Patient Workplace Nursing Human Resource Issue - Essay Example

? Nursing Table of Contents I. Introduction 3 II. Review of the Literature 4 III. Solutions and Insights from the Literature Review 7 References 9 I.Introduction This paper details the results of an exploration of academic and scholarly literature relating to a pertinent workplace nursing human resource issue. The issue of nurse retention is tied to a host of related and vital issues such as staffing, shortage of nursing workers, the need to hire nurses of caliber, the need to train and retain nurses whose skills and inclinations are a good fit to the kind of skills and training that patients in different settings need. All these issues impact one another and make up a rich dynamic that affects the way nursing care is given at present. They also impact the way planning for future care is done in hospitals and other institutions of care. There is a need to explore the literature to find answers, sort out the issues, and get to a more nuanced and deeper perspective of how such issues affect and feed off one another. Hopefully at the end of the exercise the literature will point the way towards possible solutions, or at least towards new and rich insights that can guide planning on the part of hospitals and other institutions, and the way nurses pursue career tracks in the different related disciplines. At the very least, the review of the literature hopefully brings us up to date with regard to what the state of those issues are, what the terrain looks like so to speak, and what major milestones and watermarks are present that nursing practitioners, health care managers, and all the other stakeholders in the process should be on the watch for, with regard to nursing staffing, turnover, career development, and related issues of vital interest. Moreover, the review of the literature ought to guide creative endeavors aimed at resolving key bottlenecks and main points of dispute and concern. The thinking is that an intelligent look at the literature ought to give practitioners and involved parties the right kinds of perspectives and tools without which creativity in the crafting of solutions to pressing human resource issues cannot be undertaken successfully (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). II. Review of the Literature There has been two sides to a debate that constitute the push and pull forces as far as nurse staffing and human resources management is concerned. On the one side are arguments that point to quality of care levels being correlated with the quality and number of nurses allocated for every patient in a health care setting. The greater the quality and the greater the number of nurses allocated on a per patient basis. On the other side are arguments that treat the issue of health care provision as a numbers/financials game. To be financially viable, nursing human resources must be treated as a financial variable, as a cost that must be managed. Of course as a cost, hospitals and other health care institutions being for the most part for profit operations, nursing staffing must be managed to optimal levels, rather than to the maximum, because the latter means suboptimal profits. The balancing act is with regard to providing optimum care via staffing of nurses that is also financially viable for the institution concerned (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). Yet the literature also states that the problem of staffing is not an easy one to tackle and solve, owing to the fact that there are a host of factors that impact hiring and staffing decisions. While it is known that staffing levels correlate positively with quality of care, aside from the financials there is the matter of the lack of qualified nurses to provide quality care. This is a problem of qualification. At any given time, though there are vacancies, not enough qualified nurses are available to man and fill up those vacant nurses' positions. This means that if a hospital, for instance, goes ahead and decides that it is willing to spend more for higher quality of care via more nurses, it is not able to do so at least not immediately, owing to the chronic lack of qualified nursing personnel (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009).. On the other hand, from a cost perspective, other studies point out that nurse staffing levels are just one part of the equation. There are also costs associated with for example hiring and keeping nursing talent. The reality is that the market is characterized by rapid turnover among nursing staff. Such rapid turnover, when not properly managed, translates to higher costs of nursing staffing overall, not to mention increased costs associated with having to provide for additional buffer nursing staff to make allowances for the turnover and the attrition that occurs within the health care system. Such costs are substantial and are the focus of renewed attention among nurse practitioners and managers as a vital human resource issue that touches on present and future health care prospects for patients and providers. As such there is a need to investigate the matter further to come to an understanding of just how turnover and attrition affects the system, how much money is lost or gained due to the reality of turnover, and what can be done to successfully manage this tricky human resource problem (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009).. The costs of turnover are large and not factored or highlighted enough in discussions of human resources issues in the nursing workplace. For example, while some hospitals are fixated on limiting costs associated with nurse staffing in a bid to stay profitable or at least to continue operating for the medium term, many are missing out on the fact that turnover itself is a large financial, organizational, and quality of care drain for hospitals and other institutions of care. For instance, figures indicate that losses due to turnover for just one nursing staff equate to the salary of one nurse multiplied by two. This means that it is twice as expensive to lose a nurse year on year, as it is to retain that same nurse. For example, in a hospital that loses five percent of its nursing staff yearly to turnover, the additional costs to the hospital for such a loss is about US 1.5 million dollars, with an additional US 300,000 dollars of costs for every percent increase in nurse staff turnover year on year (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). There are other ways by which turnover negatively impacts on profits. Care quality deteriorates. Costs