Shortage of Nurses - Research Paper Example

? Shortage of Nurses Introduction Shortage in nursing staff has been a serious concern forthe most countries, both developed and developing countries. Nursing shortage referrers to a situation where the available nursing staffs are less than the number of patient requiring nurse’s care. Nurse patient ratio should be adequate to achieve the required quality of care. Nurses play a vital role in the care for both inpatients and outpatients. Because of this shortage, many countries and hospital management has taken the initiative of training more staff in order to attain the required nurse patient ration. Current global shortage of nursing staff has contributed to an increased number of mortality rates. Causes of nursing staff shortage Shortages of nursing staff have been attributed to various factors; addressing these factors can drastically reduce these shortages. Issues related to these shortages include insufficient enrollment of students into the nursing profession, underinvestment by the involved country’s government into health sectors, high turnover rate, poor working conditions, rapid increase in population, increased incidences of rare diseases, and few number of institutions offering nursing education (Andrist et al, 2006). Insufficient enrolment into nursing Students enrolling for nursing education are far much below to address the existing shortage. According to the survey by international nursing council, the number of students enrolling for the nursing profession is below the expectation to address the shortage of staff, and there is a need to increase the number of intakes. Comparing the number of students enrolling for other faculty and with those entering into nursing, few students pursue nursing profession. Reasons for this low enrollment have been contributed by the poor pay that nurses receive, poor working condition, long working hours, and high cost associated in training. Nurses work hard to improve the quality of patient’s life. Despite deplorable working condition, nurse’s wages are much below, hence shying off many students. Because of shortage in staff, nurses end up working for many hours than expected working hours. Most of institutions offering nursing education charges high fee, increased cost in educating nursing student has led to many parents and guardians to convince their children to pursue other courses that are less costly and have better pay (Cowen & Moorhead, 2011). Another contributing cause of the shortage in the nursing industry is an inability of nursing schools and college to enroll a large number of students. According to America, association of nursing (AAN) there has been regulation in the number of annual intake in nursing college. According AAN, the Regulation in number of students is to avoid flooding the industry with many nurses. Despite an increase in the shortage, colleges have not taken an initiative to increase the number of nurse’s students. In addition, the numbers of institutions and colleges offering nursing training are few. This has translated to reduce in number of students enrolling for nursing (Kalisch, 2004). Underinvestment in health sectors Most of the developing countries have invested a lesser amount of their budget in health sectors. In Philippines, the country invests 3.6% of their gross domestic income to health sectors. This is contrary to what United States invests; it invests 16% of their gross domestic income. Because of this underinvestment, it has been difficult to attain millennium development goal (MDG) where it aimed at reducing child mortality rate and improving maternal health. Because of poor investment, it has led to poor recruitment programs. Less number of nurses are employed annually; this weak recruitment has failed to breach the gab in the existing shortage. In addition, due to less investment, nurses are paid less salary; inadequate wages have shy off many student to pursue nursing, hence causing a shortage of nursing staff (Kalisch, 2004). Poor investment has also contributed to poor hospital infrastructure. Most of the hospitals do not have adequate hospital facility and equipment to improve the quality of patient’s life. Inappropriate facilities have resulted in many nurses resigning their position or seeking better positions such as managerial posts. High turnover rate High numbers of nurses have resigned from their profession due to various reasons. One of the contributing factors to this high turnover rate is lack of equipment and facility. Large numbers of nurses have resigned their duties due to burnout. Lack of facilities and poor working environment led to nurse’s high turnover rate. Insufficient balance between personnel and resources available contributes to high turnover. It is therefore, necessary for each country to improve the quality of working environment to retain more nurses hence improving on the quality of care delivery (Mason & Colby, 2011). According to international nursing council, about 90% of nurse’s works in poor working condition. Working condition entails facilities and equipment in the hospitals, nurse’s internal publics and salaries they are paid. In developing countries, there is lack of infrastructure development, leading to nurses using more forces and power carrying out their tasks, hence shying off most of the students from joining the industry. In internal publics, there has been a wrangle or misunderstanding between doctors and nurses, hence; nurses referred as a helper of doctors. Less people prefer working in an environment where they have no control. Leadership in nursing and nursing industry has been associated with women, many men fear to enter in an industry where it is highly dominated with women. College selection should not favor any gender and encourage more men to enter into the industry (Mason & Colby, 2011). Brain drain In most developing countries, they pay low salaries