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Nurse to Patient Ratios Fixed to Reduce Nurse Burnout and Turnover
Dear Assemblywoman Solages,
Senate Bill S1032 addresses the nurse-to-patient ration in New York by mandating that a “safe staffing for quality care” standard be defined and implemented for nurse practitioners (NPs) in the state. Specifically, the legislation if passed would “require acute care facilities and nursing homes to implement certain direct-care nurse to patient ratios in all nursing units; sets minimum staffing requirements; requires every such facility to submit a documented staffing plan to the department on an annual basis and upon application for an operating certificate” (Senate Bill S1032, 2020). This is an important bill because it ensures both that patients are adequately provided for and that nurses are not overworked or pushed towards burnout. Considering how high the turnover rate is in the nursing field, it is about time that our legislators address the issue of patient…
Livanos, N. (2018). A broadening coalition: Patient safety enters the Nurse-to-Patient ratio debate. Journal of Nursing Regulation, 9(1), 68-70.
McHugh, M. D., Aiken, L. H., Windsor, C., Douglas, C., & Yates, P. (2020). Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study. BMJ open, 10(9), e036264.
Senate Bill S1032. (2020). Retrieved from https://www.nysenate.gov/legislation/bills/2019/s1032
Shin, S., Park, J. H., & Bae, S. H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273-282.
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 .
Nurse etention Capacity
Standards & Analysis on Nurse etention
The demand for nursing staff in the United States has significantly increased and according to the Center for American Nurses, employment in these positions have increased to an amazing 83% which is now at the highest it has been since 1980, and considering that this role is the biggest job in healthcare offering over 2.6 million jobs, the problem in hospitals, healthcare facilities, and in home care is the lack of nurses (Bureau of Labor Statistics, 2011). Furthermore, there are many reasons as to why experts and the healthcare facilities are unable to hire enough people to fulfill the positions within their establishments, and most research has determined that the main reasons there is such a shortage in nursing jobs is because of the poor management and leadership within the nursing work environment, the increased amount of responsibility and work load…
Bureau of Labor Statistics. U.S. Department of Labor, Office of Occupational Statistics and Employment Projections. (2011). Occupational outlook handbook 2010-2011 edition, registered nurses on the internet Washington, DC: Retrieved from http://www.bls.gov/oco/ocos083.htm
Chart Your Course International (2011). Nursing shortage. Retrieved from http://www.highretention.com/nursing_research.html
Monaghan, H.M. (2009). Effective leadership + nurse retention. Retrieved from http://www.visioninghealthcare.com/pdf/Article-Effective-Leadership-Nurse-Retention.pdf
Runy, A. (2006, January). Nurse retention. H&HN Magazine, Retrieved from http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/PubsNewsArticle/data/0601HHN_FEA_Gatefold&domain=HHNMAG
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.
739, p=0.009, e?=0.727). This study clearly highlighted that sleep shortage and work fatigue poses a threat to patient safety and that nurse self-care is warranted.[Dorrian et.al, (2006)]
Nurse Support Services
An earlier Australian study by Moore KA (2001) which observed 201 nurses working in three different hospitals had concluded that organizational restructuring policies and the consequent work overload was a high stressor for nurses and this was made worse by the poor communication style (top -- down approach instead of consultative style) that only contributed more to nurse burnout. [Moore KA, (2001)]. Given the high levels of occupational stress and burnout among nurses, it is important that nurse self-care interventions are prioritized. A recent literature review on the subject of work stress and coping methods among Australian nurses revealed that 'work load ', 'role conflict' and 'expression of aggression' were the three main stressors. The literature study also revealed 'seeking…
1) Linda H. Aiken, 'Image of Nursing Global Trends', retrieved Sep 4th 2010, from, http://www.fpnl.co.za/downloads/Presentations/Presentations/Prof%20Linda%20Aiken%20-%20Image%20of%20Nursing%20-%20Global%20Trends.pdf
2) Jillian Dorrian, Nicole Lamond & Cameron Van del Heuvel et.al (Oct 2006), 'A Pilot study of the Safety Implications of Australian Nurses' Sleep and Working Hours', Chronobiology International, Vol 23, Issue 6, pg 1149-1163
3) Lim J, BOGOSSIAN F. & AHERN K. (2010), ' Stress and coping in Australian nurses: a systematic review. International Nursing Review 57, 22-31
4) Moore KA, (2001), 'Hospital restructuring: impact on nurses mediated by social
The stengths of this design ae elated to the ease of application and usage. The design of the suvey was easy to administe and self explanatoy. While the weakness was elated to the willingness of the paticipant to Chapte Thee 5
paticipate complete the suvey and povide tuthful esponses. An additional weakness is elative to the age goup that was pesent fo the suvey and thei elationship to the use of computes.
