Impact of Nursing Shortage on the Healthcare Industry - Essay Example

The shortage of acute care nurses is one of the primary concerns in the healthcare industry across the world. The issue has created a substantial impact on the fitness activities efficiency in hospitals and healthcare centers. Several studies have shown that the nursing graduates entering in the nursing profession and those who are still in the occupation are not enough to facilitate the hospitals and patients. The healthcare professional shortage is one of the chief impediments in the achievement of United Nation’s Millennium Development goals to remove poverty, hunger, improvement of education systems, reduction in morbidity, and mortality as written in the guidelines of the year 2004 that are provided by the international nursing council (Littlejohn, Campbell & Collins-McNeil, 2012).

The problem of shortage of acute care nurses has a relation to the past historical staffing, appointment, resources, nursing demand estimation, and nursing concerns for healthcare services of a country. The issue of shortage of nurses is not easily measureable and demands extraordinary planning and requirements. The relative shortages involve the accessibility of qualified and skilled professionals for the vacancy; however, they do not meet other criteria for employment (Dinsdale, 2004). The absolute shortage represents a situation that lacks availability of skilled people for a particular vacancy. The shortages may include the impact of fair consideration, geographical position, retention, and recruitment challenges meeting the replacement demands. The challenges to resolve nurse related issues include coordinated policies and package development to provide long term and sustained solutions (Buchan & Aiken, 2008).

The nursing requirement can be fulfilled through the promotion of education as well as by the availability of facilities for the professional nurses to deliver sufficient care to patients. It can further assist in improving the community health and to attract more clients to the healthcare industries. According to the Bureau of Labor Statistics it is expected that the government will increase the number of registered nurses up to 22% by the end of year 2018. This reflects that the designing of proper policy agenda can decline the challenges related to decrease nursing workforce (Deloitte, 2012).  

The nurses are decreasing in number in many countries of the world, and the number of people suffering from different diseases is increasing. There are few nurses who are ready to help the suffering mankind due to many reasons and shortage of nurses is creating many impacts on patients as well as the healthcare industry.

This study has been selected to examine the impact of nurse shortages on the health care industries to deliver adequate health care assessment, diagnosis and treatment services to patients. The evaluation of the required number of nurses based on the patient to nurse ratio and availability of floor nurses is crucial in terms of getting the right considerations to the problem (Dinsdale, 2004). The issue of shortage of nurses requires more hiring of nurses and their placement in the emergency rooms to provide immediate to the patients and more hiring of skilled and professional nurses to promote education.

The determination of the scientific factors for the nurse wellbeing and improvement through the reduction of cost containment pressures is among one of the reasons. This also involves the hospital consolidation and staff downsizing, to develop strategies for the promotion of resources that facilitate people to get nursing education and manage healthcare set up resources to facilitate the professional healthcare staff and patients, as well. The rationale behind the study is also the evaluation of the concerns related to decline in patient satisfaction due to inappropriate care, decline in units or hospital departments, rise in patient complains and reduction in satisfaction of patients (Texas Centre for Nursing Workforce Studies, 2006).

According to the Joint Commission on Accreditation of Healthcare Organization (2004), the nursing shortfalls are involved in the 19% of medical errors that result in serious injuries and about 85% of nursing home lack skilled and professional nurses to deliver even the basic care to patients. The research on this topic is conducted to determine the issues that are related to nurse’s shortage in the healthcare industries. The shortage of nurses results in the longer wait of the patients, reduced quality of delivery of care to patients and delay in providing emergency services (Shields, 2004). In addition, a nurse is responsible to develop the healthcare plans for the patient, therefore, the shortage of nurses also develops constraints among the healthcare professionals. The topic is also selected to determine the methods to provide good quality of care to the patients because the shortage of nurses also results in reduction of quality of care. The methods of job security to the nurses are also identified in order to avoid their professional lack of interest and shortages. The research will also project focus on the allocation of the funds and resources to hospitals and nursing institutes to hire more skilled and professional staff to educate the enrolled students (People Management, 2006).

