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Nursing shortages and high nurse turnover are very common issues faced in the health care industry. This instability of workforce in the health care industry in many countries is raising questions about performance of the nurses and quality of the patient care.
Gray & Phillips (1996) pointed out that nursing turnover has a negative impact on the organization's ability to meet the needs of the patients and provide them quality care. Tai et al., (1998) also considered nursing shortage and turn over as an important factor responsible for the poor performance of the health care centers. This is due to the reason that the high turnover affects the morale and productivity of the nurses who are left behind to take care of the patients while the health care unit hires the new staff members (Sofer, 1995; Cavanagh and Coffin, 1992; Shields and Ward, 2001)
Aiken et al., (2001) pointed out…
Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J.A., Busse, R., Clarke, H., Giovannetti, P.,
Hunt, J., Rafferty, A.M and Shamian, J., 2001. Nurses' reports on hospital care in five countries. Health Affairs 20 (3), 43 -- 53.
Cavanagh, S.J and Coffin, D.A., 1992. Staff turnover among hospital nurses. Journal of Advanced Nursing 17 (11), 1369 -- 1376.
Gray, A.M. And Phillips, V.L. (1996). Labor turnover in the British National Health Service: a local labor market analysis. Health Policy 36 (3), 273 -- 289.
1%." (AACN, 2008)
VII. Negative Affects of Nursing Shortage on Patient Care
Study findings indicate that a connection exists between adequate nursing staffing and patient care and specifically state in the findings of the latest studies published in the journals of Health Services Research (August 2008) and the Journal of Nursing Administration (May 2008) are findings that confirm previous study findings linking education level and patient outcomes. This indicates that "…efforts to address the nursing shortage must focus on preparing more baccalaureate-prepared nurses in order to ensure access to high quality, safe patient care." Additionally reported in March 2007 in a report of the Agency for Healthcare Research and Quality in what was a meta-analysis is that the shortage of registered nurses "…in combination with an increased workload, poses a potential threat to the quality of care. Increases in registered nurse staffing was associated with reductions in hospital-related mortality and…
Addressing the Nursing Shortage (2009) Kaiser Family Foundation. Online available at: http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=138
Buerhaus, Peter et al. (2008) the Future of the Nursing Workforce in the United States: Data, Trends and Implications. Online available at: http://www.jbpub.com/covers/newlarge/0763756849.jpg
Buerhaus, Peter, et al. (2008) Finding Solutions to the Healthcare Staffing Shortage. Council on Physician and Nurse Supply. Online available at: http://www.physiciannursesupply.com/
Nursing Shortage (2008) American College of Association of Nursing. 29 Sept 2008.
The objective of this work is to research the current nursing shortage and identify two articles published in nursing journals related to the nursing shortage. One of the article should discuss approaches to resolving the shortage and the other should discuss a perspective on the recruitment and impact of foreign nurses. The implications of the information gained in this brief study of the two articles introduced at the beginning of this work in writing is quite simply that foreign nurses who are professional, ethical, and educated and trained and who as a result are deemed to be competent will serve excellent in the U.S. healthcare field and fill a much needed role in what is a partial solution to the nursing shortage. The nursing shortage must be addressed through discovering how healthcare employers can provide an environment that is conducive job satisfaction among employees. Job satisfaction is key…
Potera, C. (2008) The Nursing Shortage. American Journal of Nursing. Vol. 109, Issue 1. Jan. Retrieved from: http://journals.lww.com/ajnonline/fulltext/2009/01000/the_nursing_shortage.15.aspx
Are Immigrant Nurses a Threat to the U.S. Nurse? (207) Journal of Nursing. American Society of Registered Nurses. Retrieved from http://www.asrn.org/newsletter_article.php?journal=jn&issue_id=44&article_id=252
Background and Current eality
The shortage of nursing staff in the workforce has become a global crisis. Numerous research articles and even books have been written on the subject from all around the world, all giving causal factors and possible solutions. As far back as 2002, "90 nurses' organizations, representing 69 countries and every geographic region of the world, reported shortages in their countries" (Clark & Clark, 2003). Moreover, the United States is drawing many immigrant nurses into the profession as a result of higher pay, further depleting the numbers in other countries such as "Oceania, Africa, Central America (including the Caribbean), and in central and eastern Europe" (Clark & Clark, 2003).
Although there have been nursing shortages reported off and on for the past 60 years (Spetz, 2005), the labor force has been able to gradually "correct itself" over time; however, in this case the shortage is…
Cangelosi, P., & Whitt, K. (2005). Accelerated Nursing Programs: What Do We Know? Nursing Education Perspectives, 113+.
Clark, P., & Clark, D. (2003). Challenges Facing Nurses' Associations and Unions: a Global Perspective. International Labour Review, 142 (1), 29+.
Hathorn, D., & al, e. (2009). The Lived Experience of Nurses Working with Student Nurses in the Clinical Environment. The Qualitative Report, 14 (2), 227+.
Heller, B., & Nichols, M. (2001). Workforce Development in Nursing: Priming the Pipeline. Nursing and Health Care Perspectives, 70+.
Institutions may have to devote more resources to improving the workplace for nurses, and make cutbacks in other areas, so patient care is not compromised.
Addressing the nursing deficit from the perspective of nursing schools, rather than simply offering more money to nursing has been one strategy deployed by the state of Florida. For example, nursing colleges and universities in Florida have worked to form strategic partnerships with private insurance companies like Blue Cross and Blue Shield of Florida. This company donated $600,000 to both the University of North Florida and the University of Florida for nursing education, a sum that was matched by the State of Florida by $420,000 at each school. This illustrates yet another fundamental principle of economics, that of principle seven, that government can sometimes improve market outcomes through intervention (Mankiw, 2004). By infusing more financial capital into nursing education, more nurses can be served by…
Mankiw, N.G. (2004). Principles of economics (3rd ed.). Chicago, IL: Thomson South-Western.
Rosseter, Robert. (2008). Nursing Shortage. American Association of Colleges of Nursing. Retrieved 18 Oct 2008 at http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm
Michigan Center for Nursing.
Survey of Nursing Education Programs: 2005-2006 School Year. 24, July 2007. http://www.mhc.org/mhc_images/edprogramsurvey06.pdf
Mancuso-Murphy, Josephine.Distance Education in Nursing: An Integrated eview of Online Nursing Students' Experiences with Technology-Delivered Instruction
Journal of Nursing Education. (2007) 46.6); 252-261
Northwest Michigan College. 8/15/06. Online Nursing Frequently Asked Questions.
24, July 2007. http://www.nmc.edu/healthoccupations/nursing/online-nursing-faq.html
Segal-Isaacson, Adam Ezra. Distance learning: Technology puts continuing education within reach..
Nursing. (2002) 32.1 14-17
Washington State Department of Health. Nursing Care Quality Assurance Commission
Nursing Programs Annual eport Summary. 2004-2005 Academic Year. 24, July 2007 https://fortress.wa.gov/doh/hpqa1/hps6/Nursing/documents/Nursing_Annual_eport.pdf
American Association of Colleges of Nursing (AACN). March 2007. Fact Sheet. Nursing shortage. 24, July 2007. http://www.aacn.nche.edu/Media/FactSheets/NursingShortage.htm
American Association of Colleges of Nursing (AACN). January 2000. Distance Learning is Changing and Challenging Nursing Education. 24 July, 2007. http://www.aacn.nche.edu/Publications/issues/jan2000.htm
Nontraditional Approach to Educating Tomorrow's Workforce
The foundation of health care system is comprised of the different medical and health-care professions, each considered of playing important and significant role in maintaining satisfactory health care service to people. To be able to maintain an excellent health care service, the system must meet and satisfy the law of supply and demand in our health care professionals -- one aspect in which the nursing area has been experiencing a shortage in supply for some years now.
Nurses are important components of health care service. Without them and the roles they perform, the task of providing care to people's health will be incomplete. Aside from doctors, nurses are among the key characters in health institutions. However, as much as how vital doctors and patients consider the nurses' roles, interest on entering in this type of profession seems to decrease. This is perhaps due to the shifting interest of…
Domrose, C. (2002). A Guiding Hand.
Retrieved Jan 23, 2003, from Nurseweek.com.
Web site: http://www.nurseweek.com/news/features/02-02/mentor.asp
Gamero, T. (2002). Marsha Hunt Jackson, on Solving the Nursing Shortage.
