NURSING PRACTICES 11
Analysisof Nursing Shortage in United States
TheUnited States has experienced an enormous shortage of nurses in thecountry as a result of nursing faculty that act as an agent thatoutsourceable and capable qualified staff within health premises. Thescenario is projected to prolong in the near future since theshort-term interventions that have been placed to curb nursingshortages are diminishing with an increase needs of both growing andaging population. The country, therefore, should invest in increasingnewly educated nurses within the health sector to meet the demandwill be very vital.
Pre-determinedstrategies to curb the situation prior to the crisis and sustainableinterventions to eliminate nursing shortages within United Stateswill be required to time. This research finds solutions to thenursing faculty shortages by examining key factors that has led tonursing shortage in United States and the layout of interventionsthat have been taken to curb the situation. Consequently, the paperalso gives description of the current deficit in relation to demandfor nursing services in different hospitals, the supply of qualifiedregistered nurses to the market, the productivity or output benefitas well as the educational system preparations made to equipprofessional nurses that offer quality services within health systemenvironment.
Thefaculty also outlines recommendation to be implemented to help solvethe situation at hand. Indeed, the U.S governments have experiencedtremendous adverse effects concerning the retention of registerednurses, poor wage compensation as well as an increasing swing indemand for nursing services and supply of nurses. The nursing councilwith the help of other health officials has a role to play inaddressing such challenges, creating awareness, and to find solutionsto such problems.
Thestate should work ways of increasing newly educated nurses in orderto meet the projection of future demand within health systems.Consequently, in order to increase the constant supply of nurseswithin healthcare centers, the entire nation should expand nursingfaculties as well as the educational resources. There is aninterrelation between college expansion and the demand for qualifiednurses in the market. Other elements such as educational preparationarrangement, nursing supply, and productivity are also key figures indetermining the adequacy of nursing faculty to meet the future needof maintain nurses within healthcare systems.
Newlyeducated nurses influence the demand for nursing faculty. Due to thegradual growth and aging of the state’s population in relation tothe health care needs, the federal agencies have projected that newnursing positions will increase in the near future. The growth isinfluenced by medical technological advancement as well as practices,which are highly dependent on nurses. The projection made by anincrease in nursing jobs will increase the demand for nurses thuscall for faculty expansion to offer more study pack for nursinggraduates to fill in the positions and to replace the gaps created bythe aging staff. It is evident that when healthcare centers want tomaintain graduate with bachelors of Science in Nursing, there will bea high demand for nursing faculty that provides related programs.
Educational Preparation of Faculty
Prioreducational preparation is very vital for every nursing faculty. Thereinforcement has been made through raising the standards foracademic grades and advancement to doctorate level. Nursing schoolsshould reinforce high training through research-oriented curriculumwithin the faculty as well as to increase academic standards thatreduces the supply of nurses in the market.
Increased Supply of Nurses
Inmost cases, inadequate supply of nursing faculty that offers nursingprograms constrains the enrollment process of new students. Manyqualified students have been turned town due to a shortage of nursingfaculties within schools that could accommodate such large number ofqualified students.
Causesof Nursing Shortage in the United States
Fluctuationand the nursing shortage in the State have over-burdened nursesforcing them work extra time. The nurses’ fatigue that results fromthe nature of workload exposes them to be prone to commit medicalerrors. The consequences affect patients’ safety as it endangersnurses’ reputation in their field thus the national health caresystem provider is compromised.
Workloadand work environment
Workload,as well as work environment, forms the key critical issues that haveresulted in the nursing shortage. Nurses have reported cases relatedto excessive workload, lack of motivation that leads to low morale,unrecognized duty done by individual nurses, lack of encouragementswithin line of work and dissatisfaction and safety issue. Nursingcare for patients has been reduced by these factors, which have alsocontributed to the resignation of nurses within healthcare. The workdone by nurses need to be respected by health institutions’administrators who in turn contributes to decision making in sectors.Consequently, assigning the nursing duties that are beyondindividual’s capability of performing neurosurgical will not onlycause their anxiety but it is also stressful.
