Introduction and Theory Section
Several theories have been used to explain America’s nursing shortage that begun in mid 1980s and is projected to peak in 2020s. Among them is the fact that there are too many nurses leaving the profession through retirement but replacements have been hard to come-by. This is happening at a time that the nation is in need of many more nurses, because of the increasing demand for nursing services. The result: lots of patients in need but too few nurses to provide care.
The US is not alone in this scenario; several developed nations such as Britain, Japan and Australia are faced with the same challenge. Some researchers (Wagner, 2005) have used the catastrophe theory to explain the history, current, and future of nursing shortage in United States. This theory is meant to understand different causes of the shortage and thus help in developing solutions to this problem. Catastrophe theory is further used in understanding the needs of nursing professionals that are currently in the workforce.
The heavy pressure upon current workers has had a big tall that cannot wane until all more nurses have been hired. Solutions should however be found as soon as possible because commitment to the profession could be diminished soon, which will have dare consequences on the already delicate situation. Understanding the needs of new hires should also be taken into consideration; this will help in increasing job satisfaction in this demanding profession. The theory demands senior management in the nursing profession to understand what will make nursing environment friendlier to the nurses. This could be done through regular surveys that will later be used in developing environments that will motivate nursing employees. Management should also understand consumers (patient) needs.
Finding on patient needs should be well communicated to nurses so they can provide the most personalized care to patients. This will actually be a good way of ensuring that quality of nursing care is not compromised by the diminishing quantity of nurses available. It should be understood that the current crop of nursing professionals are the best ally in the attempts to increase the supply of future professionals. This is because making employees happy through provision of best working conditions and remuneration possible, which will serve as magnets to future employees.
Methods Section
This paper has three distinct parts that will help understand nursing shortage in the United States as well as other developed nations faced with the same challenge. The three areas include addressing the past, present and the long term future of nursing industry in the United States. Looking at the past of the industry, especially the entire twentieth century, will help understand when and how the problem begun. This will aid in looking at how the country addressed previous shortages and why those strategies could or could not be applied today. The impacts of previous measures in today’s shortage will also be addressed.
The second are to be addressed the present situation facing the country. Reasons as to why the problem has gotten this far will receive special focus. Also the extent of the problem in the country will be looked-into. Since other developed nations are also facing the same problem as United States, the paper shall partially address extensity of nursing shortage among the affected countries. It is not just Americans and other developed nations are facing feeling the pinch of nursing shortage in their economies. In fact, developing nations in Africa, Asia and Latin America have been experiencing an exodus of their nurses to the developed nations.
This exodus has been a double edged sword in these countries as their populations get better paid jobs in developed nations. On the other hand, these supplying countries are left with fewer nurses—thus leave them will gapping shortages, too. The result: a global shortage of nurses. Third, the future of nursing in the United States and its effect on global economies will be investigated in detail. Most emphasis will, however, involve the measurers taken by different stakeholders in addressing the problem. To begin with, federal government’s policies on solving nursing shortage problem will be elaborated in full. This is because nursing shortage is not a local or state problem, but a national one.
After all, foreign help is dire needed in foreign help. Different solutions being developed by different states will also be inspected. Best among the measures will be selected and recommended to be copied by other states and probably the federal governments. Further, how individual healthcare facilities are addressing their shortages will be investigated and best practiced equally highlighted. There shall be an emphasis on the importance of letting individual hospitals to develop their own measures.
History of the nursing shortage
United States never had a formal training of nurses prior to 1908, when the University of Minnesota started a baccalaureate degree in 1908 (Seargo, 2004). It was, however, not easy for the school to establish the formal training because of the strong resentments among medical professions; they argued that formalized studies were not needed, thus favored practical training. Before this happened, nursing students were just receiving diploma education before they were enrolled into the profession; they however served in hospital during their studies. Students were not paid for the services they provided while attending school. This training and free labor was seen as the best education for future nurses, because they were exposed to specific operations of the profession.
It was not until 1923 that a many universities and colleges started offering decree courses in nursing. This is after a Rockefeller Foundations Goldmark Report (Goodrich, Nutting, & Wald, 1922, p. 1) recommended that nursing be taught in schools rather than colleges as well as the introduction of two level of nursing, CN and RN. This resulted to increased supply of well educated nurses to serve the entire country. The different levels of nursing education, from CN to degree and postgraduate levels provided a wide rage of professional to serve in different levels of operation. Educating more nurses proved fruitful during the height of Second Word War, which led to high demand of professions. The end of the war and increased demand for nursing services was to be served by the new graduates in the profession.
