Review of a Current Healthcare Issue: Nursing Shortage Discussion
Organizational Policies and Practices to Support Healthcare Issues
Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.
For example, using 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care? Review of a Current Healthcare Issue: Nursing Shortage Discussion
In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of policies to address that issue.
To Prepare:
Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1 (please see attached).
Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.
Post an explanation of how competing needs, such as the workforce, resources, and patients, may impact policy development. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.
Review of a Current Healthcare Issue
Healthcare sectors worldwide work tirelessly to provide the best possible care to patients. However, challenges like a lack of adequately trained and regulated care providers may stymie the process. According to a report by the United Nations High-Level Commission on Health, Employment, and Economic Growth, investing in education and job creation in the health and social sectors results in a triple return of improved care outcomes, global health security, and inclusive economic growth (Organization for Associate Degree Nursing, 2020), emphasizing the importance of having an adequate number of healthcare workers. Since nurses make up most of the healthcare workforce, their scarcity impedes the delivery of effective healthcare services. This paper aims to describe the nursing shortage as a national healthcare issue and stressor, highlight its impact in my work setting, and provide a summary of two articles related to the issue and strategies to address it. Review of a Current Healthcare Issue: Nursing Shortage Discussion
Description of Nursing Shortage
Nurses and midwives are arguably among the essential healthcare workforce members. A nursing shortage occurs when the demand for nursing professionals exceeds the supply locally (for example, in a healthcare facility), nationally, or globally (Haddad et al., 2022). The World Health Organization (2022) estimates that there are 27 million men and women in the nursing and midwifery workforce globally, with 3.9 million individuals working in the United States. Nurses and midwives account for more than 50% of the global health workforce, highlighting the apparent severity of their shortage in healthcare. Haddad et al. (2022) attribute the nursing shortage to a variety of factors, including an aging workforce (about 1 million registered nurses are older than 50, implying that a third of all nurses in the United States will reach retirement age in the next 10 to 15 years), nurse burnout, career advancements, family migrations, and violence in healthcare. The impact of the nursing shortage is felt across all healthcare organizations due to nurses’ and midwives’ frontline roles in care delivery across various settings.
Impact of Nursing Shortage in My Work Setting
I work in a primary care organization, specifically, the medical surgical department, where we treat patients with various medical and surgical conditions. We have had issues, particularly with perioperative nurses, whose low numbers jeopardize the delivery of effective perioperative care. According to statistics released by our administration last year, the medical surgical department admitted 3956 patients, 1477 of whom had medical conditions and 2479 of whom had various surgical conditions. 1136 of the 2479 patients had multiple types of surgeries. Thirty-four people died postoperatively while still in the hospital, representing a 2.99% postoperative death rate. According to the hospital’s report, some deaths were attributed to poor postoperative care due to a shortage of perioperative nurses. As a radical measure to reduce postoperative deaths, my facility incurred additional costs in training other nurses about perioperative care, a three-month training in which the facility spent approximately $10,000 for each of the ten nurses, an incident that nearly resulted in the facility’s financial crisis. As a result of the nursing shortage, my facility has suffered a financial blow and has reported the highest post-operative deaths in the last five years.
Beitz, J. M. (2019). Addressing the perioperative nursing shortage through education: A perioperative imperative. AORN Journal, 110(4), 403–414. https://doi.org/10.1002/aorn.12805 Review of a Current Healthcare Issue: Nursing Shortage Discussion
The aging nursing workforce and other reasons for nurses leaving the profession have resulted in an unprecedented nursing shortage. According to Beitz (2019), many current perioperative nurses are retiring or leaving the field for other reasons, necessitating a strategy to increase the skilled perioperative workforce. In response to the perioperative nursing shortage, the Association of Perioperative Registered Nurses (AORN) invited 79,336 potential respondents to participate in a survey during the summer of 2018. There was a 4.7% (n=5343) response rate, with only 3754 usable responses (Bacon & Stewart, 2018). According to the survey, the average age of the respondents was 46%, and 76% were between the ages of 30 and 60, indicating that the nursing workforce is aging. 28% of respondents said they wanted to leave the profession for various reasons. In the study, perioperative nursing education is proposed as a solution to the shortage.
