Nursing Shortage in Canada - Essay Example

Introduction Though nurses offer very important services and nursing is a stimulating career option, Canada is facing a serious problem provincially and nationally of shortage of nurses. The number of available nurses in country has continued to decrease. Funding cuts from the government have led to insufferable working conditions and detrimental working atmosphere. Poor recruitment policies leading to intense workloads, coupled by lack of professional advancement opportunities have resulted to physically and emotional worn out nursing workforce. The well-known move to casual work and part-time has resulted to disjointed patient care and made many nurses to be disillusioned in their profession. The issue; shortage of nurses in Canada This paper is going to critical examine the nursing shortage facing Canada at present. Canada is going through a nursing crisis; this is an observation being expressed by many people across the country, by the public and the health managers. Where as, there are various perspectives to explain the situation, there is a general concurrence that the present shortage on nurses is worsening and should be addressed, before it leads to poor provision of health care in the country. There is every reason why the nursing profession should be an attractive profession of choice. McIntyre & Thomlinson (2003), states that the profession of nursing has the elements to being a fulfilling and exciting lifetime career of choice, providing challenging and different practice opportunities. Nursing profession allows for flexibility of job employment and gives a chance for a balanced work and family life. It provides endless opportunities in education, research, administration and a lot more. Yet in Canada, fewer students are enrolling for this profession contributing to the shortage. (McIntyre & Thomlinson, 2003) The barrier of solving the problem has been lack of proper health policies that can address the situation. Failure of stakeholders coming up with ways to address the problem and creating good attractive conditions to retain the nurses in the profession from moving have highly contributed to persistence of this problem Nature of the issue; what makes this issue a nursing issue Studies reveal that, some nurses in Canada are simply not taking up their jobs of nursing and opting to stay back home waiting for full time jobs. It has also been observed that the rate of absenteeism has increased reducing the number of nurses availing for patients. This has continued to contribute to the problem of shortage of nurses in the country. A related alarm is the rate of nurse graduates leaving the country to work else where after graduating, this also have contributed to the shortage of the nurses in the country. (Canadian Nurses Association, 2005) The healthcare is facing a nursing shortage that is as a result of workforce related issue. In Canada there is basically less nursing care funded hours yet there are too many nursing needs. This has resulted to those nurses available being overworked and stressed, this is the main problem. The current shortage of nurses is mainly also caused by the following factors; 1. A real present shortage of available nurses that is limited number of available seats for nurses in education programs and also a nursing workforce that is aging. 2. Human resources management aspects which, makes it difficult to exploit fully on the productivity of the available nurses. These aspects are high overtime, high level of part-time, high absenteeism increased number of tasks that are no-nursing and limited range of practice. 3. Limited funds allocated to hire the required number of nurses who are needed to deliver appropriate care services needed. (Canadian Nurses Association, 2005) Working in the concept of rising acuity, complexity and intensity of patient care surroundings and an corrosion of leadership in nursing themselves resulting from the effects of downsizing witnessed in the 1990s, the above three factors are the root cause of nursing shortage in Canada that is being witnessed presently. The issue of nurse shortage was first raise by the public due to reduced number of nurses available in the hospital to serve them. The public become alarmed and raised to issue as a concern to the health problem facing the nation. This as been seen as being the result of downsizing there was an increased workload for the nurses leading to many nurses losing morale and having low job satisfaction. This contributed to high level of absenteeism threatening the nursing care quality that patients were receiving. this cycle that was set in action in the 1990s has probably led to the current situation of nurses shortage that now require national strategy to intervene and rescue the health sector. Historical Analysis of the Issue Nursing shortages in Canada can be traced back to the 1990s, following the effects of budget cuts in the health sector and the reforms that the health system undertook. The reforms affected the nursing working conditions negatively making many nurses to go elsewhere or leave the profession. This situation has led to overwork to the present nurses and has become a major concern to all in the health sector. (Bower & McCullough, 2004) Bower & McCullough (2004) argues that the policies undertaken by the government in conjunction with the health sector of cutting funding and downsizing the number of nurses in 1990s remains to be viewed as major reasons as to why the Canada is experiencing the current nursing shortage. The measures and policies led to many nurses to view the profession have having bad working conditions and environment and immigrate to other countries creating the present shortage. For example in a study carried out in 2002 named "Earning their Return: when and why Ontario RNs Left Canada and what will Being them Back" 62.7% of nurses who left Canada for other countries revealed that they left because of; 1. Downsizing 2. Lack of permanent employment 3. Limited number of employment opportunities. 