NRS 440 Discuss the events that have contributed (or will continue to contribute) to the nursing shortage, or that contribute to a shortage in a region or specialty
NRS 440 Discuss the events that have contributed (or will continue to contribute) to the nursing shortage, or that contribute to a shortage in a region or specialty
Nursing shortages have become more of an issue throughout the medical field since Covid. The crazy patient ratios, under staffed, nurse burn out. During the beginning of the pandemic nurses were seen as the heroes but as the pandemic came down and vaccines began to come out the right to refuse vaccine turned nurses into the enemy. People went from praising nurses to blaming them for the spread of the pandemic. All of these things combined has led to many nurses pulling away from bedside nursing. Those experienced nurses were the backbone of many specialties, med tele, er, icu etc. With the need for more nurses, new grads had the opportunity to get hired into specialty areas that would typically require at least 1 year of experience in an acute setting. These new nurses soon became the senior nurses as more and more experienced nurses decided to leave the bedside. Overwhelmed new nurses put in positions where they are responsible for training more new nurses when they themselves haven’t found their footing yet is also a cause of new nurses leaving the bedside. Many hospital have restarted clinical nurse residency programs. These programs allow for new nurses to go through the hospital program according to the specialty they were hired for. This ensures that these new nurses are properly trained and feel confident in their skills by the time they hit the floor on their own. I also think a variation of this program should be available for experienced nurses who choose to change specialties.
The events that have led to this shortage include the aging population, limited supply of new professionals in the nursing field and aging workforce. It is a fact that the aging population is increasing and that they require more nursing interventions. Due to the increased demand for nurses, there have been no enough nurses to meet all their needs. the supply of new nurses is also limited as the nursing schools each day release few graduates who are expected to join the workforce. The aging workforce also has led to less nurses. The shortage is due to the increased demand while there is less availability of the nurses. One of the ways the nursing profession is dealing with the nursing shortage is by empowering nursing career development. This is ensured by making sure that nurses get the best education possible and get the required certificates, This will be an encouragement for the nurses to hold on their career and keep working. Listening to the nurses, advocating for them and allowing flexibility of schedules will encourage more nurses to keep working and work more towards their success.
Nursing shortage is not a new problem that is being faced in healthcare. However, I do believe that the COVID-19 pandemic has sped this process up. There is an anticipated shortage of nurses, especially with the baby boomer generation retiring and the need for health care growing (“News & Information”, 2022). There are many things that can also contribute to the shortage that is expected including nursing school enrollment not growing at the rate to meet the projected demands, shortage of nurse faculty, a large segment of the work force is nearing retirement age, there is a larger need to care for the aging population, and the recent pandemic led to greater stress levels which impacted job satisfaction and drove some people out of the profession (Whitney, 2022).
One of the largest ways that these shortages can be addressed are through the nursing schools themselves. As this seems to be the basis for the problem as is faculty shortage and there aren’t as many nurses that are being produced that are needed. A way that the schools are attempting to address this are through forming strategic partnerships and seeking private support to help expand student capacity (“News & Information”, 2022). Building this basis and being able to produce more nurses is one way to attempt to address these problems. Allowing more students to be admitted and graduate can put more nurses into the work force in attempts to compensate for those, especially in the baby boomer generation, that are going to be/have retired.
“News & Information.” American Association of Colleges of Nursing: The Voice of Academic Nursing, Oct. 2022, https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage.
Whitney, Stacey. “The Future of Nursing in an Evolving Health Care System.” BibliU, 2022, https://bibliu.com/app/#/view/books/1000000000592/epub/Chapter1.html#page_11.
