Nursing Shortage

Six years prior to the publication of Spetz and Given, reports of the US media indicate a shortage of registered nurses (RNs) in the US. In that article too, forecasts see the continuity of this trend, such as that of the Bureau of Health Professions projecting a shortage of 800,000 nurses by 2020. However, Buerhaus et. al. suggests that the nursing shortage may actually be satiated, with hospital RNs’ employment and earnings â€Å"increasing sharply in 2002.† No matter how we look at it, whether or not the shortage is easing, the problem of shortage is there. The question now is, what causes the shortage of registered nurses? Spetz and Given discusses four reasons that account for the shortage of registered nurses, first of which are licensure delays. Since World War II, nursing shortages have occurred cyclically, and this led to the birth of studies regarding labor markets. They (Spetz and Given) found most of these studies agreeing on the point that â€Å"the delay between people’s choice of the nursing profession and the time they are licensed as nurses is a central reason for these recurrent shortages.† Poor working conditions also account for the shortage of RNs, and this includes wage and benefits in general. Not much was mentioned by Spetz and given, but they have cited that these are â€Å"a primary cause of nursing shortage.† Aiken et.al. gives a more detailed explanation, stating that nurses spend an â€Å"inordinate amount of time in nonnursing tasks† resulting from â€Å"poor work design, underinvestment in information and other nurse-saving technologies.† They further add that is associated with high levels of nurse burnout and dissatisfaction. The third reason for the nursing shortage is comprised of wages and demand. Spetz and Given maintains that â€Å"demand for RNs should decline as RNs’ wages increase during a shortage,† and they have seen evidences showing that wages do affect demand. However, there are reasons for demand to be not responsive in today’s labor market. Two of these reasons are the reluctance of health care institutions to reduce staffing, and the growing number of RN Unions that want to maintain, if not to expand, the current staffing levels. Another scenario relating to the issue of wages and demand is seen in Aiken et.al., where it was mentioned that â€Å"the Philippines is the leading primary source country for nurses internationally by design and with the support of the government.† A motivator for Philippine nurses to migrate to other countries is higher wages, which cannot be earned in the local setting. This may account for the shortage that the country itself was experiencing, as Aiken et.al. found that â€Å"there are more than 30,000 unfilled nursing positions in the Philippines.† Last of the causes of the nursing shortage, as discussed by Spetz and Given, are exits from the RN workforce. According to them, the magnitude of retirements poses the question of whether it is possible to raise the number of new RNs to meet future demands. One solution to the nursing shortage, and maybe the most popular today, is to recruit foreign nurses. Spetz and Given consider this to be only a short-term option as it is expensive and the WHO reports majority of the countries experiencing nurse shortages, thereby putting a pressure on hospitals to limit foreign recruitment. Buerhaus et. al. goes farther to discuss other issues relating to the employment of foreign RNs to meet US health care demands. They cite impediments such as â€Å"likely negative impact on wages,† â€Å"quality of care,† and foreign policy. Another solution suggested by Buerhaus et. al. is to retain older RNs. In order to do this, facilities of health care systems should be designed so as to minimize physical strain. According to them, â€Å"altering schedules (working fewer hours), developing new roles (becoming mentors to younger RNs), and offering economic incentives can help to retain older RNs.† But among the three broad types of policy responses that Buerhaus et.al. suggested, I find increasing the flow of RNs in the workforce to be the most responsive, because that is exactly called for by the situation. This can be done either privately or by the government through raising money to increase faculty salaries and scholarship grants, and expand the physical learning space of nursing students. WORKS CITED: Aiken, Linda, Buchan, James, Sochalski, Julie, Nichols, Barbara, and Mary Powell. â€Å"Trends in International Nurse Migration.† Health Affairs 23.3 (2004): 69-77. 25 November 2008, http://content.healthaffairs.org/cgi/content/full/23/3/69?maxtoshow=&HITS=60&hits=60&RESULTFORMAT=&fulltext=nursing+shortage&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Buerhaus, Peter, Staiger, Douglas, and David Auerback. â€Å"Is The Current Shortage of Hospital Nurses Ending?† Health Affairs 22.6 (2003): 191-198. 25 November 2008, http://content.healthaffairs.org/cgi/content/abstract/22/6/191 Spetz, Joanne, and Ruth Given. â€Å"The Future of the Nurse Shortage: Will Wage Increases Close the Gap?† Health Affairs 22.6 (2003): 199-206. 