept stage" and would not be brought in without the approval of regulators.
The journal also reported an email from trust chief executive John Adler to staff saying Brexit was having an effect on recruitment.
On Tuesday Health Secretary Jeremy Hunt announced a 25% increase in nurse training places to boost numbers of home-grown NHS staff as Britain leaves the EU.
Mr Hunt announced that an extra 5,500 nursing associates will get training on the job to qualify as full registered nurses via a new apprenticeship path.
The Department of Health said the moves were designed to "reduce the reliance on expensive agency nurses and overseas recruits".
Last month hospitals were urged to review job titles for workers after it emerged that a number are employing unqualified support staff as "nurses".
England's top nurses wrote to NHS trusts expressing concern after a study found that unqualified support workers were practising in the NHS with job titles that describe them as nurses with advanced skills.
In response to the situation at the University Hospitals of Leicester Trust, Janet Davies, of the Royal College of Nursing, said: "This worrying picture is proof that the nursing shortage is truly beginning to bite.
"Support staff on the wards are having to do the job of nurses to make ends meet. It is not fair on patients or staff alike. The shortage is made even worse as European nurses leave, but few can live with the uncertainty during the negotiations.
"The Government must increase the number of qualified nurses and give our European colleagues real assurances, not more meaningless rhetoric."
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