¶ … Nursing Shortage The issues and challenges orbiting around the world of professional healthcare are no secret; one of the major obstacles that have received a great deal of media attention in recent years has been the nursing shortage. The shortage persists in North America and has even been found to be affecting Europe. Much literature has been written about this subject and a range of theories exist regarding the reasons why this shortage is so pervasive. Many of the theories relate to the difficulties connected to being a nurse: it's well-known that nursing is a truly demanding job and one which can lead to burn-out, two trends which have given the profession an unappealing reputation to many. While efforts are being made in hospital units all over the country, nurse managers and hospital leaders are still working with limited resources on this issue, however, progress is slowly being made, as the profession still isn't widely valued and it's one where success is difficult to ensure.

One factor which aggravates the situation is the gap between nursing education and the realities of being a nurse. Many nurses don't graduate from their degree programs with an adequate understanding of what it means to be a nurse and what their professional career is going to require on a day-to-day basis: there is an inadequate understanding and preparation for the demands of being a nurse in a modern healthcare environment. Furthermore, there needs to be a more nuanced understanding of humanism, health and quality of life in care. Thus, in order to counter the shortage as it persists now, and to ensure that it doesn't get worse, identifying and adequately comprehending the causes of the nursing shortage is one of the main strategies for the betterment of the professional healthcare arena, for both patients and clinicians alike.

Literature Review

The research study "The Global Nursing Shortage: An Overview of Issues and Actions" by Oulton (2006) looks at all the factors in connection with the nursing shortage, and summarizes the actions taken by organizations like the International Council of Nurses (ICN). As Oulton acknowledges, the ICN organizes all of these factors into five arenas: "…policy intervention; macroeconomics and health sector funding; workforce planning and policy, including regulation; positive practice environments; and retention and recruitment (includes migration); and nursing leadership. Internationally momentum is building, providing the opportunity to bring attention to these issues and to take action" (2006). However, throughout all this thorough appraisal and assessment, one of the most insightful things that Oulton concludes is that there is absolutely no "magic bullet" to combat the crisis. Oulton concludes that the shortage is caused by a variety of factors and that to fix it, there will need to be sustained and concerted action. One of the causes of the shortage, Oulton explains, is that hospitals are unable to engage in retention in a meaningful way, and the field has become a revolving door of sorts. Improving retention, Oulton argues, means that momentum will be gained and will be able to positively impact things like recruiting.

"The Nursing Workforce Shortage" by Keenan and colleagues is expertly written in that it pinpoints the reason for the crisis and illuminates them succinctly. The reasons that Keenan highlights are as follows: bolstered demand as the result of an ageing population, other career options (women in the 1950s chose to be nurses as other career paths were few), responses to health care cost pressure (nurses now treat patients who are sicker in general), undesirable wages, an intense workload, and a high pressure work environment (2003). One of the brilliant solutions that Keenan suggests is that she stresses the importance of putting more money into nursing education. Keenan suggests subsidized training, and overall better RN training for nurses to prepare them for the rigorous demands of working as a professional. Keenan also suggests a very practical solution, which is that overall wages for RNs needs to be increased: this will undoubtedly make the job more appealing to new recruits. This article also talks about the necessity of providing a more aggravated level of culturally sensitive care so that nurses graduate from their degree programs with an ability to care in a relevant and appropriate way for a diverse population.

Likewise, the article, "Solving Nursing Shortages" by Buchan and associates looks at some of the more common factors of the nursing shortage, and addresses some of the policy issues which...

One factor that no doubt contributes to the shortage, as Buchan illuminates is "…the continued existence of gender-based discrimination in many countries and cultures, with nursing being undervalued or downgraded as 'women's work'; the persistence of violence against health workers in many countries with nurses often taking the brunt because they are in the forefront of the direct delivery of care; and the legacy of demotivation that exists in some organisations or countries which have persevered with ill conceived or badly implemented health sector reforms or 're-engineering' projects or adjustment programmes" (2008). Gender is indeed a factor and is one which needs attention as it does play a role in the nursing shortage. If there was a way to remove the bias that nursing was simply a profession for women, there would be a positive rectifying impact on the shortage at large. If nursing schools were able to recruit from males in a successful manner, this crisis would have a progressive rectification. Buchan and colleagues also assess that there will be no single solution to this issue but it needs to be a multi-faceted approach which targets public policy initiatives, along with recruitment methods and more meaningful means of retention.
Another undeniable issue that persists and contributes to the nursing shortage is the manner in which nurses are portrayed by the media. On television and in films, nurses are often just portrayed as simply the "helper" to the doctor or as "sex kittens" who don't engage in any real medical practice. With the power and pervasiveness of the media, it's no wonder that there's a nursing shortage in this manner. In fact, the article, "Media Portrayal of Nurses' Perspectives and Concerns" by Hall and colleagues, touches upon how nurses are portrayed by the media and how this portrayal can impact how people either view it or dismiss it as a career (2004).

While there is indeed a nursing shortage, there still needs to be more fiscal investment in professional healthcare so that professional facilities have the money to actually hire nurses. The shortage of nurses does exist, but that doesn't necessarily mean that jobs exist. Many hospitals need more nurses, but they need experienced ones, and often can't afford to hire them. This leaves a lot of new graduates from nursing programs feeling misled: they invested their time in a field that would offer them a good job and they're left in debt without any job prospects. "Many new graduates felt that their programs had misled them as to the prospects of employment. The analysis of their comments yielded three major themes. The theme of fabrication was strong in many of the comments. Some said that they were told they would be hired anywhere. They were led to believe that they would have a job quickly after passing the boards. Some thought that their universities were as much in the dark as they were. One respondent said, "I believe my university was either not up-to-date on their knowledge of the prospective job market for new graduates or they did not care because more nursing students just means more money for the university and for them'" (Stone & Feeg, 2013). These remarks demonstrate just how pervasive and aggravated the problem is with the nursing shortage: more nurses are needed, but few facilities can afford them. This means that capable new graduates are going to waste as hospitals and clinics can't afford to hire them.

Discussion

Ultimately, one has to agree with the fact that a multi-faceted approach for targeting the nursing shortage is the most ideal. This is a result of the fact that this as the general consensus in the literature examined, and because the nursing shortage was caused by a variety of factors: thus is needs to be solved by a variety of factors. It appears as though momentum is key: once one area is addressed, the success of that fix needs to be used to springboard into the next area of need. Before solving the problem begins, there needs to be a federal influx of cash into the profession, so that hospitals can actually hire the able-bodied nursing graduate that they come in contact with. Then the next key area appears to be working on retaining nurses: speaking to nurses about how their professional lives can be improved and working to make changes in those areas. Increasing their pay and lightening their workload seem to be key. Once those changes are in place, the profession can then recruit with better confidence and success.

References

Buchan, J.,…