The research will determine the magnitude of the shortage through the assessment of the current requirements. The shortage of the registered nurses is an issue of prime concern for the healthcare organizations. Most of the long term and short term care procedures suffer from the shortage of nursing staff that are responsible to deliver the basic care to patients. An increase in the number of patients along with the decrease in number of nurses is a prescription to danger. This requires the promotion of safety issues to reduce working errors (Texas Centre for Nursing Workforce Studies, 2006). Significance of this research is established through the determination of the factors that encourage the hospitals to develop the nurse’s clinical executive leadership to increase work efficiency and restructuring initiatives.

            The research aims to improve the nursing workforce in hospitals and other healthcare sectors through:

• The determination of the factors that influence the culture of retention.
• The determination of the job security and assurance through the improvement in the financial assessment.
• The establishment of the policies and strategies to improve nurse satisfaction and dedication towards their work.

This research emphasizes on the reduction of impacts of shortage of nurses on the healthcare set up across the world. The research also evaluates the factors that influence the nursing workforce decline. The research aims here to study the impact of the nursing shortages in the health care system that have a direct influence on the patients, hospitals and healthcare industries, local authorities, and the government. This issue is one of the reasons behind the decreased work morale among the nurses and the increased dissatisfaction of patients related to care provided in the hospitals.

The American National Council is trying to establish the guidelines that will better address the concerns and consequences and ultimately reduce the issues prevailing in the present healthcare setup related to the shortage of nurses. The research also emphasizes the development of the future workforce recruitment through the promotion of nursing, education among students and strengthens the nursing care through the care patterns management and increase in the wages of registered nurses. To retain the registered nurses in the workforce by the designing the strategies that will develop the interest through the allocation of funds to improve nurse quality of life, facilitate them with latest equipments and decrease in the workload through hiring more nurses.

The issue of shortage of nurses can be understood by focusing on the consequences of occurrence of the problem. It is reported by Oulton (2006) that this issue is more difficult to cater according to the present situation because the supply and demand chains are higher than the past situations. In addition, the shortage of nurses occurred in the past because there were few nurses available but in the present situation the demand of nurses has increased because there are a number of people who are in need of care. The reasons of shortage of nurses can be unfavorable work conditions, decreasing number of applicants, and higher number of nurses retiring (Buchan & Aiken, 2008).

Bureau of Health Professions (2004) has reported that there will be a need of approximately one million nurses at the end of the decade of 2020. The issue of shortage of nurses in United States is also increasing because the nursing schools have fewer seats available and less numbers of people are getting the chance to get enrolled in the nursing schools. Other factors that contribute to shortage of nurses are an increase in age of registered nurses, modification in the characteristics of patients, increase in the turnover number of nurses and amplifying rates of vacancies.   

The registered nurses are the largest healthcare providers and the shortage of projected nurses is a big concern for the healthcare agencies that is hard to address without planning. The main consequences behind the shortage of nurses despite the increased requirement in the healthcare sector which also involves the reflection of nursing work under the influence of demographic factors and the employee’s work procedure (Keenan & Kennedy, 2003). The major concerns involved are:

The shortages are projected by the increase in the nursing care demand, as it is expected that till 2020, the population will increase by 19%, hence the population aged over 65 will require more healthcare services (Keenan & Kennedy, 2003).

Due to drastic changes in the social and employment attitudes and layouts, the latest contemporary world population is aware of more options to switch to the profession that gives more facilities (Keenan & Kennedy, 2003).

The development of the cost pressures for the hospitals that avail the registered nurse facility the most and in the past years the lowest number of the managed care nurse professionals is enrolled. The issue of the nurse payment, workload and the increased stress due to job threat also exists that reduces the nursing professional interest in this field (Keenan & Kennedy, 2003).

There is no financial assistance and support program for the nurses to carry on their daily activities. An increase in wages in accordance with the inflation is also a concern (Keenan & Kennedy, 2003).

Due to the pressure of costs, the hospitals started downsizing and enforced mandatory overtime policies for the nurses to work in the hospital and serve. In addition, there are no clear guidelines addressing the incentives and assurance of job security. This resulted in the decline in the quality of care delivery to the patient (Keenan & Kennedy, 2003).