Alternatively, it may lead them to focusing on their economic stability first then to sharing their expertise and skills later when they are more financially secured.
However, this leads to another of Linda Allen's cited reasons, which are the increased age of the current Faculty, their inevitable lessened period of service and their retirement in numbers.
Allen explained that the "average age of a Faculty is at 51.5" and Yordy provided that the "average age of their retirement is at 62.5." If that is so, this means that a faculty may have about ten years of service ahead of him. This may be good but if they will retire at the same period because they are at the same age group, a sudden decline in Nurse Faculties will result.
This may leave the nursing practice out of nurse experts and in great need of competent and qualified teachers who will…
Los Angeles Almanac. Retrieved June 6, 2009. Website:
Bureau of Labor Statistics. Retrieved June 13, 2009. Website:
How can the facility recruit and retain sufficient nursing staff?
Nursing shortage is a global trend (American Association of Colleges of Nursing, 2012)
Ageing patient population
Long hours and stress mean high turnover
How the nursing shortage effects the facility
Not enough nurses per shift to cover patient needs
Nurses showing signs of physical stress (American Nursing Association, 2012a)
Nurses showing signs of emotional stress (American Nursing Association, 2012a)
atient care is delayed, jeopardizes patient safety
High turnover rates (Raphael, 2011)
Lack of experienced staff, everyone is new
More medical and drug errors (American Nursing Association, 2012a)
Lack of experienced staff compromises patient health (Aiken, 2008)
Facility cannot grow without enough nurses to handle increased patient load
Greater number of patients means potential for increased business
Opens up opportunities in other local facilities to take away business from the facility
III. otential solutions to the problem of how…
Pequet, J. (2010). New Study State Highlights Solutions to Nursing Shortage. The Hill. 28 June
2010. Retrieved from http://thehill.com/blogs/healthwatch/state-issues/105777-new-study-highlights-state-solutions-to-nurse-shortage
Raphael, T. (2011). Nurse Turnover in Hospitals. ERE.net. 8 June 2011. Retrieved from http://www.ere.net/2011/06/08/nurse-turnover-in-hospitals/
The new nurse should not be left to muddle through alone.
Benner's work (cited in Messmer, Jones & Taylor, 2004) showed that nurses become more proficient and develop better cognitive skills and judgment when they are exposed to competent and proficient preceptors. A preceptorship program in which the new nurse is paired with an experienced professional nurse for a time could greatly ease the transition. The preceptor helps the new nurse to fit into the new role of professional and smoothes the way for a novice with minimal skills to grow to a level of competency. Preceptors who are educated in learning styles, communication, and conflict management make preceptor programs more effective (Block, Claffey, Korow, & McCaffrey, 2005).
Moreover, the new nurse needs a mentor for guidance in making career decisions, understanding the nursing profession, the hospital organization, and the politics (Butler & Hardin-Pierce, 2005; and Jannetti, 2003). A mentor…
AACN web site. (American Association of College of Nursing). Nursing Shortage Fact Sheet: http://www.aacn.nche.edu/Media/Backgrounders/shortagefacts.htm .
Agrantiflax, a. (2001). NSNA offers tips for guiding and keeping new nurses. The American Nurse, March/April, 4-5.
Block, L.M., Claffey, C., Korow, M.K. And McCaffrey, R. (2005). The value of mentorship within nursing organizations. Nursing Forum, Oct. 40 (4), 134.
Boswell, S., Lowry, L.W. And Wilhoit, K. (2004). New nurses' perceptions of nursing practice and quality patient care. Journal of Nursing Care Quarterly, 19 (1), 76-81.
Nursing Shortage: Its Effect on Patient Outcome
In today's environment of rising costs in the health care industry, one of the first casualties in many hospitals is the level of RN staffing. In fact, across the country, hospital RNs are increasingly forced to work in an atmosphere in which they are understaffed, overworked, and charged with responsibilities wholly unrelated to direct patient care. This is a phenomenon illustrated in alarming detail in the article "Identifying Nurse Staffing and Patient Outcome Relationships: A Guide for Change in Care Delivery," published in the July-August, 2003 issue of Nursing Economics, in which a solid connection between inadequate RN staffing and negative patient outcomes is presented.
Most RN's are acutely aware of the negative repercussions they experience personally as a result of understaffing -- particularly in acute health care units. Most also realize that this understaffing is the result of the popular administrative notion…
Potter, Patricia. Barr, Norma. McSweeney, Maryellen. Sledge, Jennifer. (2003). "Identifying Nurse Staffing and Patient Outcome Relationships: A Guide for Change in Care Delivery." Nursing Economics. Vol. 21, No. 4. July/August.
Sasichay-Akkadachanunt, Thitinut. Scalzi, Cynthia, Jawad, Abbas. (2003). "The Relationship Between Nurse Staffing and Patient Outcomes." JONA. Vol. 33, No. 9. September/October.
Nursing leadership is a much debated and much talked about subject when it comes to the broader paradigm of nursing and its practice. When speaking about nursing leadership, the author has been asked to focus on a specific subtopic of nursing such as nursing shortages, nurse turnover, nurse staffing ratios and unit closures. The author of this report shall focus on nursing shortages. The author, per the assignment, will compare and contrast how the author would expect nursing leaders and managers to approach the selected issue. The assertions made in response to the question will be supported by rationale using theories, principles, skills, and roles of the leader vs. manager describing in the reading. There will be an identification of the approach that best fits the author's personal and professional philosophy and explain why it is best suited to the author's personal leadership style. While the impending nursing shortage is…
Bortoluzzi, G., Caporale, L., & Palese, A. (2014). Does participative leadership reduce the onset of mobbing risk among nurse working teams?. Journal Of Nursing
Management, 22(5), 643-652. doi:10.1111/jonm.12042
Byrne, D.M., & Martin, B.N. (2014). A solution to the shortage of nursing faculty:
awareness and understanding of the leadership style of the nursing department head. Nurse Educator, 39(3), 107-112. doi:10.1097/NNE.
Nursing shortage is a problem in many countries. It is often difficult to get trained nurses. While nurses are an integral part of the health care system, a shortage of trained nurses leaves an impact on the health care system.
Due to the shortage of nurses there is often a heavy workload on the serving nurses.
One of the major concerns about the shortage of nurses and the consequent workload on serving nurses is that effect on the safety of patients. Overworked nurses or nurses who have to attend more patients within a limited period of time, they are not able to give the adequate importance to each patient as is warranted for proper nursing care. Hence the safety of patients is affected.
The job satisfaction of the nurses are affected which leads to high turnover and creates further nursing shortage. This also leads to deteriorating morale and lack of…
Aacn.nche.edu,. (2015). American Association of Colleges of Nursing | Creating a More Highly Qualified Nursing Workforce. Retrieved 23 July 2015, from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce
American Nurse Today,. (2010). Nursing's role in healthcare reform - American Nurse Today. Retrieved 23 July 2015, from http://www.americannursetoday.com/nursings-role-in-healthcare-reform/
Black.house.gov,. (2015). Biography | Congressman Diane Black. Retrieved 23 July 2015, from http://black.house.gov/about-me/full-biography
Blegen, M., Goode, C., Park, S., Vaughn, T., & Spetz, J. (2013). Baccalaureate Education in Nursing and Patient Outcomes. JONA: The Journal Of Nursing Administration, 43(2), 89-94. doi:10.1097/nna.0b013e31827f2028
proportion of nurses with a baccalaureate degree to 80% in the next five years would be a great way to increase the pool of qualified nurses. Although there are many nurses that have received their baccalaureate, many have not. This rings true especially in other countries. Nurses are often the first line of treatment for a patient. They must have the mental capabilities to prescribe and treat patients. Now that doctors have an increasing number of patients, they need assistance in prescribing and patient monitoring. This is a where a nurse comes in. If they cannot handle their job duties because of lack of training or lack of schooling, then that presents a dilemma. I personally want to earn my baccalaureate before I attempt nursing as this gives me a leg up on any competition and provides me with more qualifications.
A doctorate is the same thing. This means that…
1. Nazarko L. Careers & Jobs In Nursing. London: Kogan Page; 2004.
2. Satterly F. Where Have All The Nurses Gone?. Amherst, N.Y.: Prometheus Books; 2004.
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…
Buchan, J., & Aiken, L. (2008). Solving nursing shortages: a common priority. Journal of Clinical Nursing, 17(24), 3262 -- 3268.