Despite the increased supply of nurses that was occasioned expansion in educational facilities and opportunities, the country experienced its first nursing shortage in 1940s, during the height of the Send World War II (Seargo 2004). The shortage led to further demands upon nursing students; they were required to work form extra hours in hospital and other healthcare facilities. End of the war led to a slight nursing surplus until another shortage occurs in mid 1980s (Seargo 2004). This shortage has continued to grip the country since, except for a little period in early 1990s when it seemed to have been disappearing. The current shortage is the most serious since and does not seem to wane anytime soon.
Impact of the Nursing Shortage
Patient Safety
The decrease in the number of nurses serving patients in healthcare facilities is a danger to the well being of patients. Owing to the fact that one nurse is forced to serve many patients than one could comfortably handle, a scenario where each patient is not accorded enough attention is suspected to be compromise the intended goal of quicker recovery (Feldman, 2003, p. 152). This scenario could precipitate to as a situation where emphasis will be put on the number of patients that are service by a team of nurses rather than the quality of care being provided, which will hurt patients further.
Quality of Healthcare
The increase with number of patients served by one nurse will have the tendency of loosing the personal touch that has been associated with the nursing profession for too long. It has to be understood that nurses are among the most significant part of patients’ recovery period because they are with patients longer than physicians, family and friends. They therefore understand better what patients are going through during treatment period, whereas other parties understand some sections of it. This important section of treatment period is being threatened by the number of patients per nurse, and is destined to get worse if solutions on shortage are not found soon.
Medical Errors
Lack of enough helping hands in operation room could men that doctors are forced to do a lot of tasks, all at the same time. This could easily lead to medical errors due to lack of concentration. Checking on patients’ progress will also be compromised because doctors do not have enough time to allocate on each patients progress, and thus the importance of nurses in this area. But the diminishing number of nurses means that doctors must themselves check on patients’ progress. Keeping track on the information doctors collect from patient is a hard task for doctors with many engagements to undertake; this raises the chances of making errors of mixing data, which could lead to wrong diagnosis or medication, all because there were no enough nurses to perform that task.
Results Section
Increased demand of nursing services and reduced number of nurses joining the profession has meant that an average nurse serves eight patients compared to four previously (Anderson, 2007, p. 3). Those figures bring out the mot clear picture of what current nursing professionals are going through. Though most are dedicated to the profession, the job that they do in caring for too many patients is hard enough, of not heartbreaking. To complicate the matter, these nurses serve their patient not for too many hours—some work for over 18 hours, seven days a week notwithstanding mandatory overtime. This is a scenario that is repeated in most healthcare facilities in the nation.
Opinion Section
Owing to the growing integration of international world economies, other countries in the world are and will be affected by the rising nursing shortage in the developed world. This means that the solution to the American problem should be developed in collaboration with other countries. Developing countries in Asia and, Latin America and Africa have a big contribution to make. In fact, they are awash with untapped nursing labor that can help in alleviating the problem.
But before this happens, American immigration policies have to be looked into; they should in fact be friendlier to immigrants coming-in as nurses. Policy makers should be obliged to follow that route because fewer and fewer Americans are willing to join the profession.
Other than using immigrant labor in alleviating the problem, state and national authorities should consider developing policies that will encourage the existing professionals to get more education regarding patient-care, which will increase productivity. Individual healthcare facilities should also develop programs that will re-educate their nursing staff. Provision of better working conditions should also come in handy in these institutions; policymakers have a contribution to make in this regard.
Academicians and industry leaders should engage on further research that will lead to opening of new management styles that will ensure better working conditions for nurses and best care for patients. This is because enlarging the wealth of knowledge in the field is crucial in helping the industry sail through the shortage problem that could be present for many years to come (Friss, 1994).
Discussion Section
Industry leaders should have been learned in late sixties when it became clear that the catastrophe will face the nations in the near future (Yett, 1970). It should be understood that the retirement of baby boomers that was to start in the beginning of the twentieth century would have come with special challenges to the country. But this never happened due to lack of enough faculty to expand such studies at that time.
Despite that fact, it is not too late to start doing research and developing plans to sail through this catastrophe. Another lesson involves giving individual healthcare facilities free hand in choosing the way they want to hire and manage their nursing shortages. Such moves will foster competition in the field as each facility try to get the best professionals in the market. The competition has higher chances of healthcare facilities offering incentives that will lead to higher retainance rates that will help in avoiding employees being poached by competitors. Nurses will thus benefit from higher pays and better working conditions than the ones exist today. Patients will on the other hand experience high quality care from the nurses that are motivated to perform their tasks with great zeal.
