This research paper explores shortages of Registered Nurses (RN) who successfully complete an associate degree or higher in relation to the demand required to fill the workforce market. This research paper will explore past, present, and future contributors to the epidemic of nursing shortage that affect the present health care system. These factors include the aging nursing workforce, increase in elderly population which will result in more medical care, insufficient resources to supple the demand to educate future nurses, and potential increase for current nursing workforce turnover inflicted from the current shortage.
This paper will illustrate the adverse effects of patient care resulting from the shortage and possible solutions to increase nurse staffing numbers. Understanding the reasons that contribute to the nursing shortage and ways to identify improvements may lead to end of the nursing shortage in the future. Nursing Shortage Epidemic The “Nursing Shortage” has been a topic for years now and to this day remains a relevant unsolved crisis not just affecting the United States healthcare systems but healthcare worldwide.
Nurses constitute the largest single healthcare profession in the United States. They play a vital role in successful delivery of patient care and positive outcomes. Exploring the factors that have contributed to the shortage of nurses and that still remain prevalent today must be understood and addressed in order to formulate appropriate solutions. Factors of Past, Present, and Future Shortage Past: Influences to how the shortage of nurses ever began The shortage of nurses is not a new phenomenon ever since World War II the U. S. ealth care system has had to cope with these issues where the national supply could not meet the demand. (The Kaiser Family Foundation, 2012)
Nurses were predominantly staffed by women ages 18 to 40 but between the 1980 to 1990s nursing as a profession became less attractive as other career pathways opened up and women other opportunities in other professions that were once male dominated. Between 1990’s and the early 2000sthe acute cyclic shortage of nurses was a direct result from the struggle to implement managed care as means of controlling the high cost of health care.
Present: The Issues That Are Contributing To the Shortage Today The nursing shortage today has lasted longer and become more severe than previous shortages. It is twice as high as any nursing shortage seen since 1960. This may be attributed to an increase in population growth in certain states, lower number of new nursing graduates, increased retirement of current nurses and educational faculty, and overall aging population that require more intense medical care. (The Kaiser Family Foundation, 2012) While the nursing profession has evolved in its gender and ethnic diversities it has become older over time.
The workforce of nurses are aging and are retiring or coming to the end of their career leaving a gap that will be hard to fill with regard to experience and sound decision making(Tierney, 2003) The average age of a working nurse today is 46. More than 50% of the nursing workforce is close to retirement (The American Nurses Association, Inc. ). Over half of registered nurses intent to retire between 2011 and 2020 (The Kaiser Family Foundation, 2012), which leaves less experienced new nurses entering the workforce replacing older more experienced nurses.
The awareness for the nursing shortage has merged the increase of educational recruitment methods and programs from private, public and community universities. As more recruitment is set forth to encourage new applications to enter the nursing workforce there becomes more need for qualified faculty to supply the demand. The faculty is also aging which inflicts the need to recruit more nursing centered faculty. (Tierney, 2003) Finding appropriate staff to teach the nurses that are needed to enter the workforce is another problem that that surrounds this crisis.
Universities lack of funds to support new nursing programs and lack of clinical sites to carry out appropriate hands on learning environments have led to the inability to accept the number potential nursing student applicants. (FCN: Florida Center For Nursing, 2009) The population of baby boomers entering senior care has amplified with in the last couple of years. The increase of people 65 years and older require more health care needs which puts more of a demand on required health care staffing.
As the increase for more care raises the demand for more nurses also increases leaving a supplementary demand that must be addressed. Future: Influences That May Hold Presidency of Future Shortage The United States health care system adapted many changes over the past decade but now new political changes may increase medical care insurance policies that will allow millions of people to receive healthcare benefits. This change will put another strain on our health care system and in the need for nurses will continue to escalate.
In order for any organization to be successful they must be able to retain their employees by providing a health work environment conducive to the professionals wellbeing. The nursing shortage continues to put a strain on present nurses currently working in the field. These nurses are taking up the slack and experiencing longer shifts with more hours, heavier workloads, and increased stress. This can lead to potential burnout and loss of job satisfaction. Insufficient staffing resources resulting from labor market shortages cause increased turnover.
