Nursing Concepts and Research

Nursing Workforce Issues and Concerns The article, "Nursing Workforce Issues and Trends Affecting Emergency Departments" by Robinson and colleagues (2004) looks at the range of contemporary issues which directly impact the quality of care which is received in America's emergency rooms (ER).The authors argue that looking at the most pertinent issues which impact the nation's ERs is a sound way of taking the temperature of the general healthcare climate as a whole.

Examining things like workforce issues, staffing issues and the ratios of patients to nurses can help all individuals involved get a better sense of the challenges that this professional arena faces when it comes to delivering a high quality of care. One of the strengths of this research article is that a host of strategies are engaged in to better improve the quality of care for patients while bolstering the number of qualified nurses and other staff team members that directly work in the ER.

One of the strengths of this article is that it is able to seize upon hard data which helps to give the average healthcare professional a better sense of the industry as a whole: this data is able to provide a crucial snapshot of the needs and realities of the industry as it now exists.

Consider the following: "From 1992 through 2002, the number of emergency department (ED) visits increased by 23%, an increase from 89.8 million to 110.2 million visits annually, while the number of hospital EDs in the United States decreased by about 15%" (Robinson et al., 2004).

This definitively shows that the ER department is now being relied upon more heavily as a means of primary care: it's not that more American are getting hurt or getting into more serious accidents or sudden illnesses, it's that they are now relying on ERs to fulfill health needs that a primary care physician would previously fulfill. This no doubt puts a stress on the ER staff as a whole. Another concept that the article correctly scrutinizes is how the current supply and demand for nurses is skewed.

Given the added pressure and importance of the ER department in current society, the role of the nurse now has an added importance and significance in society. This means that there's a greater demand for nurses now, and an even greater anticipated demand for nurses in the future. As Robinson and colleagues closely examine: "It is estimated that by the year 2020, there will be at least 400,000 fewer nurses available to provide care than is needed.

The total demand for services will rise by the year 2025, when 68.3% of the current nursing workforce will be among the first of 78 million baby boomers reaching retirement age and enrolling in the Medicare program" (Robinson et al., 2004). So much of the greater demand for nurses will be as a result of the fact that the elderly population is going to approach almost 20% of the entire national population. This fact adds additional pressure to a group of professionals who are already under high amounts of stress.

Nurses today already are in the danger of feeling overworked and underappreciated. This is so problematic because it creates a psychological mentality that things are only going to get worse and that we're not well equipped to deal with the future in any meaningful way. It creates a climate where all individuals feel like there are a multitude of concerns which need to be addressed.

At the same time, the authors explain the various reasons which contribute to the much-discussed nursing shortage and how there are fewer and fewer nurses who enter the field as a result of more employment opportunities elsewhere and a desire to seek out less stressful roles for their career (Robinson et al., 2004). On the other hand, nursing programs all over the nation do report an increase in employment One of the strengths of the article is the variety of data upon which is draws.

For instance, Robinson and colleagues harness a chart which documents the number of nurses who report being satisfied with their jobs. The chart is taken from a national sample survey from HHS/HRSA. The chart demonstrates that the lack of job satisfaction in the industry as a whole is a very real problem for nurses everywhere and for ER departments.

The levels of stress and the intense demands of the ER department mean that surviving and thriving in such an atmosphere will depend exclusively on the personal investment, enjoyment and thus overall job satisfaction of the professionals there. Frankly, there's no room for nurses who feel low levels of satisfaction, as the intensities connected to the job are too intense. "Aggregate levels of job satisfaction vary by the setting where nurses work. Nurses working in hospitals report the lowest levels of overall job satisfaction, at 67% (Fig 1).

Even at 83%, the job satisfaction level among those in nursing education only approaches the level of job satisfaction in the general population" (Robinson et al., 2004). All of these results are caused by a culmination of factors, such as staffing which is largely inadequate, workloads which are heavy and intense, overtime which is abused, and salaries which do not feel adequate in terms of the amount of energy and time that is being expended for the nurses who work these jobs.

In the emergency department, all of these factors become aggravated and intensified, as nurses not only deal with the high stakes game of life and death, but the fact that ERs are now being abused and misused and expected to provide care to patients that they're actually not designed to do. Another strength of the usage of data within the article is that fact that it is able to present the main reasons as to why ER departments are being misused in this marked and consistent.