It shall however be important for federal authorities to open their nursing market to international nurses that would be glad to make a contribution. This will be a good way to ensure that competition between healthcare providers does not lead to exorbitant prices for their services; internationals will help in reducing customer costs due to the increased supply of nursing labor. Developed countries such as Australia and Great Britain have followed the international route to their nursing shortages and have lived to enjoy the benefits.
This is because, like their American counterparts, most residents of these countries are less inclined join the nursing profession due to the other opportunities different sectors. Federal authorities just need to ensure that training colleges in the source countries are teaching using aspects parallel American syllabus, which will ensure that graduates understand consumer demands they will be faced with. Going for international solution will help American to quickly escape the problem than has started to show serious repercussions in the country’s healthcare system.
Federal and State Efforts to Address the Nursing Shortage
The federal government has been developing several measure aimed at reducing the impact of nursing shortage in the country. All its measures are direct and ensuring the long run supply of nurses in the national market other than looking for short cuts that will just address current problems, instead of short-term solutions that would compound the industry’s future. One of the ways bused by the federal government includes the increased funding for nursing educational and facilities (AACN, 2002). This ensures that nurses receive high quality education that will enable then to meet patients’ demands through the provision of high quality care. Further, the educational programs will ensure that nurses could serve several patients at the same time without compromising on care standards.
Through the federal funded educational programs, the government has been facilitating increased research on the industry. This is a sure way of guaranteeing new ways of dealing with the shortage in the country. The government seems to be considering that new technologies have to be applied if the country is to avoid catastrophic turn of events. Successes on these attempts have not shown themselves fully because they just started being implemented recently. To help the government in these attempts, nursing profession especially in colleges should be obliged to doing extensive quality research on nursing shortage in the country. Only then can a strong foundation in fighting with this nightmare can be realized.
Together with local and state authorities, the federal government has been, and should continue, making modification on regulatory frameworks so as to improve efficiency in the sector. Policies directed at making it easier for independent healthcare facilities to develop their own systems. This should lead to the decentralization of decision making process regarding dealing with nursing shortage issue. Further, instead of having all the decisions regarding the shortage at the state or national level, the most local authorities should be given a chance to play. This will ensure that the solutions takes are inline with the demands of specific localities.
Factors Contributing to the Nursing Shortage
Aging Population
Soon after the World War II, American experienced unprecedented birthrates that led to sudden increase of the country’s populations. Individuals born at that period are now starting to retire and will soon jam formative age nursing facilities. Their health will even before retirement require constant medical checkup. This has and will continue to be the major source of demand for nursing services. Their demand for care is expected to peak around 2020, when smaller retirement groups will start demanding nursing services. This is the same scenario in other developed countries that will also have to source nurses from elsewhere since their systems, too, are clogged with too many patients and too few nurses.
The ageing population American population, which means significant increase on the number of old people compared to the young. This makes it hard for the young people to take care of the old in their homes and thus necessitate the importance of nursing homes. In addition, today’s lives are more demanding that in former days. This means that it is no longer possible for the younger generation to take care of the elderly at home. Apart form the generational gap, the recent improvement in medical technologies has meant more access to health facilities that has increased patients while the number of nurses has been rising marginally (Flinn, 2007, p. 1).
Fewer Workers
Recent decades have seen significant decline in the number of patients served by each nurse. This has meant that one nurse is currently responsible for the welfare of even more patients than it used to be some few year ago. As motioned earlier in this paper, today’s nurse is supposed to serve eight patients compared to four some few years ago. This means that new entrants into the nursing profession are met with heavy working pressure they had not envisioned before entering that job.
On experiencing pressure at work, the new nurses would naturally have the tendency to express their frustrations on their job to consider who would have considered entering profession. This ends up serving as repellants against future employees in the profession, which will have to contend with the decrease of workers—exactly what is happening currently.
Comparing the pressure faced on the job, remuneration, and working environment with other industries leaves most people with impression that nursing is no longer one of the best industries it used to be. The would be nurses thus see the professions as a stepping stone to other professions or as a vocation for those inclined to make a contribution in the health sector, but not as a job. This has resulted to decline in enrollment rates in the profession especially at the higher educational levels of bachelors and masters classes. This sentiment will have to change for the younger generation to consider nursing as a choice among their career choices.
Recent years have also seen a significant competition among various industries, which has provided younger people with varieties of careers to choose from. This has especially happened in the technology sector that so many young people are so inclined to consider as their chosen career path. Nursing has therefore taken a beating in the technological breakthroughs because the profession rarely provides the tech-survey generation to enjoy the gadgets that have characterized their lives.