25 November 2008, http://content.healthaffairs.org/cgi/content/full/22/6/199 Nursing Shortage This paper aims at analyzing the consequences of understaffing nurses. Some of the outcomes I observed this semester are nurse burnout and dissatisfaction that arise due to nurse shortage. The focus of this context is on the socio-economic impact in the nursing field, ethical bias, legality of the matter and psychological interference that have adverse impact to the nurses, patients, clinical working field and the nursing sector. In this paper, I will look at some of the problems associated with the nursing profession. NURSES WORKING AND CONDITIONS These are stipulations and circumstances, which enhance persistence and commitment to work comfortably as a nurse, with all due satisfaction and dignity for human life, for better supply of work force toward a proper medical care to the patients. NURSE BURNOUT This is a character associated with nurses when they become psychologically or emotionally exhausted to attend the patients. This is because of being overworked, exploited, due to fatigue or due to dissatisfaction in their field of work. INTRODUCTION In order to curtail on the trauma of nurse shortage, I would like to say that nurses’ shortage only creates some awareness that patients are at risk of substandard health care and the working nurses are being overworked. This is because in this semester, I have observed that small nurse/patient ratio does not guarantee for better patients’ outcomes and assurances of proper health services. When nurses become physically exhausted due to being overworked, they cannot perform their duty efficiently. Nursing is a professional course and a career that need to be addressed from all perspectives, to encourage proper working conditions for the nurses in order to have a maximum labor output for the wellbeing of the patients. EXECUTIVE DISCUSSION Actually, overworking nurses by allowing them to work for long hours and overtime makes nurses to be susceptible to making prescription errors. This is highly exaggerated when the salary income does not correspond with the work nurses do. However, if these errors occur, it is contrally to the nurses’ professional ethics, it is illegal to prescribe a wrong dosage to a patient and again there is abuse of human rights in that the patient can suffer psychological torture if he realizes that he was specified a bad prescription. This is what raises the legal issue of nurses. Because of such mistakes, nurses are forced to spend too much money in hiring private lawyers or insuring themselves against such bias. Beside legal issues, wrong prescriptions of drugs leads to wastage of medicines that could be used by another patient effectively, hence wastage resources since medicines are among the most expensive items. Additionally, Wrong prescription of drugs can lead to loss of life, retardation or other body malfunction. This can cause more harm to the Nation by losing individuals. If overall effects of such errors were analyzed, the conclusion would be wastage of time when prescribing wrong dosage, wastage of resources and drugs, loss of human labor and abuse of human rights. Therefore, there would be bleach of law, socio-economic impact and denial of safe health care. Eventually, this would be a great loss to the nation and the impact is felt in the near future. Therefore, means of solving the above problems need to be realized. I think labor motivations, recruitment of more nurses and retention of the registered nurses should be encouraged in order to maintain successful dedication of nurses to their nation as they work smoothly without strain. Understanding of the staffs’ requirements and avoidance of understaffing in this sector is of paramount importance. According to the article on â€Å"Allied Health Source and ProQuest Nursing†, the executive summary is that nurses are not satisfied in their career. Due to this outcome, some of the repercussions are that physically exhausted nurses do prescribe wrong dosage to patients or they may prescribe right drug but misguide patients on how to use the drugs. Another outcome is that most nurses are leaving the nursing profession and pending nurses are not willing to join the sector. Low level of job satisfaction is the main reason as to why most nurses are migrating to other fields of employments. This again leads to understaffing of hospitals leading to high death rate, failure to provide safe and effective care to the patients. Eventually this results to failure to rescue the patients from undesired death especially in the surgical department where the patients are not rescued. From the same article on nurse staffing and hospital outcomes (Linda H. and Julie S.),it is found that the dissatisfaction is caused by law salary income, poor working conditions such as nonflexible hours of work that do not give married nurses time to look after their siblings. Another finding is that starting salary or wages do not increase with the prolonged period of work, therefore, there is successive exploitation to the nurses. According to the article on â€Å"Allied Health Source and ProQuest Nursing†, work conditions that affect the outcomes of nurses involve lack of labor motivations such as baby boomer packages, failure to provide flexible working hours for the nurses, failure for the government to provide scholarship to nurses who want to advance their knowledge on this career. According to the same article by Linda H. and Sean