The Nursing Shortage: Its Causes and Effects - Essay Example

Running Head THE NURSING SHORTAGE The Nursing Shortage: Its Causes and Effects The twenty first century is seeing anunprecedented shortage of qualified nurse worldwide. While the causes for this calamitous shortage range from availability of other more attractive jobs women to the ageing of the existing nurse population. With the non availability of fresh trained nurses, the burden of work falls on the existing nurses who are already overworked. This results in stress and fatigue which is reflected in the quality of work. Although nurses are experts in multi tasking, the overload of work takes its toll. Being rushed for time, the nurse no longer has any time to give to the elderly and the suffering, thus depriving of their emotional support. Unless some wise decisions are taken which result in increasing the nurse population, the ageing general public will have a hard time in the future when they need the services of a nurse. Nursing Shortage : Its Causes and Effects My friend Thomas, when he had an ankle injury recently while playing basketball, had to wait in the hospital emergency room for a long time till he was attended to. The reason for his long wait: there were too few nurses, and they were all too busy. This is the story in all hospitals in the country. There is a dire shortage of nurses throughout the world. and it is affecting the health services everywhere. Fewer young women are opting to take up nursing as their profession. Considered one of the noblest professions, nursing has traditionally been the territory of women. Ever since the well born Florence Nightingale took up nursing in the late nineteenth century, it has attracted intelligent, educated and dedicated women . Although there are male nurses who are indispensable, their numbers are very small. The nurse is the indispensable helpmeet of the doctor and the patient. Her work is manifold- She helps the physician in his office, she cleans and bandages minor injuries, and gives emotional support to the patient. She can even help a pregnant woman in her labor. She teaches the patient's family how to take care of the patient. Nurses write detailed report of the patient's symptoms which helps the physician to diagnose the illness and treat the patient. Some nurses work in the operating theater. The operating surgeon relies on the nurse to assist him while he is doing the surgery. The nurse in the Intensive Care unit has a different set of duties than the nurse in the Trauma Center. A trained nurse is indispensable for the care of the seriously ill patient. Many patients become emotionally dependent on their nurse. According to a report of the Bureau of Labor Statistics, "Home health nurses go to peoples' homes to help them. Flight nurses fly in helicopters to get to sick people in emergencies. "(BLA report p1) Any shortage in the number of trained Registered Nurses will be a catastrophe which should be avoided at all costs. The twenty first century is witnessing such a shortage of nurses worldwide. The reasons for the diminishing number of nurses are many. Steps must be taken immediately to arrest the shortage of nurses by all concerned so that the nurses and the public will not suffer.. The job of the nurse, besides being stressful, is emotionally exhausting. As Hingley says in The Nursing Mirror, "Every day the nurse confronts stark suffering, grief and death as few other people do. Many nursing tasks are mundane and unrewarding. Many are, by normal standards, distasteful and disgusting. Others are often degrading, some are simply frightening"(Hingly ) The daily confrontation with death and disease takes a heavy toll on the nurse's physical and emotional health. Being constantly exposed to various kinds of infection, the nurse is always in danger of catching one. She has to be extra vigilant in avoiding infection. The tasks a nurse has to do in the course of the day are sometimes disgusting. She has to put up a stoic front and do the task satisfactorily. Many times, the patients behave unreasonably, when the nurse should do her duty without losing her cool. Quite often, the nurse is called upon to help many people at the same time, when she feels stressed for time. The nurse's job requires a lot of walking and standing. Long hours of standing might injure her feet, which can be very painful. All this walking and standing is likely to bring on physical exhaustion . A nurse's job involves handling of toxic chemicals and radiation, which can lead to serious health problems. One of the most common effect of nursing shortage is over work for the nurses. Since hospitals are increasingly becoming understaffed, the nurse is called upon to do long hours of duty. She works in night shifts, often continuing into the next shif., foregoes her weekends and holidays attending to the call of duty. Overwork results in reduced efficiency.zz The nursing force is becoming aged, as lesser and lesser young people are joining it. The middle aged nurses are increasing in number and they find their job very stressful and dissatisfactory. According to a fact sheet published by the American Association of Nurses, "Insufficient staffing is raising the stress level of nurses, impacting job satisfaction , and driving many nurses to leave the profession". When there are fewer nurses than required, the nurses present will have to work harder. A nurse may find it hard to find time to even wash her hands. She has to attend to many patients , many of whom may be needing her urgent attention. She finds it impossible to give give quality time to the patients, and to give them the emotional support they need. The constant hard work without respite adds to her job dissatisfaction. If you ask a nurse advice about your career plans, she will most certainly tell you not to opt for a nursing career. Nurses dissuade their friends and daughters from taking up the nursing profession, as it is a stressful, underpaid job. At the same time, they are troubled by an inferiority complex that their job is not good enough. As Andrist says, "Convincing nurses that they are gifted human beings who have struggled against great odds and accomplished much is not an easy task."