Afte appoval of the study fom the Institutional Review Boad at Indiana
Wesleyan Univesity and Methodist Hospitals, Inc. Nusing staff wee ecuited to paticipate in fo the study. Paticipants wee eligible fo the study if they wee cuently an employee of the employed by Methodist Hospitals, Inc., It was also necessay that they hold a cuent nusing license, paticipated in online leaning, and wee able to ead and wite English. A egisteed nuse who has paticipated in…
Student characteristics for online learning success
The Internet and Higher Education, Volume 9, Issue 2, 2nd Quarter 2006, Pages 91-
105 Marcel S. Kerr, Kimberly Rynearson, Marcus C. Kerr
Chapter Three 13
Nursing Workforce Issues and Concerns
The article, "Nursing Workforce Issues and Trends Affecting Emergency Departments" by obinson and colleagues (2004) looks at the range of contemporary issues which directly impact the quality of care which is received in America's emergency rooms (E).The authors argue that looking at the most pertinent issues which impact the nation's Es is a sound way of taking the temperature of the general healthcare climate as a whole. Examining things like workforce issues, staffing issues and the ratios of patients to nurses can help all individuals involved get a better sense of the challenges that this professional arena faces when it comes to delivering a high quality of care. One of the strengths of this research article is that a host of strategies are engaged in to better improve the quality of care for patients while bolstering the number of qualified nurses and other staff team…
Robinson K.S.; Jagim, M.M.; Ray, C.E. (2004). "Nursing Workforce Issues and Trends
Affecting Emergency Departments" Retrieved from nursingcenter.com:
Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.
Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures…
More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA
Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: https://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_ -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newsletters
Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft
For the Council on the Economic Impact of Health System Change. Retrieved from: http://council.brandeis.edu/pubs/hospstruct / Council-Dec-14-2001-Aiken-paper.pdf
The Shared Governance arrangement:
offers an apparatus for registered nurses to show guidance in the development of practice decisions authorizes all nursing staff to add to work redesign advances the quality of patient and family outcomes.
In the shared governance arrangement, the staff nurses are a big piece of the course, designated and chosen from their units to stand for an area of practice on one of many councils. it's all about shared choice making and authorizing staff nurses to affect their practice atmosphere and have a say in unit choices (Shared Governance at Henry Ford Hospital, 2011).
A new nursing deficiency is revitalizing shared governance. This pioneering organizational model gives staff nurses power over their practice and can expand their affect into administrative areas formerly controlled solely by managers. But nursing shared governance is tough to describe. Its configurations and procedures are dissimilar in every business. Shared governance, is…
Drenkard, Karen. (2010). Going for the gold: The value of attaining Magnet recognition.
Retrieved February 18, 2011, from Web site:
Estlund, Sarah. (2010). List of Nursing Labor Unions. Retrieved February 17, 2011, from Web
Nursing Problem: Shortage of Nurses in Healthcare
The researcher works at Phoebe Memorial Hospital, where there is an extreme nursing shortage. Without an adequate amount of nurses, patient care and safety may turn out to be compromised, while nurses themselves may be stunned, upset, and dissatisfied. At the researcher's workplace, high patient-to-nurse ratios has been displaying that there is a lot of frustration and job burnout, which is linked to higher yield. At Phoebe, there is an inadequately staffed nursing force which has been discovered to play a negative part in patient results. In difference, studies have confirmed that hospitals like Phoebe Memorial Hospital with low nurse turnover are the ones that have the lowest rates of risk-adjusted death and severity-adjusted span of stay.
