Posted: March 28th, 2021

National Nursing Shortage

National Nursing Shortage

National Nursing Shortage
The nursing shortage is on the rise as the baby boomers age, demand for health services increase and nurse educators decrease. Nursing institutions are turning away thousands of hopeful nurses due to limited training capacity (Monahan, 2015). For example, in 2014, institutions of learning turned away 70,000 students due to insufficient capacity. Institutions of learning are unable to recruit nurse educators since most of the qualified educators are 50 years or older (Armmer, 2017). Additionally, the qualified doctoral or masters graduates are lured into better options as nurse practitioners with better pay. By 2030, studies project that various states will have over 10,000 nurses of full-time equivalents.
Shortage of nurses has been associated with reduced patient care, high mortality rates, and increased hospital-acquired infections. The healthcare facility is likely to experience 2-7 percent mortality rates for Intensive Care Unite patients and 10 percent for patients in normal wards (Lin, Zhang & Dixon, 2015). The shortage will affect my organization by increasing medical complications such as mistaken medicine, medicine omission, and giving medicine to the wrong patient. My organization is also likely to experience an overcrowded emergency department. Overcrowding in the emergency department will result in disability, deaths and increased medical procedures (Fischer, 2016). Reports indicate that over 75 percent of patients may wait for over 3 hours before they are treated. My organization is likely to experience nurse burnouts due to low nurse-patient ratio.
Article Summary
Aiken et al. (2017) carried out a study on nursing skill mix in European hospitals: a cross-sectional study of the association with mortality, patient ratings, and quality of care. The aim of the study was to examine nursing skills on mortality rates and the quality of patient care. The study adopted a cross-sectional design. It was carried out in Finland, Ireland, Spain and Switzerland, Belgium, and England. A survey method was applied in collecting data from 13,077 nurses and 18,828 patients. The findings of the study indicate that a reduced nursing skill mix may lead to preventable deaths and safety of hospital care.
Bridges, Griffiths, Oliver and Pickering (2019) carried out an observational study on hospital nurse staffing and staff-patient interactions. The study was carried out in 6 wards in two National Health Service hospitals. It comprised of 270 patients whose interaction with the nurses was observed. The study concluded that it was impossible to substitute Registered Nurses (RN) with assistant staffs. It indicated that low RN staffing levels reduced the quality of patient care and nurse-patient interactions significantly. The study recommends that RNs were significant in improving the quality of patient care and that the shortage of nurses could not be substituted with assistant nurses.
Addressing the Nursing Shortage
Healthcare organizations are applying various strategies to deal with the menace or nursing shortage. One of the strategies is to use an onboarding program to make nurses feel welcome (Snavely, 2016). It comprises of organizing events to introduce new nurses and make them feel part of the community. Additionally, new nurses are not allocated the severely sick patients, but they are allocated light duties as they get to know the work environment. Another strategy is long-term training and professional development. New medical issues require extra skills, thus making training necessary (Johnson, Butler, Harootunian, Wilson & Linan, 2016). Training helps reduce turnover and encourage nurses to apply for employment. For example, Mayo Clinic offers professional development and training opportunities such as leadership, management and surgical conferences to their nurses.
Hospitals are fighting the nursing shortage by turning current nurses into recruiters and compensating for referrals. Therefore, nurses are encouraged to refer their friends or former classmates in school. Additionally, organizations provide friendly schedules for personal and professional needs (Monahan, 2015). For example, Cleveland Clinic provides ‘mom shifts’ which run from 9 AM to 2 PM to allow mothers ample time with their young children. Other hospitals provide summer leaves to ensure parents spend time with their children on holiday. Nursing leaders have taken drastic measures to curb the momentum of the nursing shortage.
Strategies Used to Address the Organizational Impact
The study by Aiken et al. (2017) presents various strategies that are aimed at addressing the impact of the nursing shortage in organizations. One of the strategies is the introduction of a nursing associate in England. Political leaders have indicated that a nursing associate would help improve patient care and reduce preventable diseases. The nursing associate receives 18 months of on-job training. Additionally, the nursing associate will improve the nursing skill mix in Europe whose shortage has led to poor quality of hospital care. Germany is also debating on strategies to improve the number of professional nurses. Hospitals in Europe are also focusing on improving the work environment to enhance productivity and motivate nurses.
Bridges, Griffiths, Oliver, and Pickering (2019) indicates in the research findings that assistant nurses play a critical role in enhancing the quality of care. Therefore, the study proposes that assistant nurses can be useful in addressing the organizational impact. The study suggests that poorly trained assistant nurses are likely to compromise the quality of care. It thus indicates that high-quality training is required. It also indicates that flexible staffing levels can be important in minimizing the organizational impact. The study also recommends that assistant nurses should not substitute RNs since they cannot match their qualifications.
Effect on the Organization
The policies will affect my organization both positively and negatively. The strategy of a nursing associate will affect my organization positively since it can improve patient care and thus enhance the quality of patient care. The idea of improving the work environment to motivate nurses and reduce the turnover rate will affect my organization positively (Monahan, 2015). The reason is that when the work environment is enhanced, nurses will refer their friends to apply for vacancies available. It will also improve the productivity of nurses. The studies suggest that poorly trained staff compromise the quality of patient care.
The recommendation will help my facility to adopt better strategies to train assistant nurses and enhance assessment of their skills. The studies have also indicated that assistant nurses cannot substitute RNs. The strategy will help my organization to still invest in hiring and maintaining RNs since their roles cannot be shifted to the assistant nurses (Armmer, 2017). The findings of the study will negatively affect my organization since they recommend that RNs cannot be substituted. Therefore, the healthcare facility will invest more in hiring nurses. It has also exposed the facility to public ridicule due to the high number of assistant nurses compared to the number of RNs. The facility will thus be required to take drastic measures to address the issues as proposed in the summarized studies.

References
Aiken, L. H., Sloane, D., Griffiths, P., Rafferty, A. M., Bruyneel, L., McHugh, M., … & Sermeus, W. (2017). Nursing skill mix in European hospitals: a cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf, 26(7), 559-568.
Armmer, F. (2017). An inductive discussion of the interrelationships between nursing shortage, horizontal violence, generational diversity, and healthy work environments. Administrative Sciences, 7(4), 34.
Bridges, J., Griffiths, P., Oliver, E., & Pickering, R. M. (2019). Hospital nurse staffing and staff-patient interactions: an observational study. BMJ Qual Saf, 22(5), 122-183.
Fischer, K. M. (2016). How the educational funding provisions of the Patient Protection and Affordable Care Act will affect the nursing shortage in the United States. Nw. JL & Soc. Poly, 11, 54.
Johnson, W. G., Butler, R., Harootunian, G., Wilson, B., & Linan, M. (2016). Registered nurses: The curious case of a persistent shortage. Journal of Nursing Scholarship, 48(4), 387-396.
Lin, V., Zhang, X., & Dixon, P. (2015). Occupational therapy workforce in the United States: forecasting nationwide shortages. PM&R, 7(9), 946-954.
Monahan, J. C. (2015). A student nurse experience of an intervention that addresses the perioperative nursing shortage. Journal of perioperative practice, 25(11), 230-234.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-101.