It will take several more years before technology becomes a mainstream component of nursing operations. Only then that this and future generations will be able to start choosing the profession as their career, and probably the beginning of end for the biting nursing shortage.
Another contribution to the shortage of workers in the nursing profession is the punitive working hours that workers in the profession have to be on the job. Some nurses have absolutely little time of their on as they work close to eighteen hours daily, including some mandatory overtime they need to cover. This could be one of the reasons that so many potential workers avoid the profession that has the tendency to take over employees’ leisure and social time. Attractiveness of nursing is further worsened by the lack of facilities that would help employee to relax well at their places of work. Owing to the many hours put on the job, healthcare facilities should consider recreational facilities that will help employees to have enough relaxation during their breaks.
Lack of proper managerial skills among officials in healthcare facilities top management has also made ac contribution in the fewer workers scenario in the industry. The management fails to understand the needs of the employee and thus fail to provide the best working environments at all times. It is thus important for the senior management in institutions to develop descent human resources skills that are so critical at a time that the industry needs to manage the small workforce in best ways possible Barnum et. al., 1995, p. 84). Failure to improve management practices could lead to deterioration of the situation to catastrophic levels.
Ageing Workforce
The significant numbers of baby boomers are and will be leaving the nursing professions as their time for retirement arrives. The exit of the most experienced and probably most productive members of the workforce is rubbing the industry in two ways. First, it means that productivity has to deep due to the retirement of some of the most productive members of the bursting profession. This is exacerbated by fact that enrollment of new employees has been low until the recent surge (Feinsod & Davenport, 2006, p. 14), which means most of the burses in the workforce are not well experienced. Secondly, the lag time between baby boomers retirement and the peak of productivity among their replacements could be larger than expected due to exits.
Diversity
The lack of use of diversity in talent in the nursing profession has made the profession less attractive to potential nurses (ANSR, 2007, p. 5). Nursing profession is thus seen as a boring career because players in the industry hardly enjoy their hobbies; most of their time is dedicated to patient care through regular and overtime work demands. Only through improvement of working conditions and increase in the number of employees that can help individuals to fully participate in the industry and not pay a price by leaving their hobbies; most of them will find the diversity of talents and interests as one of the strong reasons to work in the industry.
News Opportunities for Women
Nursing had been a women dominated profession for the larger part of twentieth century (Springer et al., 2007, p. 26); their dominance has however been declining since 1950s and has left a dent in healthcare industry. This is because the number of women that left nursing since 1950s were replaced by insignificant number of male workers. As a result, the profession has been seeing increased exodus of women from the profession and lower entries by men. Unfortunately, employees joining nursing to replace exiting female workers could not be as productive, which further affect their effectiveness on the job. On facing the challenges in the industry, the men could easily exit; this leaves the industry at even worse position.
Women exodus has been occasioned by the rising opportunities in other industries. The previously dominant gender separation of labor and industries has nothing but disappeared (Office of Professions, 2001).. The success of progress in careers previously dominated by men folks has been a boon to the economy as large, whereas that nursing industry has been left yearning for more women participation in the industry. The high demand that nursing has on its participants makes it possible for women with kids to balance between work and family, and thus choose to choose working in other sectors that will provide that flexibility.
The transition between women dominated nursing industry to the one that is mixed between the sexes and other diversity has been very slow, which has resulted to decreasing productivity per nurse. The decreased productivity and increase in the number of patients has really hurt the nursing industry. Nursing has thus become a stepping stone to women career as it has been seen with many young women; they join the industry before embarking on their chosen career path. Sticking to the nursing industry has been a hard thing to come-by but needs to change for the looming shortage to be averted.
Generational Differences
Nursing is among the nation’s most geretaionally integrated industries, as explained by the diversity of age seeing it the ranks. It is not hard to see a baby-boomer nurse working hand in had with nurses born in the seventies and early eighties. Mix of generations in the industry is positive and negative aspects. Positive aspects include the mentorship that young generation gets from the older generation.
This makes the on the job training much beneficial, because the young get to know the hurdles that industry has gone through in recent times. Negative aspects develop from the fact that some of the young generation nurses could not be willing to work with people of their grandparents’ age—which makes the industry less appealing. The younger generation could easily be forced into leave the industry due to peer pressure. With regard to formative age care facilities, young people would consider it as un-cool job, which reduces their chances of enrolling in the industry.
In order to ensure that age difference is not a problem in the industry, senior management of healthcares should consider understanding the basic needs for each generation. This is an important aspect in the attempts to attract excellent nurses that will be with the facility for longer periods, just like the generation before them (Karen & Parsons, 2007). The young generation will start appreciating the industry and subsequently pass that appreciation character to the generations to come after them.