There is no very exact way of describing the concept of nursing shortage at the Phoebe Memorial Hospital Phoebe, but a report of this…
NURSING PROBLEM: SHORTAGE OF NURSES
They also need to research how much increasing the staffing levels will increase costs, and where funding will come from to cover those costs.
There is another aspect of the argument that must be addressed, as well. There is a nursing shortage, and even if staffing levels are increased, there may not be enough nurses to bring the staff up to the mandated levels, and then health care facilities would be in non-compliance. The union proposal to adopt mandated staffing levels should also address implementing new training and recruiting techniques to help health care entities meet the staffing challenges that a mandate would bring. Without the nurses and other trained professionals to work in these areas, staffing mandates do not do much good, and if the union wants to be successful, they must recognize that.
Atkins, Siegel & Slutsky. (2005). Making policy when the evidence is in dispute. Health…
Atkins, Siegel & Slutsky. (2005). Making policy when the evidence is in dispute. Health Affairs, 24(1), 102-113.
Feilding & Briss. (2006). Promoting evidenced-based public health policy: can we have better evidenced and more action? Health Affairs, 25(4), 969-978.
Wharam & Daniels (2007). Toward evidenced-based policy making and standardized assessment of health policy reform. JAMA 298(6): 676-690.
The data gathered is subjected to statistical analysis using statistical methods of linear regression and chi square testing.
The main purpose of the study was to confirm the hypothesis that consultation with CNS or RN in a drug-monitoring clinic has a significant positive impact on the well being of patients with rheumatoid arthritis. The study involved a single blinded randomized controlled trial over a period of three years. Subjects were chosen from the rheumatology out patient setting in a district general hospital with a drug monitoring service. A total of 71 subjects who were starting out on anti-rheumatic therapy were randomly assigned to either the interventional or the control group. While the interventional group was supervised by the CNS to assess patient needs (using Pendelton's framework) alongside drug safety evaluation, the control group was seen by an outpatient staff nurse purely for drug safety concerns. oth the groups were assessed…
Teri Britt Pipe; Kay E. Wellik; Vicki L. Buchda; Carol M. Hansen; Dana R. Martyn, 2005, "Implementing Evidence-Based Nursing Practice," Urol Nurs. 25(5): 365-370, Available at, http://www.medscape.com/viewarticle/514532
Ryan, S, Hassell, a.B, Lewis, M, & Farrell, a. (2006). Impact of a Rheumatology Expert Nurse on the well-being of patients attending a drug monitoring clinic. Journal of Advanced Nursing, 53(3), 277 -286.
Considine, J. & Botti, M. (2004) Who, when and where? Identification of patients at risk of an in-hospital adverse event: Implications for nursing practice. International Journal of Nursing Practice. 10: pp. 21-31
Modern nursing has become a multi-disciplinary career that encompasses a number of roles and requires more expertise than ever before. In modern nursing, there are a number of stakeholders: patients, families, the community, insurance companies, governmental agencies, administrators, colleagues, staff and physicians. Healthcare solutions in the 21st century require a collaborate effort that remains focused on continual progress towards customer service satisfaction. The key is to understand the overall paradigm of healthcare and nursing management -- even through the terms "manager" and "leader" are often used interchangeably, they are not. In general, management organizes affairs, projects, and people -- therefore subordinates are involved. The manager is in charge, but not necessarily leaders in that they do as directed and then direct tasks. Leaders do not have subordinates, rather they have followers. Leaders motivate, challenge, coach and inspire vision, enable others to act and encourage (Carrroll, 2005; Kouzes and…
Nursing Students Attitude Towards the Elderly: Literature Review
The changing demographics in many of the populations in industrialized countries has changed the aggregate needs of the nursing workforce and this trend is expected to continue into the future as the population continues to age. One issue that has arisen is that the younger generation of nurses have demonstrated through various means that their preference for their nursing roles within organizations is not for working with the elderly patients. Therefore, a gap exists between the demand for nursing jobs that deal with elderly patients and the supply of nursing students that are willing to fill these positions. This article will look at two research efforts that try to focus on this precise trend and provide information about how this trend could possibly be reversed and finding a more optimal point in the supply and demand for nursing positions in the future.…
Bleijenberg, N., Jansen, M., & Schuurmans, M. (2012). Dutch nursing students' knowledge and attitudes towards older people - A longitudinal cohort study. Journal of Nursing Education and Practice, 1-8.