(Andrist ,p27) Nurses should be encouraged to attend special workshops and courses which improve their prospects. According to Andrist, "Challenging the myth that they are inferior is the first step" (Andrist p.27) A nurse who is emotionally well balanced and has an idea of self worth is less likely to leave her job. In recent times, the role of the nurse is becoming very important in advising adolescents about sexual problems. With the grave shortage of nurses in the Western countries, teen age pregnancies and incidence of sexually transmitted diseases are increasing alarmingly. According to a report by the BBC, which quoted a report by the Royal College of Nursing, lack of specially trained nurses is hampering the efforts to tackle the sexual health crisis, with the number of people with confirmed sexually transmitted infection reaching a record high. (BBC News, September3,2004) Teenagers are at special risk as they are ignorant of the facts of sexually transmitted infections. Nurses play a pivotal role in advising the young people about the STD and also in educating them to prevent unwanted teenage pregnancies. The diminishing number of nurses available for the work has resulted in an alarming increase in teen age pregnancies in the Western world. More and more young people are becoming the victims of sexually transmitted diseases like syphilis, HIV and others. According to BBC News, "This nursing intervention is a positive step forward to help meet some of the goals to reduce the UK's number of teenage and unplanned conceptions as well as in the prevention, assessment and referral or treatment of clients with sexual infections." Another effect of nursing shortage is the effect it has on the "Baby boomers" of America. As Mary Ruff-King says," Baby boomers, who represent a large segment of our population, are reaching the age where they require more medical and nursing care. This is problematic because of a shortage of qualified nurses in the healthcare industry. As a consequence of the graying of America, quality nursing is reaching a crisis of near epidemic proportions." With the graying of America, the nurse population is also graying , and has to do more work than ever., which leads to dissatisfaction with their job and a bleak outlook. Nurses have become older and fewer, while the patients have increased. Understaffing a hospital has another risk factor- error in judgment. The overworked, multi-tasking nurse is more likely to make an error. According to a report by Dennison in the Daily News Central, "Patient care in American hospitals may be compromised because of nursing errors resulting from a system in which understaffing is common, multitasking is sometimes carried to extremes, and frequent distractions come with the territory." (Dennison ) He says that most errors are related to medication, which were mainly the result of the multiple tasking they do. Other errors such as transcription errors and procedural error were also were noticed although these were not so common. Delays in giving medication usually result from the nurse not being able to leave the bedside of a patient. In one example quoted in University of Pennsylvania School of Nursing Study, a nurse reported a 90-minute delay in giving medications to one patient and a 40-minute delay to another because she could not leave the bedside of a third unstable patient. According to Dennison, such situations may become more common as hospitalized patients need more and more nursing care, and the nursing shortage intensifies. Although the nurse prides herself on her ability to do multi tasks, she might become fatigued by doing the work, as the number of nurses is reduced. The fatigue is likely to impair her judgment and thus lead to errors. Frequent overtime also fatigues the nurse and she might perform some procedural errors. Since the hospitals and nursing homes are facing an acute problem of shortage of nurses, doing overtime has become common among nurses. Since nursing is a physically challenging occupation, doing overtime is more likely to exhaust the nurse. The stresses of her job also contribute to the error in judgment. The nurse is likely to suffer from lack of adequate sleep, as her daily routine is disturbed. This is another cause for errors. The shortage of nurses adds to the problem. In a report to the Chairman, Sub-committee on health, J.Heinrich says, "Ageing of the nurse workforce, and reduced entry of younger people into the profession , as well as nurses' job dissatisfaction"(Heinrich p 2) contribute to the causes of the shortage in nurses. Citing a number of sources for the nurses' job dissatisfaction, Heinrich says that heavy workloads and overtime are some of the main causes. "A serious shortage of nurses is expected in the future as demographic pressures influence both demand and supply."