Introduction
The nursing process is heavily reliant on the theoretical framework it is associated with. Organizing the nursing process on different scales depends on a specific nursing theory or model applied. The result is the formation of a working environment, conditions, policies, and practices that influence all aspects of the nursing process. Changing the theoretical framework may significantly alter the effectiveness and the specifics of nursing (Zhang et al., 2018). In this paper, we discuss the issue of staff shortages in nursing, identify the reasons for it and the effects it has on nursing in America. A nursing theory and a corresponding strategy to resolve the issue are proposed.
Description of the Problem
Staff shortage in nursing has been a global issue for some time, particularly for American mental health institutions. It has had a significant negative impact on the quality of psychiatric nursing care, the well-being of practicing nurses, and the American healthcare system in general. A study by Jun et al. (2021) shows that burnout among nurses correlates with lower quality of care and patient safety rates and negatively impacts the working environment and morale inside their unit. Despite governmental economic support and universities encouraging the pursuit of a nursing career, professional dissatisfaction of the nursing staff, high burnout rates, and stressful working environments contribute to a growing number of retiring nurses. Specific challenges associated with psychiatric nursing cause high turnover rates leading to a constant lack of young qualified, and motivated staff (Wampole et al., 2020). The economic implications of high nurse turnover are significant, costing $37,700 to $58,400 per nurse (Jun et al., 2021). For the United States, a loss of up to forty billion dollars annually is estimated as a result of burnout-induced nurse turnover. This situation leads to a closed circle of increasing burnout rates among practicing nurses, having severe consequences for patients, nurses, and the nursing care system (Fontaine et al., 2021). Those include job dissatisfaction, feelings of low personal accomplishment, loss of confidence, a decline in general health, patients’ dissatisfaction with the quality of nursing care, increased patient injury and mortality ratios, and increased malpractice claims. Issues associated with nurses’ burnout can severely affect the American healthcare system locally and nationally.
Nursing Theory
Kanter’s theory of structural empowerment is a potential tool to resolve at least partially the issues contributing to the nurses’ burnout and subsequent staffing shortages. According to the theory, properly structuring the work environment makes nurses feel empowered to implement their duties in ways that coincide with their views, methods, and expected goals. The guiding principles of the theory are recognizing each member’s strong sides and preferable methods of achieving a common goal, understanding personal and collective responsibility and involvement, mutual respect, and collaboration. Structural empowerment includes access to information and resources, receiving support, and having the opportunity to improve professionally. Access to information implies having the required knowledge for the job. Access to resources involves having the necessary material means and time.
Receiving support includes feedback and guidance from colleagues. Opportunity to improve refers to the opportunity for growth and movement within the organization and to increase relevant skills. Giving nurses decision-making autonomy, access to information and opportunities, necessary resources, and support grants them strong motivation and job satisfaction (Zhang et al., 2018). As a result, nurses show a high job attitude, and professional and personal confidence, leading to a healthier and more sustainable working environment.
Application of Theory
We selected Kanter’s theory of structural empowerment to propose possible solutions for the issue of staffing shortages in psychiatric nursing. Creating a sustainable and comfortable working environment for nurses is essential to avoid conditions that lead to professional burnout. The selected theory provides a framework for developing a strategy to create such an environment (Al-Hammouri et al., 2021). The proposed strategy involves the following steps.
Compensating tuition and certification training costs, encouraging online courses and mobile educational applications, and providing on-site interactive training for practicing nurses are essential. These steps aim to provide the new and practicing nursing staff with relevant knowledge and skills, promote self-education, and engage them in a broad discussion on new and existing nursing practices.
Material encouragement can involve a bonus pay system for nurses who wish to improve their qualifications and show the best results at later evaluation. Providing privileges for the nurses’ families, subsidizing materials for professional practice development, and equipping the work area with modern equipment would encourage the staff to engage in work with more comfort and dedication (Whittaker et al., 2018). These measures can be implemented by a joint effort of regional governments and health institutions, potentially attracting agents from other areas, including IT specialists, social workers, education facilities, and medical equipment manufacturers.
A healthy work environment should be promoted by encouraging horizontal and vertical interactions between the nursing staff. The proposed option is to arrange regular informal meetings involving mutual evaluation and sharing of experience between the nurses. Involving management in the nursing process to aid the nurses during high workload periods would significantly improve nurses’ perception of the professional relationships in the unit (Whittaker et al., 2018). Creating shared-governance decision-making procedures will give the nurses more control over the working process, and enhance their job confidence and motivation.
Encouraging nursing students to pursue a higher degree will improve retention and form a better qualified and skilled nursing staff. Supporting nursing programs at the community colleges and lobbying for expanding licensed practical/vocational nurse and associate-degree nursing programs are proposed. A further way of increasing the diversity in the nursing workforce is to provide bridge programs for easier access to nursing schools. Bridge programs include emergency medical technicians, paramedics to RNs, and surgical, pharmacy, and anesthesia technicians. These steps, if implemented successfully, will improve nurses’ retention and encourage an inflow of qualified and skilled nurses into the field.
More studies should be conducted on the correlation between professional burnout and nursing staff shortages. The role of burnout in the nurses’ decision-making process is to be further examined to develop a more comprehensive and complete model of the issue (Chang et al., 2018). Personal questionnaires are a good way to gather data on first-hand experience detailing the reasons for and the effects of burnout on the turnover rates among nurses. Developing and introducing additional strategies and policies for preventing and managing professional burnout requires a comprehensive theoretical mapping of burnout and its job-related consequences.
Conclusion
Staffing shortages in nursing, including psychiatric nursing, are a global problem requiring immediate and practical solutions. One of the main reasons for nurses quitting their jobs and a low inflow of young nurses into the field is professional burnout and its negative consequences. Kanter’s theory of structural empowerment is an empirically tested framework to create working conditions for nursing staff to mitigate the effects of burnout and to encourage participation in the organizational procedures of the nursing process. This theory is based on creating a comfortable and inspiring working environment that allows nurses to develop professionally and apply their skills more effectively while receiving adequate material and psychological support.
References
Al‐Hammouri, M. M., Rababah, J. A., & Ta’an, W. F. (2021). Structural empowerment, formal and informal power, and job performance quality: A moderated mediation analysis. Journal of Nursing Management, 29(6). 1596–1602. Web.
Chang, H.-Y., Friesner, D., Chu, T.-L., Huang, T.-L., Liao, Y.-N., & Teng, C.-I. (2018). The impact of burnout on self-efficacy, outcome expectations, career interest, and nurse turnover. Journal of Advanced Nursing, 74(11), 2555–2565. Web.
Fontaine, D. K., Cunningham, T., & May, N. (2018). Self-Care for New and Student Nurses. Sigma Theta Tau.
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