Haron, Y., Levy, S., Albagli, M., Rotstein, R., & Riba, S. (2013). Why do nursing students not want to work in geriatric care? A national questionnaire survey. International Journal of Nursing Studies, 1558-1565.
Any insult, harm or damage brought to their personality, profession and family is considered to be an offensive act, and in past many such actions have been quoted where the nurses were mainly regarded as sex symbol, such disgrace of feminism has been widely condemned, and is possible cause towards the de-motivation of the youth and public towards the profession (Gilbert, 2004).
The cultural, social, legal and feminist analysis is not to be considered responsible towards the reduction in the quantum of the enrolments in the nursing school and hospital. There is no particular beneficiary from the overall exercise; rather there are different groups which can be placed into the series of the intensity of harm experienced by them, within the domain of the activity. Primarily it is the nurse itself who have suffered massively due to the reported discriminatory and unethical approach adopted towards them, secondly, it is…
Barbara Sibbald. Nursing shortage more severe, urgent than expected. Canada Medical Association Journal. 2003
Harriet R. Feldman. The Nursing Shortage: Strategies for Recruitment and Retention in Clinical Practice and Education. Springer Publishing Company. 2003.
Gilbert G. Gonzalez. Labor vs. Empire: Race, Gender, and Migration. Rout ledge. 2004.
Bernice Buresh, Suzanne Gordon. From Silence to Voice: What Nurses Know and Must Communicate to the Public. Cornell University Press. 2006.
Salary Inequities for Nurses in Florida
Inequities in Nurses' Salary Schedules
In the decade between 2004 and 2014, the estimated number of open positions for registered nurses was anticipated to be 2.1 million. This number reflects both attrition and the growth of the healthcare and medical fields that are responding to an aging national population. Best practices in staff recruiting in the medical arena call for an "adequate supply of nurse and high-quality patient care through competitive, transparent wage-setting, collective bargaining, and nurse/patient ratio standards" (Lovell, 2006).
An interesting phenomenon has occurred in research on the state of nursing in the U.S.: just over 20% of the nearly 50 studies conducted to analyze the nursing workforce recommended wage increases in order to attract more nurses into professional preparation programs and into the workforce. The U.S. Government Accountability Office conducted a study to look critically at the key factors that influence…
____. (2012). Florida Registered Nurse Salaries. Salary.com. Retrieved http://www1.salary.com/Florida/registered-nurse-salary.html .
____. (2002, July). Projected supply, demand, and shortages of registered nurses: 2000-2020. U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, National Center For Health Workforce Analysis. Retrieved http://www.google.com/
____. (2012). Registered Nurse (RN) Hourly Rate. PayScale. Retrieved http://www.payscale.com/research/U.S./Job=Registered_Nurse_%28RN%29/Hourly_Rate .
Future of Nursing
The future of nursing: Leading change, advancing health
According to the Institute of Medicine (IOM) report The future of nursing: Leading change, advancing health, the future of medicine as a whole is inexorably tied to the future of nursing. Nurses are increasingly called upon to perform complex tasks as more of the healthcare burden gets shifted to nurses in the name of managed care and cost-cutting. The expanded population base of patients due to changes in legislation such as the Affordable Care Act (ACA) and the aging of the population further underlines the need for appropriate education of tomorrow's nurses and the reeducation of the nurses of today. This will require major policy changes and overhauls.
