Question

Briefly discuss the solution nursing could use address the current issue topic Nursing shortages

Answer 1

Ans) Demand > supply:

One of greatest challenges
Contributes to:
-long wait times, adverse pt events, untenable work situations for RNs and other workers.

Shortage calculation:
Determine required nurse-client ratio OR determine required nursing patient care hours pr day.
THEN: Establish number of FTEs required.
LASTLY: subtract projected figure from actual figure.

Reason for nursing shortage:
Nurses are the most common HCP.
Nurses are expensive.
1. Salary (more money, better shift differentials)
2. Schedule flexibility (constantly working different shifts)
3. Work load (shortage, ^life expectancy, pt acuity, faster hospital d/c rate, staff cuts- nonRN)
4.No time/ $ for PD (have to use own money/on own time)
5. Lack of FT work (no benefits, no time off, no mat leave)

Shortage outcome:
Increase OT (forced), inadequate resources, lack of support from co-workers/admin, med errors

Effects of RN shortages:
Mortality and morbidity following complications.
Odds of p mortality ^7% for every added pt on an RNs workload.

The Shortage Paradox
RN are looking for work, not enough RNs working in system.
Not enough RNs looking for work, enrolment has decreased.

Shortage worsening:
- Workforce is aging (impending retirement)
Workforce is not expanding.
Small number of new RNs, jobs stagnated.

1. Increase RN productivity
2. Reduce annual RN absenteeism
3. Increase RN student enrolment
4. Improve retention of practicing RNs
5. Reduce RN student attrition rates
6. Reduce international in-migration

Increase productivity:
Best short-term yield, would reduce shortage by 50% by 2022.
Method:
-Remove non-nursing tasks
-Provide support staff
-Make availave technology, equipment, job specific staff

Reduce absenteeism:
Decrease from 14 to 7 days (must last 3 years, equal to adding 7000FTE RNs)
Method:
-Improve health and well-being
-Address high overload
-Acquire/implement technologies to dec. injury/infection
-Address workplace morale
-Ameliorate shfit work
* safe, happy, healthy workplace

Increase students:
Increase by 1000/yr across Canada, would not be felt until 2015
Method:
-Develop more pedagogical delivery methods
-Available faculty
-Location of programs
-Inter-profession education
-Practice

Improve retention:
Dec. exit rates to 2%
Method:
-Increase job autonomy
-Reduce overload
-Inc. feelings of value/ respect
-Include in decision making
-Provide opps. for education and PD

Reduce Student Attrition
From 28 to 15%
Method:
-Evaluate admission requirements
-on-campus guidance
-on-campus counsellors
-Remediation
-Availability of faculty
-Student financial aid
-Teaching methods

Reduce in-migration:
Have 50% fewer foreign trained nurses, would increase shortage (by 10%)
Method: national policies/ laws regulating practice.

Shortage exists b/c more RNs needed than there are employed (working conditions, govt. response, nursing silence)
Shortage approx. 11 000, going to be 66000
CNA proposes strategies.