Nursing Shortage Essay
The impact of nursing of nursing shortage on the provision of quality healthcare and patient safety was discussed in this paper. The negative impact of nursing shortage on the quality of care and patient safety is that when nurses are few, patient safety is threatened and health care quality is diminished. This can incur high cost to hospitals. Nurses who have heavy workload are more likely to experience burnout and intend to leave their job within the next year causing high turnover rate. When nurses leave their job, an additional cost is needed to hire and train new nurses and the nurse shortage can increase overtime pay and heavy workload to those that are currently employed. Increasing job satisfaction within the hospital units, improving method used to manage nurses after they are hired, increasing nursing candidate, making jobs more attractive to nursing candidate, and increasing nursing faculty and members are some the solution. The
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outcome of sufficient staffing includes nurses that are satisfied with their job, improved job performance, decrease in patient mortality rates, decrease turn-over rates, decrease work loads, increase staffing and decrease liability cost to the hospital.
In a distinct scientific field and autonomous profession where people lives are at stake, skilled practitioners are to save lives and improve patient outcomes in a wide variety of settings. It is very important to analyze the negative impact of nursing shortage on the quality of care and patient safety because when there are fewer nurses patient safety is threatened and health care quality is diminished.
The nursing shortage is a global challenge affecting countries worldwide. It simply means a widespread and dangerous lack of skilled nurses who are needed to care for individual patient and the population as a whole. It could further be defined in terms of professional capacity standard as shortage of nurses, which are needed to provide the high quality of care and from economical perspective as not enough number nurses to provide the best quality standards and no supply of fund available to fill open positions (Littlejohn, Campbell, Collins-McNeil et al., 2012).
The core values of nursing are caring, diversity, integrity and excellence of the essential values of caring. Nurses show caring through empathy, compassion, respect, and by advocates for patients’ health and wellness. Virginia Henderson's, “Need Theory”, addresses this issue and helps nurses help patients so that they can care for themselves when they leave the healthcare facility (Theory of Nursing, 2013). If there are not enough nurses due to the nursing shortage then nursing turnover and burnout nurses will result. There is no way they can provide the best nursing care or help their patients. With the nursing shortage the risk of causing harm to the patient is higher, which deviates from the essentials of baccalaureate education for professional nursing practice, that is patient safety (Marquiz & Huston, 2015).
The nurses are the primary source of care and support for the patient at the most vulnerable points in their lives.
With this in mind, this paper will include causes of nursing shortage, solution to the causes, and what it cost to make a change. The principal factors contributing to nursing shortage are high turnover rate, burnt out nurses, heavy workload, an aging nursing workforce, a diminishing pipeline of new student in nursing, steep population growth resulting in a growing need for health care services, nurse short-staffing, poor work conditions, inflexible schedule, lack of adequate administrative support, and stress. According to the American Association of Colleges of Nursing (AACN) 2010-2011 reports 67, 563 qualified applicants were turned away from baccalaureate and graduate nursing programs due to lack of available faculty and resources (AACN, 2011). In addition to factors affecting the U.S nursing shortage is the nursing schools’ inability to increase enrollment due to scarcity of nursing school faculty
members.
American Nurses Association (ANA) recognizes the risk of nurse fatigue and sleepiness associated with heavy work load such as increased risk of error, decrease in short-term and working memory, reduced learning ability, negative impact on divergent thinking, innovation, and insight, increased risk-taking behavior, and impaired mood and communication skills (American Nurses Association, 2014). ANA’s position statement indicates that registered nurses and employers in all healthcare settings must collaborate to reduce the risk of nurse fatigue and sleepiness associated with heavy workload due to nursing shortage. Nurses have ethical responsibility to practice healthy behaviors to reduce the risk of working while fatigued or sleepy and to minimize the risk of causing patient harm. They are responsible for negotiating or rejecting heavy workload compromise patient safety. ANA also recommend to eliminate the use of mandatory overtime as staffing solution and to adopt an official policy that will give nurses an ability to refuse to work extra shifts without being penalized.
