VII. Negative Affects of Nursing Shortage on Patient Care
Study findings indicate that a connection exists between adequate nursing staffing and patient care and specifically state in the findings of the latest studies published in the journals of Health Services Research (August 2008) and the Journal of Nursing Administration (May 2008) are findings that confirm previous study findings linking education level and patient outcomes. This indicates that "…efforts to address the nursing shortage must focus on preparing more baccalaureate-prepared nurses in order to ensure access to high quality, safe patient care." Additionally reported in March 2007 in a report of the Agency for Healthcare Research and Quality in what was a meta-analysis is that the shortage of registered nurses "…in combination with an increased workload, poses a potential threat to the quality of care. Increases in registered nurse staffing was associated with reductions in hospital-related mortality and failure to rescue as well as reduced length of stays. In settings with inadequate staffing, patient safety was compromised." (AACN, 2008)
VIII. Strategies to Address the Shortage of RNs and Nurse Educators
A report released July 2007 by PricewaterhouseCoopers entitled: "What Works; Healing the Healthcare Staffing Shortage" states specific strategies for addressing the shortage of nursing professionals. These strategies include those as follows: (1) development of more public-private partnerships; (2) creation of healthy work environments; (3) using technology as a training tool; (4) designing more flexible roles for advanced practice nurses given their increased use as primary care providers. (AACN, 2008) Other strategies include necessary grant funding to assist more individuals to enter college in the nursing program as well as for enabling an increase in schools of nursing faculty. Hospitals are also reported to be using educational strategies for addressing nurse shortages. These strategies are stated to include those as follows: (1) partnering with schools of nursing; (2) subsidizing nurse faculty salaries; (3) Reimbursing nurses for advancing their education in exchange for a work commitment; and (4) Providing scheduling flexibility to enable staff to attend classes. (AACN, 2008) the Kaiser Family Foundation report entitled: "Addressing the Nursing Shortage" state that the nursing shortage is "the product of several trends including: (1) steep population growth in several states; (2) a diminishing pipeline of new students to nursing; (3) a decline in RN earnings relative to other career options; (4) an aging workforce; (5) Low job satisfaction; and (6) Poor working conditions. (Kaiser Family Foundation, 2009) the Kaiser Family Foundation report states that typical solutions used in the past to address the nursing shortage "have included wage increases and recruiting nurses from other countries…" (Kaiser Family Foundation, 2009) However, these solutions are expected by experts to have little impact since these are only short-term solutions. Required in addressing the nursing shortage are attention and efforts which aim "both at recruitment and retention of nurses." (Kaiser Family Foundation, 2009) Retention strategies are stated to be focused on "retaining current nurses and encouraging those who have nursing careers to reenter the workforce. workplace conditions and enhancing the education and professional development of nurses are primary retention strategies. High levels of job dissatisfaction related to scheduling, unrealistic workloads, mandatory overtime, and hospital administrators' lack of responsiveness to nurses' concerns have resulted in high turnover and early retirement among RNs." (Kaiser Family Foundation, 2009) Stated as the primary federal response in addressing the nursing shortage is the 'Nurse Reinvestment Act of 2002' which is stated to authorize the provisions as follows: (1) loan repayment programs and scholarships for nursing students; (2) public service announcements to encourage more people to enter the nursing profession; (3) career ladder programs for those who wish to advance within the profession; best practice grants for nursing administration; (4) long-term care training grants to develop and incorporate gerontology curriculum into nursing programs; and (5) a fast-track faculty loan repayment program for nursing students who agree to teach at a school of nursing.
Summary and Conclusion
There are still issues of debate among policymakers in addressing the current nursing shortage however, a focus on recruitment and retention strategies have been identified as being key toward increasing the level of individuals who enter the nursing profession as well as those who remain in the nursing profession following graduation from college. There is no 'pat' answer or simple solution to solving the current nursing professional shortage however, answers and solutions are critically necessary just as are bringing about an increase in both recruitment and retention of nursing professionals in the future workforce.
Addressing the Nursing Shortage (2009) Kaiser Family Foundation. Online available at: http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=138