Resolving Nursing Shortages Using Systems Theory

Systems Theory- Nursing

One of the major issues in nursing is the international shortage in staffing of health care professionals. This shortage negatively affects the quality as well as the sustainability of the entire nursing service, as well as that of health care professionals in general. In response to this complex and manifold issue, many decision-makers have listed the nursing practice setting and structural performance as strategic foci for intervention. In general, nursing services are arranged through an employment association or related organization. It is imperative to consider scarce and insufficient human resources in an effective manner. The global staffing shortage in nursing is an issue and a challenge in the health services sector (Meyer and O'Brien-Pallas, 2010). This is being addressed in manifold ways, including an increase in nursing education and attempts to broaden the purview of nursing skills.

A system-based practice is an element that can be employed to initiate health care changes and also promote the quality of health care rendered. Executing and applying a holistic approach to healthcare for the welfare and well-being of the patient is at the core of developing and advancing effective all-inclusive plans of care (Johnson et al., 2008). This particular paper will seek to offer a solution to the problem of shortage in staffing by using an Open-System Approach (vide infra).

The theoretical basis of the Nursing Services Delivery Theory System (NSDT) is Open System Theory, as is practiced for large organizations (Katz and Kahn (1978). According to these authors, an organization is made up of a dynamic input and output system. An organization is reliant on its supporting setting for continued inputs to ensure its sustainability. The organization processes these inputs by use of recurrent and patterned actions and exchanges of individuals to generate outputs. Open System Theory distinguishes the ordered nature of organizations, in the sense that every level of the entity is made up of a subsystem of correlated parts. In large-scale establishments, the conversion of energy takes place in construction subsystems that split the labor to complete and achieve goals. The purpose of the production subsystem is to convert energy that takes into account job necessities, and to improve job achievement by means of technical expertise (Katz and Kahn, 1978). The supporting mechanism is the separation of labor; this regulates the organization and work flow in the subsystem of production. Dividing up the tasks generates disruptions in work flow. Entities take this challenge into consideration by incorporating work procedures across job responsibilities and subunits by means of dexterity policies. As an organization differentiates, extra incorporation and organization are necessary to bring together system operation. As a result, the scope, intricacy, and organizational demands of an entity increase as its subsystems increase and specialize in purpose (Katz and Kahn, 1978).

The Nursing Services Delivery Theory (NSDT) makes use of the Open System Theory for nursing assignments in large healthcare facilities and organizations. With regard to the structure of the system, the NSDT pinpoints that health care is rendered by nurses who comprise work groups that are collected in a subdivision or unit in the larger overall organization. Inpatient divisions or departments in a hospital, or nursing groups in home healthcare, are instances of production subsystems. These work groups of nurses transform generic inputs to provide nursing services and to generate outputs. Introduced inputs are made up of care receivers, staff, physical, and financial wealth and material. These are afterwards converted in a nursing production subsystem by means of the work undertaken, its organization, and its interior work circumstances (Meyer and O'Brien-Pallas, 2010).

The professional standards expected from the nursing staff are to serve the patients or the clients in a diligent manner at all times. Irrespective of any exhaustion or shortage, the staff ought to be professional and provide health care to all patients in an equal manner devoid of any partiality. In this particular system theory model, inputs comprised of the individualities of the patients or the consumers, nurses and the behaviors of the system. The throughput encompassed the subsystem of nursing care delivery. This is where interventions are undertaken and the complexity of the nursing setting. Lastly, the outputs consisted of the outcomes for the patients or the consumers, the nurses and the system as well. The cycle of events would be the processes undertaken in the nursing facility with regards to taking care of the patients. In addition, any sort of negative feedback would be attained from appraisals undertaken, comments from the patients concerning health care received and also the ineffectiveness of the subsystems.

The desired outcome formulated is ensuring that there is no nursing shortage and that the facility provides quality health care. The main objectives include providing the best quality health care to the patients whenever needed, ensuring the nursing staff is not worn out or exhausted by the tasks undertaken and that the system of the healthcare facility is effective on its operations. In particular, these goals and objectives' can be transformed into policies and procedures for the department or unit. The policies include structuring or organizing the nursing departments in a way that complements the setting and technology employed. Another policy is the centralization of the unit or department structure.

There are a number of ways in which systems theory can be applied to help in solving the issue of staff shortage. For instance, buffer personnel inventories are one alternative to react to random and irregular staffing needs of health care organizations. Agency nurses as well as 'float pools', which constitute inputs, may potentially decrease and/or minimize organizational expenses. However, it should be realized that these inputs may have a negative impact on the effectiveness of clinical treatments if circumstances are not optimized. According to Meyer and O'Brien-Pallas (2010), who performed a research study of an Intensive Care Unit (ICU), the observed quality of patient healthcare varied between permanent and temporary nursing staff. When the data were controlled for medical conditions of patients, those individuals being given care from temporary 'pool' and/or agency nurses were at considerably higher risk for blood stream contaminations. Meyer and O'Brien-Pallas (2010) concluded that these observed variations between the patient-care offered by these two sets of nurses might reflect lower levels of training with regard to central venous catheter care; as well the agency and/or 'pool' nurses might be less conversant with team operation and unit procedures. This latter interpretation illustrates a need to ensure that any temporary staff be exposed to a routine 'in-house' training upon employment.

Another aspect outlines the prospective for inter-professional practice to advance the delivery of health care. Nursing work settings continue to be of great significance among healthcare establishments or businesses; these establishments are highly involved in nursing staff employment, and face aspects of retaining staff given ongoing and potential future increases in nursing shortages. According to Meyer and O'Brien-Pallas (2010), a research study of recent nurse graduates considered as 'inputs', showed that those who experienced superior personnel-job fitting were more probable to give an account of enhanced and developed human resource outcomes which are considered to be outputs.