The Effect of Nursing Shortages on Patient Care Patient care is the most important aspect regarding the nursing profession. Inadequate staffing of nurses can result in many negative outcomes for patients seeking the care of nurses in many medical settings. Trying to supplement nurses with other less qualified staff may be detrimental to overall care and patient satisfaction. Shortages of nurses have contributed to an increase in medical errors, low patient mortality rates, and unsatisfied patient outlooks on the care they received.
The Kaiser Family Foundation, 2012) Is there a shortage of nurses? Or is there a shortage of nursing? Some experts argue that nurses are performing tasks that can be done by other staff inferring that it is hard to tell if there is a shortage of nurses or just staff able to perform certain nursing duties. In efforts to address the nursing shortage Licensed Practical Nurses (LPN) have been generated to execute some of the Registered Nurses (RN) duties. Certified Nursing Assistants (CNA), Licensed Practical Nurses (LPN) and other health are personal are given limited permissions to preform duties that are generated to give the RN more time to perform tasks more relevant to their higher educational level.
Because of the limited educational level and scope of practice of LPNs there remains a decreased effectiveness for overall patient safety in critical care settings. Hospitals and other health care facilities are moving toward higher educational credentials to reduce the probability of malpractice suits resulting from medical errors. FCN: Florida Center For Nursing, 2009) Registered Nurses (RN) that once where assigned total patient care requiring many if not all of duties relevant to patient needs now would take a more of a managerial role and delegate appropriate tasks to the LPN, CNA or other certified staff, which is known as the nursing team model approach. This approach can be effective in some healthcare settings by creating more efficient facilities but also leave room for lapse in communication and patient care needs.
Patients often experience interacting with many different health care staff that preforms different tasks, which can cause the patient to feel overwhelmed and confused. (Cherry & Jacob, 2011) Solutions: ‘Think globally, act locally’ Many different avenues have been explored to address the pressing issue of the nursing shortage that is being felt worldwide. Many nurses that are now working in U. S. health care facilities were recruited from different countries to help supplement the shortage.
From 2002 to 2006, the number of full time positions filled by foreign-RNs working in the United States increased by 93,000. (Cherry & Jacob, 2011) Increased benefit packages and sign on bonuses have played a role in the recruitment efforts around the world. When nurses are recruited from other countries and states it provides only a short term solution to a long term goal. One compelling argument is that ‘poaching’ of nurses from one country to another achieves nothing in solving the global nursing shortage as a whole and that it should be stopped immediately.
The Journal of Advanced Nursing argues that the Nursing shortage is a global problem that only a local solution will provide a promising long term effect. When the needs for staffing at a local level arise, those needs can only be met by individuals that live locally. The old-fashioned approach where students learned at their local hospital and then were fired on after graduation to serve their community could make a positive contribution to reducing shortages in local communities.
Educational resources need to be strengthened by addressing issues that limit the educational paths that nursing students must take to enter into the nursing field. Focusing on more sufficient recruitment efforts is the only way to provide the opportunity for advancement toward this career. Government and state efforts to increase the capacity of nursing schools and help to fill community needs for future nurse placement should be at the forefront in this movement to replenish nurses.
Educational facilities need to be provided with sufficient staffing that will be able to lead the future nurses of America. Because of the economy, financial aid for students entering this profession needs to be increased and more scholarships to help students should be adopted. In 2011, United States nursing schools turned away 75,587 qualified applicants from having the opportunity to pursue a baccalaureate degree program for nursing due to insufficient resources.
As many hospitals start to wean out LPNs from critical care setting encouragement for educational advancement should be put into place by employers. Educational programs to convert current LPN to advance to a RN degree programs will help reduce the shortage. (Cherry & Jacob, 2011) Immediate attention must be placed on the present workforce. Unfavorable working conditions must be address so that high retention levels remain in this field. Facilities must provide an increase in training and continuous educational programs.
Creating a better working environment will help to eliminate high job turnover rates, create more positive patient outcomes, and overall satisfaction. (The Kaiser Family Foundation, 2012) Without taking action and addressing these key issues appropriate health care provided to patients will be compromised. These issues will not go away and have been affecting health care for decades. No one solution seems to be the key but support from government bodies, local and state officials and the local community can make a different in providing aid to the nursing shortage.