Introduction Did you know that there is 126, 000 nursing positions unfilled in hospitals across the country ( Jackson, 2006) and the average nurse is 46 years of age? ( Alexandra, 2006). The public needs to see that the shortage of nurses is a major issue that is only going to get worse if something is not done about it. It has been shown that since the beginning of the shortage there has been an increase in mortality rates due to a increase of poor patient care.
If this nursing shortage continues it will only decrease the quality of care the public receives, increase costs, make hospital stays longer, and health care less effective and efficient. Teamwork, good communication, critical thinking, and problem solving are all things that are needed in the healthcare system but are minimized due to the nursing shortage ( Buerhaus, Donelan, Ulrich, & Norman, 2007).
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In this professional paper many issues will be discussed such as patient care, nursing issues, communication and teamwork, research, and effects of the shortage on nursing and on society. Patient Care When patients come into the hospital they are well aware of the kind of care that is provided for them and how they are the main focus. They are provided with the best possible care that can be provided from all health care workers. The patients don’t know what really goes on be hide the walls of their room and what the nurse really all does, not only for the them, but everyone else.
Nurses assess changes in their health and if a change is needed they make it and accommodate, catch medical errors that could safe the patient’s life, use teamwork with the healthcare team to ensure care is efficient, advocate for patients who cant speak for them selves or the doctors don’t agree with what is being Shortage 3 said, administer many medications all at one time for many different patients and ordered by different physicians and could be incompatible with one another.
Not only do nurses do this they also answer the call bells that never stop ringing, health teach patients, listen carefully, keep all their assigned patient’s pain under control, keep the area quite and have all this done for 8-12 patients depending on the area or hospital ( Murphy, 2007). The nursing shortage cases a lot of problems with the nursing care to the patients. This is because the shortage causes the nurses who are still in the nursing field to work harder to make up for the nurses needed. This causes burn out and stress levels to rise.
The nurses get tired and this doesn’t allow them to complete the work the best they can. This then involves patient safety. Nurses cant work with the efficiently and most effectively if they are stressed out and tired. ( Buerhaus, Donelan, Ulrich, & Norman, 2007). Since patient care isn’t as good as it should be patients are having to stay longer in the hospitals due to complications. This takes up beds for longer periods of times and being there is already a bed shortage it only makes it worse. Patients who are ill come into the emergency and are admitted but have no bed to go to, so they must be kept in the emerge until one opens.
This then takes up beds and rooms in the emerge causing a longer wait in the out patient part of the emergency department ( Kaestner, 2005). Just a few interesting facts to think about: Ninety percent of long term care facilities are lacking nurses so much that they cant even provide their residents with the most basic cares, Home healthcare organizations are being forced to not accept new admissions needing them, and 81% of the public is aware of the shortage, 65% thinks it’s a huge issue and 93% think it effects the care they receive ( Jackson, 2006).
Shortage 4 Nursing Issues The average age of the nurses of today is about 45 and by 2010 it will be up to 50. This is because of all the baby boomers and shortage starting in the late 1990’s ( Jackson, 2006). The shortage of nurses has put a strain on the nurses them selves. There is a higher burn out percentage now with more sick time occurring. This also is not good as it only makes the shortage worse, having no one to call to come in for the person who is sick. It really all is a just a vicious cycle.
The normal shifts for nurses are usually twelve hour long and having to work harder many nurses say they are tired before they even reach eight hours ( Weil, 2008). There has been an increase of workplace injuries due to the shortage and nurses having more of a workload and less time to do it. This sometimes puts nurses on light duties or once again off on sick leave (Kaestner, 2005). Nurses have become dissatisfied with there jobs and have had to resort to others to make them content and happy.
Mid-career nurses had the highest dissatisfaction along with those who worked with more critical cases such as acute care, medical/surgical patients, and intensive or cardiac care. There main reasons for be dissatisfied or leaving the profession were not enough compensation, not being happy in the workplace, and scheduling problems. There was many other reasons such as poor support systems, not being able to make their own decisions, no growth opportunities or very little, no recognition for everything they do, poor relations with staff or manager, or the intensity of the work just being too high.
Unsafe working conditions and on the job abuse was also mentioned by nurses. Abuse was normally verbal and given by physicians, as well as a small amount from patients being verbal and physical ( Jackson, 2006). One way that has Shortage 5 been thought of to relieve a little bit of the shortage is trying to bring back retired nurses, nurses who are licensed but not working in the field, or having nurses come in from out of country. It was shown that there was 490, 000 nurses not working as nurses in The United States of America, Thirty one percent of them being under the age of fifty.
The nursing shortage is a world wide problem. When these nurses were asked what it would take for them to return to the nursing profession the most common response was a more refresher courses available to them and a more flexible work schedule ( Williams, Stotts, Jacob, Stegbauer, Roussel, & Carter, 2006). Communication and Teamwork With the shortage there is a loss of communication and teamwork as nurses are other healthcare workers are stressed and over worked. They try and focus on the quality of the patients care and getting the basic care done rather then communicating and working together.
Teamwork makes things a lot easier but during the rush of things and the nurses being focused on there assigned jobs they seem to forget about this. Communication makes things easier so everyone knows what is going on, allowing things to not be repeated and time can be saved for other jobs that need to be done. It has been shown that teamwork improves quality of care and efficiency and that its not used enough even without the shortage of nurses. The shortage only makes it harder to be done.