Recent studies found that hospitals where nurses treat fewer patients at a time have better patient outcomes. Furthermore, the Joint commission on Accreditation of Healthcare Organizations reports that staffing was a contributing factor in a quarter of adverse events resulting in death or serious injury.
The nursing shortage is already negatively impacting home health-care agencies, about 90% of long-term health-care facilities report a severe nursing shortage. As a result, many organizations are forced to refuse admission of new patients. It is predicted that by the year 2020, there will be at least 400,000 available nursing positions in the USA that must be filled to provide care for the ageing population (Hussain, Rivers, Glover et.al, 2012). A growing shortage of qualified nurses has led to the steady increase in turnover rate among nurses. The main focus is going to be on high turnover rate contributing to the nursing shortage.
Nursing turnover rate ranges from 10-21% per year globally with countries such as USA and Australia reporting rates over 20% per year. Voluntary turn over is an issue of critical importance to health care system globally. Nursing turn over is considered a serious problem that has an impact on several levels, including the hospital, clinical unit`s and individual providers. Furthermore, high turnover reduces a hospital’s ability to meet patients’ needs and to ensure high quality care (M. Galletta et.al, 2012). When a nursing turn over occur due to nursing shortage, the workload increases and high patient acuity for those who remain on the job. Research has shown that a heavy workload adversely affects patient safety. Furthermore, it negatively affects nursing job satisfaction and as a result a result to high turn over and the nursing shortage (Carayon & Gurses, 2008). Heavy nursing workload also increases burnout and job dissatisfaction, which in turn contribute to high turn over rate.
According to the System Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety, structural or organizational characteristics of health care work systems such as nursing workload can affect quality of care and patient safety.
Heavy nursing workload my lead nurses not to follow rules and guide line due to lack time and may generate slips and lapses and knowledge error, which may lead to unsafe patient care. This lack of time may also result to inadequate training and supervision of new nurses. In addition, nurses experiencing stress and burnout may not be able to perform efficiently and effectively because their physical and cognitive resources may be reduced. This performance may affect patient care and its safety. Job dissatisfaction of nurses can also lead to low morale, absenteeism, turnover, and poor job performance and potentially threaten patient quality and organizational effectiveness.
According to the 2014 National Healthcare & RN Retention Report, the national average turnover rate for nurses in hospital was up at 16.5% in 2013 from 13.5% in 2011 (NSI Nursing Solutions, Inc., 2014). The report also mentioned that the cost of turnover for bedside Registered Nurse (RN) is anywhere from $44,000 to $63,000 causing hospital to lose $4M - 6M and an additional $350,000 hospital cost for every percent increase in RN turnover. The amount is attributed to cost of termination, unfilled positions, advertising and recruiting, new staff hiring, new staff training and orientation cost. The Bureau of Labor Statistics projected an increase in the RN workforce demand from 2.71 million in 2012 to 3.24 million in 2022 (U.S. Bureau of Labor Statistics, 2013).
The US government must develop incentive to increase the number of nursing faculty and staff members to accommodate the existing high demand of nursing enrollment. If this is not done the cycle of nursing shortage, heavy workload, and burnout nurses, and high turn over rate will still continue which might. By increasing job satisfaction within the hospital units, improving method used to manage nurses after they are hired, increasing nursing candidate, making jobs more attractive to nursing candidate will further break the cycle. Nursing staff must have thorough evidence based knowledge of the impact of care that they provide on the outcomes of patients’ experience. Annual revision of salaries should be considered. Doing this will help will enable nurses to increase their standard of living without seeking for other employment with pay and benefit.
Promotion and training opportunity will help out with dissatisfaction leading to nurses staying with their current employer. If the administration are able to do away with long shift hours and compulsory overtime will enhance retention rates. Attractive retirement benefit will influence nurses of all ages to remain with their current employer. Also adequate advancement opportunities in the healthcare system will allow the new nurses to feel at home. Further more effective communication among nurses will help alleviate high turn over rate. Making available to nurses resources, social support, affective support, informational, and practical support to assist them in accomplishing their duties. By doing all this will help in high turn over rate.