 What are the impacts of shortage of acute care nurses in the healthcare industry? 

Several variables include:

1. a) Determination of the post training period length for nurses in the hospitals
2. b) The nurse’s financial level of satisfaction
3. c) Job safety assurance
4. d) The mental and physical wellbeing of the nurses to satisfy the patient

This is the prevention, treatment, and diagnosis of injury, illness, disease, and other psychological and physical problems in humans. Healthcare industry is thus the group of stakeholders that are responsible for the healthcare of humans (Orlovsky, 2005).

There are eight international development goals that were formulated by the millennium summit in 2000. This was on a bid to eradicate poverty in the world, achieve basic education, enhance gender equality and empower women, reduce the mortality rate of children, improve maternal healthcare, fight diseases, ensure sustainability of the environment, and partnering globally to achieve development. These are goals set for 2015 (Oulton, 2006).

A registered nurse is a nurse who has graduated from a nursing course and has done a licensing exam and passed. We can say this is a licensed nurse having finished her courses in nursing (Buchan & Aiken, 2008).

This is a training period that those who have just concluded nursing courses undergo. It is performed in a hospital where a nurse is shown how to do things around the hospital with use of case scenarios that present themselves in the hospital during her training (Moule & Goodman, 2009).

This is a project set out to identify and make known the facts that have risen from nurse shortages in the healthcare industry. It is interested in the impact the shortage of nurses to all the stakeholders in the healthcare sector. The project is set out to have a reliable and validated research that will enable me get a grasp of the reality and situations that are noticeable in the health industry. This is a project that with the use of questionnaires to collect data from the stakeholders in the health sector will come to a conclusion on the impact of nursing shortage in the healthcare industry after an analysis of the collected data.

This research paper aims to study the impact of nursing shortages and the expected solution and strategies designed by the hospitals in collaborative working with the government. The role of local funding authorities to promote the nursing education and training through the introduction of the funds in hospitals to increase wages and decrease in workload with the increase in the patient care compliance is also studied. Some studies have indicated that the shortage of nurses is a result of economic regression which will not last for a longer period (Luzinski, 2012).

The hospital management has a significant impact on the management of the nurses through the development of the short term and long term strategies. The management also puts emphasis on the development of strategies to address temporary staff hiring, nursing education and counseling, and spirited compensations. The hospital management has increased the cost and raised the assistance and facilities for the healthcare suppliers that have a direct and potential impact on the patient care (May, Bazzoll, & Geriand, 2006). The nursing students who are newly graduated experience difficulty in looking for clinical placements and many nursing institutes face a competition in acquiring clinical placements for their students (Orlovsky, 2005). The short term strategies of patient care include the hiring of temporary staff to cover temporary workload through the flexible schedule and other benefit allocations. However, the long term care involves the allocation and attraction of the educational scholarships, care delivery variations, incentives, and the clinical rotations to avoid the workload on a single person. The capacity of the nursing school was also required to reduce the shortage; therefore, the hospitals themselves developed the nursing strategies to train the workers on job under the assistance of the qualified and professional nurses (Orlovsky, 2005).

The Health Affairs (2006) have reported in their study to respond to the shortage of nurses in the hospital by making use of the educational and the financing incentives strategies to address. The strategies include the partnership working with the nurses to decrease the work load through the introduction of the supporting staff. This requires the financial support to the hospital to hire more care staff (American Association of Colleges of Nursing, 2009)

Nevidjon and Erickson (2001) state that the nurses are also provided with the money to cover the time through the financial compensation benefits to develop their interest in the work. These assessments will improve the capability of the nurses to investigate the estimation data for diagnosis. The registered nurses must be capable of identifying the problems in the evaluation record. The validation of the diagnosis is checked with the healthcare user with standard system of classification and tools to support clinical conclusions.

