Ethical Manuscript - Ethical consequences/implications of nursing shortages - Assignment Example

?Ethical Manuscript - Ethical Consequences/Implications of Nursing Shortages Affiliation with more information about affiliation, research grants, conflict of interest and how to contact Ethical Manuscript - Ethical Consequences/Implications of Nursing Shortages... Introduction: The ‘Advanced Journal of Nursing’ has published several articles on the topic of ‘nursing shortages and ethical implications.’ Data was gathered and analyzed from several model articles relating to health resources and services administration. Nursing practice issues have ethical components regarding healthcare practice. Implications for Nursing: Nursing implications refer to elements that are connected to nursing, such as medicines, diseases as well as the procedures. Nurses are the main health care labor force in the nation and there are almost three million of these diligent and committed nurses working in the country. Nursing care is given to people in all health care surroundings. Increasing difficulties and rapid changes in health care arises the need to develop patient care, technical advances, revolutionize the practice of nursing and so on. Nursing theories do not give direction on how to care for the adults and elderly, or on how to sustain them in the developmental process of aging. Therefore, there is a need to increase a nursing care model that in excess of modern theories takes an aging person into deliberation. Others agree that nursing needs to increase more circumstances that would create certain theories to guide nurses on how to treat the aged people. The two main new theories in nursing are – “the functional consequences theory and thriving theory” (Mauk, 2010, p.65). Nurses are mainly depended on for managing this detonation of new equipment, frequently without knowledge of their basis. While equipments and new procedures offer chances to progress health care delivery, actual and potential impacts arise with relation to these new procedures as well as tools and can be a reason for medical errors committed by them. Multidisciplinary methods regarding patient care require nurses to be obedient of the implications of evidence-based performance on the control of nursing. Nursing shortage means a condition where the demand for nursing experts, for instance registered nurses, exceeds the number of nurses actually available, locally, nationally or globally. In the book ‘Transformational Nursing Leadership: A Vision for the Future,’ Anne M. Barker suggests that most nursing departments have a written “philosophy of nursing, which states that nurses use the nursing process” (Barker, 1992). The stable purpose of the nursing division should contain some statement about the use of the nursing procedures. Frequently this is not affirmed in the departmental objectives. But sometimes, staff nurse candidates are questioned or chosen by considering their nursing procedure. (Transformational nursing leadership: a vision for the future, pg-133, 1992. Anne M. Barker.) Demographic transformations in the coming decades may be worsened due to the shortage of nurse assistants in hospitals as well as homes. As the population grows, demand for nurse assistants is expected to grow dramatically, while the supply of workers who have traditionally filled these jobs will remain almost unaffected. Following are the impacts that scarcity of nursing causes to the health care manufacturing and the state financial system: •Nursing is a well-paid profession as compared to the rising number of low-wage service jobs being formed. This raises independence and reduces the need for assistance. • The nursing career increases job opportunities and thus results in employment of people. •Dislocated employees can get a full time job and ensure good wages with the help of nursing. This is chiefly true in the case of rural areas like Minnesota, where job chances are restricted. •Nursing is a specialized career and it proposes the capacity for people to obtain degree, gain knowledge and then maintain their education. For instance, if a person does not have enough money to obtain a bachelor's degree instantly, they can create as an authorized nursing supporter, labor in the field whereas receiving a 2 year listed nursing degree and then labor whereas receiving a 4 year registered nursing degree. A person can pursue a master's degree too and turn into a highly developed practice nurse. This includes clinical nurse specialists, nurse practitioners, nurse anesthesiologist and nurse midwives. Nursing assessment is a critical step of the process and is important in determining interrelationships between individuals and families. Giger and Davidhizar (1991) suggest six cultural phenomena that nurses require to recognize in order to give effective treatment to all patients. These phenomena connect to transcultural treatment in the post genomic period. “They include communication, space, social organizations, time, environmental control and biological factors” (Jenkins & Lea, 2005, p. 262). Knowing the communication norm in a particular culture is significant to help communication and reduce miscommunication. A Registered Nurse (RN) is a person who holds a multistate license to practice professional nursing in the state and is required to conduct professional services without compensation, also if required to promote heath in the state. Registered nursing requires special qualification and judgment skills. “The three typical educational paths to registered nursing are a bachelor's degree, an