Question

Describe the current Nursing Issue on the Topic Nursing shortages

Answer 1

A nursing shortage is a situation that occurs when the demand for qualified nurses is greater than the current supply of existing nurses. When this occurs the ability to provide quality healthcare begins to decline. The amount of time it takes to help patients increases, while the amount of work each nurse has to manage becomes increasingly overwhelming.

In the worst situations healthcare centers have to turn down new patients in order to try and meet the demands of the patients they already have. As the economy’s age and population size continues to grow and existing nurses increasingly reach the age of retirement new nurses will be needed to fill the gap.

Nurses are a critical part of healthcare and make up the largest section of the health profession. The nursing profession continues to face shortages due to lack of potential educators, high turnover, and inequitable distribution of the workforce. The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows. Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care given the national move toward healthcare reform. The American Association of Colleges of Nursing (AACN) is working with schools, policy makers, nursing organizations, and the media to bring attention to this healthcare concern. AACN is leveraging its resources to shape legislation, identify strategies, and form collaborations to address the shortage.

The causes related to the nursing shortage are numerous and issues of concern.

Aging Population

The population, on the whole, is aging with the baby boom generation entering the age of increased need for health services. Currently, the United States has the highest number of Americans over the age of 65 than any other time in history. In 2029, the last of the baby boomer generation will reach retirement age, resulting in 73% increase in Americans 65 years of age and older, 41 million in 2011 compared to 71 million in 2019.

As the population ages, the need for health services increases. The reality is that older persons do not typically have one morbidity that they are dealing with, but more often have a multitude of diagnosis and co-morbidities that requires them to seek treatment. The population is surviving longer, as a whole, causing increased use of health services as well. Many disease processes that were once terminal are now survivable for the long-term. Treating these long-term illnesses can strain the workforce.

Aging Work Force

Like the populations they serve, the nursing workforce is also aging. There are currently approximately one million registered nurses older than 50 years, meaning one-third of the workforce could be at retirement age in the next 10 to 15 years. This number includes nurse faculty, and that presents it's own unique problem, training more nurses with fewer resources. Nursing faculty is experiencing a shortage, and this leads to enrollment limitations, limiting the number of nurses that a nursing school can generate. Decreased and limited amount of faculty can cause not only fewer students but the overall quality of the program and classes can decline as well.

Nurse Burnout

Some nurses graduate and start working and then determine the profession is not what they thought it would be. Others may work a while and experience burnout and leave the profession. Turnover in nursing seems to be leveling off, but only after years of steady climbing in rates. Currently, the national average for turnover rates is 8.8 % to 37.0%, depending on geographic location and nursing specialty.

Career and Family

Adding to the shortage problem is the fact that nursing is still majority female, and often during childbearing years, nurses will cut back or leave the profession altogether. Some may eventually return, but others may move to a new job.

Regions

Current shortages and potential growth can be confusing when looking at regions and areas of the United States separately. Some regions have a surplus of nurses and lower growth potential, while other areas struggle to fulfill the basic needs of the local population as a whole. Nursing shortage amounts can vary greatly depending on the region of the country as well. Higher shortages are seen in different areas depending on specialty of nursing. Some areas have real deficits when looking at critical care nurses, labor and delivery and other specialties.

Growth

The fastest growth potential in the United States projected for West and Mountain regions, with slower growth in the Northeast and Midwest. A higher need is seen in areas that have high retirement populations. Even with these differences, every state is projected to have at least 11% growth through 2022.

Violence in the Healthcare Setting

Violence in the healthcare setting plays a role in the nursing shortage, the ever-present threat of emotional or physical abuse, adding to an already stressful environment. Job satisfaction and work effort affected negatively, as the physical and emotional insults take a toll on the well-being of the healthcare professional physically and emotionally. Emergency department and psychiatric nurses at a higher risk due to their patient population. A study conducted in Poland between 2008 to 2009 concluded that nurses represent the profession most vulnerable to aggression in the workplace with regards to a healthcare setting. Verbal abuse in the form of being spoken to by a person using loud vocal tones was the most common form of violence nurses were subjected to, with the inpatient nurses suffering more insults than those in an outpatient setting. Health care workers are at high risk of violence in all parts of the world with between 8% and 38% suffering some form of violence in their careers.

