Nursing Shortage Risk Management Plan Nursing staff scarcity constitutes a widespread issue across several segments of the healthcare sector. It is often a challenge to find an adequate number of qualified nursing professionals for meeting staffing requirements. Nursing professionals represent a crucial part of healthcare teams and facilities. A dearth of qualified nurses may leave a healthcare facility vulnerable. Furthermore, because of staff shortages, existing workers are usually expected to work more than normal. A key concern with regard to this shortage and the resultant workload on the existing workforce is: Continuance of safety practices within healthcare organizations may be impacted eventually. This may successively lead to perpetual hospital vulnerability. Overworked nursing staff members or those who are made to take care of a greater number of clients (patients) have to typically make sacrifices. They can't focus sufficiently on individual patients, as is necessary for ensuring satisfactory nursing care. Thus, patient safety is impacted, as are the healthcare organization and its stakeholders, from a broader perspective.

Quality and risk management are an essential and basic element of several healthcare facilities. Personnel turnover and satisfaction are major issues for all organizational risk mitigation strategies. Several research works have been performed on this subject, thus enhancing the possibility that mitigation strategies will prove more effective; also, one can construct implementation strategies on sound evidence-based research. Improving satisfaction levels of workforce ensures low personnel turnover rates; turnover leaves organizations susceptible. A large number of best-practices have been devised, which have proven their ability to enhance job satisfaction. For instance, employee training levels have been found to correlate to overall satisfaction of individuals with their jobs (Schmidt, 2007). Thus, a study of factors linked to personnel satisfaction may be the perfect basis for developing a hospital risk management strategy.

Major Issue

A key problem linked to patient care rationing is the associated negative publicity. In numerous circles, the 'healthcare rationing' notion is frequently a politically and emotionally charged topic. People fail to understand implicit rationing pattern frequency. But irrespective of people's views regarding care rationing, it is quite a common process. In a Texas research, nearly all participants reported some level of rationing in a minimum of one nursing activity, while a majority of the participants rationed several activities. Moreover, rationing preference trends support the accomplishment of tasks aimed at meeting the immediate physiological requirements of patients over other tasks (Jones, 2015). Nursing staff has to personally decide on the areas it is best to commit their time to, at different points in their entire workday, as well as how to prioritize specific issues they are faced with.

Despite implicit rationing now being a widespread practice, one will come across numerous situations wherein it may be exaggerated because of inadequate resources, thereby making the organization susceptible. For instance, researches into this area suggest that nursing staff constantly ration their care and time, and this seriously threatens patient care quality and, subsequently, patient safety. Areas like hygiene, patient mobilization, patient assistance, feeding, communication, discharge planning, patient education, care documentation and surveillance are frequently omitted or inadequately handled (Papastavrou, 2013). Often, appropriate patient care levels represent a somewhat subjective measure, but with resource shortage, implicit care rationing will more likely be interpreted as a practice more in keeping with patient neglect and inferior health outcomes, resulting in organizational and stakeholders susceptibility towards major connected issues or errors.

Care rationing by nurses -- a term used to refer to holding back or failing to perform specific care activities owing to scarcity of resources -- is a moral as well as economic challenge. The challenge is economic in nature because patient care delivery occurs within numerous socioeconomic constraints; further, multiple nursing components have to be budgeted. Rationing has a moral aspect to it as it entails judgments potentially at odds with professional and personal standards (Papastavrou, 2013). As per the 'missed care' theory, the choice of completing, delaying or omitting care elements is governed by an inner factor that includes attitudes, beliefs, and values held by nurses, with regard to their responsibilities and roles, shaping their behaviors.

Three Potential Impacts of Risks and How They Affect...