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Worldwide, hospitals continue to be confronted with a nursing shortage problem, which has been a concern for decades. According to Whitney (2018), there is a deficit in the nursing workforce related to the age of the current nursing workforce, the need for schools to enroll more students at an accelerated rate to meet the projected demand, and a shortage of nursing faculty and clinical sites. Moreover, the population is aging, and long-term care needs are increasing. Patient care can become too overwhelming as one age. The solution to this problem can be found by employing older nurses in the facility’s education and non-direct patient care areas as resource personnel (Marquis & Huston, 2017). With more experienced nurses retiring earlier, younger nurses will need to gain exposure to the valuable experience and knowledge that older nurses have accrued during their careers. The availability of clinical preceptor sites for nursing students also contributes to a need for more nurses. Because many nursing students apply at the facilities where they do their preceptorships, hospital systems that partner with nursing schools can benefit financially and as employers. As a result of staffing shortages, higher patient needs and pressures, and potential violence, nurses are feeling burned out and are seeking employment outside of healthcare. There is a need for changes within the nursing industry. There are several issues related to nursing, but there are also options, and nurses tend to go where they are well-paid and treated.
To improve the quality of service, facility leadership should pay attention to and listen to the staff when they talk about issues. This is the biggest issue in the region I practice; nurses are not being incentivized or paid anywhere near what they are worth for the knowledge and experience they bring with them. Nursing salaries in Oklahoma are among the lowest in the nation. RNs in Oklahoma earn an average salary of $64,800 a year. Accordingly, Oklahoma nurses make an average hourly wage of $31.15. Meanwhile, the national average for RNs is $77,460. In terms of an hourly wage, this is approximately $37.24 an hour annually (Registered nurse salary in Oklahoma (2021): Trusted health).
Lack of mental health support and understanding is another issue plaguing nursing. We have had two attempted suicides by two nurses at my current facility. I can only speculate as to the reason, but there is no doubt that the current working conditions of nursing were not one of the possible and probable reasons for them to attempt such a permanent act. Mental health strains result from long shifts, staff shortages, and a lack of resources, so healthcare organizations must support nursing staff. Establishing a mental health-positive workplace culture that provides mental health resources to destigmatize mental health issues is essential. Nurses’ mental health can be enhanced and protected by peer support groups and self-care strategies, enabling them to perform at their best (2022). Happy and healthy nurses are essential in creating and maintaining happy and healthy patients. A healthy work environment contributes to the retention of nurses by creating a positive work environment. It is important to note that as nurses are retained, staff shortages will decrease, thus positively impacting patient satisfaction and safety.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing (9th ed.). Lippincott Williams and Wilkins.
Trusted. (n.d.). Registered nurse salary in Oklahoma (2021): Trusted health. Registered Nurse Salary in Oklahoma (2021) | Trusted Health. Retrieved February 22, 2023, from https://www.trustedhealth.com/nurse-salary-guide/oklahoma
University of North Dakota. (2022, August 8). Supporting mental health for nurses: Why it matters. University of North Dakota Online. Retrieved February 22, 2023, from https://onlinedegrees.und.edu/blog/supporting-mental-health-for-nurses-why-it-matters/
Whitney, S. (2018). Reader. BibliU. Retrieved February 22, 2023, from https://bibliu.com/app/#/view/books/1000000000592/epub/Chapter1.html#page_6
Patients’ health concerns are increasing despite the nursing shortage, which is a challenge in the nursing practice. It has been determined that more nurses will be needed within the practice (Tamata et al., 2021). The nursing shortage is one of the challenges that different events have contributed. It has been determined that the number of older people is increasing globally, contributing to increased concerns for patients who require critical care (Tamata et al., 2021). Statistics have also indicated that in the future, there will be an increasing number of individuals 65 years and above. These are among the main factors contributing to the worsening nursing shortage in healthcare (Haddad et al.2020). Another event contributing to the nursing shortage is the increasing number of nurses retiring due to old age. This is a fact that should be considered to be impacting nurses.
There are also events that have contributed to the nursing shortage, such as adverse environmental impacting factors. This includes fatigue within the workplace, contributing to increased turnover. The rate of health professionals that enrol as nurses have also been low because of the increased number of patients and an example of unemployment whereby there is exhaustion. Internal challenges such as burnout and low job satisfaction also attributed to increased turnover of nurses from the health practice. The nurses, therefore, end up taking longer time to provide care within the practice. In some cases reported within the health practice, violence has also contributed to the nursing shortage (Haddad et al., 2020).