Hall, L.M., Angus, J., & Peter, E. (2004). Media portrayal of nurses. Journal of Nursing
Scholarship, 35(3), 211 -- 216.
Keenan, P. (2003). The nursing workforce shortage: Causes, consequences, proposed solutions. The Commonwealth Fund, 1-5.
nursing shortage in Ontario has the potential to have a catastrophic impact both on the health of patients and the health of nurses. Nurses as a whole are committed to providing excellent care and upholding the standards of their profession. However, when they are operating in facilities that are chronically understaffed, achieving this goal can seem impossible. Nurses are forced to oversee insupportably high patient loads and to work long hours, literally doing the work of two people with one body. Despite this fact, "almost 90 per cent (89%) of patients in Ontario rated their nursing care as excellent or good is the high cost that nurses often pay to provide that care" (MacKinnon 2001).
But as nurses retire and age out of the profession and are not replaced by new nurses, the shortage will grow even more critical. While nursing shortages are common in the United States as well,…
Better working conditions, full-time jobs for nurses will mean improved patient care. (2004).
Ontario. Retrieved: http://news.ontario.ca/opo/en/2004/03/mcguinty-government-tackling-nursing-shortage.html
MacKinnon, Sine. (2001). High patient satisfaction excellent news, but nurses paying the price; outcomes confirm problems with chronic nursing shortage. RNAO. Retrieved: http://allnurses.com/international-nursing/ontario-nursing-shortage-8522.html
Nursing shortage. (2006). RNAO Knowledge Depot. Retrieved:
Leading in a Complex, Evolving Environment
Nurse leaders of today face a wide range of challenges in the execution of their mandate. It is important to note, from the onset, that to be able to effectively address some these challenges, today’s nurse leaders ought to have a unique set of skills and capabilities that enable then to navigate the said challenges so as to ensure that patient care is not adversely affected. This text concerns itself with nursing shortage as one of the main challenges in care delivery facing nursing leadership today. In so doing, it will not only assess the impact nursing shortage has on patient care, but also some of the options that ought to be taken into consideration in seeking to rein in the challenge.
Throughout history, the United States has had periods of nursing shortages as well as surpluses – with this cyclical nature…
Cherry, B. & Jacob, S.R. (2018). Contemporary Nursing: Issues, Trends, & Management (8th ed.). St. Louis, Missouri: Elsevier Health Sciences.
Haddad, L.M. & Toney-Butler, T.J. (2018). Nursing, Shortage. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493175/
Masters, K. (2018). Role Development Professional Nursing Practice (5th ed.). Burlington, MA: Jones & Bartlett Learning.
Seo, S. & Spetz, J. (2013). Demand for Temporary Agency Nurses and Nursing Shortages. INQUIRY: The Journal of Health Care, 50(3), 216-228.
Stanley, D. (Ed.). (2016). Clinical Leadership in Nursing and Healthcare: Values into Action (2nd ed.). Hoboken, NJ: John Wiley & Sons.
Staffing Problems in the Nursing Field
Within the U.S., nursing represents the largest health care profession. With 2.7 million nurses currently fulfilling roles within the profession there remains a widespread need for nurses to enter the career in order to replace the aging nurse population, and prepare for increased level of expected medical needs in the future. If left unaddressed, this discrepancy between supply and demand will eventually result in a massive shortage of nurses, and will seriously impact the quality of the U.S. healthcare system. At the same time, a large number of citizens are reaching an age when they will likely be in increasing need of health care services. Thus a continued shortage of qualified nursing professionals will be devastating to the overall quality of the U.S. health care system.
According to information provided by the ureau of Health Professions (HP) with the U.S. Department of Health and…
Davies B., Neary M. & Phillips R. (1994) The Practitioner-Teacher: A Study in the Introduction of Mentors in the Pre-registration Nurse Education Program in Wales. School of Education, University of Wales, Cardiff.
Federation of Nurses and Health Professionals (2001). The Nurse Shortage: Perspectives from Current Direct Care Nurses and Former Direct Care Nurses (opinion research study conducted by Peter D. Hart Research Associates)(Washington, D.C.: 2001).
Government Accounting Office (2001). Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report # GAO-01-944. Washington DC: Government Accounting Office.
Pontius, C. (2001). Meant to be a mentor. Nursing Management, 32 (5), 35.
It is no secret that America is facing a shortage of nurses. The current shortage is very real and it is not like any that has been experienced in the past. There is evidence to support the shortage in that there are fewer nurses entering the workforce. With the reduced number of nurses entering the workforce, America is left with an aging nursing workforce. According to the Bureau of Labor Statistics, there will be about 1.2 million vacancies emerging for registered nurses in the years 2014 and 2022 (Snavely, 2016). By the year 2025, the shortfall of nurses will be more than twice as large as any other nursing shortage that has ever been experienced. The looming shortage is mostly due to the rising incidence of chronic diseases, the limited capacity of nursing schools, and an aging workforce. It is reported that there are around one million registered nurses who…
MacLean, L., Hassmiller, S., Shaffer, F., Rohrbaugh, K., Collier, T., & Fairman, J. (2014). Scale, causes, and implications of the primary care nursing shortage. Annual review of public health, 35, 443-457.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98.
Inadequate Staffing in Nursing
Explain the nursing/patient care concern, problems, issues observed at the senior level clinical practice
During the past decade, there certainly has been a rapid decline in quality patient care in the healthcare industry. This has been proven by cutting down the staff in hospitals, nurses working overtime along with quite a steeped nurse to patient ratio. The hospital staffing issue has driven great controversies. On the up side, hiring down nurses from the hospitals results in expanding costs and training them in return, while on the down side, cutting down staff results in unattended patients, which tarnishes the reputation of a hospital. The economy has been on a roller coaster ride since the last five years or so. The hospitals, private insurance companies and healthcare industry are head over heels with monetary crisis at helm. Thus, hospital works with least staff. The power struggle between hospital…
Aiken, L.H., Clarke, S.P., & Sloane, D.M. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223 -- 229.
Aiken, L.H., Smith, H.L., & Lake, E.T. (1994). Lower Medicare mortality among a set of hospitals known for good nursing care. Medical Care, 771 -- 787.
Aiken, Linda H., eta l. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. The Journal of the American Medical Association. 288 (2002): 1987-1993. Retrieved from: http://jama.ama-assn.org/content/288/16/1987.full#sec-7
American Nurses Credentialing Center (ANCC) (2013a). Forces of Magnetism. Retrieved from http://www.nursecredentialing.org/ForcesofMagnetism.asp
Nursing Problem: Shortage of Nurses
Nursing Problem: Shortage of Nurses in Healthcare
esearchers in Phoebe Memorial Hospital, gathered information to help them understand the extreme nursing shortage. The shortage they discovered, comes from not having an adequate amount of nurses, thus producing high turnover, potentially compromising patient safety and care. High turnover rates come from nurses themselves feeling upset and dissatisfied with long works hours and low pay. Data collected reveals, high patient-to-nurse ratios leads to high frustration levels and job burnout (Currie and Carr Hill 2012, p. 1180). At Phoebe Memorial Hosptial, inadequate staffing played a negative role in patient results. Various studies have confirmed that hospitals like Phoebe that experience high nurse turnover are the ones that have the highest rates of risk-adjusted death and severity-adjusted span of stay (CHAN et al. 2012).
While there is no definitive way of evaluating the reasons behind the…
NURSING PROBLEM: SHORTAGE OF NURSES
Nursing Shortage isk Management Plan
Nursing staff scarcity constitutes a widespread issue across several segments of the healthcare sector. It is often a challenge to find an adequate number of qualified nursing professionals for meeting staffing requirements. Nursing professionals represent a crucial part of healthcare teams and facilities. A dearth of qualified nurses may leave a healthcare facility vulnerable. Furthermore, because of staff shortages, existing workers are usually expected to work more than normal. A key concern with regard to this shortage and the resultant workload on the existing workforce is: Continuance of safety practices within healthcare organizations may be impacted eventually. This may successively lead to perpetual hospital vulnerability. Overworked nursing staff members or those who are made to take care of a greater number of clients (patients) have to typically make sacrifices. They can't focus sufficiently on individual patients, as is necessary for ensuring satisfactory nursing care. Thus,…
Clarke, S.P. & Donaldson, N.E. (2008). "Nurse Staffing and Patient Care Quality and Safety." In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (U.S.).