Staffing Ratios

Bedside nurses, actually deciding acceptable nurse-patient ratios, instead of managers, will lead to better job satisfaction, higher retention rates, and less desire to leave one's chosen profession. Appropriate staffing levels will decrease errors, increase patient satisfaction, and improve nurse retention rates. Nursing shortages lead to errors, higher morbidity and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout, dissatisfaction, and the patient’s experienced higher mortality and failure-to-rescue rates when compared to lower patient-to-nurse ratios. Some states have begun to pass legislation to limit patient-to-nurse ratios. Despite this, when staffing is short, ratios go up to meet the need.

Technology

Introduction of the Electronic Medical Record (EMR) and other technological advances can also affect nurses staying in the profession. While some specialties such as nursing informatics in booming, that adds to the shortage problem by removing nurses from direct patient care areas. Some seasoned nurses struggle with the technology and remove themselves from the profession at an earlier rate.

Empowerment

Organizations must be creative in meeting the needs of nurses while providing the best and safest care to the patients. An environment that empowers and motivates nurses is necessary to rejuvenate and sustain the nursing workforce. Empowerment in autonomy in staffing ratio decisions taking into consideration high volume and acuity levels will lead to less burnout, and strong desire to leave the workforce. Many organizations have endorsed and sought after the Magnet Certification as a way to provide superior nursing processes and high level of safety, quality and patient satisfaction.

Hospitals and healthcare facilities must do their best to recruit and retain good nurses by creating an atmosphere that appreciates nurses, offers advancement opportunities and gives them a stronger voice in the system. The publication composed a list of ways healthcare organizations can keep nurses on staff amid the threat of a nursing shortage. Strategies include:

• Allow scheduling flexibility. This helps nurses juggle their busy work schedule with home life and educational opportunities, and also allows them to decompress between stressful, emotionally demanding shifts. Keeping nurses happy when it comes to scheduling will create a more positive work atmosphere and help the hospital retain quality nurses.
• Promote career development. With new Institute of Medicine recommendations that call for 80 percent of nurses to have a bachelor's degree by 2020, it's important that hospitals help nurses obtain the highest education possible. As a result, nurses will feel more satisfied and more likely to stay within the organization.
• Listen to nurses' voices. Give nurses and staff ample face time with supervisors and managers, so they can voice concerns and share ideas about improving workflow. Implementing those ideas and suggestions also shows nurses that hospital managers are serious about their opinions and input.

Solving the nursing shortage

There is no easy way to go about solving the nursing shortage, however there are some steps that can be taken to help move it in the right direction. By improving education, workplace conditions, technology and some of the legal aspects of nursing we can help to move the needle on the nursing shortage and maximize the healthcare that can be provided to the patients that are in need of quality care.

Education

One of the biggest challenges and leading factors in getting more nurses into the field is solving the shortage of qualified nursing teachers/professors. It is estimated that most nurses that move into the education field experience a pay cut in their salary and may also see reductions in terms of other benefits. These reductions make it difficult to compel more nurses to continue their education and/or become nursing instructors/teachers. By increasing the education budget for nursing programs and providing more incentives for nurses to go into teaching colleges and universities can expand their nursing program and except more students. While it is easier said than done being able to increase campus resources, teacher capacity and the nursing programs being offered at the schools we can see less students being turned away and more growth in the nursing industry as a whole. The ability to improve this area is largely dependent upon offering nursing teachers enough incentives, increasing education budgets and expanding campuses to except a greater capacity of nursing students. The legal, financial and academic aspects of improving the education field are complicated but may be necessary to see positive movement in nurse education and healthcare.