Work Environment
The pressured work environment with scarce recreational areas could further be contributing to the decreasing attractiveness of the industry to potential employees. The twenty first century is surely not meant to be same as 18th, 19th and 20th centuries that were characterized with long working hours in various industries. The century is rather characterized by information technology that continues to make work easier for employee while increasing productivity. Nursing is however different; employees are required to work for many hours, most of which are spent standing or walking around. This has to change for the industry to attract more people.
The use of technology and better areas to rest are two of the main measures that industry leaders have to take. Apart from standing all the time, having little rest time, and experiencing sub standardized resting areas, nurses have to contend with fact that each of them has to oversee around eight patients at a go—double the number (four) of patients that one nurse used to serve a generation ago. This has to for the industry to attract the right crop of workers, especially the vibrant youth. Attracting the youth will further demand aggressive use of technology in the industry. This is because the youth demand the use of technology, especially on entertainment (Shi, 2007, p. 195), in their chosen careers. Few would like their working places to interfere with the entertainment life they are so use to enjoying.
Consumer Activism
Breakthrough in information technology has enabled healthcare consumers to access information regarding their ailments even before going to health facilities; they even understand the special care that has to be undertaken in the progress of their medication process (Bryant, 2001, p. 15). This makes them to demand too much from the nursing community without care that nurses have to serve many patients at the same time. This raises chances of new entrants into the professions being frustrated and leaving the industry all together. If they do not leave, they might ensure advice their friends and family against joining the nursing profession.
By accessing the same information, patients’ families and friends also happen to put nurses at hard task regarding the care taken on their party. Again, they care less that the facility, or even the nation, is suffering from acute shortage of nurses; all they want for nurses to be around their party at all times. This is especially seen when members of the patients’ family are footing hospital bills, which becomes their main argument. Another source of consumer activism pressure comes from community harboring care facilities, especially when they are state owned. It has recently become common for the local community to lobby their legislators into investigating the job done by health facilities. Legislators turn heat onto healthcare management who then turn onto nurses. This leads to unpleasant work environment for the nursing fraternity.
Competition in Healthcare
Increased demand of healthcare among American population has resulted to a surge of healthcare facilities, some of which are specialized in certain ailments or age group. This has opened up the healthcare market to aggressive competition as facilities try to outdo each other in terms of cost and quality (Diers, 2004, p. 146). All these have worked to the benefit of the American consumers who have been getting quality care at competitive process.
However, the increased competition among healthcare providers has resulted contributed to the shortage of nurses in some facilities. Eason: because facilities are doing their best to attract top performers from nursing schools; others go to an extent of poaching competition’s nurses, which exacerbates the competition streak. Since some of these hospitals are profit oriented, they tend to have huge war chests to ward off competition from poaching on employees.
This works to the benefit of nurses, who go to work with facilities that have more money. Facilities further do their best to improve their nurses working conditions. As it works in other industries, higher pay and good working conditions help in retaining excellent employees as well as attracting good crop of future workforce. Facilities that have money thus benefit whereas those without, especially public ones, continue to reel from shortage of nurses. This trend can only be controlled when there are enough nurses to be supplied into all healthcare facilities. Should that fail to happen, public hospitals and some non-profit ones will face more serious shortage in days to come.
Local, state and federal governments should therefore consider releasing their tight leash of public hospitals; these facilities should be left to govern themselves like their private counterparts. Only then can their potential be realized, and thus be able to deal with their nurse shortage and the local level other than crying fowl to authorities and all times.
Increased Demand for Care
The United States has been experiencing a surge in the demand for care. The first cause has been the dawning retirement of the baby-boomer generation, which will put the biggest pressure on the nursing fraternity for the next one or two decades (Broberg, 2001). This will be serious because this group of retirees will be large and could move into nursing care almost at the same time. Moreover, they are group that cannot be ignored because they will need the best care possible.
The second reason for the increased demand for nursing care has been population increase in the American population. The country is among the few developed nations that is not experiencing significant decline in birth rates. In fact, United States could be termed as the youngest and most vibrant developed country—a tag it owes to the high young-to-old generation ratio. This population increases and accessibility to healthcare facilities has increased demand for care at the time that nurses are not being supplied according to demand, which leads to the acute shortage being experienced currently. The third cause of the increase in healthcare demand is the technological breakthrough in medicine field.
Furthermore, American healthcare system is regard as less tainted with socialized systems in many developed nations. Citizens of countries with less efficient healthcare system, like Canadians, have been flocking American hospitals in search for better and cheaper health solutions (Curtin, 2007, p. 106). American healthcare system is also regarded as one of the best and is frequented by people from all over the world, which leads to significant demand of nurses in the country and hence the shortage being experienced currently.