associate degree, and a diploma from an approved nursing program” (Occupational Outlook Handbook, 2010-11 Edition, 2009). A study conducted in Virginia revealed that the scope of practice of registered nurses in Virginia is based on the state’s definition of nursing practice and there are separate laws for the initial license as well as the continued or renewed license. Nurses are considered to be less in number when the nurse to patient ratio is less or the nurse to population ratio is less. Registered nurses mainly appear to be less in number because the number of patients has increased. One of the main reasons why a shortage of nurses was felt was because many of the registered nurses enrolled for higher education. These nurses, when enrolled as students, do not attend the hospitals and, therefore, there are only a few nurses available in hospitals. “Although students who earn an associate degree in nursing are able to more rapidly enter the workforce, this may have unintended consequences in relation to the nursing profession as whole” (Truelove, 2008). Nursing shortages were noticed in the late 1990s and several causes of nursing shortages were found to be due to licensure delays, poor working conditions as well as the salary and wage requirements. It is necessary for hospitals to create an atmosphere in which the nurses get a free environment to treat the patients. When nurses are satisfied with their work environment, the hospitals will be able to retain them. From the ‘Advanced Nursing Journal,’ an article called ‘Transition Shock: The Initial Stage of Role Adaptation for Newly Graduated Registered Nurses’ states that the new nurses identify their professional adjustment with the feelings of anxiety and insecurity. The shortage of nurses, especially registered nurses, is a cause of real concern as it reduces patient care and increases the number of patient deaths or lack of care for patients. The shortage of nurses is an ethical issue as the shortage affects the total moral values in the organization. Registered nurses are the largest group of professional nurses in the United States and there are more than 2 million registered nurses who are employed in the health care sector in this country. There is shortage of registered nurses in the US and another factor for this is the less number of new registered nurses who turn up each year. Another reason is only highly experienced nurses can be taken into the category of the registered nursing workforce. But due to the increased age of the registered nursing work force, the efficiency of the nurses reduces and this impacts their work life. When registered nurses continue to grow old, they start becoming incapable and eventually will not be able to meet their long-term work requirements. Therefore, one of the prime causes of the decrease in the number of registered nurses is because of the aging workforces who are less efficient in their duty. Ethical Issue: Nursing shortages and ethical concerns Nursing ethics were primarily indented to create awareness among the nurses regarding their duties and responsibility towards the society. Nursing ethics include the profession’s commitment to respect, promote and protect the rights of patients as well as the providers of health care. “Nursing ethics are the major basis of nurses in making moral judgments on certain situations” (Gilford, 2011). The nursing profession identifies and accepts the critical relationship between health and human rights. It also has made a powerful contribution in improving health among the public. Nursing ethics provide guidelines to respect a patient’s confidentiality and autonomy. It is the duty of a nurse to conceal the details regarding the patients, but in certain circumstances, the nurse or clinic can disclose the information provided by the patients only on the interest of public. “The British Royal college of Nursing stressed that the primary duty of nurse is to work to restore the optimum degree of autonomy to the patient that is compatible with what has been lost as a result of disease, injury or mental disorder” (Thompson et al. 2001, p. 18). Nurses are liable to provide quality treatment to patients. Every nurse should have the knowledge, skill and experience to provide safer treatment to patients within the boundaries of their professional role. Nursing shortage would affect the values and beliefs of the profession and they may not be able to fulfill their responsibility to the society. Nurses are obligated to provide quality treatment and care to all patients irrespective of their lifestyle, values or nature of illness. “Nurse staffing is a matter of major concern because it greatly affects patient safety and quality of care. During a nursing shortage, the delivery of safe, quality patient care can suffer, as the tendency is to create short-term fixes to workforce demands, which ultimately fail to address the real problems” (Position Statement: RN Staffing Effectiveness and Nursing Shortage, n.d., para. 3). They should respect the dignity of patients and should provide the best possible treatment and care to their patients. Patient safety is an important aspect of this profession and requires the nurse to ensure the safety of patients while treatment. The nurse is supposed to tell the truth to patients, as according to their professional ethics, they should disclose the facts to the patients pertaining to the treatment they would receive. Nurses should explain all aspects related with treatment to the patients and must gain support from them. “With shortages of nurses reaching critical point throughout the world, this issue is going to become worse before it becomes better” (Quan, 2007, para. 5).       