Duffin, C. (2014). Increase in nurse numbers linked to better patient survival rates in ICU. Nursing Standard, 28(33), 10.
Hunt, S.T. (2009). Nursing Turnover: Costs, Causes, & Solutions. SuccessFactors, Inc.
Joint Commission on Accreditation of Healthcare Organizations, (2002).Health Care at the Crossroads: Strategies for Addressing the Evolving Nursing Crisis.
Nursing Shortage on Nurse Retention and Patient Care Delivery
The work of Gess, Manojlovich, and Warner (2008) entitled "An Evidence-ased 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…
Kotzer, Anne Marie and Arellana, Kerry (2008) Defining and Evidence -- Based Work Environment for Nursing in the U.S.A. Journal of Clinical Nursing. Workforce Issues.
Gess, Ericka, Manojlovich, Milisa and Warner, Sharon (2008) An Evidence-Based Protocol for Nurse Retention. Journal of Nursing Administration. Vol.38(10). Oct 2008.
Newman Nursing Shortage
Newman's Theory of Expanding Consciousness and the Nursing Shortage
The education which is required to effectively train today's nursing professional is constituted of equal parts applicable procedure and theoretical underpinning. It is the theory element of this training which offers stability, a framework for proper decision-making and guidance on deciphering the needs of the patient in an often volatile field of work. Such stability, framing and guidance are especially necessary in this era of healthcare provision, where nurses must work to navigate the difficult realities of universal staffing shortages. This can make certain theoretical models particularly pertinent. To the point, this discussion will offer a theoretical framework which is extremely valuable in helping to bridge the gap between the modern healthcare practice and global or holistic philosophies of wellness. To instruct a theoretical approach to nursing that is, therefore, based on Margaret Newman's groundbreaking "Health as Expanding…
Cullen, E.; Ranji, U. & Salganicoff, A. (2010). Addressing the Nursing Shortage. KaiserEDU.org.
Newman, M. (2004). Health as Expanding Consciousness. Nursing Theory.
Oregon Center for Nursing (OCN). Is There Still a Nursing Shortage? The Lund Report.
Current Issue in Nursing: Nursing Shortage
Nursing quality and adequate staffing are intertwined. Adequate levels of nurses, lower nurse to patient ratios, and also more highly trained nurses are associated with better health outcomes and lower mortality rates. But despite the fact that there is high demand for nurses, and also increased interest in entering this very exciting profession, retaining qualified nurses and recruiting new nurses is a struggle for many hospitals. Also, in a desire to cut costs, many institutions are often unwilling, despite evidence-based research supporting higher staffing ratios as leading to lower-cost and superior patient outcomes, to hire more nurses as healthcare staffing makes up as much as 40% of all intuitional operating costs (“Nursing Shortage,” 2019).
The attempt to cut costs by reducing staff levels reflects an unfortunately misguided view of the value of the nursing profession. It also reflects a misguided view of an aging…
Evidence-Based Practice and Nursing
A growing consensus has emerged within the field of modern nursing which holds that the most effective patient care is delivered through the use of evidence-based practice (EBP) by nurses and other health care providers. Although there are several distinct models of evidence-based practice, each typified by its varying approach to research utilization, EBP has been authoritatively defined as "the integration of the best research with clinical expertise and patient values" (Sackett et al., 2000). Two of the most prevalent models of EBP throughout the nursing profession are the Iowa Model and the Star Model, and each relies on a unique philosophy regarding the factors used to guide the implementation of academic research into clinical application. Conceived by Marita G. Titler, PhD, N, FAAN and her colleagues, the model officially known as the Iowa Model of esearch-Based Practice to Promote Quality Care was "developed and originally…
Pipe, T.B. (2007). Optimizing nursing care by integrating theory-driven evidence-based practice. Journal of Nursing Care Quality, 22(3), 234-238.
Sackett, D.L., Straus, S.E., Richardson, W.S., Rosenberg, W., & Haynes, R.B. (2000). Evidence-based medicine: How to practice and teach EBM. London, England: Churchill Livingstone.
Spector, N. (2003). Evidence-based nursing regulation: A challenge for regulators. Journal of Nursing Regulation, 1(1), 30-37.
Stevens, K.R. (2004). ACE star model of EBP: Knowledge transformation. Academic Center for Evidence-based Practice. The University of Texas Health Science Center at San Antonio. Retrieved from www.acestar.uthscsa.edu
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…
Cho, S. (2001). Nurse staffing and adverse patient outcomes: a systems approach. Nursing Outlook 49(2):78 -- 85
Johnson, J.K., Miller, S.H., & Horowitz, S.D. (2008). Systems-based practice: improving the safety and quality of patient care by recognizing and improving the systems in which we work. Retrieved 17 June 2015 from: http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Johnson_90.pdf
Katz, D., Kahn, R.L. (1978). The Social Psychology of Organizations. New York: John Wiley and Sons.
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.
Response to Peer Discussion PostIn the present write-up, my colleague opted to focus on RN retention. As my colleague points out, the demand for nurses has been on an upwards trend in recent times. This is largely true owing to the aging nurse workforce. With the shortage of nurses, clinics ought to put in place strategies to reign in high turnover rates. In the case of Clearwater Hospital and Clinics (CH&C), the turnover rate has been identified as 26%. This is a rather high turnover rate, and thus an indication that something ought to be done to remedy the situation. It would be prudent to note that as my colleague points out, there are numerous causes of a high nurse turnover. One of the most prominent cause, according to Perry, Richter, and Beauvais (2018) is nursing dissatisfaction. More specifically, in the words of the authors, nursing dissatisfaction contributes to turnover…
Kelly, L.A., Gee, P.M. & Butler, B.J. (2021). Impact of nurse burnout on organizational and position turnover. Nurs Outlook., 69(1), 96-102.
Perry, S.J., Richter, J.P. & Beauvais, B. (2018). The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three?Level Multisource Study. Health Serv Res., 53(6), 4943-4969.
According to Meyer & O’Brien-Pallas (2010), to address organizational problems such as staff shortages, a systemic perspective is demanded, one which integrates “clinical, organizational, financial, and outcome variables from a nursing perspective” (p. 2829). All too often, staffing is merely addressed from an individual, closed systems perspective. For example, nurses are encouraged to join an organization through the use of an introductory bonus, or to remain with a retention bonus. This only skims the surface of the problem, which is rooted in deeper and more systemic problems within the healthcare system, including a shortage of nursing faculty, high levels of nursing burnout, and low levels of support for nursing and nurses on an administrative level.
The Problem: Nursing Shortage
Within my own institution, there is a clear nursing shortage. Nurses are being forced to care for patients at a higher ratio of caregivers to patients, even though this has been…
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
Health policy and initiatives are used to guide and direct my clinical practice as an Advanced Practice Nurse (APN) by directing my work towards the Triple Aim of healthcare: 1) improved care, 2) improved health and 3) at lower cost (Hain & Fleck, 2014). However, barriers to these three goals still exist, and policies like that of the IOM (2011) report help to identify the obstacles so that APNs can help to be aware of the challenges they will face when they go to provide quality care to patients.
As the IOM (2011) reports, one of the obstacles is the nursing shortage. In my practice, I can help staff to be aware of the problems that lead nurses to want to exit the industry—problems such as overwork, stress, fatigue, burnout, and low job satisfaction. By working to improve the morale of nurses in my sector and promoting a positive workplace…
Hain, D., Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare
redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). Doi: 10.3912/OJIN.Vol19No02Man02
IOM. (2011). The future of nursing. Retrieved from http://nacns.org/wp-content/uploads/2016/11/5-IOM-Report.pdf
eview On Nurses Shortage
The supply of professional nurses relative to the increase in demand for their services has been on a general decline over the years. As a career choice, nursing has been facing perennial shortage of professionals. Most healthcare organizations will affirm that their daunting tasks were recruiting fresh nurses and retaining the ones already in practice. The 2008 projections from the Bureau of Labor Statistics showed that the demand for professional nurses would increase from the then two million to three million, which represents sixty percent increment. In ideal situations, the number of those who have enrolled in nursing will be sufficient to supply the rise in their number. Nevertheless, this would not be the case if nothing were done to salvage the worrying trend of most students not graduating or resorting to other careers. According to Benjamin Isgur of PWHC Health and esearch Institute,…
American Association of Colleges of Nursing. (2009, September, 28). Nursing Shortage Fact Sheet. USA: AACN.