If all this changes are successfully implemented, hospital will have nurses who are satisfied with their job, decrease turn over rates, decrease mortality rates and improve nurse’s performance.
outcome of sufficient staffing includes nurses that are satisfied with their job, improved job performance, decrease in patient mortality rates, decrease turn-over rates, decrease work loads, increase staffing and decrease liability cost to the hospital.
In a distinct scientific field and autonomous profession where people lives are at stake, skilled practitioners are to save lives and improve patient outcomes in a wide variety of settings. It is very important to analyze the negative impact of nursing shortage on the quality of care and patient safety because when there are fewer nurses patient safety is threatened and health care quality is diminished.
The nursing shortage is a global challenge affecting countries worldwide. It simply means a widespread and dangerous lack of skilled nurses who are needed to care for individual patient and the population as a whole. It could further be defined in terms of professional capacity standard as shortage of nurses, which are needed to provide the high quality of care and from economical perspective as not enough number nurses to provide the best quality standards and no supply of fund available to fill open positions (Littlejohn, Campbell, Collins-McNeil et al., 2012).
The core values of nursing are caring, diversity, integrity and excellence of the essential values of caring. Nurses show caring through empathy, compassion, respect, and by advocates for patients’ health and wellness. Virginia Henderson's, “Need Theory”, addresses this issue and helps nurses help patients so that they can care for themselves when they leave the healthcare facility (Theory of Nursing, 2013). If there are not enough nurses due to the nursing shortage then nursing turnover and burnout nurses will result. There is no way they can provide the best nursing care or help their patients. With the nursing shortage the risk of causing harm to the patient is higher, which deviates from the essentials of baccalaureate education for professional nursing practice, that is patient safety (Marquiz & Huston, 2015).
The nurses are the primary source of care and support for the patient at the most vulnerable points in their lives.
With this in mind, this paper will include causes of nursing shortage, solution to the causes, and what it cost to make a change. The principal factors contributing to nursing shortage are high turnover rate, burnt out nurses, heavy workload, an aging nursing workforce, a diminishing pipeline of new student in nursing, steep population growth resulting in a growing need for health care services, nurse short-staffing, poor work conditions, inflexible schedule, lack of adequate administrative support, and stress. According to the American Association of Colleges of Nursing (AACN) 2010-2011 reports 67, 563 qualified applicants were turned away from baccalaureate and graduate nursing programs due to lack of available faculty and resources (AACN, 2011). In addition to factors affecting the U.S nursing shortage is the nursing schools’ inability to increase enrollment due to scarcity of nursing school faculty
members.
American Nurses Association (ANA) recognizes the risk of nurse fatigue and sleepiness associated with heavy work load such as increased risk of error, decrease in short-term and working memory, reduced learning ability, negative impact on divergent thinking, innovation, and insight, increased risk-taking behavior, and impaired mood and communication skills (American Nurses Association, 2014). ANA’s position statement indicates that registered nurses and employers in all healthcare settings must collaborate to reduce the risk of nurse fatigue and sleepiness associated with heavy workload due to nursing shortage. Nurses have ethical responsibility to practice healthy behaviors to reduce the risk of working while fatigued or sleepy and to minimize the risk of causing patient harm. They are responsible for negotiating or rejecting heavy workload compromise patient safety. ANA also recommend to eliminate the use of mandatory overtime as staffing solution and to adopt an official policy that will give nurses an ability to refuse to work extra shifts without being penalized.
Recent studies found that hospitals where nurses treat fewer patients at a time have better patient outcomes. Furthermore, the Joint commission on Accreditation of Healthcare Organizations reports that staffing was a contributing factor in a quarter of adverse events resulting in death or serious injury.
