Critical Nursing Shortage in the Medical-Surgical Unit at ABC Hospital - Case Study Example

Critical nursing shortage in Medical-surgical unit at ABC Hospital Name Course Instructor’s Name Date Introduction Nursing forms an integral part of the society since people cannot function well or execute their duties if they do not have the fullness of health. Nursing as an active organ in the institution of medicine, helps promote good health, advice people on how best to improve their lives, diagnose, treat, and manage illnesses. Be it as it may, nursing as profession, has seen an extensive shortage of personnel globally, this is well illustrated by 100 people being served by one nurse in developed countries while the situation worsens in developing countries especially sub-Saharan Africa, where a nurse serves 5000 people in one locality, thus causing a universal public health crisis (Timofeeva, 2002). The shortage has been felt more so in the medical surgical unit at ABC Hospital. The report therefore, seeks to find out what are the contributing elements to the shortage, action plans for combating employee shortage in nursing and evaluate ways in which ABC Hospital’s medical surgical unit can be able to decrease the turnover of its nurses. Factors Contributing to Nursing Shortage The objectives of this report is to highlight factors that cause nurses to quit their jobs, analyze possible plan of actions in retaining nurses, and what the management can do to recruit new nurses and be able to retain them. There are factors and elements that have contributed the extensive turnover of nurses in the medical surgical unit in ABC Hospital. It is important to highlight these factors because, research done has shown that inadequate number of professional, skilled and experienced nurses has a fundamental negative impact on the outcomes of patients, that is, the success of treating and managing illnesses, diagnosing illness, and mortality rates (Charles, 2007). This means that shortage of nurses is causing deaths of patients, causing health impairment and wellbeing of the society. One factor is imminent and existing retirement of qualified and experienced veteran nurses who assists in surgeries (Feldman, 2003). More workforce exits in the medical unit are being experienced, by nurses who have served in the department long enough and feel they cannot work anymore. However, the entry level of new nurses is so low such that they are unable to fill the void that is left. This can be associated with fewer students studying nursing and low enrollment in nursing schools, and if they do, they prefer to work in other departments other than the medical units due to the workload in the department and the long hours in theatres. Relocation of nurses from one to department to the other in the medical surgical unit forms the highest factor to the shortage of its nurses (Timofeeva, 2002). This is caused by high demand for skilled nurses in departments like ambulatory care surgical units, inpatient units, maternity wards, consultation unit, emergency wards, intensive care units among other units, have an increased influx of patients. This forces the management to transfer or relocate nurses in the medical surgical unit in order to increase healthcare delivery and allow patients to be attended to in good time. Another factor is inadequate nurse staffing (Myers & Dreachslin, 2007). This shortage of nurses in medical surgical unit is due to logistics, management is only able to afford to employ few nurses per department to care for the patients. Another reason for the short- stuffing can be cited as low regard and opinion for skilled nurses. Many a medical management has operated without the service of a nurse because they do not understand the value of skilled nurses and instead employ unlicensed assistants who are paid minimally and carry out the duties of a nurse. Moreover, one nurse is delegated a lot of chores in the unit, and due to pressures of work and experiencing burn outs, they quit in search of more accommodative careers. Short staffing causes the patients out of surgeries to lack the care they so desperately need, which can result in deaths or other medical complications. Another primary reason for the exits of nurses in the unit is due to unfair treatment of junior nurses by their seniors (Timofeeva, 2002). Most of the case, nurses in the medical surgical units are female under the supervision of male doctors who at times may ask for sexual favors thus sexually abusing the nurses. Other reasons for the unfair treatment are experienced where promotion of nurses is done not by merit but by favorism, and discriminating against nurses due to either the color of their skins, gender, race, age, skills, nationalities or religious affiliation (Feldman, 2003). ABC Hospital due to the fact that they have a large number of patients that they have to handle - they have opted to employ nurses on temporal terms or in contracts. This has resulted in job insecurity for the nurses, who opt to look for work in other medical institutions that can be able to offer them financial and job security, further more it has been hard to attract and maintain preoperative nurses in the unit, since there has been high demand and competition for them Moreover, healthcare and healthcare frameworks are constantly evolving, being flexible to adapt to new changes socially, biologically, environmentally, economically, legally and technologically. The increased complexity of healthcare issues has necessitated and increased the need for complex technology to counter it (Feldman, 2003). This has resulted in increased need for nurses to be techno savvy, which has been a challenge to the aging nurses in the nursing fraternity. Furthermore, nurses straight from school are unable to handle machines used in surgeries due to inexperience and inaccessibility of surgical education contents. All these elements can be based on inadequate or shortage of funds and resources allocated to the nursing research and its education in higher learning institutions. Plan of Actions to counter Nursing Shortage Due to the great need to improve health care and improve outcomes of patients in the medical surgical unit in ABC Hospital, the report highlights fundamental steps and action plans that will help eliminate shortage of nurses, increase retainment of nurses already employed and addresses issues that have caused the increased shortage of nurses in the unit. These plans of actions include forming committees consisting of veteran nurses, medical personnel and managerial staff, which shall conduct research and survey of existing nurses, new nurses and exiting ones to understand what influences their decisions to remain or leave (Charles, 2007). After receiving the