Solutions to Nursing Shortage
There is no single solution that is panacea to America’s nursing shortage problem. A mix of solutions should thus be applied it the attempts to reach concrete solutions to the problem that is looming large in the country’s healthcare systems. A mixture of five solutions discussed in this section should be incorporated into local, state and federal policies. First, the use of immigrants should be considered as one of the best options.
Or why should America reel in the shortage of nurses whereas millions of foreign born and educated nurses are willing to help? The immigration issue is however policymakers’ hot potato because of the strong sentiments exposed by different political viewpoints. It however stands-out among the easiest routes to the long run solution to the nation’s nursing shortage. There could be fears that foreign non-English-speaking nurses are not the best choice for America’s retirees and invalids. However, such arguments holds little weight considering that the nurse could be sourced from outside sources that completely meet the requirements set by American authorities.
Secondly, the state should consider expanding the roles played by the private sector in healthcare facilities. This is because private initiatives have been successful in slightly escaping nursing shortage that has been so chronic in government operated facilities. Deregulating the industry further should ensure more room for private hospital to be established and compete again each other at level playing fields. Regarding the use of immigrant labor in alleviating the problem, private companies should be encouraged to take part in helping source for labor.
Thirdly, the federal government should consider encouraging individual states to accept licenses from states that they currently do not accept. This will reduce the cost of education that they have to go through before acquiring licenses from other states. Regulatory frameworks across states should also be harmonized so as to ensure uniformity and make it easy for professional in the field to migrate between states, that is, ease their relocation to areas where their services are needed most.
Fourthly, working conditions for the current crop of nurses should be improved so they can be comfortable in the industry. This will lead to their longer stay as well as inspiring the vibrant youth to consider a career in nursing. Salaries paid to different levels of nursing should also be considered; the wage should be consistent with the amount of work that nurses put into their activities. These shall be sure ways of ensuring that nursing professionals stick with the industry until their retirement, and that young people start getting attracted into choosing nursing as their career of choice as opposed to competing industries (Gerson & Oliver, 2008).
Culture of Retention
Retaining best performing employees is a goal searched by many institutions. A nursing facility is no different; senior management in this industry should strive to retain high performing nurses at all time. In fact, they should strive to ensure that nurses stick to the profession until their retirement periods arrives. For that to happen, working conditions and the remuneration have to be competitive compared to the other industries that nursing professionals could consider moving into.
Senior management must first understand the needs of their employee before planning on ways and means of improving working conditions. This can easily be achieved through the use of consultants well exposed to the workings of nursing organisation. The management just needs to inform the consultants what they would like to achieve. Nurses should be involves in the entire process through the use of questionnaires and interviews that will provide them with a chance to express their needs, that is, what would make them more productive even with the looming nursing shortage. It is the results of these studies that should be used to develop organizational policies that will befit the nursing profession; which would be involved in all the steps.
After the development and implementation stages of the new organizational procedures, the same consultants or different ones should be involved with follow up studies to see effects of new policies on nurses’ job satisfaction and productivity. The policies’ weak areas should be improved appropriately so they can be successful in the attempts to retain employees and attract new ones to the profession (Joint Commission Resources, 2005, p. 17).
Zero Tolerance Policies
Despite the heavy work pressure faced by nurses, it has to be understood that they have to perform their tasks according to organizational rules and procedures as well as adhering the regulatory frameworks set by various occupational and government bodies. This should be the major task of the management in healthcare facilities. Nurses should at the same time feel obliged into following the procedures for the benefit of their patients and dignity of their nursing industry. Nursing professions should further understand that adhering to the standards set by different bodies is meant to make their work easier as well as helping patients recover at descent speeds (AACN, 2002, p. 2). It also help in avoiding suitcases that might arise, because nurses will not be obligated to any wrongdoing had they followed the laid down procedures.
The management should consider undertaking regular assessments on how nurses are fairing in terms of adhering to institutional regulations. This shall be an important way of identifying problems with some areas and improving them before issues get out of hand. Management should further make sure that nurses are consistently reminded of the rules and regulations they should adhere to all times. Any change in these rules should be communicated immediately to the affected nursing teams.
Nursing Leadership
Leadership and management classes should be considered for the nurses climbing the career ladder. This should be made mandatory after nurses attain certain years or points in their career. When that happens, all nurses in an organisation will be ready to take helm of leadership at any given time. This becomes important when nurses are working on teams because leadership and management qualities get sharpened.