Buerhaus, P.I., Staiger, D., & Auerbach, D.I. (2009). The future of the nursing workforce in the United States: Data, trends, and implications. Boston: Jones and Bartlett Publishers.
Blakeley, J., & Ribeiro, V. (2008). Early Retirement among Registered Nurses: Contributing Factors. Journal of Nursing Management, 16(1), 29 -- 37
Cummings, G., et al. (2008). The Relationship between Nursing Leadership and Nurses' Job Satisfaction in Canadian Oncology Work Environments. Journal of Nursing Management, 16(5), 508 -- 518.
What causes staffing shortages in the field of nursing? Staffing shortages can be the result of many variables—turnover, unmet demand for services due to a lack of RNs, overwork (nurses calling in sick), and so on. Buchan (2002) identified the problem of staffing shortages in nursing as having an underlying cause in the nature of the health system itself as well as a social one: “Nursing in many countries continues to be undervalued as women’s work, and nurses are given only limited access to resources to make them effective in their jobs and careers” (p. 751). This is especially true in countries like Saudi Arabia, where nursing is viewed as woman’s work but is not valued highly by society—though it is recognized as being highly needed (Alyami & Watson, 2014). To address the issue of staffing shortages, the Institute of Medicine (IOM, 2012) has called for more nurses to…
Nursing Staff Levels Affect Patient Mortality
Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.
Litvak, E., Buerhaus, P.I., Davidoff, F., Long, M.C., McManus, M.L. & Berwick, D.M.
Date of publication: June 2005
Examination of the operational issues affecting health care delivery, including patient driven peaks in demand and effects of nursing shortages or inadequate staffing on clinical outcomes for patients.
esearch question and/or hypothesis:
In this study the researchers propose that increases in adverse clinical outcomes occur when hospital nurse staffing is inadequate. Further the researchers suggest that increases in census rates increase the potential for serious stresses for patients and nurses working in the field. Lastly the researchers suggest that if hospitals reduce unnecessary variability of staff levels in a hospital, the hospital can reduce the probability of negative patient outcomes, improve safety for patients and improve the overall quality of care.
Aikan, L.H., Clarke, S.P., Sloane, D.M, Sochalski, J. & Silber, J.H. (2002 -- Oct).
"Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction." JAMA, 288(16): 1987-93.
Halm, M., Peterson, M., Kandels, M., Sabo, J., Blalock, M., Braden, R., Gryczman, A.,
Krisko-Hagel, K., Larson, D., Lemay, D., Sisler, B., Strom, L., Topham, D. (2005 -- Sept). "Hospital nurse staffing and patient mortality, emotional exhaustion and job dissatisfaction." Clin Nurse Spec, 19(5): 241-5.
Globally, a nursing shortage is impeding the advancement of healthcare systems around the world. The nursing shortage refers to any situation in which the labor market cannot keep up with patient demands. Causes of the nursing shortage include poor working conditions leading to high turnover rates, insufficient nursing education programs, and lack of incentives for nurses to work in areas of critical concern. Effects of the nursing shortage include further staff shortages due to high stress environments and poor patient care—including higher rates of mortality and morbidity. Nursing shortages have affected almost every region of the world, and may become worse unless concerted efforts are made to remedy the problem.
Even the most advanced healthcare systems in the world are short on nursing staff. As a result, existing nurses are working longer hours under high duress, and are more prone to making errors or experiencing workplace violence and…
Nursing shortage basically means the demand for nursing professionals exceeds the professional nurses, this can be in a given healthcare facility, nationally or globally. his can be measured through the number of job openings demanding high number of nurses than the ones who are available or even the disproportionate ration between qualified nurses practicing and population. his is a rampant challenge in both developing and developed countries all over the world. From the Second World War, hospitals in the U.S. have had to deal with a cyclical shortage of nurses. he national supply of nurses cannot meet the high demand nationally. With this recurrent shortage in nurses in the U.S. means that the quality of patient care will by and large continue declinig. his is a complex issue that is multifaceted and the causes are very many.
he shortage that has been observed recently is due to multiple…
These solutions require economic investments as well as contribution from the public. When addressing this issue there is need of efforts that aim to recruit as well as retain nurses and at the same time strengthen the capacity of nursing schools. These strategies call for the supply of educational facilities with ample faculty and funding, improvement of aid in terms of finances to students such as scholarship that target groups that are underrepresented like minorities and even men. Therefore many stakeholders as well as the government should invest financially to ensure that these strategies are a reality. The lay public should be involved with these efforts since they are the ones who feel the impact of nursing shortage, and it is through them that the civil sensitization mobilization of more of our citizens to enroll for the nursing courses can be achieved. The lay public must also be involved since they are the ones who own the basic, community focused solutions at the grassroots that can be converted to policies and implemented to the betterment of the healthcare.
KaiserEDU.org. (2012).Nursing Workforce. Retrieved February 25, 2013 from http://www.kaiseredu.org/Issue-Modules/Nursing-Workforce/Background-Brief.aspx
First, nursing schools must be able to compete with clinical employers because there is little incentive to pursue a teaching career when first-year nurses can earn as much as their professors. Second, it will likely be impossible to eliminate the nursing shortage as long as American nursing schools are unable to accommodate thousands of qualified students annually. Finally, because FENs are likely to continue playing such a large role in American nursing, the accreditation system of their institutions or their degrees must be adjusted to ensure that FENs who intend to practice in the U.S. are fully prepared for their careers and not just trained in the technical aspects of nursing. Ultimately, the U.S. nursing shortage is probably capable of reversal, but not without a concerted effort in at least those specific areas.
Albaugh JA. "Resolving the nursing shortage: legislative issues." Urologic Nursing
(June 1, 2004). Accessed January 27,…
Albaugh JA. "Resolving the nursing shortage: legislative issues." Urologic Nursing
(June 1, 2004). Accessed January 27, 2010 from:
Gordon S., Buchanan J., and Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient
Coping With the Nursing Shortage
Like many healthcare institutions, Nightingale Home Care Inc., in La Mesa, CA is suffering from a severe staffing shortage. The nursing shortage has been a persistent problem within the profession for many years due to what has been called a perfect storm of circumstances. First, the aging of the population as a whole has increased the demand and need for more nurses. People are living longer yet require more assistance from the healthcare profession to navigate the problems of aging. Chronic diseases such as heart disease, diabetes, and osteoarthritis are likewise on the rise in the elderly population and this requires continued monitoring and support. Secondly, the current population of Ns is itself aging and leaving the profession for retirement. A third, concurrent problem is that nursing schools lack sufficient faculty to admit and teach even all qualified candidates who do wish to…
Robeznieks, A. (2015). Looming nursing shortage fueled by faculty shortfall. Modern Healthcare. Retrieved from: http://www.modernhealthcare.com/article/20150124/MAGAZINE/301249971
Rosseter, R. (2014). Nursing shortage. AACN. Retrieved from:
Wood, D. (2008). Hospitals offer big incentives to attract nurses. Nursing News. Retrieved from:
Leadership and Management of Nursing Shortage and Nurse Turn-Over
Several research scholars have stressed the significance of effective healthcare leadership, and leadership by nurses is critical to this, since nurses constitute the largest healthcare worker group. For more effective nurse recruitment, hospital leadership should support the profession of nursing. It is vital for them to recognize their most capable nurse managers and nurses, and place them within communities for attracting individuals possessing similar traits into the profession. Furthermore, hospital leaders must team up with colleges/universities and secondary schools for picking out students who possess the traits needed for thriving despite challenges accompanying slow improvements to the healthcare sector. World-class hospitals or healthcare facilities do not simply sit back waiting for potential nurse candidates to find recruiting organizations (Curtis, de Vries & Sheerin, 2011).
One way of addressing this issue may be for a healthcare employer to offer a school/college with…
Bowles A. & Bowles N. B (2000). A comparative study of transformational leadership in nursing development units and conventional clinical settings. J Nurs Manag 8(2): 69-76
Curtis, E. A., de Vries, J., & Sheerin, F. K. (2011). Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306.
Hughes R. L, Ginnett R. C, Curphy G. J (2006) Leadership: Enhancing the Lessons of Experience. 5th edn. McGraw Hill, Boston.
Marquis B. L. & Huston C. J. (2009) Leadership Roles and Management Functions in Nursing: Theory and Application. 6th edn. Wolters/Kluwer/Lippincott Williams and Wilkins, Philadelphia.
