Nursing Shortage - Research Paper Example

Nursing Shortage, a Major Healthcare Issue Introduction The shortage of nurses in U.S has assumed serious proportion in last few years. American Association of Colleges of Nursing defines nursing shortage as the insufficient number of qualified nurses to meet the future needs of the country in a given healthcare settings. World Health Organization defines nursing shortage in terms of demand and supply gap wherein demand of nurses far exceeds the available supply. Such shortages may have serious implications in providing adequate healthcare services and in maintaining the healthcare standards to the citizen of the country. The seriousness of the matter can be gauged from the following reports. In July 2007, American Hospital Association released a report that U.S hospitals needed approximately 116,000 RNs to fill vacant positions. Percentage wise this translated into 8.1 percent of occupied positions. Dr. Peter Buerhaus and his team estimated that shortages of registered nurses in the U.S. would reach as high as 500,000 as per their report released in 2008. They stated in their report that demand for RNs is likely to grow by 2-3 percent each year. (Nursing Shortage…) The 2008 survey of registered nurses indicate that as of March 2008, there were 3063,162 licensed registered nurses staying in the U.S. This survey indicated that only 153,806 RNs were found to be working more over the last survey of 2004. However, it was found that 444,668 RNs obtained their license between 2004 and 2008. This indicates that 291,000 RNs surely went out of nursing services either due to retirements or due to other reasons. (The Registered Nurse (a)…) This trend surely indicates that matter could become grave in few years time. U.S. Bureau of Health Professions report supply demand projections of Registered Nurses up to the year 2020 that is depicted in the following graph. National Supply and Demand Projections for RNs, 2000 to 2015 Source: Bureau of Health Professions, RN Supply and Demand Projections URL: http://bhpr.hrsa.gov/healthworkforce/nursingshortage/default.htm History and Evolution of Shortages of Nurses in Healthcare Though nursing shortages are observed from the days of World War II, it has impacted now significantly. The four factors that have contributed heavily in creating the shortages of nurses can be described as per the following. 1. Rise in population of U.S 2. A fewer people opting for the career in nursing 3. A generation called baby boomer is now retiring to create pressure on health care services. 4. Ageing workforce gets out of nursing services In 1950, U.S population was 152,271,000 that have now almost doubled at 307,212,123 in 2009. Population has gone up at the rate of 1.8 percent per year. In view of the increasing standards of health, nursing population need to rise at much higher rate than the general population rise but that is not happening. The reasons for shortages in nursing are not sudden. The results obtained from the National Sample Survey of Registered Nurses carried out in 2000 indicated that too few people are choosing careers in nursing. The statistical data as available for the employment of young between 1980 and 2000 are worth noting to indicate the trend. In 1980, 52.9 percent of RNs were the age below 40 and 26 percent were the age below 30. In 2000, 31.7 percent of RNs were the age below 40 and 10 percent were the age below 30. (The Registered Nurse (b)…) Shortages of nurses are also being felt because baby booming generation (born between 1946 and 1964) is now getting retired causing increasing pressure on healthcare services and so on the services of nurses. Ageing and trained workforce gets out of nursing services due to retirement or other social reasons causing more pressure on services. Currently, the nursing profession is the largest segment of the U.S healthcare system. Nurse to Patient Ratios are under pressure affecting healthcare services severely. Unfortunate part is that there is a continuous decline in the availability of nurses as they prefer to digress to other professions after getting license in the nursing career. Implications of Nursing Shortage Implications of nursing shortage could be many and varied on patient, community, nurse and other healthcare worker. The foremost implication will come in the form of patient not getting appropriate and timely healthcare. The very purpose of establishing healthcare institution with latest technology and sophisticated equipments is defeated, if adequate healthcare professionals are not made available to make full use of those facilities. For balanced growth of healthcare services, it becomes necessary that healthcare workers including trained nurses are also available in appropriate numbers from time to time. Merely establishing good institutions will be only eyewash in the name of providing health care services. Other implication of nurse shortage is on nurses themselves for those who are in job will be overloaded in the work; they will not be able to take time off or leave as per their need resulting into over burn in the job. This also prompts them to digress from the job at an earliest opportunity creating further shortages and thus a vicious cycle sets in. Insufficient worker in any profession is likely to create pressure on peers and the quality of service gets affected and the same is applicable in healthcare services with respect to nurses. The fallout effect trickles down to community and society who finds them in dilemma in receiving proper healthcare. Buerhaus in his report showed that 4 million days of hospital care and 6,700 patient deaths could be averted every year by increasing the number of nurses. (Dunham, 2009) Implication of such shortage also reflects in GDP of the country as in absence of inadequate and proper healthcare services, working class fail to contribute in national economy to its fullest capacity. Though its actual effects are difficult to measure yet at times, it can be perceived if seen in a correct perspective. Global Scenario There are currently 57 countries facing shortages of nurses, doctors and midwives. The shortfalls are greatest in Africa and South-East Asia. Most of the countries suffer from urban concentration and rural deficits of the healthcare workers. The crisis is likely to deepen further. With the growth of population the demand of service providers will increase in all the countries regardless of whether the country