4. Working/workload conditions Any deliberation of the situation of shortage of nurses in Canada has to begin with accepting that the problem is real regardless of the cause. Bower & McCullough (2004) reminds us that, in 1997, Ryten predicted that by 2011 there will be between 59,000 to 113,000 shortages of nurses in Canada and presently there is evidence that the predictions are becoming real. In order to improve the situation it is important that a stable working environment has to be created to ensure that nurses are assured job security. The government, nurse employers and other policy makers have to recognize the need of enhancing good working conditions Ethical and Legal Analyses of the Issue The Canadian Nurses Association's (CAN) code of ethics replicates the changing social values and also conditions that are affecting health care structure; the code also creates new challenges and opportunities for the nursing ethical practice. One of the challenges that the code highlights is that, Nurses are currently more independent in their services as a purpose of enhancing nursing knowledge, skills and research and the changing patterns of health care. (Canadian Nurses Association, 2002) The ethics nature in nursing The capability of nurses to take part in ethical practice in their daily work and deal with ethical circumstances, concerns and problem is the result of decisions which are made at various level; individual level, organizational level, regional, provincial level, national level and international level. Different capabilities, responsibilities and methods of working towards changes are also present in these different levels. (Canadian Nurses Association, 2002) Ethical situations Nurses in their duties frequently are faced with situations that involve ethics; these situations can be defined in various ways which are underlined below; Everyday ethics; the manner in which nurses advance their performance and reflect on the nursing ethical duty to the patient they serve, this entails nursing ordinary ethical issues such as to protect a patient physical privacy. Ethical violations: deserting basic nursing duties in circumstances where the nurse is aware that such an action or inaction is not proper. The code of ethics has eight core values, nurses are supposed to follow these eight core values which are; safe, proficient and ethical care; health and well-fare; choice; dignity; confidentiality; justice; accountability and quality environment. So mod these ethical issues may have contributed to the nursing shortage as some nurses may fail to keep the code of ethics and opt to leave the profession. (Canadian Nurses Association, 2002) Social and Cultural Analyses of the Issue Nurses are the main pillar in the healthcare system which is at the moment being faced with problems challenges and opportunities. Through out the day and the night nurses are always there whether in metropolitan hospital or community healthcare facilities, nurses the ones on most occasion first to provide services to the people. The current nursing shortage is a social problem that affects the whole society, on the social context, the problem is being created by the fact that population of the nursing workforce has become highly aged. Currently the average age of the nurses in Canada is 45 years, this means that less young people are getting into the profession. This is alarming because in the near future many of the present nurses will retiring which will highly increase the present shortage that is already being witnessed. A number of factors are estimated to reduce the supply of nurses if no countermeasures are undertaken. Demographic tendency such an ageing population is estimated to reduce the number of young people joining the nursing profession. More so the societal drift towards a more relaxing work, part-time jobs, partial and early retirements are anticipated to reduce the nurses working in the healthcare. Another society issue compounding this problem is the low esteemed and respect that society is showing the nurses, the society has continued to view nursing profession as a low class profession. This has discouraged many potential young people from joining the profession. Political Analyses of the Issue The issue affecting the shortage of nurses in Canada is a complex issue which has occurred because of different factors. At the moment, it is difficult to view the benefits of the situation to any group in the health sector. However, the nurses themselves are bound to benefit from the situation has they became highly demanded for; this will mean that they can negotiate for better remunerations working conditions as they will be on high demand. As in any market, when the demand is high and the supply is low the price of the product normally goes up, thus the value of the nurses will automatically go up. We are aware the solving the problem is important as excellent care is required for maintaining and also improving the healthcare of the Canadians. Thus the people who will benefit if this situation is solved are the public, since they will experience a better nursing care. Ross, et al (2005) observers that, both private and public hospital will also benefit if the number of nurses available increases as they will have enough nurses to recruit and improve their service delivery. Shortage of nurses also affects the research and general health care services providence in Canada, hence if the situation is solved the whole healthcare sector is bound to benefit from an increase in number of nurses. It is also worth noting that as large number of nurses continue to be highly educated and gain better skill to become highly professional they become more aware of their high value and look for greener pastures worsening the situation. (Ross, et al (2005) There have been arguments brought forward by ageist and other ideologist that the current problem is being witnessed because of the demographic changes being witnessed in Canada. They point out that the population of Canada is aging faster than the number young people coming in the population for example it is pointed out that the average current age of Canadian nurses is 45 years, meaning that less young people