Shortageof nurses has resulted in the additional workload, double shifts andother of casual staffs by the employer agencies, which have led toincrease in casualties within the hospitals and the entire healthsector to perform the required tasks within stipulated time. Inadditional, work life and regulation of the practice have been foundto be the cause of internal issues that affect nurses workingenvironmentally. Factors such as higher pay rate for assistant nursesthan those who are registered by the relevant nursing council haveled to compromise in the health sector. Needleman et al., (2002)states that the number of hours per day of nursing care to a patientprovided by qualified nurses in United States was 7.8 hours asopposed to 11.4 hours recorded in Australia. This clearly shows theeffect of nursing shortage that affect the current population.
Organizationalstructures and management systems
Organizationalstructures and management systems are one of the most importantfactors that have contributed to the nursing shortage in the UnitedStates. Restructuring of related institutions that offer nursingprofession has resulted into low morale to nurses getting admissionto such schools thus increasing the turnover (Beyer 2001). Accordingto Tourangeau et al. (in press) observed that wards and unitsrestructuring resulted in big loss of experienced nurses whicheventually has led to an increase in 30-day patient mortalityexperienced in U.S and Canada. Nurses have lost loyalty as well astrust that is built by the employers through the process ofrestructuring.
Impacton patient and staff safety
Asrecorded by Forrester & Griffiths (2001), health careinstitutions have a significant task to provide daily care to theirpatients to avoid unnecessary risks that may expose clients todanger. However, there are certain current risks that have exposedboth the patients and institutional staff to risks. Overseascountries have initiated strategies that possess a negative influenceon nurse especially when it comes to job satisfaction and the servicesatisfaction offered by nurses (McGillis Hall et al., 2001). Theratio at which nurses are assigned to patients is very low that bringcomplication when attending to patients an evident can be seenwithin Intensive Care Unit where nurses have the heavy workload toaccomplish.
Inadequateor less nurse staffing has contributed to medication errors,pneumonia and other organ infections to patients. The satisfaction ofpatients and staff is achieved when the workload assigned to them isonly manageable. Nevertheless, in most cases, employers have suffereddire consequences of allowing unqualified employees to perform tasksthat are beyond their skill level. When nurses are employed withininstitutions possess inexperienced skills required for competency,all operations will take more hours to deliver health care topatients thus increases the waiting period to be attended to thuscostly.
Inanalyzing the nursing workforce in terms of supply, there are certainchanges that have been experienced. According to O’Brien-Pallas &Baumann (1999), there has been a gradual decrease in enrollment fornurses to curb the shortage. However, United States experienced anincrease in the number of nurses who got enrollment. Even though thelargest percentage (41%) of the nursing workforce constitute of theaging group i.e. nurses above 40 years of age, the country expect toenroll a large number of youthful nurses who will take fullresponsibility for future generation to offer quality health careservices. This has been made worse with the recorded increasing ageprofile of student registering for nursing courses withininstitutions.
Therehas been uncertainty and inequitable supply of qualified nurseswithin the country though the issue should be recognized and givenprior preparation on how to solve the shortages that arises. Thenursing shortage experience in the United States is contrary to thatof Australia. The country records an increasing skilled and qualifiedstaff with significant number of degree holders as clinicians andnurse managers in health care systems. Duffield & Frank (2002)records that nurse managers possess desired qualities as their healthservice counterparts thus increase their marketability withinhealthcare industries. Institutions also offer multiple careerprograms to break the high demand for entry requirement for thenursing curriculum.
InUnited States, the demand for nurses has increased as the majority ofthem are employed at an increasing rate. An Increase in employmentrate shows how nurses’ skills, as well as nurses`, expertise are onhigh demand. Nevertheless, in the foreign countries the situation iscontrary. More nurses will be required only with the introduction ofnew roles that an individual will be attached to such as nursepractitioners and practice nurses within healthcare centers.Lifestyle choices that offer the flexibility of nurses workingpart-time will need additional nurses that will fill the gaps withinworking shifts. Consequently, nurses who will possess certifiedqualifications and work experience shall be valued as long-termassets that can be transferred across the health care industries withease.