First and foremost, nurses must be better prepared to cope with a population that is very different from the population nurses treated in the past. Not only is it…
The future of nursing: Focus on education. (2010). IOM. Retrieved from:
The future of nursing: Focus on scope of practice. (2010). IOM. Retrieved from:
Horizontal Violence in Nursing
Nursing and the Prevalence of Horizontal Violence in the Workplace
The core of the nursing profession is undermined by Horizontal violence. Horizontal violence affects the quality of health care that is delivered in institutions where this repugnant behavior occurs. Many reports suggest that horizontal violence is rampant, particularly in relation to new nurses and recent graduates. It is typically covert and incorporates nonphysical and emotional damage. Examples include sabotage, destructive criticism, back-biting, undermining, scapegoating and verbal confrontation.
The targets usually express feeling ridiculed, demeaned and humiliated. Potential targets range from new hires to long-time or tenured nurses. Similarly, nurses engaged in horizontal violence cross all demographic lines and all areas of specializations. They are usually experienced nurses and are over-burdened by the stress of the job and the long hours associated with their work. At the current time, it is recognized that this problem exists and…
Erdreich, B., Slavet, B., & Amador, A. (1994). "Sexual Harassment in the Federal Workplace." U.S. Merit Systems Protection Board. Washington, D.C.
McKenna, B., Smith, N., & Poole, S. et. al. (2003). "Horizontal violence: experiences of Registered Nurses in their first year of practice." J. Adv Nurs.Apr;42(1):90-6.
Thompson, S. & Burk, R. (2009). "Junior nursing students' experience a vertical violence during clinical rotations." Nursing Outlook. 57 (4), 226-231.
If nursing students are being asked to absorb 30-40% more information during undergraduate years, it is logical to see that they do so early in their academic career -- almost as a prerequisite for more advanced practicum.
Then, of course, there is the matter of the learning curve in professional education. If one compares schooling for registered nurses with that of physician's assistants or physicians, one often sees a growing gap between the clinical abilities of nursing staff and actual patient care needs. This cause has been attributed to deficiencies in some skill sets of new graduates -- which has the effect of pushing nursing schools and curriculum toward more robust materials (Berkow, Virkstsis, Sewart, and Conway, 2008). However, is the solution simply adding more materials to memorize and read, or might it be more efficient to take a look at the time frame of the educational experience and ask…
Berkow, Virkstsis, Sewart, and Conway. (2008). Assessing New Graduate Nurse Performance. Journal of Nursing Administration, 38(11), 468-74.
Burritt and Steckel. (2009). Supporting the Learning Curve for Contemporary Nursing Practice. Journal of Nursing Administration, 39(11), 479-84.
Heller, Oros, and Durney-Crowley. (2009, July 30). The Future of Nursing Education: Ten Trends to Watch. Retrieved September 20, 2010, from http://www.nln.org/nlnjournal/infotrends.htm
Holzmer, W. (2006). Quality in Graduate Nursing Education. Nursing Education Perspectives, 26(4), 236-43.
It is not the patients themselves that get impacted but the families of these patients as well. There is a certain connection that nurses make with the families of loved ones admitted in hospitals since these nurses are the one the ones in frequent care of their loved ones.
Just the other day, as I was unloading some shopping from my car, a woman from across the road came up to me and asked me if I was a nurse to whom I replied that I was. She expressed that she had recognized me and that I was the nurse who had taken care of her husband at a time when he was admitted at the hospital. She was grateful that I was very caring and showed such compassion that she would always remember. These kind words from patients that are grateful and their family members are just a sample…
The shortage of nursing staff remains a major challenge in the U.S. According to the American Association of Colleges of Nursing (AACN) (2014), the shortage is expected to be even greater in the next one decade or so. The shortage has been fuelled by factors such as reduced enrolment into nursing schools, increased retirement of the nursing workforce, as well as higher demand for healthcare due to population ageing and greater incidence of lifestyle diseases (AACN, 2014).
