Nursing Shortage: An Open Systems Approach to Solutions
This paper examines the nursing shortage through the lens of open systems theory, drawing on Meyer and O'Brien-Pallas's (2010) nursing services delivery framework. It analyzes the problem across key systems components — inputs, throughput, output, and feedback cycles — to identify both institutional and systemic causes, including nursing faculty shortages, horizontal violence, burnout, and unfavorable staffing ratios. The paper proposes a change plan combining micro-level workplace improvements (fair scheduling, anti-bullying orientation) with macro-level strategies (supporting nursing education, institutional collaboration with universities). Evidence from the American Association of Colleges of Nursing (AACN) and peer-reviewed research is used to ground the recommendations in professional standards and data.
- Introduction: A Systemic View of the Nursing Shortage: Systemic perspective needed beyond individual staffing fixes
- The Problem: Nursing Shortage: Institutional shortage, ratios, burnout, and horizontal violence
- Open Systems Concepts: Problems and Solutions: Inputs, throughput, output, and feedback applied to staffing
- Change Plan: Micro and macro strategies for reducing the shortage
- Professional, Mission, and Values-Based Nursing Standards: AACN standards, education data, and patient safety evidence
- Conclusion: Open systems solutions aligned with institutional mission
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What makes this paper effective
- It consistently grounds practical institutional recommendations in a named theoretical framework (Meyer & O'Brien-Pallas's open systems model), giving the argument academic coherence rather than relying on common sense alone.
- It moves deliberately from problem diagnosis to solution, applying each systems component (inputs, throughput, output, feedback) to a concrete aspect of the nursing shortage — a disciplined analytical structure.
- It integrates authoritative external evidence from the AACN and peer-reviewed journals to validate claims about staffing ratios, infection rates, and educational gaps.
Key academic technique demonstrated
The paper demonstrates framework-driven analysis: rather than listing problems and solutions loosely, the author maps each issue onto a specific element of open systems theory. This technique shows the reader exactly how the theoretical model earns its explanatory value and makes the change recommendations feel logically derived rather than arbitrary.
Structure breakdown
The paper opens by framing the broader systemic problem and critiquing individualistic staffing fixes. It then identifies the nursing shortage within the author's own institution before systematically applying open systems concepts (inputs, throughput, output, negative feedback) to diagnose causes and propose solutions. A focused change plan follows, distinguishing micro from macro interventions. The paper concludes by anchoring recommendations in professional standards set by the AACN and aligning them with institutional mission and values.
Introduction: A Systemic View of the Nursing Shortage
According to Meyer and O'Brien-Pallas (2010), addressing organizational problems such as staff shortages demands a systemic perspective, one that integrates "clinical, organizational, financial, and outcome variables from a nursing perspective" (p. 2829). All too often, staffing is addressed only from an individual, closed-systems perspective. For example, nurses are encouraged to join an organization through an introductory bonus, or to remain through a retention bonus. This approach merely skims the surface of the problem, which is rooted in deeper and more systemic issues within the healthcare system — including a shortage of nursing faculty, high levels of nursing burnout, and low levels of administrative support for nursing staff.
The Problem: Nursing Shortage
Within many institutions, there is a clear nursing shortage. Nurses are being forced to care for patients at higher caregiver-to-patient ratios, even though research has shown this results in higher rates of medical errors due to nursing fatigue. There is also the issue of horizontal violence — nurses bullying other nurses — which can be exacerbated by the tensions that accompany understaffing.
Viewing this problem through an open systems perspective of inputs, throughput, output, cycles of events, and negative feedback, as described by Meyer and O'Brien-Pallas (2010), can be useful. Inputs, in the case of a human relations issue, take the form of both patients and nurses, and can also include institutional personnel outside the immediate care environment. Addressing input-related problems by increasing staff numbers is critical, though the other elements of open systems theory must likewise be addressed.
References
Meyer, R. M., & O'Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017742/
Nursing faculty shortage. (2017). American Association of Colleges of Nursing (AACN). Retrieved from http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Faculty-Shortage
Nursing shortage fact sheet. (2017). American Association of Colleges of Nursing (AACN). Retrieved from http://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage
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