The leadership has an important responsibility here together with the sponsorship administrator and the chief decision-making in the expansion of a belief commendable relation with the patients, staff and the commerce partners along with the profit generation for self. Nurses are forced to leave the job because of the transactional style of leaders and the reason behind is that they find themselves comfortable to work in an ideal working environment (Geneviene & Thyer, 2003). They must be vigilant to fix each financial issue and competent to employ senior clinicians also in the foundation organization issues. The financial balance in an organization can be attained through the corporation among the board members, finance staff, and clinicians (People Management, 2006)

The issue of shortage of nurses requires the development of the nursing issues through the governmental policies. Joint Commission on Accreditation of Healthcare Organization (2004) has recommended that the local and the federal burden on the government can reduce through the development and evaluation of the strategies that assure patient safety as well as, the benefits to the nursing care. The nurses are provided with the latest equipment and facilities to decrease the work load on them, this will mentally and physically relax them. The introduction to the “magnet recognition programs” is also a prime factor that can act as a better solution to the nursing care. It is a program which promotes the nurses so that they can provide better quality of care to the patient. Furthermore, they provide different strategies for the facilitation of nurses (Luzinski, 2012).

The US California government has recently developed strategies to address the patient care patterns through the development of the basic care strategies. Through the better governmental strategies the nurses are encouraged to advocate better health practices in delivering care to the patients (Cargan, 2007).

Buchan and Aiken (2010) have also studied that the priorities to resolve the nursing shortages issues, as the nursing care is a global health challenge. The research also evaluates the factors that influence the nursing workforce decline. In addition, it also emphasizes on the development of the future workforce recruitment through the promotion of nursing education among students and strengthens the nursing care through the care patterns management and by increasing the wages of registered nurses. The capacity of the nursing school was also needed to be increased in order to reduce the shortage; therefore, the hospitals themselves developed the nursing strategies to train the workers on job under the assistance of the qualified and professional nurses.

Littlejohn et al. (2012) has significantly established through her studies that the requirement of the future recommendations to assure the decline in the nursing care in cooperation with the government, local bodies and the professional nurses to promote the nursing education and training to assure the delivery of better care systems to the patient. Buchan and Aiken (2007) have addressed in studies about the “International Nursing Strategies” to determine the impact of the positive nursing practices in the environment, the organizational interest in the promotion of facilities for nurses and the health set up funding agencies interest in the allocation of the fund to assure patient safety through improvement in the nurse care patterns, recruitment and the retention followed by the leadership in the organization to assure patient safety.  The recommendation also places emphasis on strategies to address the nursing shortages that have a relation to the countries past historical staffing, appointment, resources, nursing demand estimation and nursing concerns for healthcare services.

The nursing shortage issues require the development of the nursing issues through the governmental policies. These nurse shortages are not easily measurable and require extraordinary planning requirements. The reason behind this study is to examine the impact of nurse shortages on the health care industries to deliver adequate health care assessment, diagnosis and treatment services to patients. The shortage of the registered nurses is an issue of prime concern for the healthcare organizations. Most of the long term and short term care suffer from the nursing staff shortage to deliver the basic care to patients. The patient incline with the nurse’s decline is a prescription to danger.

In this chapter, the provision of the detailed outline of the design of the proposed study is going to be availed in a comprehensive fashion. It expounds on the elements of the research design, in particular, the research approach. The study did involve qualitative and quantitative method. In view of the proposed study, the researcher considered sending the research questionnaire to the health care professionals in order to gain the information that is increasing the shortage of nurses in the industry. This survey technique is effective since it gives the participants the privilege to give the opinions on the reason for the escalated shortage of nurses. Methodology in researches refers to the principles and methods of collecting the information. This is done to elaborate the materials reliability and validity in order to be considered as plausible (Cargan, 2007).

This research seeks to answer the effect of having the shortage of nurses in the industry. There have been elaborate researches that have been conducted in the recent past on the case of possible causes and the impact on the quality of the health service offered to the patients. In the research, the evaluation of the professionals in the industry did serve the purpose to give opinions on the surging pressure regarding the escalation of the reduced numbers of nurses in the industry. It is evident that there is the decline in numbers of the nurses posed by several reasons spanning from low wages, increased requirements in the practice among others (Nevidjon & Erickson, 2001). The nursing association has professed to the increased career options, unfavorable working conditions rising demands of the aged requiring more attention and staff problems. The evaluation tools and methods in the study were the use of a structured questionnaire for the primary data and the researches done in the past are the secondary data sources. The research relies on 17 participants who are administrators and nurses who work in the same hospital with varied experiences in the field. The participants were required to give their opinions of the impact as answers to the questionnaires.

