Chapter Summary
The chapter Nursing Work Force and Health Policy by Linda O’Brien and Laureen Hayes focuses on the shortage of nurses that resulted from the intensive restructuring and downsizing of the Nursing sector in the 1990’s in Ontario, Canada. To reduce operation costs, nursing assistants and part-time casual employees were recruited while the laid off Canadian registered nurses migrated to the USA. The poor working conditions also killed nurses’ enthusiasm and willingness to work. The aging nursing work force also contributed to the shortage. Government initiatives attributed to Health Human Resources (HHR) policies led to an improvement in nurse supply.
The HHR strategies included policy change to reverse the nursing workforce shortage. Through various reports, the government set to improve the working conditions in order to retain nurses and increase recruitment by setting up a nursing research unit to make recommendations to the policy makers. This was meant to link policy making and research in order to promote the use of research findings in practice for proper projections regarding nursing requirements.
The HHR’s conceptual framework covers issues useful to policy makers and health service researchers and takes into account the health needs of a population. It entails planning and focusing to predict future service requirements and the number of providers needed using the available data. The framework also considers the number of available health service providers, the financial resources available, the production cost involved in training new nurses, the health status of both the population and the health providers among others. This framework requires complex mathematical models to provide simulation both at micro and macro scales.
The HHR studies also encompass the need-based studies where the needs of a population and factors that affect the use of health services are considered. This is important in understanding the complex relationships between ages, health, and birth years. The nurse staffing and workload also called the Patient Care Delivery Model, focuses on the key causes of dissatisfaction and concern amongst nurses working in hospitals to establish the relationship between nurse staffing and the nurse-patient outcomes. The work environment of nurses is important in nurse retention and staffing stability and preferred policies should consider this.
The research findings derived from the HHR studies together with the Canadian government funding have contributed to the current provision of quality health services to Ontarians. In addition, a new strategy termed Ontario Nursing Strategy, aims at looking into the plight of the nursing workforce to avoid shortage through graduate initiatives to create new future permanent nursing positions.
Influence of Research on Policy
The HHR’s conceptual framework is useful to policy makers and planners in planning a healthcare work force to meet the health needs of the population. The HHR studies provided models for policy makers that provide a broader spectrum that considers the underlying factors of population health and healthcare provision in human health resource planning in order to avoid shortage of nurses.
Research also came up with the patient care model that focuses on the concerns of the nurses working in hospitals. The evidence based Standards for Measuring Nurse Staffing and Performance study provided empirical evidence to link between nurse staffing levels, provider outcomes, and system effectiveness. This was important in designing new strategies to improve nursing health and provision of incentives to retain nurses. Research into the working environment of the nurses showed that it influences the nature and efficacy of the nursing care. This is important for the decision makers to formulate strategies that promote nurse retention. The policy initiatives aimed at nurse retention include the Ontario nursing strategy and the graduate initiatives.
Key Insights
In terms of the role of research in policy, I learnt that, research into the human resource planning in Ontario, Canada proved the necessity of research findings in policy formulation. The HHR framework used in the Ontario case has been helpful to health policy makers for it provides a context for assessment of the needs and outcomes of service provision. This shows that research provides necessary empirical evidence for policy makers.
Moreover, research provides meaningful insights for future health planning like in the Ontario case, research led to the formulation of the Ontario Nursing Strategy that focuses on looking into the plight of the nursing industry to prevent the recurrence of nursing shortage experienced in the 1990’s. It also led to the establishment of initiatives like the New Graduate Initiative to ensure permanence and stability in staffing.
Research is useful in improving the productivity of a workforce as the research findings provide information on how to improve the work environment and contributes to high staff retention ability of an organization. This is seen on how the nursing provision of healthcare improved tremendously because of improvement in their working conditions and incentives to work. Research into health systems in Ontario shows that, proper staffing-patient ratio is necessary in maintaining high staff productivity. It was found that the more a unit is understaffed (meaning the available human resource is over utilized), the less the actual nursing attention accorded to each patient leading to decline in the quality of services rendered.
Reference List
Linda, O. & Laureen, H. Nursing Work Force and Health Policy, 231-246.