necessary information from the survey, the council can then come up with strategies to address grievances presented in the report. Motivating the nurses through a reward system that is comprehensive is another action plan (Myers & Dreachslin, 2007). They should implement rewards relative to the fact that they make sense to the nurses, and it is what the nurses would want for a reward. Reward system can be in terms of money, promotion, annual leave, and regular off days. Reward systems that make sense to nurses and improve their professional or personal lives, are bound to motivate them, make them offer their full potential, and result in best outcomes for patients. Another plan of action is incorporating veteran nurses or aging nurses in educating new nurses. This will help present the profession as an enjoyable one. Veterans can offer their own experiences in the profession and offer practical applications that new nurses can use during medical complications (Charles, 2007). Use of this action plans is beneficial in that the Hospital will reduce the rate of employee turnover, increase the morale of nurses and improve the working conditions in the medical surgical unit, thus making it an enjoyable unit to work at. Other action plans include reducing instances of unfair treatment of nurses, which can be done through team building exercises, and putting in place punitive measures for errant supervisors. Encouraging diversity and promotion should be done through merit and not by favoring a candidate over the other. The Hospital should invest in nursing research and education to equip its nurses to the ever-evolving healthcare issues. Further resources can be placed in surgical educational training of nurses, be techno well informed and have relevant experience (Timofeeva, 2002). Use of Recruitment Strategies as an Action Plan Before the Hospital resorts to recruiting new nurses, it should first assess its own management style and ensure that its culture upholds professional morals and ethics, and advocate for quality and competence of its employee. This allows democratic processes, minimizes abuse of authority, and creates balance of power in the working environment (Feldman, 2003). They can retain nurses through incorporating elements of diversity by creation of learning opportunities from experiences of veterans and technical know how of the young people. By investing in development of nursing as a profession within the organization is integral in making it stable and be able to compete with its competitors effectively and discourage its staff from quitting to go join others (Myers & Dreachslin, 2007). This can be done through incorporation of diversity, addressing physical needs of nurses like safety in working environment and increasing proficiency in technology. The Hospital can analyze the operational strategies of other quality service delivery and high performing medical institutions and emulate them (Charles, 2007). When using recruitment strategies as a plan of action to combat the shortage of nurses in the medical surgical unit, the management of ABC Hospital needs to be strategic in measuring the organization’s objectives against its culture and reputation, and assess ways in which diversity can be diffused in. While advertising and offering vacancies to potential nurses, the Hospital needs to understand the need to align its strategic objectives with critical recruitment procedures and activities. These critical recruitment activities are elements that influence people to seek work in a particular firm (Charles, 2007). These include the firm’s policies on recruitment, promotion, offering ranks to particular groups of people based on the race, color of the skin, religion among others. Furthermore, the Hospital needs to be open and honest about its policies, culture and what they expect of their employees when recruiting. Nurses would feel needed and appreciated if they are rewarded not necessarily by money but also treated with respect, integrity and with honesty (Myers & Dreachslin, 2007). The Hospital when recruiting should encourage diversity in terms of sociodemographies, experience, and use of diverse screening methods that will portray the nurses’ experience, competence, cognition, emotional stability, and technical skills. Nurses are more willing to seek employment in facilities that are committed to diversity; whose policies on ranks and status are standardized and apply to any nurse and offer safety and security in term of job and financial security. ABC Hospital then, can use this in their recruitment criteria. Findings of the Study The study has found out that shortage of nurses has been caused by relocation of nurses from one department to another due to increased demand for skilled operative nurses. Other factors include nurses resigning to seek jobs that offer them financial and work security, unfair treatment of nurses and abuse of power by supervisors, and exits of aging nurses not efficiently being replaced by new nurses. The study has highlighted the need for the Hospital to internalize its objectives against its culture, thus encouraging diversity. Conclusion Nursing as an active organ in the institution of medicine helps promote good health, advice people on how best to improve their lives medically, diagnose, treat, and manage illnesses. Be it as it may, nursing as profession, has seen an extensive shortage of personnel globally causing a global public healthcare crisis. The shortage has been felt more so in the medical surgical unit at ABC Hospital. Among the factors contributing to the shortage as analyzed in the report is existence of a void formed by exiting veteran nurses and lack of enough nurses replacing them, exits due to unfair treatment of nurses, nurses who leave the unit due to relocation, and nurses who seek work elsewhere in search of job and financial security. Nurses moreover, have not been keen to seek work in the unit due to lack of diversity, work overload and long hours associated with the unit. Action plans to address the shortage includes implementation of committees to address problems faced by nurses, use of reward systems that are comprehensive, retaining employees and recruiting new nurses. References Charles, R. M. (2007). The Health Care Managers Human Resources Handbook. London: Jones and Bartlett Publishers. Feldman, H.R. (2003). The nursing shortage: strategies for recruitment and retention in clinical practice and education. New York: Springer Publishing Company. Timofeeva, A.A. (2002). The nursing profession: description and issues. New York: Nova Publishers. Valerie, L. & Janice, L. (2007). Recruitment and Retention of a Diverse Workforce: Challenges and Opportunities. Journal of Healthcare Management, 52(5), 290-8. Read More