to nurses, because of poor wages, nurses relocate to developed countries in seek of greener pastures. Developed countries benefit from brain drain, as they are able to reduce their shortages. On the other hand, developing countries continues to suffer from a shortage of nursing staff. In South Africa, nurses work only for one year to gain the required experience. With adequate experience, nurses seek job outside borders especially Britain and United States (McConnell, 2000). Enlarged population Population increase has been the foremost concern for many countries. In recent year, the estimated population density has been skiing rocketing. Increased population translates to an increased number of patients seeking health care, hence increasing the number of patients in the hospital setting. Despite the high number of patients in wards, number of nurses has remained constant, hence increasing workload of nurses. Increased workload has lead to burnout leading to more nurses resigning. With resigning, it leads to worsening the situation causing more and more shortage of staffs. Poor distribution of nurses is characterized in most developing countries. Most of The referral hospitals have adequate nursing staff compared to district and regional hospital. Despite most of the conditions being managed at the regional level, they have a shortage of nurses, hence poor delivery of care. Therefore, mal-distribution of nurse in a country results to the nursing shortage. Increased incidences of rare diseases In the recent years, there has been an increase in cases of rare diseases; especially cancer and diabetes. Most of The nurses are not trained to handle this kind of emerging diseases. Therefore, increased incidences of rare diseases have led to shortage of nursing staff specialized in this field. Continuing nursing education With increased institution of higher learning, vast majority of nurses continue with education to specialize in one specialty. About 40% of nurses that have advanced their skills and knowledge shift from their working environment to another with a better environment. These shifts from one working environment to another create shortage in nursing. According to Mason and Colby, about 34% of nurses that have advanced their education, they tend to seek managerial position rather than bedside nursing. About 17% of nurses who have advance on their education, they changed their career from nursing to the teaching profession (Mason & Colby, 2011). Impact of the Nursing Shortage Nursing shortage has affected the quality of care delivery. Quality of care delivered, heavily depends on the ratio between nurses and patient. Due to increase the number of patients in hospital, the quality of care delivered is highly affected. According to McConnell, the increased rate of mortality is highly a credited by a shortage of staff (McConnell, 2000). Some of the procedures required by patient end up not performed effectively, nurse rush to serve a large number of patients. Because of this rush, the quality of care delivered in not enough to improve the patient’s worth. In Philippines, most of immobile patient admitted between May 2011 and June 2011, were discharged with bedsores and other complications. According to research by Huber, patients seeking medical intervention from overstretched hospitals; less qualified nursing staff, are at risk of developing fatal complications. About 28,000 patients die every year due to medical complications, which can easily be avoided with adequate nursing staff (Huber, 2006). Nursing shortage has largely contributed to dissatisfaction in the profession. Nurses need to work for long hours to compensate shortage of staff. Recommended working hour is about 8 hours, however, in some hospitals especially in developing countries nurse’s work for almost 12 hours. In addition to long hours, they also work in a deplorable working conditions and stressful condition leading to fatigue and injuries. In South Africa, about 300 nurses resign annually because of burnout (Huber, 2006). Solutions to Shortages Different measure needs to be taken into account to address the issue of nursing staff shortage. Government and relevant bodies governing nurses should join hands to address the matter at hand amicably. Increase enrolment in nursing schools To increase the number of qualified nurses, it requires each country facing these challenges to encourage students to enroll in nursing schools. This can be attained through government sponsoring students. One of the hindrances for a student taking nursing profession is the high cost of training. According to Mertig (2003), most of medical schools are extremely expensive; hence, many parents cannot afford paying fees for their siblings. When these students get sponsor from the government they will be encouraged to take nursing studies. It is also known that most of the medical schools regulate their intake; one of the major reasons for this control is lack of enough facilities to be utilized by a large number of students. The government to first ensures that these institutions have adequate resources to cater for a large number of students. After the school has enough resources, issue related to regulation will be a history hence curbing the shortage in the market and improving the quality of patients care. Improving government investment in the health sector Underinvestment in the health sector has been the main reason for poor working condition and poor pay among nurses. It has been estimated that most countries spent less than 5% of their domestic gross income into sector. For example, in Philippines, the government spent 3.5% of their gross domestic income; this is far much less than recommended according to the millennium development goal (MDG), which is 15% of the GDP. With sufficient funding in the health care system, it will enable the provision of adequate infrastructure and equipment required