Nurses who are ready to lead at any given time shall become great assets to their organisations when new members of nursing teams are employed; it becomes nurse-managers role to train the new employees on important inner working of the relevant institution. This should be cultivated in the very organizational culture of every nursing facility, a culture that should be passed to9 all the incoming and future generations of nursing workforce.
Nurses should further be encouraged to undertake graduate education in nursing management. This will be important in bringing new management dimensions in the nursing leadership that are desperately needed at a time that the industry is dealing with serious shortage problem. To ensure that happens, individual organisations, state and federal governments should consider sponsoring nurses that ant to achieve higher management education in this field (Valentine, 2002). Nurses who would have gone back to school should be guaranteed promotion upon return to their professions or after completing certain academic level.
Safe Staffing Levels
As aforementioned earlier, every American nurse oversees eight patients, which is double what it used to be a generation ago. This means that nurses have to keep running up and down facility corridors attending the various needs of their patients. They do this not for just few hours but for as long as eighteen hours, which could increase depending on individuals institution’s mandatory overtime requirements. These movements are clear risk hazards that might compromise efficiency in nursing facilities. It has to be remembered that safe working environment with the appropriate staffing levels increases efficiency in nursing facilities (Joint Commission Resources, 2002, p. 99).
Facilities should thus consider the number of nurses available before committing themselves to admitting more patients in their facilities. This will give nursing teams’ time to adjust and understand their working environment, and thus work efficiently. Management should then check on nursing teams’ efficiency in dispelling their duties, after which it can be estimated whether it is possible to add several patients under nursing teams’ care. Nursing team leaders should be involved in this important process. Their involvement shall serve as incentive to work efficiently since their grievances as well as contributions to the management process are perfectly considered. In such a scenario, nurses will feel comfortable even when working over their capacity, because they could express themselves to the management, be heard and their recommendations considered.
Mandatory Overtime
Mandatory overtime that nurses are subjected to is the main cause of stress in their day to day nursing activities, as well as one of the reasons that one of the reasons that so many people are avoiding choosing this career path. This overtime is also the most significant indication that American healthcare facilities are undergoing a serious nursing shortage. It has further contributed to decline productivity in the profession; it is however beyond nurses’ control. Nursing facilities require their employees to work for longer hours because there no enough employees to cover shifts (Daniels, 2004, p. 38).
Claiming that nursing institutions can do without the mandatory overtime is an understatement, because there is no way around it. These institutions have to choose between refusing to accept patients because of the fewer nurses, and having their employees work longer hours for the benefit of the ailing clients. This is a tough call for senior management to make, by they have to make it anyways; it can be argued that they take the right decision since the matter could be putting patients’ lives at risk. Despite this fact, nursing facility management should consider providing enough rest time for nurses throughout their working hours, failure of which could lead to poorly done jobs.
Further, the management should consider retaining calendars that will show when certain nurses will be required for overtime purposes, with exception of emergency situations. This will afford nurses enough time to be psychologically prepared, or even find substitutes if the had other serious commitment.
Technology
The use of technology could prove to be healthcare facility’s best friend in alleviating the nursing shortage problem. Other industries have benefited from breakthrough in the communication technology yet the nursing industry has been left grappling with the old ways of communicating—running up and down hospital corridors. More should be done to open up the industry for twenty first century communication modes.
It can be argued that lack of use of technology in the field has been repelling potential nurses from this career, especially the youth. After all, nobody wants to work in a 19th century environment while living in the twenty first century. The application of communications technology in the industry should be the focus of industrial leaders as well as innovative American entrepreneurs that have for generations developed efficient means of performing tasks.
Should technology be used in this industry, nurses jobs will be much easier(Joanna, Mychelle, & Emily, 2002, p. 8), and will thus be able to serve many patients at the same time without the need for extra hands of mandatory overtime that have made this professions a little boring compared to its competitors. It shall not be forgotten that nursing professions should be taught on how to use the new technology in simplifying their duties so as to increase productivity. Teaching the nurses will not be a hard task because they are already exposed to information technology.
Magnet Hosptial Status
Magnet Hospital Status refers to the recognition of a healthcare facility as a provider of high quality nursing services (Miriam Hospital, 2007). This is a status that senior management together with rest of the nursing team have to sweat for; they have to be providing not only the best care in the locality but to the entire nation, considering that care centers are compared their counterparts in the country.
To attain Magnet Hospital Status, nursing facilities should first of all forget about the quantity of patients treated and instead concentrate on the quality of care provided to those patients, working environment for nurses, how nurses uphold to organizational and regulatory guidelines among other measures. There are no short cuts to attaining this status; members of nursing facility should work as a team consistently in order to gain the recognition.