Action for Nurse Shortage in a Clinic and Timeline
Strategizing to Alleviate Nurse Shortage
Traditionally-reported employment data is misleading and ineffective in measuring the healthcare sector's actual state. Studies reveal that standard nursing demand, supply and need dynamics have undergone change, owing to healthcare delivery system variations, reimbursement of Medicaid and Medicare, and local and regional cultures and practices. Care delivery method, location, and mode of payment for services are areas that have a direct effect on nursing service necessity. Furthermore, progressive aging of the population in general and the increased need for chronic illness management indicates a growth in general need for the services of nursing professionals. The present, aging nursing workforce and a drop in the number of professionals within the field's 'academic' subfield, suggests that the dearth in nursing personnel will only turn more serious with time. According to the NCSN (National Council of State oards of…
Drake, S., Pawlowaski, U., & Riley, V. (2013). Developing an effective healthcare workforce planning model. American Hospitals Association.
Lewin's Change Management Model. (n.d.). Retrieved from Mind Tools: https://www.mindtools.com
Strategies to Reverse The New Nursing Shortage. (2016, July 24). Retrieved from American Nurses Association: http://nursingworld.org/
Nurse Staffing Levels Through a Legislative Process
Despite arguments from critics who argue that mandated nurse staff levels will adversely affect the skill mix of nurses, the experiences of states that have implemented this solution clearly indicate that this alternative represents a timely approach to a nationwide issue. To determine the facts, this paper reviews the literature to identify the respective pros and cons of mandating nurse staffing through a legislative process, followed by a discussion concerning whether public reporting would be effective in achieving safe levels of staffing. Finally, a summary of the research and important findings concerning the pros and cons of mandating nurse staffing levels through a legislative process are presented in the conclusion.
eview and Discussion
Today, the low nurse-to-patient staffing levels in many states has been found to be threatening the quality of health care services and adversely affecting job satisfaction and morale levels of…
Furillo, J. & Mcewen, D. (2012, October 3). State-mandated nurse staffing levels lead to lower patient mortality and higher nurse satisfaction. National Nurses United. Retrieved from http://www.nationalnursesunited.org/news/entry/state-mandated-nurse-staffing-levels-lead-to-lower-patient-mortality-and-hi/ .
Glazer, G. & Alexandre, C. (2009, January). Legislative: The nursing shortage: A public health issue for all. Online Journal of Issues in Nursing, 14(1), 37.
Demand vs. Supply
Supply vs. Demand: Nursing Shortage
The shortage of nurses in this country is caused by a simple economic principle -- supply and demand. riefly, the demand for skilled registered nurses is greater than the supply. This may sound simple, but in reality there are many factors that contribute to the nursing shortage in today's health care industry.
Statistics from The National Council of State oards of Nursing tells us that there has actually been an increase in the number of trained nurses over the past ten years. In 2000, there were 71,475 newly certified nurses. In 2005 there were 99,187. In 2010, there were 134,708 newly certified nurses. This is a 9.8% increase during the past decade. And the demand for nurses is actually expected to be lower than the amount of nurses being newly certified. According to the U.S. ureau of Labor Statistics, the annual growth…
Dunham, Will. (March 8, 2009) U.S. Healthcare System Pinched by Nursing Shortage. Reuters.com. Retrieved on April 2, 2011 from http://www.reuters.com/article / 2009/03/08/us-usa-nurses-idUSTRE5270VC20090308.
Hopkins, Mary Elizabeth. (March 12, 2001) Critical Condition. Nurseweek.com. Retrieved on April 2, 2011 from http://www.nurseweek.com/news/features/01-03/shortage.asp
Wikipedia. (April 2, 2011) Nursing Shortage. Wikipedia.com. Retrieved on April 2, 2011 from http://en.wikipedia.org/wiki/Nursing_shortage
Fagin, Claire; Maraldo, Pam; Mason, Diana. (October 18, 2007) Q&A: What Is the Nursing Shortage and Why Does It Exist? Nursing Advocacy. Retrieved on April 2, 2011 from http://www.nursingadvocacy.org/faq/nursing_shortage.html
The comparatively simplistic provider to patient ratios and demand-based estimates cannot accurately predict need; therefore, inefficiencies in the health care system will remain. By comparison, the needs-based model provides at least the possibility of addressing most inefficiencies. This model stands out because it is essentially an iterative model that incorporates 'need' and supply data as it becomes available. Although not perfect, the model is flexible enough that it can be adjusted to include additional parameters and data to minimize the impact of unexpected developments, such as a major weather event or a severe economic downturn. Increasing the predictive accuracy of the model is also straightforward and would depend on investing into data collection efforts. As the authors discuss, the main limitation is the quality of data available; however, patient to provider ratios or demand-based models are still inferior by comparison.
A common approach used for validating predictive models such as…
Murphy, Gail Tomblin, Birch, Stephen, MacKenzie, Adrian, Alder, Rob, Lethbridge, Lynn, and Little, Lisa. Eliminating the shortage of registered nurses in Canada: An exercise in applied needs-based planning. Health Policy, 105, 192-202.
Leadership and Management
The issue at hand is nursing turnover and nursing shortage. There are many areas of the country where there are chronic nursing shortages. Using a situation like this can be an effective means of illustrating the differences between management and leadership. A manager is seen as someone who is mainly an administrator -- someone who allocates resources in the organization. Leadership relates specifically to the human elements, such as motivation, engagement, vision, organizational culture and buy-in. In essence, where management is a function, leadership pertains to relationships (Maccoby, 2000). Thus, both management and leadership can provide responses to the problems of nurse shortage and turnover, but those approaches will differ from one another, differences relating to the differences between management and leadership.
A manager will look to resource-based strategies for dealing with the issue. A manager can, for example, improve the capability of the organization to attract…
Laschinger, H. & Finegan, J.(2005). Using empowerment to build trust and respect in the workplace: A strategy for addressing the nursing shortage. Nursing Economics. Vol. 23 (1) 6-13.
Maccoby, M. (2000). Understanding the difference between management and leadership. Research Technology Management. Vol. 43 (1) 57-59.
Nevidjon, B. & Erickson, J. (2001) The nursing shortage: Solutions for the short- and long-term. Online Journal of Issues in Nursing. Vol. 6 (1) 4.
The survey population included hospital administrators and physicians as well as registered and practicing nurses, and as such it provides a comprehensive view of this issue. The research was also able to not certain key differences in perception amongst these groups as to thee likely effects of an ongoing nursing shortage, including some major differences in perception between nurses and hospital administrators, and it is suggested that this will serve as a barrier to implementing necessary changes; working to bring expectations of all stakeholders more in line would be ideal, and this research can accomplish this and ground perceptions in empirical evidence.
Buerhaus, P. (2011). Nurses Assess the Impact of the Shortage of RNs on Hospitals,
Nurses, and Quality of Patient Care. Sigma Theta Tau Biennial Convention
In this research, also a survey study that aimed to obtain qualitative results regarding nurse stress and reactions to the nursing…
One need only read the newspaper "Classified" ads to realize that employers are trying many clever marketing tactics to attract prospective nurses into their organizations. Many are offering sign-on bonuses, extra benefits and other amenities to attract a limited supply of nurses. As both the general population and the elderly population grow, the number of nurses needed to care for them increases proportionally as well. The number of people choosing to pursue nursing as a career has been on the decline, mainly due to long working hours, low pay, high job stress and other factors. These factors will not resolve themselves if the nursing deficit continues to increase. In addition, graduate nurses find it difficult to enter the workforce due to their lack of experience and a shortage of mentors to teach them. The solution is simple, more nurses are needed, and soon. Novice nurses are fresh graduates who…
Durkin, Barbara.(2002) Reliving Hospital Mistake: Mom recalls overdose case February
24, 2002. Newsday, Inc.
Lang, Susan. (1996) Lack of nursing assistants is an impending crisis, says Cornell gerontologist. Cornell University. Cornell University. http://www.news.cornell.edu/releases/May96/nursingassistants.ssl.html . Accessed June, 2002.
National League for Nursing (NLN). (2000). Unpublished Data. New York, NY. http://nursing.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.nln.org%2Faboutnln%2Fnews_tricouncil2.htm. Accessed June, 2002.
In interacting, factors may also modify each other:
nurse who might return to work for a higher salary might decide to do so only later when her children are older. The incentive of salary is therefore modified by the factor of young children.