The nursing profession is working towards addressing the nursing shortage challenge differently. This is associated with the introduction of solutions to increase the number of nursing facilities providing education. Additionally, it is the ability to have better transitions within the academics of the health professionals. Training programs have also been initiated at different levels to establish more knowledge on addressing patients’ health issues.
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing Shortage. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Tamata, A. T., Mohammadnezhad, M., & Tamani, L. (2021). Registered nurses’ perceptions on the factors affecting nursing shortage in the Republic of Vanuatu Hospitals: A qualitative study. PLoS ONE 16(5): e0251890. https://doi.org/10.1371/journal.pone.0251890
Nursing shortages decreases medical facility from being profitable as they look to balance patient centered care, creating healthy work culture that would encourage employee retention. Therefore to enable retention of nurses here are two plausible solutions, an excellent onboarding program can carefully introduce new nurses into their job so they’re less overwhelmed during the first few weeks. This can be done by not assigning them to problem patients right away. Events that would help new nurses get to get acquainted with current nurses to encourage a sense of community, (Challinor et al., 2020). When nurses feel welcome and part of a community they’re more likely to bring along their friends. Did you felt that way when you first get your nursing job? I did that for 2 of my nursing colleagues after I got my job with Mt Sinai. It was truly a welcoming and warm feeling everyone was so pleasant and nice to me and very helpful. Also a nurse residency program can be helpful, making it easier for new graduates to transition from being a student nurse to dealing with the transition to having nursing responsibilities. This allows for great mentorship for new graduates, as the new nurses together with experienced nurses spend time caring for patients together before being release to practice on their own. Another factors is investment in long-term training and professional development for nurses. where healthcare institution should commit to lifelong learning in nurses as they acquire new knowledge and skills, and employers can provide nurses with training through distance learning and self-tutorials, (Tang & Hudson, 2019).
Challinor, J. M., Alqudimat, M. R., Teixeira, T. O. A., & Oldenmenger, W. H. (2020). Oncology nursing workforce: challenges, solutions, and future strategies. The Lancet. Oncology, 21(12), e564–e574. Retrieved from: https://doi.org/10.1016/S1470-2045(20)30605-7
Tang, J. H., & Hudson, P. (2019). Evidence-Based Practice Guideline: Nurse Retention for Nurse Managers. Journal of gerontological nursing, 45(11), 11–19. Retrieved from: https://doi.org/10.3928/00989134-20191011-03
Nursing shortages can occur at different levels and various stages such as a local shortage or one that is spreading and affecting many hospitals and nurses across states and regions of the country (Buerhaus et al., 2021). A simultaneous maternity leave of several nurses in a specialty unit can produce an acute shortage or a demand driven shortage can be erected from nurses chasing higher wages and bonuses (Buerhaus et al., 2021). These background shortages disrupt operations but eventually resolve and do not spread regionally or nationally. Critical national nursing shortages are more pronounced and affect access to care, quality, safety, and healthcare costs (Buerhaus et al., 2021). Nursing shortages are a consequence of a demand or supply of nurses. According to LinkedIn 2022 fourth quarter statistics, registered nurses are essential, and their jobs are the highest in demand overall (Lewis, 2023). An aging population in the United States is fabricating ample opportunities and needs for nurses. In 2010, the baby boom registered nurses commenced retirement consisting of roughly one-third of the total registered nurse workforce (Buerhaus et al., 2021). Between 2010 and 2020, approximately sixty to seventy thousand baby boom nurses retired annually resulting in an astounding loss of clinical leadership (Buerhaus et al., 2021). There is an additional estimate of the loss of more than two million years of nursing experience retiring between 2020 and 2030 which includes 640,000 baby boom nurses (Buerhaus et al., 2021). By the year 2020, researchers estimated upwards of one million additional nurses would be needed to care for this aging population (Haddad et al., 2022). Over the past decade, new registered nurse graduates are beginning their careers however the specialty units remain void of experienced staff to supplement the retirement loss (Buerhaus et al., 2021).