The shortage of nursing staff has severe implications for the nursing workforce. A high number of patients relative to nursing staff often translate to increased workload for nurses. Indeed, nurses continue to grapple with unhealthily lengthy work shifts, often stretching up to 12-13 hours. It is an issue that has sparked a great deal of debate given the connection between excessive workload and nurse outcomes. Literature extensively demonstrates that excessive workload as a…
1997, the average pass rate for first time test takers on the NCLEX-RN was 93%. Since 1997, the national average pass rate on the NCLEX-RN has declined to 83.8% (National Organization for Associate Degree Nursing, 2002). The pass rate for the state of North Carolina and many other states has also declined in recent years.
Community colleges are the prime educators of new registered nurses in the United States. In 1997, 701 community colleges awarded 41,258 associate degrees in nursing (National Center for Education Statistics 1997). The combined ADN graduate pool constituted 60% of the U.S. graduates who took the NCLEX-RN exam in 2000,and these graduates represent the largest group of nurses entering the profession (National Council of State oards of Nursing 2001). On the other hand, baccalaureate programs graduated 37% of the total; and diploma or hospital-based educational programs, graduated 3%.(Teich, et al.)
In addition to educating the majority…
Adams, Carolyn, Valiaga, Theresa, Murdock, Jane. McGinnis, Susan & Wolfertz, Joanne (2002). Trends in Registered Nurse Education Programs: A Comparison Across Three Points in Time. In National League for Nursing (Ed.), pp. 1-10).:.
American Association of Colleges of Nursing (1999). Temporary Nurses Called A Serious Risk Threat At Hospitals. In (Ed.), p.).: American Association of Colleges of Nursing.
American Health Care Association.(1999).Facts and Trends, The Nursing Facility Sourcebook.Washington, D.C.:American Health Care Association.
American Hospital Association.1999.Trendwatch:RN Shortages in Hospitals. Washington, D.C.: American Hospital Association.
Finally, if the nurse and others concede that her ideas regarding policy change are successful and needed in the medical profession and that other medical professions would benefit from the implementation of these changes to their activities and systems, the nurse can then proceed to implementation of her plan. This she can do by communication with legislators by e-mail, phone, or letter (or in person, if she wishes); by attending forums or other official meetings with political candidates; by working in political campaigns; and by involving herself in similar activities. This would provide the nurse with networking opportunities and enable her to find a platform for and to share her ideas.
An example of just such a successful attempt was that achieved by nurses in 31 organizations (such as the Academy of Medical-urgical Nurses, the American Nurses Association, and the American Organization of Nurse Executives) who, in 2008, pushed for…
Anderson, L. (Tuesday, February 22, 2011). The Role of Nurses in Politics and Health Policy, Nurse Together.com. Retrieved on February 22, 2011 from:
DNP has been a relatively new one for the nursing profession. Today, "there are many enthusiasts toward the DNP. Seen by some as a symbol of social progressivism, the endorsement of doctoral education for advanced practice nursing has many potentially positive outcomes. Among them, better parity with other practice disciplines" (Bellini 2012: 6). However, there have also been many naysayers about the degree. They "strongly argue for the retention of MS-level preparation for APNs based on economic and workforce issues… [they argue that the DNP is] detrimental to society, as the projected number of APNs needed is expected to rise in the years to come, The authors argue that this is unlikely to occur if the DNP-mandate deters potential APN students from pursuing graduate study" (Bellini 2012: 6). This reflects the idea that nursing, however much theory might inform the teaching of nursing, is ultimately always a practical discipline.
Bellini, S. (2014). The doctor of nursing for entry into advanced practice. Medscape.
