The Shortage of Nursing Workforce - the Magnitude, Nature, and Scope of the Problem, Impact on Nursing Quality and Patient Outcomes - Essay Example

Running head: The Shortage of Nursing Workface. Student’s name Institution Course Professor Date Introduction Nursing care is a crucial component of heath care delivery and determinant of the quality of patient care and clinical outcomes. Shortage of nurses is an existing and growing major problem in hospitals not only in Australia but also globally as reviewed below. This shortage has far reaching consequences to the patients, nurses themselves and the entire nation.This report explores the magnitude of the shortage of nursing workforce, influencing factors, approach to the problem and strategies to improve it with relevant examples drawn from mental health nursing and then provide a conclusion to the report. This is addressed especially to the local government in addition to other stakeholders in order to help in providing sustainable solution to this problem. The Magnitude, Nature and Scope of the problem It is not easy to quantify staffing levels, however, according to Buchan & Aiken (2008), nursing shortage is defined and measured relative to historical staffing levels, resources and healthcare services. Australia has a deficit in the nursing sector as well as other health departments (NHWT, 2009). Workforce shortage in nursing in Australia is about 27% (Health work force Australia, 2012) against an ever rising demand for health services from an increase in aging population, increased chronic lifestyle diseases and increased number of severely ill patients. To reflect global shortage both developed and developing countries are hit by this problem such as in US a shortage of more than 8.1% exists. Nursing shortage affects developing and developed countries, such as the United States of America where the shortage is more than 8.1% reflecting global trends, (American Healthcare Association, 2008). To have a healthy nation, the number of skilled and qualified nurses has to be sufficient and hence impact positively on the quality care and provision of essential health services to the citizens (Holmes, 2007). Effects of the shortage Impact on nursing quality and patient outcomes Shortages of nurses have negative effects on the quality of care and patients’ outcomes. Quality of care   The nursing care quality relates to carrying out assessments, management and interventions correctly and safely. Safety issues that arise in nursing shortage include increased rates of errors, potential complications that put patients in high risk leading to poor clinical outcomes. Outcomes It has been documented that Clinical outcomes influenced by staffing include mortality rates, length of hospital stay, therapy adherence and functional status, (Aiken, 2008). Nurse-patient ratios correlate with patient mortality rates where the higher the ratio the higher the mortality rates. More commonly in intensive care units, the overwhelming workload is associated with severe problems commonly: medication errors, infections (such as pneumonia) decubitus ulcers and ultimately increased mortality rates. These problems are more related with long working hours especially in multiple patients setting with this lower nurse to patient ratios in an environment of technological advancements, and the need to provide quality care to patients (O'Brien-Pallas, Griffin, Shamian, Duffield, Hughes, Laschinger, 2006). Staffing Levels Staffing levels related to nurse workload is related to occupational health risks (like needlestick injuries) and altered psychological states and experiences such as fatigue and burnout which all translate to poor patient care and safety and also a high nurse turnover from specific units and from the profession (O'Brien-Pallas et al, 2006). Also this has a negative impact on nurse job satisfaction occurs from this environment created by overwhelming workload. In addition, these challenges are not only limited to patients and nurses, but also, the entire health care workforce, facility planners and ultimately the government. To the governments and organizations affiliated to health this hinders the attainment of targets to improve health systems globally at local, regional, national, or global levels causing failure in healthcare systems with subsequent poor healthcare outcomes, (Buchan & Aiken, 2008). Factors/influences of the shortage in Nursing Various factors and influences on the nursing workforce include: Increased nursing workload, the nature of work environment, Health sector funding, Organizational structure and management systems of health institutions, Nursing training and recruitment and retention. Other factors include workforce policy and planning and leadership in the nursing sector. Each of these is described as followed. Nursing shortage may interfere with nursing care. This is also an integral component of mental health care where Mental Health Nurses (MHNs) are involved in both actual and potential health problems related to mental disorders and conditions through involvement in preventive, curative and rehabilitative care. The total clinical workforce in mental health care in Australia consists 77% of nurses (Fisher, 2005). MHNs have vital roles given that they comprise 91% of the psychiatric hospital workforce in public setting and moreover mental illnesses are the third among the overall disease burden in Australia (Begg et al, 2007). Increased nursing workload There is an increased demand for nurses worldwide from increased workload that exceeds the current staffing capacity. This is due to the existing disease burden from several factors discussed above. In the year 2007, 1 in every 4 people, (450 million) suffer from some form of mental illness (Australian Institute of Health and Welfare, 2007) showing the need for mental health nurses needed to provide health services for mental health. The nature of work environment influences nursing staff levels through safety issues that exist such as bullying and harassment that has negative impact on retaining staff. This occurs amidst an environment of excessive workload, lack of recognition and autonomy, low morale and safety issues. This leads to job dissatisfaction, burnout and ultimate exit from the field (Salt, 2008). Funding Funding of health sector also influences the nursing shortage. For instance, mental health services have been poorly funded in the past receiving less than 7% of total budget expenditure (Hickie et al, 2005) in the background of where mental illness burden is 27% of all disability costs in Australia. This also influences