are in the nursing profession. At the same time the number of seniors or older people has continued to increase, these older people require home nursing care taking up a large number of available nurses. (Ross, et al (2005) Another issue worth mention is the argument that states that the Canadian authorities limited the number of black nurses who can migrate to the country to take up nursing jobs in the country. This view suggests that the present shortage could have been controlled if the government could have allowed all nurses willing to work in Canada regardless of their race or color. McLean & Anema (2004) underscores this point when he points out that nurses foreign nurses form Haiti and Mexico who came over to work in Canada where not treated well and they qualification was not respected. at the same time the Canadian authorities have been accused of favoring nurses coming from nurses from English speaking countries than those form French speaking countries, today many nurses have refused to contend with the linguistic, cultural and racial discrimination and opted to work in more responsive countries. (McLean & Anema, 2004) Critical Feminist Analysis of the issue Modern feminist concept explains that clustering of roles on basis of gender is an aspect brought about bet the society. In Canada it is argued that the government has slightly contributed to the current nurse shortage by not giving a lot of consideration to female nursing students in the country. The estimates tend to show that a high number of scholarships for example, go to male students as opposed to female. Another aspects is the qualification for nursing in the universities, it is argued that they should be lowed a bit, for female students. Many feminists also observers that many parents still seem highly encourage their male children to further education, but do not show high such high esteem to their girl children. It has also been observed that sexual harassment that female nurses have encountered in the profession also have contributed to low high number of female nurse leaving the profession contributing to the current shortage. Economic Analysis of the Issue There is enough evidence to suggest that nursing shortage becoming a global phenomenon as many other countries are also experiencing nurse shortages. in this present situation of globalization , professional labor, especially nurses are being highly sought to work in different regions and demand for health care has continued to increase all over the world. (Almada, 2004) Nursing shortages are occurring because the demand for nursing professions has exceeded the amount of supply of the nurses in the market. Shortage of the nurses are not measured directly but, can be estimated basing on complex concepts of demand and supply. Demand of nurses is mainly determined by the occurrence of diseases, technology available and the public expectations. On the contra the supply of nurses is decided by the amount in numbers of active nurses available and the amount of time they can work. (Almada, 2004) Various factor influence the demand of nurse in Canada, even though the many hospital have tended to reduce the number of days stay in the hospital, other factors like increased activities created by the an aging population, advance in medical technology and higher consumer expectations has continued to increase the demand of nurses. To a great extent, the present nurses' shortage in the health sector is as a result of many nurses leaving the country to work elsewhere where they are offered better payment remunerations. For example nurses in Canada are leaving to work in America and other countries creating a shortage in Canada. (Andrews & Watson, 2005) The figure below shows the demand estimates for full time nurses in hospital and home cares between 2005 and 2025 in Canada. Source; (Canadian Nurses Association, 2005) According to the studies shortage of nurses in Canada is caused by a multifaceted mix of demand and supply factors. Some of the factors are demographics, globalization recruitment policies and working conditions. (McIntyre & Thomlinson, 2003) Conclusion The current nursing shortage is a complex and historical problem that was created by short sighted polices by the government of downsizing and reducing of funds which were undertaken in 1990s resulting to poor working conditions. This led to a high number of nurses leaving the country to work in other countries and others leaving the profession. Globalization is also another reason that has contributed to the shortage of nurses has the world nursing market has become competitive and many countries are seeking highly qualified nurses. In order to correct this situation the whole society has to take initiative and new policies have to be formulated especially those that create better working conditions for example better wages and salaries for the nurses. Otherwise, Canada will continue to face nurse shortage until they create attractive working conditions and atmosphere for their nurses. Reference: Almada, P. et al. (2004): Improving the retention rate of newly graduated nurses. Journal for Nurses in Staff Development, 20(6), 268-273. Andrews, J. & Watson, R. (2005): Nursing and Healthcare Management and Policy: Employment transitions for older nurses: Qualitative study. JONA, 51(3), 298-306. Bower, F. L. & McCullough, C. (2004): Nurse Shortage or nursing shortage: Have we missed the real problem Nursing Economics; 22(4) 200-203. Canadian Nurses Association (2002): Code of Ethics for Registered Nurses; Retrieved from www.cna-aii.ca accessed on 19/11/07 Canadian Nurses Association (2005): Health care system in crisis: More RNs needed now. (Communiqu) Ottawa: McLean, T. & Anema, M (2004): Reduce the nursing shortage: Help inactive nurses return to work. The Journal of Continuing Education in Nursing, McIntyre, M & Thomlinson, E (2003): Realities of Canadian Nursing: Professional, Practice, and Power Issues-US- Publisher: Lippincott Williams & Wilkins Ross, S. J. et al (2005): Nursing Shortages and International nurse migration. International Nursing Review, 52, 253-262. Read More