Motivation as a Factor in Nurse etention
The decreasing recruitment and retention of nurses throughout the United States and internationally is a growing concern that must be addressed and remedied. As front-line workers, nurses play an integral role in the provision of quality healthcare to those who are most in need - the patients. In order to remedy the problem of increasing numbers of nurses leaving the profession, it is crucial that influential factors be identified. This study will explore the effects that motivation has on the job satisfaction of nurses and on nurse retention. It is hypothesized that nurses who are more motivated in their jobs are more satisfied, and are thus less likely to leave the profession. The findings from this study will provide information as to what changes can be made so that nurses are more motivated in their profession.
Nursing retention is a prominent factor in…
Callaghan, M. (2003). Nursing morale: What is it like and why? Journal of Advanced Nursing, 42 (1), 82-9.
Cooper, E.E. (2003). Pieces of the shortage puzzle: aging and shift work. Nursing Economics, 21 (2), 75-9.
Donley, R., Flaherty, M.J., Sarsfield, E., Taylor, L., Maloni, H., Flanagan, E. (2002). What does the nurse reinvestment act mean to you? Online Journal of Issues in Nursing, http://nursingworld.org/ ojin/topic14/tpc.14_5.htm.
Ma, C.C., Samuels, M.E., Alexander, J.W. (2003). Factors that influence nurses' job satisfaction. Journal of Nursing Administration, 33 (5), 293-9.
Health Care Economics
Monopsony power is defined as a situation where there is only a single buyer in the market (Investopedia, 2014). In a monopsony situation, all of the bargaining power rests with the buyer, such that the seller is a price taker, and also a taker on term as well. The buyer therefore pays what it wants, and on whatever terms. A monopsony is an unusual natural market condition. In some situations, monopsony is related to monopoly, a good example being health care in Canada, where the government is the employer. With a government monopoly, there is also only one buyer for health care supplies, and health care labor. Unions can also constitute a monopsony in labor, in situations where non-union workers are prohibited. One must work to the terms that the union has negotiated, or not at all. This paper will look at the nursing shortage in the…
Buchan, J., Parkin, T., & Sochalski, J. (2003). International nurse mobility. World Health Organization. Retrieved December 1, 2014 from http://apps.who.int/iris/bitstream/10665/68061/1/WHO_EIP_OSD_2003.3.pdf
Goodin, H. (2003). The nursing shortage in the United States of America: An integrative review of the literature. Journal of Advanced Nursing. Vol. 43 (4) 335-350.
Investopedia. (2014). Monopsony . Investopedia. Retrieved December 1, 2014 from http://www.investopedia.com/terms/m/monopsony.asp
Link, C. & Landon, J. (1975). Monopsony and union power in the market for nurses. Southern Economic Journal. Vol. 41 (4) 649-659.
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
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American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
Healthcare Practices in Nursing Today
Over the last 50 years, health care systems all over the world have experienced rapid and significant changes. Some of these changes have been the result of innovative developments in medical science and technology that have greatly benefited patients, prolonging and saving the lives of millions. Some of these changes, however, have had the unfortunate result of limiting patient access to prescribed treatment and diminishing the overall quality of care.
Significant challenges are being faced in health care as systems restructure and reinvent themselves in a difficult and often painful effort to make more efficient use of their available resources (ICN, 2001). Since health care is such a labor-intensive industry, the stresses on these systems inexorably trickle down to affect those employed by the system. Nurses, who are the most highly trained caregivers who have ongoing, regular patient contact, stand at the very heart of…
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Student success a - endeavor. The student give 100% instructor provide students a 100%. The student responsibility prepared learn material assigned, turn assignments time, pay attention taught discussed, questions needed.
I agree that the process of education is a dialogue, not a monologue. Although an educator may have a plan about what he or she wishes to teach, the teacher must respond to student input. The students may not understand the material in the manner in which it is initially presented; they may be bored or ill-prepared; they may have probing and unexpected questions; or they may have different learning styles.
Using different approaches is particularly essential in healthcare education, given that new scientific knowledge builds upon old knowledge. emediation is successful because it ensures students have knowledge of the foundational concepts early on, before the student becomes completely left behind. Given the nursing shortage the nation is facing, finding…
Smith, A. (2010). Learning styles of registered nurses enrolled in an online nursing program.