Since attaining this status requires institutions to be practicing the best care for their patients through the provision of best working conditions for nurses who must obligedly adhere to guideline, it means that such institutions are applying the best and most efficient nursing processes.
Results are mutually beneficial: patients benefit from best care from well experienced nurses, nurses work in great environments that enable them to be most productive, and the institution benefits by meting its mission of providing best care and providing best working environment for its employees. The entire society benefits when those three parties are satisfied. Acquiring this status does not however mean that relevant institutions should now sit back and keep doing what it has been doing; management should ensure increased improvement of institutions services for greater recognition, better health for its clients and keeping the most motivated and productive nursing staff.
Next Generation Recruitment
The present nursing workforce should be treated well so it can act as magnet to attract the next generation of nursing in individual nursing centers and all over the country. Most importantly, when the young people in the profession are kept motivated through modest remuneration and good working environment, they will tend to talk their peers into taking nursing as their career of choice, which will help increasing the number of youth in nursing team and thus reduce the undesirable generational gap (Wright, 2001).
But before this happens, the management must first understand the needs of every generational group, that is, what will make each group to increase productivity. Findings from such a study should be used to develop strategies to keep them motivated. Incentives directed at various age groups should be considered; one-size-fits –all system should be avoided at all costs. After all, these groups have different interests that are depicted at their age and generational lifestyles.
Nursing Faculty
Lack of clear interest in the nursing faculty career has been a cause to worry other than nursing shortage (Yordy, 2006). As a result, not many nursing colleges offer graduate degrees in the field. Those who want to get higher education in the field have sometimes considered getting other qualifications such as MBAs in order to go up the industrial career ladder.
Lack of faculty that could cultivate the culture of continuing education in the nursing industry has thus resulted to nurses who had taken certificate courses to just stick with them instead of aspiring to get bachelors in the field. This is changing rapidly due to the increased competition in the field. Keen observers could only wish for the days that degree certificates will be the minimal entry credentials for the profession. Only then that the profession will be taken more seriously by outsiders; such a time is actually not far considering the proliferation of nursing undergraduate program across the country.
Graduate Nursing Training
The increased undergraduate offering should subsequently be followed by graduate education courses in nursing. This shall finally create a window for the profession to produce students who will be dedicated into entering nursing faculty. This is not currently happening in a desirable rate because the demand for nurses too high, which makes it hard for students to sacrifice their time. However eincreased nursing graduates will almost certainly provide students willing to continue with nursing studies.
Those willing to continue with nursing educations should be provided with financial support for their institutions. They should also be promised of jobs and promotion upon their graduation from nursing graduate schools. Apart from their nursing institution’s support, both state and federal governments should play part in providing grants to nursing students willing to continue with education. Such incentives will go a long way into enabling capacity building within the nursing profession, failure of which could complicate the future of nursing profession.
Federal Funding
Federal government’s funding of graduate education for nursing students should be emphasized because it could help in establishing strong foundations for people who will lead the industry through tremulous times in the future. In fact, graduate education for the students should come at the top of the lit that the federal government should do for the industry. Other than funding education, the government should consider providing grants to facilitate research that will help the nursing profession what the future holds for the industry (Huston, 2006, p. 102).
This research can be done through the various nursing colleges in the country or through other disciplines such as economics. In case it is seen that only through the use of immigrant labor that nursing shortage could be addressed, the government should help with coaching the immigrants on specific requirements for American practices in patient care. This shall go a long way into helping develop a strong foundation for the new member of America’s nursing profession.
Opinion and Conclusion
America’s nursing deficit has been going on since mid 1980s and is expected to peat at 1.1 million by 2020(AACN, 2007). The country’s healthcare system will be in disastrous positions should that be let to happen, which makes it advisory for the stakeholder sin the industry to find solutions as first as possible. One of the solutions that should be on the forefront of consideration is the use of immigrant labor. This is because there are millions of individuals who would want to be part of the solution, only that American immigration policies come on their way. Another solution lies in giving hospitals a free hand in choosing the means to be used in alleviating their respective nursing shortage.
Where possible, government operated hospitalized should be handed over to private or non profit sector. This will leave the government with one role: to regulate and provide enabling environment. Lastly private and non-profits should be provided with incentives to establish more care facilities that shall cater fro the upcoming care need among the retiring baby-boomer, which shall reduces chances of overcrowding in the existing facilities (Anderson, 2007, p. 2). These recommendations should be combined in the search of proper solution, because none of them is a panacea to America’s nursing shortage.
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