is poor or rich. Rich countries face an issue of large elderly people causing a shift toward degenerative diseases requiring highest of care. Technological advances and income growth will exert pressure on nursing care for elders with reducing capacity of family members to take care for their elderly members. (The World health…) Nursing Research Done by Other Health Care Professionals Robert Wood Johnson Foundation Robert Wood Johnson Foundation in collaboration of the Institute of Medicine has taken a major initiative on the future of nursing. The program will undertake a study to produce a transformational report on the future of nursing. The Institute of Medicine will come out with precise blueprint for action required at local, state, and national levels. The committee's thrust will be on innovative ways to address health care quality, system changes and the nursing shortage in the U.S. The main focus will be in identifying vital roles for nurses to have more efficient and effective healthcare system covering following key issues. 1. Increasing the capacity and redesign nursing education so that sufficient number of nurses can be produced to meet future and current demands. 2. Luring and retaining well trained and well prepared nurses in different healthcare settings such as ambulatory, primary and long term care, and community health. 3. Keeping focus on nursing and its services find innovative solutions pertaining to care and professional education. 4. Understand and conceptualize the role of nurses in the context of the shortage, current and future technology and societal issues. The project duration is 24 months. Of this 13 months will be devoted in information gathering, preparation of report and regional forum summaries. It will take inputs from two policy oriented workshops and three regional forums. At the end of the 24 months, the RWJF and the IOM will organize a national conference where all the issues will be raised and discussed. (Initiative on the Future…) Resources Employed to Deal Nursing Shortage To short out nurse shortage issue, remedial measures are required in several directions. The American Nurses Association Magnet hospital program has made significant impact in improving the standards of nursing practices. Currently, 85 organizations fall under the category of Magnet Hospitals maintaining sufficient nurse staffing, nurse autonomy, strong administrative support, and better control. The program is making a positive impact on nurses, patients and their families. The productivity of nurses has increased with their high satisfaction levels. Magnet hospitals have been able to increase retention rates of nurses through their progressive outlook. (ANCC Magnet…) Many states have taken initiative to address the issue of nursing shortage. Illinois made a plan to provide grants to nursing schools to increase student enrollment. California has planned to deploy about $90 million in expanding nursing education. Pennsylvania has announced to add six new nursing education initiatives to expand in this direction. Federal Initiatives to Alleviate Nursing Shortages Federal government initiated several programs encouraging new RNs to practice in communities with severe shortages of RNs. Nursing Education Loan Repayment Program (NELRP) and the Nursing Scholarship Program are the two programs to support and motivate the nurses in this field. Another response to the nursing shortage was Nurse Reinvestment Act. The act established the Nursing Scholarship Program covering many placement sites for these programs such as Nursing homes; Rural health Clinics; Hospitals; Federally qualified health centers; Ambulatory surgical centers and many more. (Toward a Method…) In 2009, Obama administration has earmarked $100 million in meeting nursing shortages alone while devising new healthcare scheme. About nurses, Obama expressed "the front lines of the healthcare system," and stated further: "They don't get paid very well. Their working conditions aren't as good as they should be." (Dunham 2009) Conclusion New advances in medical science and technologies are being witnessed in new millennium and yet its benefits cannot be harnessed fully due to shortage of nurses. As in other services, healthcare services also need human endeavor in forms of nurses and doctors to make available these services to the common people. High-tech equipments and technology cannot make any impact on human healthcare if sufficient support staff who takes care of the patient emotionally and physically is not available. This becomes more important when ageing or retired population of the nation is increasing substantially every year demanding much higher nurse-patient ratio then it was available. This can be achieved and done by making nursing profession more rewarding and attractive so that more people join this profession and industry also retain them so that they do not digress to other professions. For this, it is required to have a long term strategy right from attracting students for nursing courses at graduate and higher levels and providing them employment at lucrative terms increasing the charm and value of the profession in the society. References: 1. Nursing Shortage Resource (n.d). Retrieved May 3, 2011 from http://www.aacn.nche.edu/Media/shortageresource.htm 2. The Registered Nurse (A) Population (n.d): Findings from the 2008 National Sample Survey of Registered Nurses Retrieved May 3, 2011 from http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/ 3. The Registered Nurse (B) Population (n.d): Findings from the National Sample Survey of Registered Nurses Retrieved May 3, 2011 from http://www.bhpr.hrsa.gov/healthworkforce/reports/rnsurvey/default.htm 4. The world health report (n.d). Retrieved May 3, 2011 from http://www.who.int/whr/2006/overview/en/ 5. Initiative on the Future of Nursing (n.d). Retrieved May 3, 2011 from http://www.iom.edu/~/media/Files/Activity%20Files/Workforce/Nursing/Project%20Background.pdf 6. ANCC Magnet Recognition Program (n.d). Retrieved May 4, 2011 from http://www.nursecredentialing.org/Magnet.aspx 7. Toward a Method for Identifying Facilities and Communities with Shortages of Nurses, Summary Report (n.d). Retrieved May 3, 2011 from http://bhpr.hrsa.gov/healthworkforce/nursingshortage/default.htm 8. Dunham, Will (2009). U.S. healthcare system pinched by nursing shortage. Retrieved May 3, 2011 from http://www.reuters.com/article/2009/03/08/us-usa-nurses-idUSTRE5270VC20090308 Read More