The table is significantly complicated by the inclusion of more than two factors:
Any combination of the factors could result in the majority of nurses returning to work. Individually, each nurse has his or her own motivations for doing so.
The iterative proportional fitting procedure can be used to calculate expected frequencies.
Note: pecifically, the indication of this study is that nurses would return to work were certain factors in the work situation to change. pecifically, the highest frequencies are assigned to work load and hours. These are also the two most common factors in causing burnout and stress in the profession. Concomitantly, if inactive nurses were…
StatSoft, Inc. (2008). Log-Linear Analysis of Frequency Tables. http://www.statsoft.com/textbook/stloglin.html
Williams, Kimberly a., Stotts, R., Jacob, Susan R., Stebauer, Cheryl C.; Roussel, Linda, & Carter, Donna (2006, April). Inactive Nurses: A source for alleviating the nursing shortage? In Journal of Nursing Administration, Vol. 36(4).
In what ways did the wave of the nursing shortage in the 1980's and in 2000 support or constrain theoretical thinking? Why? Are there ways to influence the cycle of shortage and theoretical thinking? Identify one nursing theorist that would support your discussion/views. Provide rationale for selection of theorist.
Nursing shortages have been a problem in this country for a long time. It has been found that because of these shortages there needed to be a better way to incorporate theoretical thinking into nursing education so that nurses are better prepared to be the best that they can be. The accomplishment of critical thinking abilities has been recognized as an essential product of undergraduate nursing teaching. It has been found that nursing scholars learn best by way of experiential education. Kolb's experiential learning theory is the basis for a practice incorporation technique intended to offer critical thinking skills in undergraduate…
Experiential Learning (Kolb). (2008). Retrieved September 30, 2010, from Web site:
Kim, Hesook Suzie. (2010). The Nature of Theoretical Thinking in Nursing. Retrieved September 29, 2010, from Web site:
" (Albaugh) study by Aiken et al. (2001) ascertained that the job dissatisfaction experienced by nurses was due to staff shortages and the fact that this resulted in nurses not being able to provide effective and high - quality care. This study also reiterated the fact that nurses felt that there often not consulted in important policy decisions, which had a negative effect on their level of work satisfaction.
These findings are linked to other issues which show that the shortage of nursing staff is very closely related to the perception that the working conditions often do not permit the development and attainment of a high standard of excellence in the profession. As one study indicated: " Specifically, 75% of nurses surveyed feel the quality of nursing care at the facility in which they work has declined over the past two years, while 56% of nurses surveyed believe that the…
Aiken, L.H. Clarke, S.P., Sloane, D.M., Sochaiski, J.A., & Silber, J.H. (2002).
Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993.
Albaugh, Jeffrey A. (2003) Keeping nurses in nursing: the profession's challenge for today. Urologic Nursing; 6/1/2003;
Condition: Critical; Long Hours, Burn out contributes to Nursing Shortage in Hospitals. (2002, December 15). The Washington Times, p. A01.
Nursing profession is among the oldest in history. Currently, there is much debate that surrounds the profession because of the need for more trained nurses. In recent years the nursing shortage has become a major problem for the medical profession and has resulted in poor patient care and slower patient recover. The purpose of this discussion is to provide an in depth examination of the nursing profession. We will discuss the current state of the nursing profession, including the causes for the shortage and the solution. We will also explore the status of the nursing profession in Australia. Let us begin our discussion by providing a comprehensive definition of what is means to be a nurse.
Definition of a nurse
According to the American Heritage Dictionary, a nurse is defined as " a person trained to care for the sick or disabled under the supervision of a physician." (American Heritage…
American Heritage Dictionary. (1982) Second Edition.
Bashford, A. (1997). Starch on the collar and sweat on the brow: self sacrifice and the status of work for nurses. Journal of Australian Studies, (52), 67+. Retrieved August 24, 2003, from Questia database, http://www.questia.com .
Technology-based teaching strategies can greatly accelerate the how both teaching and learning occur and therefore often reduce traditional issues and concerns faced by students and instructors. This approach changes the conventional way of thinking about how quality nursing programs are assessed and changes the levels of requirements to better suit student learning with better access to libraries, counseling and tutoring services, computing equipment, tuition, and financial aid to name a few.
But where this Associates Degree approach will benefit the profession most is in the healthcare system where it is needed most. New nurses will be better acclimated to the needs of sophisticated logging processes, medical billing and inventory as well as scheduling and other tasks now all handled via digital processing and computer. A modern day nurses are more technologically sophisticated, the overall patient care process also gets better as more available free time is offered back to the…
Research and Nursing Questions
Research is a complex and nuanced concept which means that one approach might not, in and of itself, answer the full scope of one's research questions. This is why it can sometimes be useful to combine Quantitative and Qualitative research strategies. This can help to provide a multidimensional perspective on a given research problem. The text by Bennett & Braumoller (2006) refers to the combination of these approaches as a Mixed Methods research strategy.
The use of Mixed Method research strategies is based on the view that researcher can produce greater on a subject by varying the approaches which are used to collect data. The idea that both qualitative and quantitative data gathering processes can produce a more expansive data set is driven by the understanding that there are often distinct limitations in the conclusions we can make from narrowly framed research investigations. (Bennett…
Bennett, A. & Braumoller, B. (2006). Where the Model Frequently Meets the Road: Combining Statistic [al,] Formal and Case Study Methods. APSA manuscript.
Media Relations. (2004). Nursing Shortage Fact Sheet. American Association of Colleges of Nursing
" Nurses in Indiana are also represented by the American Nurses Association, headquartered in Washington, D.C. And the International Council of Nurses, based in Geneva, Switzerland. These organizations now investigate health facilities and help control the wages of nurses.
Governments can sometimes improve market outcomes, according to the 7th principle of economics. The state government is busy helping improve the shortage situation in the state of Indiana. The Indiana Department of Workforce Development has recently developed something called the Strategic Skills Initiative (SSI), which has identified three occupations which may develop shortages. The three occupations include registered nurses; the other two are pharmacists and pharmacist technicians. If it follows national trends, the largest shortage is expected to be in nursing, where there is a desperate need for 250 more workers in the state. Because of this, SSI is giving funds for adding faculty to the schools of nursing at Purdue…
Allen, D.E. (1950). History of nursing in Indiana. Indianapolis: Wolfe Publishing Company.
Bendul, B.F. (2006). Vital signs strong for vital industry: Health Services in Northwest Indiana. In Context. Vol. 8, No. 8. Retrieved January 10, 2008 at http://www.incontext.indiana.edu/2007/august/1.html .
Buerhaus, P.I., Staiger, D.O. And Auerbach, D.I. (2004). New signs of a strengthening U.S. nurse labor market? "Health Affairs Journal. 17 Nov 2004. Retrieved January 12, 2008 at http://content.healthaffairs.org/cgi/content/full/hlthaff.w4.526/DC1 .
Greenhouse, S. (2005) Lagging wages amid growth puzzles economists. San Francisco Chronicle. 12 Apr 2005. Retrieved January 10, 2008 at http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2005/04/12/BUGCUC6H4K1.DTL&type=business
Nursing BA vs. Associates
Nursing Competencies -- Associates vs. Baccalaureates
The difference competencies between nurses prepared at the associate-degree level nursing vs. The baccalaureate-degree level are significantly different on many levels. Today's nurses work in a healthcare environment that is undergoing a constant evolution at a speed never before imagined (NLN Board of Governers, 2011). Patient needs have become more complicated; nurses must implement requisite competencies in leadership, health policy, system improvement, research, evidence-based practice, and teamwork and collaboration in order to deliver high-quality care. Furthermore, nurses are also required to master different technologies that are also evolving extremely rapidly.