the payment on nursing staffing. Nurses They receive low pay relative to other careers but still face challenges of limited or no benefits within an environment of high inflation rate. Organizational structure and management systems of health institutions The restructuring within health organizations in Australia has lead to division such as in wards and units and among various departments resulting in loss of staff due to low staff morale and diminished loyalty ultimately increasing their turnover. Division also creates competition for resources and also nurses in the structured systems have no financial and human resource control capacity adding another insult that worsens (increase) the shortage of nurses (Buchan & Aiken, 2008) Nursing training does not meet demand Enrolment and training of nurses does not meet the demand and impacts on the supply on nurses due to complex and poor coordination between nursing education and training and the health services delivery, (Productivity Commission, ‘Australia’s Health Workforce’, Research Report, Canberra, 2005). For instance in mental health, attracting more people to both undergraduate and postgraduate nursing is still a challenge (Hickie, 2005). Difficulties retaining staff Retention measures also influence the nursing shortage through its influence on turnover from the field. Aging of the current workforce also contributes to the nursing shortage showing the influence of training and retention measure. Approaches To address this shortage and breach the gap between demand and supply of nurses, one approach is to increase and reform training of nurses. Development of collaboration between the government, education institutions to promote nursing as a career will see an increased enrolment and increased number of graduating nurses (Little & Buchan, 2007). This training institutions and health department should also provide clear pathways for the nursing education, the subspecialty options and career development given that nurses constitute the largest proportion of the health care workforce in the country and globally. Especially in mental health, Australia faces constraints of shortage of both psychiatrists and mental health nurses limiting access to mental health services. Moreover, developing education and training pathway to allow diploma nurses who want to advance to degree level will help in career progression and allow them handle the complex demands that exist in the market, (Oulton, 2006) Strategies to improve the approach Strategy 1: increasing funding for nurse education One strategy to achieve increased training includes increasing funding for nursing education by providing sponsorship programs and funding of nursing faculty. This helps to ensure adequate training becomes far reaching (Buchan & Aiken, 2008) Strategy 2: retention strategies Secondly, to address the nursing shortage, more resources should be channeled towards increasing wages and other incentives. This will aid in increasing job satisfaction and boost workplace morale (Salt, 2008). This could see a decrease in turnover of nurses from the field and help breach the deficit. Strategy 3: Improve workplace safety Changing workplace design to meet the current ergonomic standards and providing adequate safety measures in the hospitals is another strategy to attain retention of nurses, (Oulton, 2006). Creating safe work environment free of hazards is important to prevent injuries especially as more nurses practice at higher age with projection that those aged over 60 years will rise to 22.9 % from 17.8% in 2021 and 2006 respectively (Health Workforce Australia, 2012)). Providing friendly and convenient stations for relaxation (with refreshments, information sources such as computers, books etc) within their wards provide them with place to ease fatigue and enhance efficiency. Strategy 4: improve public image of nurses There is also need to improve the image of the nursing profession in general and specific areas with huge shortages such as mental health nursing. Apart from remuneration, using the press to allow nurses to communicate more often about positive aspects of nursing practice will provide a platform to launch professional advertising campaigns that promote the profession and ultimately improve the image and reputation of nurses, (Buchan & Aiken, 2008 & Usher, 2006) Solutions To attract more students and train more nurses (allocate more university places to nursing) In the face of growing number of active nurses’ shortage due to massive health demands, training has to be adjusted to meet the mass shortage of qualified nurses who are needed in the current work environment to meet the changing trends. Promoting diversity of nurses enable them to smoothly face the challenging and dynamic in the healthcare market. Also to enhance diversity, modeling positive nursing practices, provide mentoring for students and developing effective and supportive transition programs for students and new nurses into clinical practice needs to be done, (Levett-Jones & Bourgeois, 2007). All in all these ensure that we not only increase enrolment into the profession but also retain them and ultimately solve the shortage in the long run. Conclusion This report presents an introduction into the nursing shortage which exists in Australia and globally. The nursing workforce shortage in australia is about 27% and due to several the factors and its nature and scope is reviewd. The shortage affects patients, nurses and other health workers, facility planners and ultimately the government and its ultimate development goals. A review of the factors and influences on the nursing workforce such as Increased nursing workload, the nature of work environment, Health sector funding, Organizational structure and management systems of health institutions, Nursing training and recruitment and retention. Other factors include workforce policy and planning and leadership in the nursing sector. Approaches to address this shortage through programs to increase and reform training and retention of nurses are explored. Efforts aimed both at increasing training, recruitment and retention of nurses in both clinical practice and teaching, as well as strengthening the capacity of nursing schools such as sufficient faculty funding, financial aid to students in the form of scholarships among others are addressed. References Aiken, L. (2008).Effects of hospital care Environment on Patient Mortality and nurses Outcomes. Journal of Nursing Adm. 38(5):223-229. American Association of Colleges of Nursing, (AACN). (2012). 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