Shortage in nursing make problems in the treatment the limited numbers of nurse cannot make the attention in large numbers of patients high nurse- patient ratio would bring the fatigue frustration stress etc in their work. The shortage of nurses leads to many problems, such as the hospital may not be able to provide quality treatment to the patients, available nurses would have to toil continuously for longer periods of time, which would create frustration towards the work etc. This would create a lot of negative impacts for the public as the quality of treatment will be decreased and the patients would have to wait for a long time to get treatment. Due to the lack of sufficient staff, the patients would be shifted to other hospitals, but if they are closed then it would affect the confidence of public in health care. So the public is affected, likewise, the existing staff also faces a lot of difficulties as they have to work for a long time to provide treatment to all patients. The various reasons for the shortage of nurses include the nurses being compelled to work for a long time and not getting adequate compensation for their work. The declining number of applicants to nursing schools is also another reason as the nurses, especially women, seek jobs in other sectors to earn more income and increase their standard of living. The shortage occurring in nursing can be conquered with the help of collaborative efforts from health care professionals, practitioner’s government as well as the media. To retain nurses and to get quality service from them, they should be provided good training and education. They should not be made to work overtime because when they get exhausted, they will be unable to use their potential to the maximum. Providing good working conditions to the nurses is equally important and they should also be taught on how to utilize the new technologies. “Improve conditions in the work place enhancing collaborative relationship between physicians and nurses and developing the work force of other health care personnel” (Feldman, 2003, P. 9). Nursing schools should develop good facilities for the students that would attract maximum students to nursing field. These students should be provided necessary assistance such as loans, scholarship and grants for studying the nursing course. Moreover, appropriate faculties should be appointed and they should be provided better remuneration as well.       The persistent deficiency in nursing is challenges the values and morals of the job of nurses and forces them to inquire how they can accomplish their ethical duties to patients when there is an inadequate quantity of the workforce available and also the nurses are not equally present in all hospitals. Nurses convey the satisfaction of their job, experiencing ethical agony, and wondering regarding their incapability to offer quality patient care. In this article, it tries to speak to the dedication to care for patients and the ethical and moral problem by way of which nurses are struggling. Safety of the patients is a critical and essential constituent of quality nursing care. The truth is that the job of nursing will be incapable to compete by way of the countless of other job opportunities unless develop working circumstances, enlarge compensations over the life span of the registered nurse and offer clinical practice chances and duties that match the registered nurse's awareness and ability. It is hard to deal with safety of the patient without acknowledge the present nursing deficiency and its impact on performances. The “Registered Nurse” (Occupational Outlook Handbook, 2010-11 Edition, 2009) employees are become old in the near term and decrease in the longer period (Buerhaus, 2000).         Code for Nurses American Nurses organization in the year of 1985 affirms that the nurse participate in the job attempts to establish and maintain circumstances of employment favorable to extremely high class nursing care. The interpretive declarations extra add the duty for circumstances of employment" and "preserving circumstances for high class nursing care. As expert says that, registered nurses are really caught among the strong need to keep to the Code for Nurses at the same time as struggling to impact an ever altering health scheme where others' inspirations may be dissimilar. Ethical consideration is essential in systematic review so that studies that are unethical by way of insufficient consideration are not taken into account. (Vergnes et al (2010). Vergnes et al suggested that considering ethical features in systematic review would help develop the ethical and procedural quality to identify the nursing shortage and ethical consideration. Stewart et al (2002) recommends that specialist nurse services assists in increase the quality of life. So that shortage of nursing leads to lack of ethical practices in the hospital.  