for keeping staff to cover for turnover go up. Hospitals lose patients. More personnel meet with accidents and miss work. It is clear that there are many interrelated factors or variables tied to quality care and adequate nursing staffing that impact the financial viability of hospitals and institutions of care, and that in general, turnover and a host of other nursing human resource issues are vital to understanding just how well hospitals are expected to fare. It is not hard to argue that as hospitals and other institutions succeed or fail at addressing retention, turnover, attrition, and other related nursing human resources issues, they also succeed or fail both financially, and as viable institutions of care in the medium and long term (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). Of particular interest in some studies are statistics and workplace realities relating to new nurses coming out of nursing school, and how much churn or turnover such nurses undergo during their initial year of service. The turnover figures are very large, and are a cause for concern, owing to the financial losses tied to such turnovers, as earlier discussed. As many as 60 percent of new nurses have been shown to change work during the first year of nursing work, and that turnover from new nurses accounts for about half of all turnover from all nurses every year. Pegging the figures of about US 300,000 dollars arrived at earlier for every percent of turnover, one sees just how large the problem of turnover is and how much impact such turnover, especially from new nurses, has on the profitability and viability of hospitals and other related institutions as going concerns (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). III. Solutions and Insights from the Literature Review The literature review shows us that the problem of staffing is a persistent and big human resource issue in the workplace, but there are bigger issues that are sometimes overlooked, and which may have a larger bearing on the way hospitals provide care and guarantee their viability as going concerns. The problem of turnover, churn, attrition and retention are large, and arguably can overshadow the more basic concerns about adequate staffing levels. In fact, by not considering turnover fully, hospitals and other institutions of care may be missing a large cost factor that impacts profitability year after year. By taking on the mindset that new nurses are always available as a ready resource pool from which to fulfill staffing requirements, for instance, hospitals are missing out on the fact that such a human resources strategy is costly. New nurses are prone to leave. Such leaving has huge financial costs, and has a huge persistent impact on overall nursing staffing costs and overall quality of care and patient outcomes in those hospitals. In the same vein, while such a human resource strategy is costly, the same problem addressed at the root can potentially yield benefits to hospitals in terms of improved cost structures and better profitability. The key is creative turnover management (Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). The literature details different solutions to the problem, some more creative than others, with the common thread being that one, the management of turnover makes good business sense, and that two, the problem needs to be addressed from a variety of angles. Not managing turnover at any rate is a costly proposition, and is an on-going drain on the resources of hospitals and institutions of care. There are bigger problems than just mere staffing levels, for instance if these levels are characterized by staff that moves regularly in and out of the hospitals. The hospitals suffer as a result, therefore, cannot really afford to be shortsighted about the solutions. There are solutions geared around doing the homework and making the changes necessary to make hospitals conducive to nurses getting on board and staying. This entails making hospitals as magnets for nurses, and such means hard work and a dedication to understand just what makes nurses stay in their work. Admittedly, this is no easy task, and not all hospitals will have the wherewithal to persist and succeed. This can spell the difference though between a thriving hospital or a hospital that is constantly on the brink of financial distress, owing to persistently high personnel costs. Other creative solutions include reaching out to nurses via innovative recruitment practices that leverage the internet and engage nurses from where they are online, including in the social networks where they are engaged (Russell, 2010; Russell, 2009; Ritchie et al., 2003; Vincent and Beduz, 2010; Doherty et al., n.d.; Sanford, 2010; Jones, 2008; Hunt, 2009). References Doherty,M. et al. (n.d.). Nurse Staffing Issues, Pacific Lutheran University. Retrieved 16 April 2012 from http://www.plu.edu/~ludlowcg/doc/staffing-issues.ppt Hunt, S. (2009). Nursing Turnover: Costs, Causes and Solutions SuccessFactors. Retrieved 16 April 2012 from www.uexcel.com/resources/articles/NursingTurnover.pdf Jones, CB (2008). Revisiting Nurse Turnover Costs: Adjusting for Inflation, Journal of Nursing Administration. Retrieved 16 April 2012 from http://journals.lww.com/jonajournal/Abstract/2008/01000/Revisiting_Nurse_Turnover_Costs__Adjusting_for.4.aspx Ritchie, J. et al. (2003). Using Individual Patients' Needs for Nursing Human Resource Planning, McGill University Health Centre. Retrieved 16 April 2012 from http://www.google.com/url?sa=t&rct=j&q=nursing%20human%20resources%20issues&source=web&cd=1&ved=0CDcQFjAA&url=http%3A%2F%2Fwww.nlcahr.mun.ca%2Fresearch%2Freports_search%2FHuman_Resources_Planning_Orchard.pdf&ei=BZeNT8OWKYnwmAXu8Ii5DA&usg=AFQjCNGC4sHXrDLtfKHK3J_Dq7F5_VHQ3w Russell, J. (2010). Journey to Magnet: Cost vs Benefits. Nursing Economics 28 (5). Retrieved 16 April 2012 from http://www.nursingeconomics.net/necfiles/hrsolutions/hrs_SO10.pdf Russell, J. (2009). Web 2.0 Technology: How Is It Impacting Your Employer Brand? Nursing Economics 27 (5). Retrieved 16 April 2012 from http://www.nursingeconomics.net/necfiles/hrsolutions/hrs_JA09.pdf Sanford, K. (2010). Staffing Issues: A Major Nursing Concern, Healthcare Financial Management Association. Retrieved 16 April 2012 from http://www.hfma.org/Templates/InteriorMaster.aspx?id=21992 Vincent, L. and Beduz, M. (2010). The Nursing Human Resource Planning Best Practice Toolkit: Creating a Best Practice Resource for Nursing Managers, Nursing Leadership 23. Retrieved 16 April 2012 from http://www.longwoods.com/content/21746 Read More