P. pg 4, nurse burnout is the main consequence of overworking staffs and it can lead to more outcomes. Actually, patients/nurses ratios that are more constructive result to lower nurse burnout and high job satisfaction among the registered nurses. Understaffing nurses can extremely influence patients’ outcomes. Working conditions that affect the outcome of nurses include poor working conditions such as understaffing that leads to overworking the nurses without paying them their due overtime. (Agency for Healthcare Research and Quality (AHRQ) < www.ahrq.gov> Another condition that affects nursing profession is failure by the health ministry to provide encouraging packages to the nurses and other benefits. These benefits involve giving nurses flexible working hours such that they can concentrate on their family matters or providing nursing homes for their children and care. Other factors include lack of offering free seminar services to the nurses in order to update and sensitize them on the need and benefits to be a nurse and to encourage those leaving the sector to rejoin it. Lack of recognizing their efforts and contributions to this sector is another issue that does not address their working conditions. Nurses must also be insured in order to safeguard their wellbeing and protection in their line of duty. Finally, lack of labor motivations to the nurses such as gifts, prizes and awards to the best performing nurses is something that derails their morale and dedications to be a nurse and can lead to nurse burnout. In this semester, I have also observation that there is high nurses work overload and low technology application. Therefore, there is need to mitigate death rate and increase retention of staffs (nurses) in hospitals. More number of nurses to patients’ ratio can lead to a better patient outcome. Therefore, work force balance for the nurses is maintained in order to enhance proper working conditions for the nurses. PERSONAL EXPERIENCE My experience with the nursing profession tells me that nursing career is not an easy profession the way most people perceive. It needs a call to be dedicated in this service. Note that nursing involves taking care mostly to sick people from casualties to labor ward and mostly contamination is a loaming threats to the nurses. Therefore, the nurse should have a maternal feeling and concern of the high level in order to safe lives strictly obeying the code of ethics. PROPOSAL FOR CREATIVE SOLUTIONS Mostly labor motivation is the main tool to fight decrease of nurses from nursing sector. These will include providing nurses with proper and flexible working hours or services that are more rewarding. Another way is by means of helping them to solve family matters or factors that lead to their failures to work comfortably. These include if possible giving nurses services of caring for their children, the aged or by providing nursing homes to them with free or minor charges. Another solution is to offer aided scholarship to those nurses willing to advance their career especially in areas where more nurses are needed e.g. in gerontology and provision of geriatric clinicians. Again, nurses should be hired or employed from different regions irrespective of ethnicity and racial segregation. Application of latest technologies in nursing sector and outsourcing can be tried to improve working conditions in this sector. Some of the proposals that address outcomes for the nurses are varied to improve the outcomes for the patients. Understaffing of nurses indirectly affects the outcome of the patients. Therefore, proposals for outcomes of the nurses are determining factors to improve the outcomes of the patients.   Mostly labor motivation is the main factor to fight decrease of nurses from nursing sector and this can improve the outcomes of the patients. These will include providing nurses with proper and flexible working hours or services that are more rewarding. By allowing nurses to work comfortably, nurse burnout can be avoided, hence patients can be attended with all due care because nurses wont be exhausted. Patients should be allowed to interact freely with the nurses to air their problems and complications. Again, patients should accorded all due respect in their treatment and assured of life continuation through proper medical care. Application of latest technologies in nursing sector and outsourcing can be tried to improve working conditions in this sector. CONCLUSION Some of the problems associated with the nursing profession include poor working conditions that have effects to both the nurses, patients and the nursing sector at large. After analyzing these problems, I have decided to draw a conclusion that creative solutions and labor motivations are the major factors that need to be addressed in order to safe the situation as far as nursing career is concerned. REFERENCE: Burnout, staffing and outcomes of nurses, retrieved on 7TH NOVEMBER 2007, available at www.ahrq.gov Dohm A, â€Å"Gauging the Work Force Effects of Retiring Baby-Boomers,† Monthly Labor Analysis (July 2000):17-25 National union for Nursing, retrieved on 7TH NOVEMBER 2007, available at www.discovernursing.com   Strategies to repeal the New Nursing scarcity, retrieved on 7TH NOVEMBER 2007, available at www.aacn.nche.edu