Validity and reliability are critical aspects of nursing researches. In order to obtain valid data, there is a need to use the most effective research methods while maintaining the integrity of the data obtained. The research aim is a critical part of the study since it gives the sample population, which is going to present data for the study purposes. The research needs a reliable plan that reflects on the portion of the participant’s population that is stipulated by the proposed research.  For the reliability and validity a sample of 17 participants were maintained to give the research a concrete research point. The participants were a crucial part of the research and dictate validity of the research. The internal consistency in the data that will be collected from the participants must be synchronized to give the validity. The study takes up the in-depth research into the issue to deliver both self-evident and pragmatic measures of validity and stability not forgetting the equivalence as measures of reliability is equally important. To maintain the reliability of the information the participants were given an identical questionnaire to have them produce the set consistent opinions of the same queries provided. To ensure validity the questionnaire is made to touch on the personal issues that they need to address as stuff hence an inclination towards truthful information is made. The assurance of their confidentiality is another way to make the results of the study to be valid and reliable. With the promised protection of their information makes the participants have a clear conscious that they are safe.  By comparison of the opinions the study will look into the consistency of the data provided and see the opinions of the participants’ relation.  Validity of the information is boosted by the fact that the volunteers are diverse and all give their take on the matter (Cargan, 2007).

To ensure there is integrity of the information rendered protection from alterations that may occur in the study process are monitored. There are numerous ways of ascertaining that researchers uphold data reliability in all the procedures pursued in the study (Moule & Goodman, 2009). The researcher did make sure that data entry and compilation personnel strive to achieve high proficiency and accuracy in protecting data. The fact that the sample is manageable, the procedures would run as requires maintaining the integrity of the information given by the research. The integrity of the study commenced the moment the study was approved, therefore the study is done under the protection of the information approval stipulation (Cargan, 2007). Since nursing is one of the professions that are sensitive and deals with the people’s confidentiality the need for integrity is important to make the information more trusted.

To maintain the data integrity the participants were treated in the same aspects for the design was specific. The researcher is equipped with the training of counter reaction in case of a crisis scenario. The integrity was placed on the length of the questionnaire the participants were allocated. To ensure they were not fatigued while answering the questions, the questions were moderated and at the same time made to cover the whole problem scope. To stamp more integrity the data monitoring in place was efficient to keep the data from the risk of any missing information and completeness of the questionnaires (Polit, 2010). Moreover, the evaluation of the data for the relevant information makes for the integrity of the information required in the process.

Maintaining date integrity is extremely imperative for any research. This confines the number of individuals who have right of entry to susceptible information as well as shielding the accuracy and reliability of researched data. This is usually done with reliable storage systems in the research process.  Moreover, the data collection process must be constructed in a way to deter the loss of relevance in terms of date by providing environs that are stable and protection of the currency of the information provided by the participants. The participants were advised to give their opinions in completion leaving no blanks on the questionnaire to promote lesser needs for more participants in the study. This was part of the data monitoring protocol in place. In this study, the information collected on the research date was done through a restricted access database system. The people authorized while having a unique password could access this.

The research questions’ seeks to answer the impact on shortage of nurses and the effective ways to counter the trend that is growing in the healthcare industry. In this paper, one gains to understand the impact and the effective measures to take in order to protect the industry from further suffering from the shortage (Shamoo & Resnik, 2009). The use of the random participants is more effective as the data involved comes from different individuals with different culture, experience, and expertise. This validates the information as diverse as compared to a selected participant’s research. The research population in the study was credible enough to give a snap shot of the situation of the healthcare industry.  The regulation of the research participants will come in handy as the sample size was set at 17 where three administrators and 14 nurses volunteered. The cross-sectional studies and the data collection in this case were done via to the use of sending the research questionnaire. That was possible since the number of the participants was tamable. The contact between the researcher and the participant was possible to achieve with the number of participants in the study. The study has involved qualitative and quantitative research method.

