Effects of Nursing Shortage on Nurse Retention and Patient Care Delivery

¶ … Nursing Shortage on Nurse Retention and Patient Care Delivery

The work of Gess, Manojlovich, and Warner (2008) entitled "An Evidence-Based Protocol for Nurse Retention" reports that turnover of nursing staff creates a "dysfunctional human resource issue" due to the loss of nursing staff that the organization prefers to retain in their employment. Turnover of nursing staff results in negative results when this turnover occurs at rates that are high and also results in continuing of care reduction, reduction in productivity and risk increases for both patients and nursing staff. The nursing shortage is an ongoing problem that is exacerbated since the shortage is not the real problem causing staff to leave the nursing profession. It is becoming increasingly challenging to replace nursing staff. The reported turnover rate stated in the work of Gess, Manojlovich, and Warner (2008) is approximately "15% to 36%" annually.

The economic costs of turnover of nurses are reported as being "4 to 5 times higher than what hospitals typically calculate." (Gess, Manojlovich, and Warner, 2008) In addition, the report states "...hidden, indirect costs…account for 79% of losses including a 4% loss during predeparture, a 15% loss while the position is vacant and an 81% loss while the new hire reaches a productive level." (Gess, Manojlovich, and Warner, 2008) Nursing leadership is reported as being "accountable for ensuring that appropriate levels of competent staff" are employed so that the patient care is characterized by both quality and safety. In order to ensure this nursing leaders and human resources in addition to other administrators must work collaboratively to retain nursing staff. Gess, Manojlovich, and Warner report that the focus of interventions on retaining nursing staff is a cost-effective method of negating the rates of turnover of nursing staff and that evidence-based strategies are promising and may potentially "generate immediate results." (2008) In order to implement the protocol for evaluation stated in the work of Gess, Manojlovich, and Warner it is necessary to conduct a baseline assessment using tools for evaluation toward making a determination of what does and does not work in retaining nursing staff. Nursing productivity is reported as being derived primarily from autonomy in the nursing practice. Recognition is also fundamental to professional development and can be utilized in various forms both tangible and intangible. Communication and openness to feedback is cited as well as important in retaining nursing staff. (Gess, Manojlovich, and Warner, 2008, paraphrased)

Article Two

The work of Kotzer and Arellana (2008) entitled "Defining an Evidence-Based Work Environment for Nursing in the U.S.A." report a study that sought to provide a description and comparison of the perceptions of nursing staff o f their work environment both in reality and ideally in a tertiary pediatric facility. The reason for the study was the shortage of nursing staff in hospitals and identification of elements in the work setting that conflict with the views of nursing staff in regards to their idea of the most conducive work environment. The study used a descriptive survey design and a convenience sample of 385 nurses on five inpatient units.

The work environment scale (WES) was used to measure the perceived work environment in this study. The WES was developed in 1994 by Moos and enables individuals to report on their perceptions of their real (R) current and ideal (I) or desired work setting. The survey is comprised by two forms (R and I) both of which contain 90 questions each and 10 subscales. The subscales include: (1) relationship; (2) personal growth; and (3) system maintenance with change. (Kotzer and Arellana, 2008) A two-point scoring of true or false is used and questions are designed so that they represent a 50/50 ratio of negative and positive aspects of the work setting. (Kotzer and Arellana, 2008, paraphrased)