The Issue of Nursing Shortage - Essay Example

Nursing Shortage Nursing Shortage Introduction As from the late 90s, it has broadly been an acknowledged truth that the United States is enduring a nursing shortage, the harshness of which has speckled over the years (AACN, 2012). The field, for instance, got an infusion of employees throughout the recession, and there was grounds for hopefulness at the start of 2012 when research showed that more freshly trained nurses were getting into the workforce. But even when confident signs have materialized, the greater worry -- whether or not there are or will continue to be sufficient nurses -- has persisted (AACN, 2012). In general, when a specific career field faces a shortage of employees, the following issues are raised: Are the career’s workers paid adequately? Does the general public know that there is a shortage in that field? And, is morale or drive low in this labor force? Even as all those issues are compelling, they are not the main issue in the field of nursing. The issues can be measured, for example, when the patient-to-nurse ratio, the population-to-nurse ratio, or the amount of job openings requires a greater number of nurses than currently available. Nurses incomes echo the importance of the work they perform, and there is plenty interest in nursing, which can be acknowledged to high-profile employment efforts, which started in the early years of 2000s (AACN, 2012). There is a lot of interest in the field. In reality, there are more persons applying to nursing schools than schools can manage. Also, nursing is tough and often demanding, but it is also highly rewarding (Buchan & Aiken, 2010). The main challenges in this field have much more to do with the aging populace, a scarcity of faculty at nursing institutions, as well as the anticipated influx of individuals with health insurance coverage in the United State who were earlier not capable of seeking medical care. This condition is seen in developing and developed nations all over the world. Internationally, the World Health Organization (WHO) projects a lack of nearly 4.3 million nurses, physicians, as well as other health human resources - said to be the result of years of underinvestment in health employees education, wages, training, management and working environment (AACN, 2012). On to the thesis, this paper will discuss this trend (nursing shortage) by presenting a literature review of the causes of the shortage, offering present and future recommendations and also discussing the economic, social, and health policy implications of this trend. Literature Review Researchers have revealed that nursing shortage is a major problem not only in the U.S., but also many other nations the world over (Ostrow, 2012). Numerous studies have been conducted to comprehend how nurses feel concerning their career (AACN, 2012). The studies recognized nurses’ most significant complaints and grievances as subordination to the health profession together with over regulation, as well as difficult working conditions (Buchan & Aiken, 2010). Also, a publication from the Australian Commonwealth Organization recognized some of the displeasure as arising from regular schedule changes, shift work, overloads, lack of gratitude by workmates and superiors and also lack of childcare (Ostrow, 2012). Insufficient income was branded as a much lesser issue rooted in the report. Soon after, a study exposed that the unhappiness among nurses centered on conflicting expectations from nurses and managers due to regulation of cost, lack of chance to offer an all-inclusive nursing care, and disenchanted workforce or frustration with or loss of confidence in the current healthcare system (AACN, 2012). Limits to all-inclusive nursing care were identified since nurses are clogged with the huge paperwork for billing aims and number of allocated patients, along with deprived staffing to cut cost (Zurmehly, 2008). In a lot of jurisdictions, government or administrative health policy, as well as practice, has endured little change in the last couple of years because cost-cutting is still the main concern, patient loads uninhibited, and nurses are hardly ever consulted when suggesting any changes in health care reform (Ostrow, 2012). The primary reason as to why nurses plan to depart the field, as argued by most critics, is due to the harsh working conditions (AACN, 2012). With an extremely high turnover rate, critics claim that the field does not have a proper chance to help recover the already irritated workers. Apart from the worsening working circumstances, the main issue/challenge is nursing’s lack to be appealing to the much younger generation (Buchan & Aiken, 2010). There is a decrease in awareness among college learners to deem nursing as a credible career. Over half of presently working nurses would not suggest nursing to people seeking career paths and a little under a quarter would counsel others to keep away from this as a career altogether (AACN, 2012). Critics have portrayed hospitals as “being managed like a business” with “money as the motive and patient care a secondary option” (Rovner, 2012). Education, emotional support, counseling and encouragement are vital to the day to day nursing practice (Rovner, 2012). Nevertheless, these practices are not simply considered and quantified by managers as baseless cost for the sick individuals, who are also only seen as clients (Rovner, 2012). Thus, only clinical tasks, such as dressing changes, medication administration, foley catheter insertions and also anything, which concerns tangible supplies, are measured and included into the organizational plan and budget of care for the clients. Also, the nursing shortage impacts the growing nations that supply nurses by recruitment to work overseas in richer nations. For instance, to accommodate the professed nursing scarcity in the U.S., American hospitals have recruited nurses from both African and Asian nations, especially South Africa and the Philippines (AACN, 2012). This, on the other hand, has led to even greater nursing deficiency in the foreign states (Zurmehly, 2008). In response to this situation, the World Health Assembly of WHO, in 2010, passed the Global Code of Practice, a policy structure for all countries for the ethical global staffing of nurses, as well as other health experts (AACN, 2012). As individuals age, they necessitate more medical care, and a large portion of Americans referred to as Baby Boomers are starting to enter their final years. However, it is not only the age of potential patients, which is rising (Zurmehly, 2008). The mean age of these professionals is also rising. 