(Heinrich, p2) The report makes it clear that the entrants to the profession of nursing are becoming fewer, and those that are in the profession are ageing. With fewer young people joining the profession, the burden of work will fall on the ageing nurses. This will directly influence their efficiency adversely. The effect of nursing shortage in the specialized fields of nursing is even more acute. With the population becoming older and more prone to the diseases of the elderly, there is a great demand for geriatric nurses. Nursing homes and homes for the senior citizens need the geriatric nurses who very often have to give constant care to their patients. Shortage of nurses in such cases increases the workload of the existing nurses with the result that the nurses not being able to give emotional support to the patients. With the harried nurse having no time to talk to them, the geriatric patient will feel lonely and depressed. Critical care nurses, who specialize in giving assistance to patients with acute , serious illness or injuries need to be constantly monitoring the patient and administer the medication frequently. A shortage in their numbers will have serious repercussions, as the critically ill patients need special care and constant monitoring. Nursing shortage may result in the mortality rates increasing. A report on nursing shortage presented at the April 2001 meeting of the New York State Board of Regents points out that some hospitals have been forced to close entire departments due to shortage of nurses. Giving the example of Johns Hopkins hospital in Baltimore, which was constrained to leave ten per cent of its surgical beds unfilled, the report goes on to say that the hospital also delayed or cancelled surgeries. As the number of nurses decrease, this will be the norm for many hospitals to follow. The shortage of nurses is becoming more exacerbated every year throughout the world. The reasons for this phenomenon are varied- the various other job opportunities in the present times for young women, the low profile of the nursing profession, the back breaking work nurses are expected to do, graying of the existing nurses , few takers for the training courses as well as economic reasons. The hard work involved deters younger people from joining the profession, which in turn, imposes more overtime on the existing nurses. It has become a vicious circle, which does not show any signs of resoving in the near future. The effects of the nurses' shortage is manifold. The overworked, fatigued nurses are prone to make mistakes however careful they are. There are bound to be errors in judgment which is the direct result of exhaustion. Nurses no longer have any time to give the patients, they have to rush to the next patient who needs their urgent attention. Patients who earlier used to depend on the sympathetic nurse to give them emotional support during their suffering now have no one to turn to. Nursing shortage is more acute in the specialized nurses' section. The geriatric patients who look forward to seeing the nurse and talking to her for a few minutes have now a harried nurse who is rushing from patient to patient. The nurses in the operation theater being fewer, now surgeries are being postponed in many hospitals. Some hospitals have even closed some beds. As the population is America and other western countries is ageing, there will be more people getting sick. They will have fewer nurses to take care of them. Sick people will become more ill and they will need special care or even constant care. That means that nurses will be burdened even more unless younger people join the profession in larger numbers. Action needs to be taken now by all the governments to make the nursing profession more attractive for the younger generation. Unless some concerted action is taken by the powers that be, the situation for both the nurses and the general public is going to be bleak. References Andrist,L.C., Nicholas,P.K., Wolf,K.A. History of Nursing Ideas Jones and Bartlett Publishers, 2006. Bureau of Labor Statistics. Occupational Outlook Handbook, 2008-09 Edition Cox,T. , Griffiths,A with Cox,S. "Safework: Work-related Stress in Nursing : Controlling the Risk to Health" ILO Manual on Stress Prevention Dennison,A.J. "Hospital Nurses: Too few, Too Busy, Too Distracted". Daily News Central 20 November, 2004. Heinman,J. "Nursing Workforce:Emerging Nurse Shortage due to Multiple Factors" GAO Report to the Chairman, Sub -Committee on Health. July 2001. Hingley,P. "The Human Face of Nursing" Nursing Mirror No.189, 1984 Nevidjon B and Erikson J. "The Nursing Shortage- Solutions for long and Short Term" Online Journal of Issues in Nursing. Vol 6, No.1. January 2001 Spence Laschinger,H.K., Finegan,J. "Using Empowerment to build Trust and Respect in the Workplace: A strategy for addressing the Nursing Shortage" Nursing Economics. 03/17/2005 "The Nursing Shortage" Report presented at the Meeting of New York State Board Regents. April 2001. . http://news.bbc.co.uk/2/hi/health/3621308.stm Sept 3, 2004 " Fact Sheet" http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htmm updated 08 September 20 Ruff King, Mary. "So Few Nurses, So Many Patients" Article Source: http://EzineArticles.com/expert=Mary_Ruff-King Mary Ruff-King Level: Platinum Mary Ruff-King is a 15-year veteran medical transcriptionist who loves to write articles about medical transcription, nursing, forensics, the health field in general, and other ... ... Outline Introduction: The nurse and her jobs are described. Thesis statement: Shortage in the number of trained nurses will be a catastrophe to be avoided at all costs. Body of the essay: Reasons for nursing shortage: 1. Stressful job 2. Long hours, overtime 3. Fewer nurses joining the profession 4. Nurses graying Effects of nursing shortage: Stress level of nurses is raised. Since number of nurses to advise teenagers are few, more teen pregnancies And STD among youngsters. Efficiency of nurses affected due to work load. Conclusion Read More