The nursing shortage is already negatively impacting home health-care agencies, about 90% of long-term health-care facilities report a severe nursing shortage. As a result, many organizations are forced to refuse admission of new patients. It is predicted that by the year 2020, there will be at least 400,000 available nursing positions in the USA that must be filled to provide care for the ageing population (Hussain, Rivers, Glover et.al, 2012). A growing shortage of qualified nurses has led to the steady increase in turnover rate among nurses. The main focus is going to be on high turnover rate contributing to the nursing shortage.
Nursing turnover rate ranges from 10-21% per year globally with countries such as USA and Australia reporting rates over 20% per year. Voluntary turn over is an issue of critical importance to health care system globally. Nursing turn over is considered a serious problem that has an impact on several levels, including the hospital, clinical unit`s and individual providers. Furthermore, high turnover reduces a hospital’s ability to meet patients’ needs and to ensure high quality care (M. Galletta et.al, 2012). When a nursing turn over occur due to nursing shortage, the workload increases and high patient acuity for those who remain on the job. Research has shown that a heavy workload adversely affects patient safety. Furthermore, it negatively affects nursing job satisfaction and as a result a result to high turn over and the nursing shortage (Carayon & Gurses, 2008). Heavy nursing workload also increases burnout and job dissatisfaction, which in turn contribute to high turn over rate.
According to the System Engineering Initiative for Patient Safety (SEIPS) model of work system and patient safety, structural or organizational characteristics of health care work systems such as nursing workload can affect quality of care and patient safety.
Heavy nursing workload my lead nurses not to follow rules and guide line due to lack time and may generate slips and lapses and knowledge error, which may lead to unsafe patient care. This lack of time may also result to inadequate training and supervision of new nurses. In addition, nurses experiencing stress and burnout may not be able to perform efficiently and effectively because their physical and cognitive resources may be reduced. This performance may affect patient care and its safety. Job dissatisfaction of nurses can also lead to low morale, absenteeism, turnover, and poor job performance and potentially threaten patient quality and organizational effectiveness.
According to the 2014 National Healthcare & RN Retention Report, the national average turnover rate for nurses in hospital was up at 16.5% in 2013 from 13.5% in 2011 (NSI Nursing Solutions, Inc., 2014). The report also mentioned that the cost of turnover for bedside Registered Nurse (RN) is anywhere from $44,000 to $63,000 causing hospital to lose $4M - 6M and an additional $350,000 hospital cost for every percent increase in RN turnover. The amount is attributed to cost of termination, unfilled positions, advertising and recruiting, new staff hiring, new staff training and orientation cost. The Bureau of Labor Statistics projected an increase in the RN workforce demand from 2.71 million in 2012 to 3.24 million in 2022 (U.S. Bureau of Labor Statistics, 2013).
The US government must develop incentive to increase the number of nursing faculty and staff members to accommodate the existing high demand of nursing enrollment. If this is not done the cycle of nursing shortage, heavy workload, and burnout nurses, and high turn over rate will still continue which might. By increasing job satisfaction within the hospital units, improving method used to manage nurses after they are hired, increasing nursing candidate, making jobs more attractive to nursing candidate will further break the cycle. Nursing staff must have thorough evidence based knowledge of the impact of care that they provide on the outcomes of patients’ experience. Annual revision of salaries should be considered. Doing this will help will enable nurses to increase their standard of living without seeking for other employment with pay and benefit.
Promotion and training opportunity will help out with dissatisfaction leading to nurses staying with their current employer. If the administration are able to do away with long shift hours and compulsory overtime will enhance retention rates. Attractive retirement benefit will influence nurses of all ages to remain with their current employer. Also adequate advancement opportunities in the healthcare system will allow the new nurses to feel at home. Further more effective communication among nurses will help alleviate high turn over rate. Making available to nurses resources, social support, affective support, informational, and practical support to assist them in accomplishing their duties. By doing all this will help in high turn over rate.
If all this changes are successfully implemented, hospital will have nurses who are satisfied with their job, decrease turn over rates, decrease mortality rates and improve nurse’s performance.