There are basically three different alternative paths to becoming a registered nurse. Some hospitals offer a three-year program that is administered in the hospital setting. Another option is a two to three-year program in which graduates receive an associate's degree and can be administered at a community college or any…
Mahaffey, E. (2002, May 2). The Online Journal of Issues in Nursing. Retrieved from The Relevance of Associate Degree Nursing Education: Past, Present, Future: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/RelevanceofAssociateDegree.aspx
Moltz, D. (2010, January 7). Nursing Tug of War. Retrieved from Inside Higher Ed: http://www.insidehighered.com/news/2010/01/07/nursing
NLN Board of Governers. (2011, January). Transforming Nursing Education: Leading the Call to Reform. Retrieved from NLN Vision: http://www.nln.org/aboutnln/livingdocuments/pdf/nlnvision_1.pdf
Rosseter, R. (2012, April 2). The Impact of Education on Nursing Practice. Retrieved from American Association of Colleges of Nursing: http://www.aacn.nche.edu/media-relations/fact-sheets/impact-of-education
Autonomy in the nursing profession states the importance of the client's role in making decisions that reflect advocacy for the client (Wade, 1999, p.310). Ultimately, this includes taking care of the patient physically as well as mentally and emotionally, developing a relationship with the patient that is beneficial to his care and actively advocating for the patient's rights and care. This type of autonomy, it is important to note, is not the same as individual or work autonomy, yet it must be considered that empowerment in nursing autonomy will inevitably lead to better professional and personal autonomy and should also lead to increased job satisfaction (Wade, 1999, p.310).
Typical definitions of autonomy would include the idea of complete independence for the person making the decisions. However, in the case of the nursing profession, the client's needs and desires must be heavily weighed and, in fact, become central…
Wade, G.H. (1999). Professional nurse autonomy: Concept analysis and application to nursing education. Journal of Advanced Nursing, 30(2), 310-8.
Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics, 2(1),
White, L. (2004). Foundations of nursing: Second edition. Clifton Park, NY: Delmar Learning.
It is thus possible for the institution to retain nurses by strengthening the interpersonal leadership and management skills that lead to empowerment within the healthcare environment. This is especially supported by studies that found that despite the fact that a nurses' pay is important, it is not as critical in enhancing retention as a positive work place or an empowered environment that promotes teamwork and encourages ongoing learning, trust, and respect. (Chan, 2001).
It must always be remembered that nursing retention is the result of a combination of factors. There is no easy solution, and managers and leaders need to choose the combination of approaches that will be effective in their specific organization, since there is no one range or combination of strategies that will fit all.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Chan, C.C.A. (2001). Implications of organizational learning for nursing managers from the cultural, interpersonal and systems thinking perspectives. Nursing Inquiry, 8(3), 196-199.
Faulkner, J., & Laschinger, H. (2008). The effects of structural and psychological empowerment on perceived respect in acute care nurses. Journal of Nursing Management. 16(2): 214-221.
Kanter, R.M. (1979). Power failure in management circuits. Harvard Business Review, 65-75.
Nursing Mentor Scenario
Introduction- Just as the theoretical and practical backgrounds of nursing have changed over the past several decades, so has the nursing education environment itself. . Students now entering the field are diverse in culture, educational background, and most especially age and experience. Traditional undergraduates coming directly from High School or Junior College often interact with more mature and experienced students. In addition, nursing instructors remain challenged to recognize different learning needs and styles, and respect that adaptive scenarios might be necessary to further the learning opportunities for many students. e thus see that the most effective way of teaching in the modern nursing classroom is to adjust one's pedagogical paradigm outward and to actively find new and innovative ways of reaching each student, rather than expecting each student to completely bend to the tried and true curriculum of previous generations (Young, L., Petson, B., eds., 2006). Too,…
Bradshaw, M., & Lowenstein, A. (Eds.). (2011). Innovative Teaching Strategies in Nursing and Related Health Professions. Sudbury, MA: Jones and Bartlett.
Bulman, C. And Schutz, S. (1998). Reflective Practices in nursing. Sudbury, MA: Jones
And Barlett Publishers.Epp, A., & Price, L. (2011). Designing Solutions Around Customer Network Identity Goals. Journal of Marketing, 75(1), 36-54.
Cramer, C., Davidhizar, R. (2008). Helping At-Risk Nursing Students Succeed on the National Council Licensure Examination-Registered Nurse. The Health Care Manager.27 (3): 269-76.
The Nurses Organization of Veterans Affairs (NOVA)
Purpose, Mission and Vision
NOVA exists to fulfill a very important function in the United States: Providing healthcare services to the nation's war veterans. To be able to do this, the organization's mission is to "shape and influence healthcare in the Department of Verterans Affairs (NOVA Foundation, 2012).
NOVA's vision has six components:
To provide high quality nursing care.
To provide nurses with an optimal work environment.
To keep nurses informed on relevant issues regarding VA health care and nursing.
To create opportunities for VA nurses to function at the leadership level.
To recruit all VA nurses for NOVA membership.
Advantages of Membership
The most obvious benefit of membership is the ability to connect with other members, who can offer support for specific challenges related to the professions. This opportunity to work with others also strengthens the ability of the VA…
Meyers, S. (2003, Oct. 2). Nurse Shortage: Recruitment and Retention. Statement of The Nurses Organization of Veterans Affairs (NOVA) Before the House Committee on Veterans Affairs, Subcommittee on Oversight and Investigations. Retrieved from: http://democrats.veterans.house.gov/hearings/schedule108/oct03/10-2-03/smyers.pdf
Nova Foundation (2012). Nurses Organization of Veterans Affairs. Retrieved from: http://www.vanurse.org/
United States Department of Veterans Affairs. (2012, Jun. 4). NOVA Foundation Scholarship. Retrieved from: http://www.va.gov/NURSING/nova.asp
In the emergency room, this distinction can have a determinant impact on the ability of the staff to preserve life and diminish pain and suffering.
The introduction of a bioethical perspective into this dialogue invokes a question as to the primacy of an interest in pursuing to the utmost the well-being of the patient. This speaks to one of the core values associating the principles of the ANA with the treatment outcomes desired in patiences. An examination of the ANA's Code of Ethics reveals that a theoretical basis exists to contend a direct correlation between the nurse's self-interest and that which is best for any given patient. There exists an essential obligation for such healthcare practitioners to "examine the conflicts arising between their own personal and professional values, the values and interests of others who are responsible for patient care and health care decisions, as well as those of the…
American Nurse's Association (ANA). (2004). The Nurses Code of Ethics. The Center for Ethics and Human Rights. Online at .
The American Organization of Nurse Executives (AONE). (2009). AONE Resource Center. www.aone.org.
Dimaria, R.A. & Ostrow, L. (2004). West Virginia University School of Nursing Makes the Move to Web-Based Learning. Technological Horizons in Education Journal, 31.
Emergency Nurses Association (ENA). (2008). Vision/Mission Statements and Code of Ethics. www.ena.org.
Tailoring employment approaches to this group is significant to their continued retention. A lot of the literature suggests that older, more knowledgeable nurses are more likely to expand their work life when the following conditions are present:
Supportive and flexible work arrangements and practices like modified workloads, flexible scheduling options and a reduction in hours of work.
An organizational culture that encourages participation in decision-making and independence over practice.
Work recognition, support and positive feedback from management.
Ergonomically friendly, safe and useful work environments.
Access to professional development actions that target the needs of experienced nurses (An Ageing Nursing Workforce, 2007).
There have been some legislative efforts put into place to battle the current nursing shortage but they have not yet had a noteworthy impact across the nation. The federal Nurse einvestment Act contains promising measures, including inducements to augment the number of nursing faculty. A number of states have…
An ageing nursing workforce. (2007). Retrieved from http://www.ichrn.com/publications/factsheets/Ageing_Workforce-English.pdf
The truth about nursing. (2011). Retrieved from http://www.truthaboutnursing.org/faq/nursing_shortage.html
" (Allen 2008) This means that nursing educators are also a key stakeholder.
Other stakeholders include healthcare facility administrators, corporate trustees and public office holders, who will often have entangled or competing interests relating to the profitability of operations and the political expediency of policy orientation. This will also be true of the various professional advocacy groups, nursing associations and lobby groups that will vie for influence in the discussion on any legislation relating to the nursing shortage.
A primary policy objective is to endorse any legislation that would aggressively enforce better recruitment of nursing students, better training of existing nurses, improvements in working conditions for nurses and mandated nurse-to-patient ratios. These objectives are underscored by evidence of the opportunities to save lives facilitated by mandated ratios. According to the text by Health Services Research (HSR) (2010), "key findings of the study reportedly include that 10-13% 'fewer surgical…
Allan, L. (2008). The nursing shortage continues as faculty shortage grows. Nursing Economics, 26(1), 35-40.
Berkowitz, B. (2012). The Policy Process. .
Cullen, E.; Ranji, U. & Salganicoff, A. (2010). Addressing the Nursing Shortage. Kaiseredu.org.
GovTrack. (2010). S. 1031: National Nursing Shortage Reform and Patient Advocacy Act. govTrack.us.