Duffin's (2014) research revealed that as many as 7 extra patients per hundred patients could be saved, if nurses increased in number from 4 to 6 for every patient. Researchers found that survival rates increased with a larger nursing staff because they could devote more time to critically sick patients compared to other healthcare providers, and will more likely be able to identify early indications of patient deterioration. A second reason for survival rate growth is: less permanent nurses implies increased dependence on agency nurses who might not be familiar with all components of organizational operations and might not be adequately qualified / experienced.
Besides its effects on care delivery quality and patient safety, scarcity of nursing staff reduces healthcare facilities' patient treatment capacity. A new research carried out for the AHA (American Hospital Association) witnessed participants reporting that nursing staff scarcity has led to overcrowding of their emergency departments (38%); emergency patient diversion (25%); decreased staffed beds in hospitals (23%); service and program stoppage (17%); and elective surgery cancellation (10%). About 60% of study participants reported that nursing workforce believes that providing superior-quality patient care in the present day is tough, owing to workforce scarcities.

In case of healthcare settings that have a high nurse-patient ratio, patients face innumerable issues: they contract infections, die, suffer injuries, or are discharged from hospital too early without being imparted sufficient information with regard to how they must manage their injury or disease. This results in them returning to the healthcare facility, more ill than when they left it. Having fewer patients per nurse ensures better patient care. Also, patients will have a greater likelihood of better understanding how to handle their diabetes, use crutches, and look for symptoms of brain injury or infection, which helps them understand when they are to seek medical assistance and avoid further deterioration or illness. The presence of too many patients will lead nurses to be neglectful when it comes to intercepting and preventing errors, increasing patient injuries and mortality rates. Further, when nurses get more time for advocating with insurance firms, doctors, or others with regard to patient care plans for ensuring patients get whatever they need, patients' health status will more likely improve.

Interventions and Alternatives

An intervention to tackle the nurse shortage issue would be to improve nursing staff satisfaction and, as a result, retention. Following enactment of California's staffing legislation, nursing workforce retention and satisfaction rates were analyzed. From 2004 to 2008, satisfaction levels of registered nurses serving in acute care settings rose (Tellez & Seago, 2013). This finding's significance is: with aging and subsequent retirement of the nation's nursing workforce, the healthcare sector will experience a scarcity of qualified nurses for addressing growing demands on the sector, created by Obamacare. This pressurizes the healthcare structure of the nation, leaving few nurses with more patients than they can handle. California State's staffing law functions to tackle this growing pressure. Nurses who have been a part of the healthcare workforce for a longer duration will certainly be more experienced as well as better equipped to deliver care to patients suffering critical illness. Urging nurses to remain in the field through mandating ratios will enhance workforce morale and job satisfaction. This has been found to lower patient mortality rates. Research works conducted following the implementation of the California government's AB394 have revealed increased nurse satisfaction with their workplace climate. Ample staffing affords registered nurses the time to educate their patients.

Another intervention for addressing the problem of nursing workforce scarcity is providing visionary and stable nursing leaders. Aside from their direct negative impacts on the field of nursing, the 1990s' restructuring programs had a second long-term impact -- on nursing in hospitals (Joint Commission, 2002). The initiatives unintentionally brought nursing leadership to an end. This isn't a trivial issue, given that nurse leaders, on account of the position they hold, are required to meet the frequently contradictory goals of clinical and administrative departments and patch up these conflicts so as to benefit patients as well as nurses nearly every single day. Solving this issue is the responsibility of trustee leaders, hospital management, and doctors. It is the inherent duty of nursing professionals to make critical decisions. Nurse leaders must accept delegated power as well as offer it to their subordinates. They may also have a central part to play in constructing healthcare teams, and cultivating a collaborative culture that calls for and rewards superior-quality and safe patient care.

Yet another alternative to resolving the issue of nursing workforce shortage is filling vacant posts. The dearth of nurses and its implications for the healthcare sector in the decades to come has created a torrent of proposals and nursing staff recruitment activities. Another way many healthcare facilities attempt to meet staffing requirements is by relying on temporary nurse staffing agencies. These businesses have made record profits in…