The need for a solution stem from the severe consequences of the shortage of perioperative staff. According to Beitz (2019), the shortage impacts patient safety, which is supported by the 2014 statistics that 11493199 patients underwent surgeries in the ambulatory setting and that even as the numbers increase, there is an increased need for competent perioperative nurses. Furthermore, Beitz (2019) estimates that a shortage of perioperative nurses has a negative impact on hospital finances due to the cost of orienting and educating inexperienced nurses, which can cost $88000 per nurse in some parts of the United States. The shortage can be addressed by incorporating perioperative nursing education into nursing curricula, which can be accomplished through one of five models: nursing program perioperative electives, perioperative content integrated into required clinical nursing courses, perioperative content integrated into the theory of nursing needed courses, internship or externship programs through academic-clinical partnerships, and perioperative content integrated into required nursing theory courses (Beitz (2019). The elective, fellowship, and academic clinical partnerships will benefit my facility, resulting in improved patient safety, lower perioperative mortality, and increased revenues. Review of a Current Healthcare Issue: Nursing Shortage Discussion
Yun, M. R., & Yu, B. (2021). Strategies for reducing hospital nurse turnover in South Korea: Nurses’ perceptions and suggestions. Journal of Nursing Management, 29(5), 1256–1262. https://doi.org/10.1111/jonm.13264
Given that the factors that cause nurse turnover are the root causes of the global nursing shortage, it is prudent to implement strategies to reduce rising nursing turnover. Despite the government’s recent efforts to improve working conditions, high turnover rates continue to challenge the South Korean health care system. Yun and Yu (2021) conducted a qualitative study using focus group interviews with 33 nurses from 11 South Korean hospitals. The nurses attributed the ongoing nursing shortage to three themes based on their interviews: excessive workload, mistreatment of nurses, and poor organizational and societal cultures (Yun & Yu, 2021). Based on the themes, nurses proposed methods for reducing turnover, which would help to address the nursing shortage.
To reduce workload, it is critical to address the patient-nurse ratio. The nurses said they had to work off the clock, sometimes without eating, to complete the workload within the allotted shift time (Yun & Yu, 2021). The nurses requested that the required staffing members be calculated based on the patient census and the acuity of each patient’s condition. Furthermore, the nurses said they are sometimes forced to perform non-nursing responsibilities, increasing their workload. They thus requested strict adherence to their scope as a strategy to reduce the burden on them. Other potential strategies suggested by nurses to reduce turnover and shortage are fair compensation, good job orientation for novice nurses, and supporting their work-life balance (Yun & Yu, 2021). My organization can implement the following strategies: fair compensation, better orientation of novice nurses, strict adherence to nursing scope of duties, motivation such as recognition for a positive endeavor, and an effective work-shift arrangement in which nurses are not forced to work off their time. Such strategies will produce a pool of motivated perioperative nurses who will give their all to improve patient safety. Review of a Current Healthcare Issue: Nursing Shortage Discussion
Conclusion
When many expert nurses are retiring or leaving for other reasons, there is an increased need to develop a strategy that ensures nurse retention and prevents further turnover. In my facility, the surgical department had the highest post-operative death rates for the first time in five years. We suffered a financial blow after spending a lot of money training inexperienced nurses to take over perioperative nursing duties. To avoid further shortages, hospital organizations have developed radical measures, with some investing in perioperative nursing education through various programs such as electives fellowships and academic clinical partnerships. In contrast, others consider providing a fair wage, promoting nurses’ work-life balance, and providing a better orientation for novice nurses. It is thus within an organization’s forte to develop an effective strategy that will lead to the achievement of its objectives. Review of a Current Healthcare Issue: Nursing Shortage Discussion
References
Bacon, D. R., & Stewart, K. A. (2018). Results of the 2018 AORN salary and compensation survey. AORN Journal, 108(6), 602–619. https://doi.org/10.1002/aorn.12424
Beitz, J. M. (2019). Addressing the perioperative nursing shortage through education: A perioperative imperative. AORN Journal, 110(4), 403–414. https://doi.org/10.1002/aorn.12805
Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2022). Nursing Shortage. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Organization for Associate Degree Nursing. (2020, April 8). OADN applauds State of the World’s nursing 2020: Investing in Education, Jobs and Leadership Report –. Oadn.org. https://oadn.org/news/oadn-applauds-state-of-the-worlds-nursing-2020-investing-in-education-jobs-and-leadership-report/
World Health Organization. (2022). Nursing and midwifery. Who.int. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery
Yun, M. R., & Yu, B. (2021). Strategies for reducing hospital nurse turnover in South Korea: Nurses’ perceptions and suggestions. Journal of Nursing Management, 29(5), 1256–1262. https://doi.org/10.1111/jonm.1326 Review of a Current Healthcare Issue: Nursing Shortage Discussion