50+ make up the main age category of nurses, and the mean age of the whole industry is 46. Not just are more nurses required to cope with the high number of patients, but surrogate nurses will very soon be required to fill the positions of their retiring workmates. Potential nurses are applying to nursing institutions in big numbers but, sadly enough, most of them have been turned away due to deprived faculty at those institutions (AACN, 2012). Again, a fraction of the issue is that professors/lecturers are going into retirement. But there is also a monetary component (Rovner, 2012). There is more inducement to turn into an actual nurse as compared to a professor of nursing. A nurse with a higher degree/masters degree can be paid tens of thousands of dollars as compared to a worker of the faculty in a nursing institution. Efforts to develop pay and raise grant monies to institutions to employ more faculties are staring to bear fruit (Buchan & Aiken, 2010). The PPACC, fostered by the Obama administration reassured that over 30 million Americans with no health insurance would have it by the end of this year (AACN, 2012). The nursing career has had to change its course simply to prepare for those likely patients. Thanks to sever advertising to draw nursing students, this has accelerated degree courses and rises in monies obtainable to nursing institutions, concerns on the nursing deficiency were reduced at the beginning of 2012. However, veteran nurses are still worried that if the sensitivity of a nursing surplus starts to spread, then the programs, which are aiding to ease the problem, will be eradicated (Rovner, 2012). Next in the chain of considerations is the association between autonomy job and satisfaction. When nurses think they have no or little control in the work setting, they become unhappy and frustrated, and the urge to leave rises (AACN, 2012). Like any other worker, nurses also desire to feel important, to be acknowledged for their roles, and enjoy the other career benefits like flexible schedules (Zurmehly, 2008). The top three areas taken into account by nurses in their choice to stay at their present job are respect and recognition, a voice in decisions and discussion, and performance assessment (Buchan & Aiken, 2010). Reimbursement ranks fourth, whereas the employment of much older nurses is last on a list of 10 (Rovner, 2012). Displeasure with someone’s profession can also be harmful to ones individual health. In nursing, this is a prominent problem (Hussain et al., 2012). Nurses are constantly considered to be among the most stressed, overworked, and sick employees, with over 8% of the workers absent every week because of illness (AACN, 2012). Recommendations It must also be considered that recognizing the ‘greatest practice’ evidence base on managing shortages is just one thing, but changing this into a broad and sustained use of the suitable package of human resource policy interventions is yet another (Buchan & Aiken, 2010). There is proof that there is a lack of proper HR practice: even as it has been confirmed by researchers, it is not always plain in everyday practice in many institutions (Ferrell et al., 2010). This stresses a significant issue for any organization or country hoping to enhance its HR practice and policy with regards to nursing shortages: it should support coordinated and sustained execution of these regulations (AACN, 2012). What now faces policy makers is a policy agenda with a focus of widespread themes. First and foremost is addressing the supply side problems: retention and getting return, enhancing recruitment, staying in touch with these comparatively scarce nurses. Research shows that nurses are very fascinated with their work and remain their due to the opportunities to grow competently, to gain independence, and take part in vital decision making, while being reasonably rewarded (AACN, 2012). Factors connected to work environment can be vital, and there is some proof that a decentralized method of management, access to long-lasting professional growth and flexible employment chances can enhance both the patient care and preservation of nursing staff (Zurmehly, 2008). Some nations also have scope to broaden the recruitment base through opening available routes into nursing for a wider array of recruits, including entrants from cultural minorities, mature entrants, as well as entrants who have work-based experience or career qualifications to compensate for the much fewer usual academic qualifications (AACN, 2012). Second, managing demand side problems. The policy interventions highlighted above deal with supply side issues (Buchan & Aiken, 2010). However, for significant solutions, other key interventions will also be required that center also on the demand side of the endeavor (Ferrell et al., 2010). These have to be rooted in the credit that health care is labor intensive and that present nursing resources should be used successfully (Buchan & Aiken, 2010). As discussed earlier, shortage is not only about numbers, but also about how the healthcare system works to allow nurses to apply their skills successfully. Many nations need to improve and ally their labor force planning capacity across disciplines and occupations to recognize the roles and skills required to meet acknowledged service needs. This is partially on longer term alignment between funded demand and education supply (Zurmehly, 2008). It is also on enhancing day-to-day harmonizing of workload with nurse staffing (AACN, 2012). Flexibility/suppleness should be on using working patterns, which are efficient and also endorse nurses in keeping a balance between their personal life and