Journal of Professional Nursing, 26(1):49-53. doi: 10.1016/j.profnurs.2009.04.006.
Nursing is not only a profession, it is a ministry. Nurses not only provide care for their patients, they oftentimes minister to them in order to provide comfort and in some cases, peace of mind. Nursing is a profession that the healthcare system cannot do without. We know that the profession of a physician goes back to even Biblical times, but even though nursing has been around for many years, it does not date back as far as the profession of a physician does. This is not to say that nursing is less important than any other profession. The field has grown so much over the past few decades and nursing is a profession that is in high demand. Nurses now have to decide if they want to do a traditional educational path or get the four-year degree; they must stay ahead of nursing trends in order to gauge the…
Delaney, C., & Piscopo, B. (2007). There really is a difference: Nurses' experiences with transitioning from RNs to BSNs. Journal of Professional Nursing, 23(3), 167-173. Retrieved May 3, 2012, from the ScienceDirect database.
Franklin, P.D., Archbold, P.D., Fagin, C.M., Galik, E., Siegal, E., Sofaer, S., et al. (2011). Building academic geriatric nursing capacity: Results after the first 10 years and implications for the future. Nursing Outlook, 59(4), 198-206. Retrieved May 3, 2012, from the ScienceDirect database.
Ozbolt, J.G., & Saba, V.K. (2008). A brief history of nursing informatics in the United States of America. Nursing Outlook, 56(5), 199-205. Retrieved May 3, 2012, from the ScienceDirect database.
Wildman, S., & Hewiston, A. (2009). Rediscovering a history of nursing management: From Nightingale to the modern matron. International Journal of Nursing Studies, 46(12), 1650-1661. Retrieved May 3, 2012, from the Science Direct database.
The profession of nursing offers many different things to many different people. For me, caring and helping people heal has always interested me and has made me feel like I am on the right path I life. The purpose of this essay is to explain my perspectives on nursing and why I feel that this profession is not only of great importance to me and my family, but also positively affecting my community and environment as well. This essay will first show the need for nurses in today's society and how well trained nurses can make a significant impact in the overall quality of life for everyone involved. Also this essay will address Jane Watson's theory of caring as a main academic influence on my nursing approach.
I was born in a relatively poor part of the world in Jamaica where many of the things that are…
Courchane, C. (2011). With nurse shortage looming, America needs shot in the arm. The Washington Times, 6 June 2011. Retrieved from http://www.washingtontimes.com/news/2011/jun/6/with-nurse-shortage-looming-america-needs-shot-in-/?page=all
Current Nursing (2012). "Jean Watson's Philosophy of Nursing." 26 Jan 2012. Retrieved from http://currentnursing.com/nursing_theory/Watson.html
Rowe, J. (2012). Why Nurses Need More Authority. The Atlantic, 7 May 2012. Retrieved from http://www.theatlantic.com/health/archive/2012/05/why-nurses-need-more-authority/256798/
Nursing Time Management Strategies
By its very nature, the profession of nursing requires effective time management. Nurses are constantly asked to balance the needs of patients and also the demands of administrators as they care for patients and attend to the bureaucratic aspects of their duties. The nursing shortage has made the need for time management particularly acute. Nurses are often overburdened with the care of many patients, whom they must attend to all at the same time while working long shifts. They must budget their time but still dispense high-quality care. With this in mind, the article by Nelson (2010) entitled "Helping new nurses set priorities" argues that time management skills must be a component of the training of all new nurses. During the first critical years of practice, the nurse develops the habits and assumptions for how she will govern her time.
In general, "orientees' time-management skills improve…
Jones, T. (2010). A holistic framework for nursing time: Implications for theory, practice, and research. Nursing Forum, 45 (30): 185-196. Retrieved from:
Nelson, J. (2010). Helping new nurses set priorities. American Nurse Today, 5.5.
Retrieved from: http://www.americannursetoday.com/article.aspx?id=6620&fid=6592