Nursing Shortage: A Problem for Healthcare Systems - Essay Example

Your Unabbreviated and number Nursing Shortage: A Problem for Healthcare Systems Healthcare needs have increased over the past decades and certain professionals are on high global demand, especially on developed countries. Several approaches and strategies have aimed to reduce the impact of this shortage, but the problem continues unsolved. In this paper, I will describe the important role that nursing shortage plays in healthcare systems, its causes, and strategies to solve a worldwide matter that continues to grow. The problem The nursing shortage is not a new problem. Since the 1980s and 1990s, several authors have tried to address this topic; Abdellah (1990) described the problem of nursing shortage as emerging from World War II, the time when demand begun to exceed supply, thus creating a severe imbalance. According to the US Department of Labor (2008), there are three major educational routes to become a registered nurse: a bachelor's of science degree in nursing, an associate degree in nursing, and a diploma. Once students graduate from an approved program, they must pass a national licensing examination in order to obtain a license. Data from the National Employment Matrix shows that Registered Nurses are projected to generate about 587,000 new jobs over the 2006-16 periods, and that they constitute the largest health care occupation, with 2.5 million jobs. The American Association of Colleges of Nursing (2002, cited by Westendorf, 2007) has revealed that the workforce is currently at a median age of 43.3 years. In addition, in the year 2020, the demand for nurses will exceed the supply by 20% (American Organization of Nurse Executives 1999, cited by Johnson et al., 2006). If the current tendency is sustained, the shortage will have catastrophic effects. Factors causing the problem New healthcare technologies, surgical improvements, and drug developments, among other variables, have increased life expectancy. Epidemiologic transition has increased degenerative, chronic, and man-made diseases, and has displaced pandemics of infection as the primary causes of morbidity (Omran, 2005). The demand far exceeded the supply, creating a severe imbalance. Various excellent models have emerged to minimize the shortage in various countries. Several revisions have listed the multiple causes for this shortage (Johnson et al., 2006): the aging of the workforce, where experienced nurses are getting older; retirement, as experienced workers in this field are quitting their jobs in hospital settings, because of other business perspectives, or time has arrived to do it; escalating needs of older patients, as we said the epidemiologic transition brings chronic diseases to the scenario and conditions such as diabetes, hypertension, stroke, and their consequences deserve chronic care; and tighter financial times in different economies: salaries are low and are not increasing, so the workforce is inclined to migrate from low-salary regions to places with better monetary conditions. Abdualrub (2007) also lists the fact that there are unattractive conditions, and fewer individuals are selecting this career. He further explains there is a vicious circle in working conditions, turnovers and faculty enrollment, and nurses are employed by a "monopsonistic labor market", where a single firm hires labor (Tuker 1997, cited by Abdualrub 2007), that is to say hospitals. In some countries, there are also "high workloads, limited clinical autonomy and poor work conditions". Potential strategies to resolve the problem As Johnson et al. (2006) disclose nursing recruitment and retention efforts have focused in: increasing supply by making nursing a more attractive, and lucrative option; improving the conditions of practice in health care institutions, and slowing the exit of nurses from the system. In this same matter, Westendorf (2007) highlights the importance of retaining the quality nurses that have been recruited; job satisfaction makes fewer nurses to leave the profession. Moreover, there is need for greater private sector involvement, and some have proposed for reconfiguring hospitals as we know them today. Another strategy is discussed in the article published by Oglesby (2007). The use of emergency medical technicians or paramedics, whose field abilities can also be applied in the emergency hospital setting, and the statement that "it has become necessary for emergency nurses to delegate more complex tasks to unlicensed assistive personnel". These tasks include venipuncture, insertion of catheters, tracheal suctioning, blood draws, EKGs, and urgent trauma care, among others. This is a useful strategy that has been applied in emergency settings, but that also could be extended to other locations. Johnson et al. recommend "Scenario planning", a model that can "provide nursing leaders with an alternate lens through which we can look at the extreme situation of today and the impending crisis of the future". I think this is an important strategy to address the problem and involving more and more actors into the topic. Several strategies have provided decisions in central governments and congress. It is important that new proposals arise, since these are used as backup and support in legislations related to the topic. My solution As I said, various proposed strategies have been tested, and some have been established with different outcomes. Here I want to expose my individual perspective and to disclose a solution that is supplied by investigators, educators, clinicians, and management specialists. If we accept the fact that the problem has been increasing since World War II, it is a crisis that has evolved during the past 60 years, and we are late in providing practical solutions. Financial aspects are crucial, and currently there is a labor crisis in the world. But, we must acknowledge the valuable commitment of healthcare practitioners with quality of services, since they finally have direct relationships with patients. There should be a better resource and input distribution in health labor; salaries should be placed based in workload, competences, educational degrees, and not only established because of worked hours and shifts; it is important to reinforce the fact that nurse practitioners are critical for health services, whether inpatient or outpatient. In this matter, and given an aging population with chronic diseases, there is also an increase in demand for nurse practitioners who work home-based. It is an interesting market that is now exploited in several European countries. Other example is the United States, where both legal and illegal immigrants have begun to work taking care of the elderly, obtaining good compensation, even though some are not trained and, when they are, most do not even have a valid license. I do not think substitution is the best alternative, because, for instance, there will always be a gap between paramedics and nurses, or between science degrees and associate degrees, among other examples. I would rather reinforce and strengthen faculties, make this career more appealing for new generations, not only working on compensations but also in job satisfaction. Government and congress have to be aware of this shortage and pressure should be exerted in these settings, by professional associations and educators. Universities should play a more central role in nurse practitioner's labor options, because if educators push for better conditions, at the end they will get more students into their faculties. Conclusion We have discussed nursing shortage and reviewed the most important variables that influence this problem. For various decades, several authors have addressed labor conditions and the impact this nursing shortage will have in the future. After taking a brief glance over several strategies, I think financial topics are vital, compensation and input distribution are major issues, and there is more than substituting or replacing human resources. Works Cited Abdellah, F. G. "The nursing shortage: dynamics and solutions. Reflections on a recurring theme." Nursing Clinics of North America 25.3 (1990): 509-16. Janiszewski, H. "The nursing shortage in the United States of America: an integrative review of the literature." Journal of Advanced Nursing 43.4 (2003): 335-350. Johnson, J.E. Billingsley, M.C. Costa, L.L. "Xtreme nursing and the nursing shortage." Nursing Outlook 54.5 (2006): 294-299. Oglesby, R. "Recruitment and Retention Benefits of EMT-Paramedic Utilization during ED Nursing Shortages." Journal of Emergency Nursing 33 (2007):21-5. Omran, A.R. "The Epidemiologic Transition: A Theory of the Epidemiology of Population Change." The Milbank Quarterly, 83 (2005): 731-757. U.S. Department of Labor. Bureau of Labor Statistics. Occupational Outlook Handbook 2008-2009 ed. Oct 2008. . Westendorf, J. J. "The Nursing Shortage Recruitment and Retention of Current and Future Nurses". Plastic Surgical Nursing 27.2 (2007):93-97. Read More