to deliver standard care (Satterly, 2004). Nurses will then work in an environment where they cannot use excess energy or excess workforces. In addition, due to increased investment in the health sector it means than there will be the utilization of technology. Improved technology will drastically reduce the time a nurse spent on one patient, hence, saving time and improving the quality of care delivered. Improved technology will change the image and perception of the hospital settings. Poor pay among nurse among nurses is because of low investment in the health sector. With increased investment, it will translate to a better salaries and allowances. Therefore, with better pay, it will change the perception of people about the nursing profession in terms of low wages and poor working environment. Weak recruitment of nurses in developing countries has been attributed with low investments in the health sector. Consequently, the government needs to invest in the health sector to ensure that more nurses employed are annually to curb these shortages. Increase in recruitment will also help to reduce long working hours among nurses and work overload. Hospital environment with good working conditions for nurses will change perceptions for many about the nursing profession, hence more students taking nursing (Satterly, 2004). Policy to regulate brain drain Brains drain being the main contributor to the nursing shortage in most developing countries. Countries such as United States should control the number of nurses entering into their country. United States should develop other strategies to curb the shortage, for example, they should train more students to breach the gab, rather than absorbing nurses from developing countries. Developing countries should improve pay and working environment for nurses so that to reduce outflow of nurses. They should also come up with policies, which control the number of nurses moving out of the country. These regulations will allow citizens to benefit from the better health care delivery (Huber, 2006). Improving nurses skills and knowledge In improving levels of nurses skill and knowledge, it will enable them cater for a wide spectrum of patients. With the emerging conditions and complications, nurses will be equipped with the required knowledge and skills to handle them. It is also beneficial for the government to control number of staff changing their career due to their better papers. Nurses should be allowed to work in hospital for a specific time before they can be allowed to seek managerial positions or changing their careers (Satterly, 2004). Recruitment and retention programs Each country facing a nursing shortage should consider recruiting more young nurses into the hospitals. There has been a trend that most hospitals require an individual to have experience of more than three years. This practice has locked out many young nurses to work in large hospitals, hence not curbing the shortage. In addition, the government should retain nurses that have already reached retirement age and they are willing to continue working. In most countries, when a nurse reaches age of 55 years, they are required to retire. The hospital then fails to get enough replacement leading to more shortage. Therefore, old nurses with experience should be retained in order to give support and mentor the young nurses entering into nursing line of work (Mertig, 2003). According to international nursing council, there is a need to have serious reforms in five different areas; macroeconomics and improved health sector funding policies, there is also needed for planning and workforce policy, constructive working environment, leadership, and better recruitment and retention. INC states that it is the mandatory for each government to address these five key reforms (Mertig, 2003). Conclusion Nursing shortage differs from one country to another, but they ultimately share effects on the health care delivery. The major contributor to these shortages is poor recruitment by the government because of low investment in the health sector. Low number of student enrolling in nursing has been other cause of the nursing shortage. Small number of student enrollment has been attributed with poor perception related with nursing, it is perceived that nursing is a profession where individual work for a long duration of time in a poor working environment characterized with poor leadership. These shortages in nursing have heavily affected the quality of care delivered portrayed with increased mobility rate. Government increase in the amount invested in the health sector can go a long way to reduce this shortage and working conditions. With better working environment, it will change unhealthy perceptions regarding nursing, hence improving the number of students taking nursing profession. The government providing incentives can achieve an increase in number of students enrolling in nursing. References Andrist, C., Andrist, C., Nicholas, K., Nicholas, K., Wolf, K. and Wolf, K. (2006). A history of nursing ideas. Sudbury, Mass.: Jones and Bartlett Publishers. Cowen, S. and Moorhead, S. (2011). Current issues in nursing (8th ed.). St. Louis, Mo.: Mosby Elsevier. Huber, D. (2006). Leadership and nursing care management (3rd ed.). Philadelphia: Saunders Elsevier. Kalisch, A. and Kalisch, J. (2004). American nursing: a history (4th ed.). Philadelphia: Lippincott Williams & Wilkins. Mason, J., Isaacs, L. and Colby, C. (2011). The nursing profession: development, challenges, and opportunities. San Francisco, CA: Jossey-Bass. McConnell, A. (2000). Burnout in the nursing profession: coping strategies, causes, and costs. St. Louis: Mosby. Mertig, G. (2003). Teaching nursing in an associate degree program. New York: Springer Pub. Co. Satterly, F. (2004). Where have all the nurses gone?: The impact of the nursing shortage on American healthcare. Amherst, N.Y.: Prometheus Books. Read More