After a critical analysis, it has been decided to use online questionnaires as a preferred method of collecting data. These questionnaires did contain both closed-ended and open-ended questions and has described opinions without limitations. The design of the questionnaire did attempt to make it easy for respondents to fill in with simple, concise, and clear questions (Czaja & Blair, 2005). Open-ended questionnaires have been proved effective in this research, especially in motivating respondents to highlight their personal opinions concerning a situation.

Online questionnaires did offer practicality. Practicality in this case implies that they are realistic data collection tools that do not consume much time compared to interviews. Moreover, it was possible to access many participants with online questionnaires (Baker, Reynolds, & Woods, 2007). In addition, questionnaires prove to be standardized tools of data collection since all respondents fill in a similar questionnaire, and this did ensure that the research does not have any bias. Moreover, online questionnaires have been straightforward to analyze with data evaluation tools, and it is more practicable to attain the research objective with the help of questionnaires.

In addition, the fact that the research did use online questionnaires presents a new set of benefits. One of the critical benefits is that less time has been consumed in the survey because everything occurs online without the bulkiness experienced with paper questionnaires. This also implies that expenses have been minimal because paper and printing costs do not feature in this case (Baker et al. (2007). Distribution of these questionnaires had taken place online, eliminating postage and distribution costs. Moreover, with online questionnaires, the researcher is assured of a higher level of accuracy and ease to analyze the collected data. For the researcher and her expected respondents, there has been a level of convenience with online questionnaires because of the selectivity and flexibility. Consequently, the respondents would be more comfortable with the idea of not seeing the researcher, which would give them more confidence in their own opinions (Kovács, Fuhr, & Meghini, 2007). The questionnaire has been distributed through the interoffice e-mail.

The research included 17 participants in one of the hospitals. They were randomly selected with the choice of retracting from the research if they felt uncomfortable. The other participation right was reserved to those who volunteered and got into the research. This was done in line with the research policy without coercion or compulsion. The 17 were to give their opinions on the shortage and effective measures to counter the trend. The research intended to have three administrators and 14 nurses with varied experience brackets in terms of years in service from 10-50 years in the industry allowed. The participants possessed the computer skills.

The request for permission was mandatory in the research hence the request for permission from different boards and individuals. Of great importance was the informed consent sought from all the participants who had to fill out the questionnaires and also from the Institutional Review Board. This has served to ascertain that all the participants agreed to offer feedback voluntarily without any form of compulsion and coercion. The IRB was to ascertain that the methods used in the research were commendable (Shamoo & Resnik, 2009). All participants had completed the consent forms. Moreover, the informed consent highlights the factor that connects the rapport or contact between the participant and the researcher. Moreover, the hospital concerns were met as the review board was delighted at the level of standard the research was to take. The participants were assured of confidentiality and anonymity when they consented to the study.

This project is aimed at providing the impact of shortage in nursing industry and the effectual approach to avert the trend. The search for consent and permissions had given the research more credibility and participants had been free to give their opinions to the best of their capacity.

In this chapter, the inferences from the research will be scrutinized in the fashion of the survey done in the hospital. The purpose of the study is to answer impact of the shortage and measures to avert the trending culture. The survey consisted of nine open-ended questions, which focused on the opinionated views of the participants giving them the room to give their entire take on the impact of the shortage. The questions were presented with similar questions hence the responses were based on the questions given to them. The results were categorized in terms of the questions.

The data analysis was made of the completed surveys done on the 17 participants. The survey was done on the answers to the questions the participants answered. Below are tables of what each participants’ take on the nursing shortage. The study took random practitioners and administrators in order to get a variety of opinions in the industry. The variation in the job rank gave a better angle of approach as the high-ranking participants have a very different view of the crisis as compared to the juniors under them. For the purpose of clarity, the choice of four nurses with different demographics and the three administrators were used in the assessment. The four nurse’s information was taken into account in terms of the divergences and the commonalities in the results that were brought, the most experienced nurse, the medium, and the least experienced. The administrators’ perspective was chosen due to the minority in the participants. The information in Table 1 shows how many years the participants have been nurses and how long they have worked at the facility.