work. Another vital field for policy intervention is to attain useful skill mix-through simplicity of roles and an enhanced balance of physicians, registered nurses (RNs) and other health professionals, as well as their support workers (AACN, 2012). The confirmation base on skill mix is growing, and numerous studies stress the capacity for efficient deployment of clinical nurse practitioners and nurse experts in superior roles (Buchan & Aiken, 2010). As discussed earlier, the main issue for policy makers is not to classify ‘one-off’ or isolated interventions to manage nursing shortages, but create a coordinated package of regulations, which offer long-standing and sustainable solutions. Economic, Social and Health Policy Implications The shortage of nurses has been connected to the following implications: augmented workloads of nurses, augmented risk for error, thus risking patient safety, augmented risk of spreading disease to staffs and patients, augmented risk for job-related injury; high turnover rates in nursing, thus causing greater costs for the medical institution, as well as the entire health care system; and rise in nurses perception of dangerous working circumstances, contributing to high shortage and blocking national or local recruitment efforts (AACN, 2012). Foreign nurses, who migrate from less developed nations to fill the shortage of nurses of developed nations, pursue their own career, economic, as well as lifestyle concerns, but there are dangers for immigrant nurses. Unfortunately enough, scholars and the media alike have remained fairly silent on the ethical issues concerning the potential use of foreign nurses. On the level of global equality and national sovereignty, there are ethical/social implications concerning the pull of well-developed countries on growing countries assets and skilled workers (Buchan & Aiken, 2010). U.S. enticements like signing bonuses can be viewed as leading to a brain drain. On a personal basis, nurses from foreign nations are subject to mistreatment by employers. In the late 90’s, six Americans were persecuted from falsely obtaining H-1A visas and utilizing them to employ nurses from the Philippines instead of RNs (AACN, 2012). Nations that send their nurses to foreign nations face strain and shortage on their deprived healthcare system. In South Africa, for instance, increased recruitment by developed countries like Australia, United Kingdom and United States, has placed much more pressure on the health care system because of occurrence of diseases like AIDS, as well as deprived resources (Buchan & Aiken, 2010). Similar to the United States, nurses who depart the institution are a financial drawback because of the need to finance recruiting and maintaining of new RNs into the current system (Ferrell et al., 2010). It has been projected that each nurse, who leaves South Africa, is a yearly loss of US$ 184,000 to the nation, linked to the economical and financial implication of the nursing shortage (AACN, 2012). Conclusion Nursing shortage has been described as the state where the need for nursing professionals, like Registered Nurses (RN), goes beyond the supply, either locally, internationally or nationally. The can be measured, for example, when the patient-to-nurse ratio, the population-to-nurse ratio, or the amount of job openings requires a greater number of nurses than currently available. This paper has discussed this trend (nursing shortage) by presenting a literature review of the causes of the shortage, offering present and future recommendations and also discussing the economic, social, and health policy implications of this trend. Researchers have revealed that nursing shortage is a major problem not only in the U.S., but also many other nations the world over. The studies recognized nurses’ most significant complaints and grievances as subordination to the health profession together with over regulation, as well as difficult working conditions. Also, some of the issues arise from regular schedule changes, shift work, overloads, lack of gratitude by workmates and superiors and also lack of childcare. Insufficient income was branded as a much lesser issue rooted in the report. Nations should broaden the recruitment base through opening available routes into nursing for a wider array of recruits, including entrants from cultural minorities, mature entrants, as well as entrants who have work-based experience or career qualifications to compensate for the much fewer usual academic qualifications. Flexibility/suppleness should be on using working patterns, which are efficient and also endorse nurses in keeping a balance between their personal life and work. Another vital field for policy intervention is to attain useful skill mix-through simplicity of roles and an enhanced balance of physicians, registered nurses (RNs) and other health professionals, as well as their support workers. References American Association of Colleges of Nursing (AACN). (2012). Nursing shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage Buchan, J. & Aiken, L. (2010). Solving nursing shortages: A common priority. Journal of Clinical Nursing, 17(24), 3262–3268. Ferrell, N., James, D. & Holland, C. A. (2010). The nursing shortage: Exploring the situation and solutions. Retrieved from http://www.minoritynurse.com/article/nursing-shortage-exploring-situation-and-solutions#sthash.NQYehohn.dpuf Hussain, A., Rivers, P. A., Glover, S. & Myron, D. F. (2012). Strategies for dealing with future shortages in the nursing workforce: a review. Health Service Management Research, 25(1), 41-47. Ostrow, N. (2012). Nursing shortage is over in U.S. Until retirement glut hits. Retrieved from http://www.businessweek.com/news/2012-03-21/nursing-shortage-in-u-dot-s-dot-is-over-temporarily-researchers-find Rovner, J. (2012). Young people put dent in nursing shortage. Retrieved from http://www.npr.org/blogs/health/2011/12/05/143154898/young-people-put-dent-in-nursing-shortage Zurmehly, J. (2008). The relationship of educational preparation, autonomy, and critical thinking to nursing job satisfaction. Journal of Continuing Education in Nursing, 39(10), 453–460. Read More