Insufficientpool of nursing school instructors
Themajority of the nursing school have had trouble with an enrollment ofthe student at the start of the course study. The country hasexperienced a long waiting list for about three years because of lackof availability of nursing instructors to facilitate nursingprograms. The nursing school faculty requires that instructors mustbe a degree holders in Masters of Science in Nursing. Majority ofqualified individuals find it more profitable if they enter into theclinical sectors as Midwives, Practitioners and Anesthetists ratherthan institutional instructors. There are also wage disparitiesbetween the nurses and tutors. Qualified nurses working within healthcenters receive better pays as compared to nurses working asinstitutional instructors.
Improperlytrained graduate nurses
Afterconducting survey using nursing colleagues who were over 50 years ofage, majority of them had the same perception that the current nurses(younger generation) are not fit and equipped psychologically,clinically and socially within the career but are prepared withtheoretical knowledge. It is, therefore, evident that large groups ofyoung and inexperienced nurses bear false expectation in the nursingarena as opposed to what is expected. Consequently, nursing studentsare not exposed and be informed of the work environment, the workloadengagement, the organizational setup of staff, demoralization thatresults from lack of appreciation by patients, patients’ family andother medical colleagues as well as lack of retention incentives. Thefocus is equipping graduate nurses, therefore, should be centered onthe actual clinical practices as well as direct patients care withintheir units.
Suggestedstrategies put to eliminate the nursing shortage in United States
Instituteincentives to train and retain nursing instructors
Asstated above that qualified nursing instructors are paid less wagecompared to clinician counterparts, the institutions should introducewage as well as other benefit parity within the nursing curriculum toeliminate high rates of waiting lists to enhance smooth nursingenrollment for students that could result in shortage of nursinginstructors (McDonald, 2004).
Passnational legislation to create minimum patient-to-nurse staffingratios. Passing legalities that establish a minimum ratio ofpatient-to-nurse is very vital as it has work best in California. Theprogram helps to maintain consistency of standard operation where astandardized number of nurses is assigned to given patients, andevery state should conform to it.
Itis advisable to outsource different individuals from differentcountries who possess required skills and are competitive in natureto offer the required service to patients. The selected countriesconsidered when selecting foreign nurses are highly regarded due tohigh commitment to provide quality educational services to nursingstudents who in turn will become mentors to individuals in thesociety, in churches as well as in associations (Fowler, 2003).Proper assessment and thorough recruitment process should beconducted in order to retain qualified individuals who arecompetitive in the health industry.
Restructurethe work environment.
Manynurses have never fully accepted the workplace environment, as theyare never receptive. Nurses have experienced many challengesassociated with working environment, leading to nursing shortages.The management, therefore, should formulate ways of adopting newstaff members or engaging current employees to perform differenttasks and rewarding those who perform within their departments. Otheractivities such as theatre events can be organized to build employeecohesiveness in working towards a common goal. Nurses need to getsatisfied from the culture setup that allows nurses to be independentand give full support to achieve the assigned duties.
Eliminatemandatory overtime by improving recruitment and retentionbrainstorming strategies
Morestrategies should be put that encourages individuals to enroll forthe nursing course through the provision of scholarships and offeringjob opportunities within hospitals or affiliated institution uponregistering in the program. Nurses who are staff members should bemotivated and supported through paying for them a portion of schoolfees depending on individual’s educational level and the past workexperience. Ever nurse assigned extra duties ought to receive a bonuspayment for a job done through volunteering to work other thanimplementing a mandatory overtime duties. Higher institutions need tocollaborate with high schools aiming to establish prior high schoolstudents’ recruitment into the nursing profession allowing them toincorporate nursing programs within their curriculum.
Enhancementof salary, hours, and benefits
Thewages paid to nurses are relatively flat as compared to the inflationrate in the economy therefore, hospitals should enhance salaryincrement, even though, most of the non-union health centers offerwage increase based on individual’s performance. The hospitaladministrators need to strive towards offering professionalcompensations to nurses enrolling for mandatory licensure, andconsider providing periodic incentive pay award, gain sharing andrise in market demand pay in order to curb nursing shortage in UnitedStates. When hospitals implement a flexible working hours, more youngmothers as well as aging nurses will be accommodated within scheduledshifts (four-hour shifts). Nurses should be entitled to otherbenefits such as finest health care package at no cost since theduties they engage in are hazardous and prone to be contaminated byblood borne pathogen exposure while rendering service to patients.
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