This also accounts for decreased cost and also a better effectiveness of the health care system. Over the last few years, the roles of nurses have climbed up the ladder helping nurses adopt to some of the roles that were exclusively undertaken by doctors. Advanced nursing role started in the year of late 1960s in United State. To speak to the various issue of meeting the necessitate of patients in the society and rural settings the final advanced nursing role –Nurse Practitioner (NP) or Advanced Nurse Practitioner (ANP) was launched. And in the current health scenario the nurse practitioner role has considerably spread around the world. Sweet (2009) declared that advanced nursing roles could facilitate in heath promotion, disease avoidance, and alteration of various risk aspects and in adopting evidenced-based performances. On the other hand, nursing education and training has facilitated nurses cross over the traditional specialized boundaries to accomplish advanced skills in diagnosing patients and prescribing medications. A plethora of studies disclose that nurse’s roles would be a successful intervention in the current health care system. Role of nurses in health care practices are increased dramatically in recent years. So that ethical practices of the nurses helps to increase the patient’s satisfaction as well as overall functioning of the community. “Ethics in nursing is focused on the standards of nurses' behavior as professionals, the right and wrong conducts in nursing procedures and responsibilities” (Gilford, 2011). Conclusion: Nursing ethics is an important concept the ethics implies the relationship between nurses and the patients. Nursing ethics is pertained with respect the human right moral and dignity and provide the nurse’s behavior as a profession. Among the 2.5 million nurses registered in the United States, almost 82.5 percent of them engaged in the role of nursing, constitute the biggest number of health care professionals in the US. The vibrant impacting the requirement and supply demand for registered nurses, mainly in this current atmosphere, are frequently dependent and changeable on forces, for example Medicare and Medicaid recompense, that are currently away from the nursing's power. Shortage in nursing sector would bring severe problems in health care such as the nurses would not be able to provide full attention on the patients. High patient nurse ratio monotonies the work and it will affect the quality of service rented by the nurses. Due to the lack of sufficient nurses the patients can not be admitted to the ward. There are various reasons for the shortage of nurse such as declining in the admission of new students in the school continues over time work and improper payment structure etc. There should take appropriate steps to attract maximum candidate in the nursing field such as provide scholarship financial assistance and loans to students for pursuing the nursing course, offer good salary to them, make better working time, provide good working conditions , and provide good dignity to their profession. Reference List Barker, A. M. (1992). Transformational Nursing Leadership: A Vision for the Future. National League for Nursing Press. Retrieved Sep. 26, 2011, from http://books.google.co.in/books?id=SsU1eGCygaEC&printsec=frontcover&dq=Transformational+nursing+leadership:+a+vision+for+the+future,+1992.+Anne+M.+Barker.&hl=en&ei=SBWATvaMEOSriAe99qGuDg&sa=X&oi=book_result&ct=result&resnum=1&sqi=2&ved=0CDEQ6AEwAA#v=onepage&q=philosophy%20of%20nursing&f=false Feldman, H. R. (2003). The Nursing Shortage the Strategies for Recruitment and Retention in Clinical Practice and Education. Springer Publishing Compny, Inc. Retrieved Sep. 26, 2011, from http://books.google.co.in/books?id=cSGsxrIdRNkC&pg=PA35&dq=nursing+shortage+and+ethics&hl=en&ei=CByATur2IInnrAennvH-Dw&sa=X&oi=book_result&ct=result&resnum=3&sqi=2&ved=0CDsQ6AEwAg#v=onepage&q=nursing%20shortage%20and%20ethics&f=false Gilford, S. (2011). Nursing Ethics. Sooper Articles. Retrieved Sep. 26, 2011, from http://www.sooperarticles.com/careers-articles/career-management-articles/nursing-ethics-345502.html Jenkins, J. F. & Lea, D. H. (2005). Nursing Care in the Genomic Era: A Case-Based Approach. Jones & Bartlett Publishers, Inc. Retrieved Sep. 26, 2011, from http://books.google.co.in/books?id=FVzeWhNslMEC&printsec=frontcover&dq=Nursing+care+in+the+genomic+era:+a+case-based+approach,+2005.+Jean+F.+Jenkins,+Dale+Halsey+Lea.&hl=en&ei=ghqATq_vFMPmrAfroMzZDw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC0Q6AEwAA#v=onepage&q=environmental%20control&f=false Mauk, K. L. (2010). Gerontological Nursing: Competencies for Care. Jones & Bartlett Publishers, Inc. Retrieved Sep. 26, 2011, from http://books.google.co.in/books?id=HbNsoi664-wC&printsec=frontcover&dq=Mauk,+Kristen+L.+Gerontological+nursing:+competencies+for+care,+2010&hl=en&ei=mRSATvPiF8jjrAfRh-nVDw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CC0Q6AEwAA#v=onepage&q=thriving%20theory&f=false Occupational Outlook Handbook, 2010-11 Edition: Registered Nurses, (2009). Bureau of Labor Statistics. Retrieved Sep. 26, 2011, from http://www.bls.gov/oco/ocos083.htm Quan, K. (2007). The Nursing Shortage. Health Field. Retrieved Sep. 26, 2011, from http://kathyquan.suite101.com/the-nursing-shortage-a13692 Position Statement: RN Staffing Effectiveness and Nursing Shortage. (n.d.). Nursing Prctice: NYSNA.org. Retrieved Sep. 26, 2011, from http://www.nysna.org/practice/positions/position13_a.htm Thompson et al. (2000). Nursing Ethics. 4th Edn. Elsevier Limited. Retrieved Sep. 21, 2011, from http://books.google.co.in/books?id=imdHTVjW_B8C&printsec=frontcover&dq=nursing+ethics&hl=en#v=onepage&q&f=false Truelove, K. S. (2008). Educational Preparation as a Predictor of Registered Nurse Retention. Arizona State University. Retrieved Sep. 26, 2011, from http://books.google.co.in/books?id=_bLEZzGmOeMC&printsec=frontcover&dq=Educational+preparation+as+a+predictor+of+registered+nurse+retention,+Sandra+K.+Truelove,+Arizona+state+University+%E2%80%93+2008&hl=en&ei=TBuATpn8I8O8rAfq1anrDw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDAQ6AEwAA#v=onepage&q=reasons%20why%20a%20shortage%20&f=false Read More