Workplace

One of the main areas of nursing that can be positively affected immediately is the current condition of the workplace. Open communication, employee satisfaction and investments in medical technologies can greatly improve workplace conditions and lead to more effective patient care. When a healthcare facility is dealing with a nursing shortage (minor or large) it becomes increasingly important to ensure that employee communication is a primary focus. Rather than simply enforcing rules and expecting compliance healthcare facilities should focus on improving their employees spirit and work satisfaction. Acknowledging and listening to employee complaints, providing constructive feedback, rewarding and incentivising good performance and investing in technologies that can take some of the workload/stress off of the employees can go along way towards improving moral and patient care. Investing in good leaders and staff is one of the most important things a hospital can do to keep employees performing, especially during times of a nursing shortage. It can also help a healthcare facility become less perceptive to a nursing shortage by reducing turnover and improving the interests of applicants. If a hospital or healthcare center can afford to hire more staff in order to reduce the stress of existing staff members and improve overall patient care then it is a move they should definitely consider.

Technology

Technology is an extremely important component of nursing in many different aspects. Technology allows nurses to communicate more effectively, manage additional workloads, provide better healthcare to patients, complete tasks faster and reduce work stress and work related injuries. Continued efforts in advancing communication and healthcare technologies will allow individual nurses to get more work done in less time with less effort, which can lead to better patient care and steal back vital time so that nurses can focus on what’s truly important. By bringing together entrepreneurs, healthcare facilities, legal institutes, government agencies and other healthcare bodies we can create technologies that can empower fewer nurses to do more and gain better results. The goal isn’t to reduce nursing sizes but to help nurses become more productive and effective while reducing their stress and workload by offsetting some of the mental/physical tasks they normally have to manage. While these are just a few brief examples of what can be done to improve the current condition of nursing they are important to consider and think about. Many things can be done to improve healthcare as a whole and for things to get better we need more focus on the education, workplace, legal and technological areas of nursing and healthcare.

Career outlook

While the nursing shortage may sound overwhelming (and at times it can be) those who work in the nursing field can appreciate a lot of positive things that are related to working in healthcare. For starters being a part of nursing and using your experience and expertise to improve the lives of patients can be extremely rewarding all by itself, however there are also a number of positives related to the career outlook of those who enter the nursing field such as job security, higher wages, employee benefits and career growth opportunities. Those who are interested in becoming registered nurses can look forward to a host of positive benefits and a fairly secure future as the role of nursing will only become more important over the years.

Job security

The constantly growing need for qualified nurses means that those who enter into the nursing field can appreciate a high level of job security. Acquiring a bachelors degree and gaining important experience can increase your odds of quickly securing a job and being able to move into advanced/specialized fields. Hospitals and healthcare centers are always looking for good nurses to improve their facilities and are often willing to offer good wages and competitive benefits to nurses that are able to provide them with the quality of patient care they seek.

Higher salaries/wages

Because the nursing field is in a growing demand nurses can expect hospitals and healthcare centers to offer excellent salaries in order to keep their nursing staff happy and attract new quality nurses. In some areas this can lead to competition which can further increase the opportunities for nurses to earn a good income.

Employee benefits

Aside from earning a higher salary nurses may also receive good healthcare benefit packages and other incentives as a way to attract more nurses into the hospital or healthcare center.

Career growth opportunities

The nursing field is quite diverse and offers a plethora of opportunities for those interested in healthcare. In fact there is a field for almost anyone who’s interested in the healthcare system whether its neonatal care, emergency care, mental health, law, research, entrepreneurship or politics there is a field that nurses can pursue. Nurses can even become practitioners and open their own clinics. With the right training, education and effort nurses can enter into almost any field they desire and because healthcare has been important since humanity first began it is fairly safe to say that nursing will continue to be an important field for many years to come.