The COVID pandemic intensified this loss of highly qualified nurses and hospitals were faced with a dire need and demand for specialty nurses overnight (Galanis et al., 2021). The months of mentorship and experience required to train critical care nurses became an immediate need leading to burnout related to the increased workload and inadequate specialized training (Buerhaus et al., 2021). The Covid-19 pandemic contributed to younger nurses exhibiting burnout related to being less familiar with infection control and having a shortage of accompanying protective measures; unfamiliarity with handling catastrophic events; and an increased death rate due to limited healthcare resources (Galanis et al., 2021). Disproportionate patient-to-nurse staffing ratios combined with a nursing shortage account for increased errors and pilot higher morbidity and mortality rates triggering nurses to experience burnout (Haddad et al., 2022). The nursing turnover rates vary based on geographic location and nursing specialty averaging 8.8 % to 37% (Haddad et al., 2022). Bedside nurses should be involved in legislative decisions to limit patient-to-nurse ratios. This would lead to stronger job satisfaction, higher nurse retention rates, decreased errors, and a diminished desire to leave the nursing profession (Haddad et al., 2022).
Nursing is pulling away from the traditional point-of-care role and is using frontline nursing as a stepping-stone to advanced practice nursing. Between 2010 and 2017, an additional nursing shortage evolved with the rise of advanced practice nurses, particularly nurse practitioners, in the nursing profession resulting in a reduction of approximately eighty thousand registered nurses (Buerhaus, 2021). According to the American Association of Nurse Practitioners (AANP), thirty thousand new nurse practitioners graduated in 2018 to 2019 and left their vital bedside role to pursue an alternative path (Admin, 2021). We need nurse educators to strengthen the nurse workforce. According to the American Association of Colleges of Nursing, over 80,000 qualified nursing school applicants were declined due to lack of necessary nursing school faculty members, clinical study sites, classroom space, and budget constraints (Mozafaripour, 2023). To maintain high-quality care for patients, health care organizations must find innovative ways to retain and invest in nurses. Competitive salaries may increase retention along with non-financial incentives, such as educational and development courses, advanced certification and leadership opportunities (Mozafaripour, 2023). Creating incentives to increase the number of clinical preceptors for students is another avenue health systems could support to promote nursing education. Establishing a culture of retention and healthy clinical nurse practice environments can improve healthcare and overall population health.
Admin, P. (2021). Nurse practitioner role contributes to bedside nursing shortage. Physicians for Patient Protection. Retrieved February 22, 2023, from https://www.physiciansforpatientprotection.org/nurse-practitioner-role-contributes-to-bedside-nursing-shortage/#:~:text=The%20most%20common%20reason%3A%20inadequate%20staffing%2C%20reported%20by,nurses%20leaving%20the%20bedside%20to%20become%20nurse%20practitioners.
Buerhaus, P. I. (2021). Current nursing shortages could have long-lasting consequences: Time to change our present course. Nursing Economics, 39(5), 247-250. NEC_SO_2021 (nursingeconomics.net)
Galanis, P., Vraka, I., Fragkou, D., Bilali, A., & Kaitelidou, D. (2021). Nurses’ burnout and associated risk factors during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of advanced nursing, 77(8), 3286–3302. https://doi.org/10.1111/jan.14839
Haddad LM, Annamaraju P, Toney-Butler TJ. Nursing Shortage. [Updated 2022 Feb 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/
Lewis, G. (2023). The most in-demand jobs right now. LinkedIn. Retrieved February 22, 2023, from https://www.linkedin.com/business/talent/blog/talent-strategy/most-in-demand-jobs
Mozafaripour, S. (2023). The 2021 American nursing shortage: A data study. University of St. Augustine for Health Sciences. Retrieved February 22, 2023, from https://www.usa.edu/blog/nursing-shortage/