This needs to addressed so that this problem can be resolved. This can make some of the stress from the shortage a little easier to deal with. The decrease in communication, teamwork and problem solving has caused professional relationships to take a down fall, thus making the work environment more stressful. These kind of issues are not Shortage 6 documented so they are not looked at. It is seen that the patient care is getting done as documented so the government is happy with the funding that is put out.
Unfortunately this is not the case and hospital executives and doctors need to document their perceptions and thoughts of what the nursing shortage is doing to affect patient care and work environment. In a survey done in 2004 it was shown that only fifteen percent of relations ships between physicians and nurses was perceived as excellent and only twenty five percent perceived there relationship to be good. It was also shown that nurse relationships with their manager were even worse.
To make teamwork even more difficult it was also shown that almost half the nurses that did the survey don’t have involvement in decisions about patient care and how it is delivered, as well as how nursing care is distributed and organized. Teamwork and communication are joined and work together. If there is better teamwork it leads to better communication which improves relationships, the working environment, and a better awareness of what each member is contributing to the team. Teamwork and communication will lighten work load and decrease burnout a slight amount, but every little bit counts ( Buerhaus, Donelan, Ulrich, & Norman, 2007).
Research The name of main article I used for this study was called Impact of the Nurses Shortage on Hospital Patient Care: Comparative Perspectives published in the Journal called Health Affairs. The authors are: Peter Buerhaus, a professor of nursing and also the director of the Center for Interdisciplinary Health Workforce studies at a University Medical Center in Nashville, Tennessee, Karen Donelan, who is a senior scientist in Shortage 7 health policy at a hospital in Massachusetts, Boston, Beth Ulrich, a senior vice president of professional services in a Healthcare Group in Dallas,
Texas, Linda Norman, who is a senior associate dean for nursing at a university/school of nursing, Catharine DesRoches, an instructor in the institute/ or Health Policy part of a Hospital in Massachusetts, and Robert Dtttus, a professor of medicine in the department of medicine at a University, also director of Geriatric Research, Education, and Clinical Centre for a Healthcare System in Nashville. All the authors hold appropriate positions for the article. The article was based all on the United States but considering that the nursing shortage is a world wide problem I didn’t see this to be an issue.
The article is Peer Reviewed and Copyrighted to The People to People Health Foundation, Inc. , Project HOPE (Buerhaus, Donelan, Ulrich, & Norman, 2007). “This study was conducted as part of a collaboration of researchers at Vanderbit University Medical Center and Massachusetts General Hospital to evaluate the Johnson and Johnson Campaign for Nursing Future. The campaign, a national initiative that began in February 2002, is aimed at increasing nurse recruitment in the United States , retaining nurses in clinical practice, and increasing the capacity of the nations nursing education programs. (Buerhaus, Donelan, Ulrich, & Norman, 2007, pg. 855). The study was done nationally with several different surveys. There was a survey for physicians, a survey for Nurses, and a also one for Hospital CNO’s and CEO’s. The data has not been skewed in any direction so the data is not bias or the article. The design of the article was easy to read and understand as it was in order. The results where shown in an over all, plus in sections for each of the surveys. The results showed everything including limitations and were not bias. In the conclusion it concluded the results and showed ways Shortage 8 o improve the shortage as we can not necessarily stop it. The funding of the surveys were appropriate and the information gone over by appropriate people. The abstract was short and gave me information that caught my attention. It had no stats and was important meaningful. It showed the major concern and the main results that were found. Overall this article was helpful and very useful for this paper. Effects on Nursing There are so many effects that the nursing shortage has on nursing in general that they cant all be listed. A few of the main points where discussed above in the beginning of the paper.
The main effects on nursing is sickness, burnout, stress, and time off. The shortage has the nurses working harder to make up for the nurses who aren’t there. This is causing the nurses to work longer hours, more of a patient load, more to worry about and organize, less teamwork and communication, and give them the feeling that they know they were not able to do all they could have or wanted to for their patients. When nurses where asked what they needed to feel more satisfied with their nursing job, the most common answer was that they needed more time to care for their patients in the way the patient deserved.
It is shown that fifty percent of nurses leave their first job just after two years ( Murphy, 2007). The shortage has causes the nurses to be frustrated easily and take it out on each other, thus ruining professional relationships and communication once again in a different way. With all the frustration, stress, being tired, and heavy work load, nurses are starting to believe it all isn’t worth what they are paid. Nurses are there for the best of times such as the birth of a baby, bringing new life into this world, and the worst of times, holding the hand of a patient who is scared to pass away and has no family to be Shortage 9 here with them ( Jackson, 2006). Many nurses don’t feel that their wages are not enough and they should be paid more. It has been shown that unemployment rates and nurses wages have had a significant impact on whether nurses decide to work in the nursing field or not. If this is not fixed it will lead to nurses getting tired and going to find a different career that has less stress and better wages, thus hurting the nursing shortage once again ( Anonymous, 2007). Effects on Society The nursing issue is not a new problem but something that is only getting worse with time.
This is due to a lot of things, one being the aging population and aging work force due to the baby boomers. People are living longer these days and the illnesses are only getting worse. As technology becomes greater there are newer ways and better medications to allow humans to get better or even just keep well enough to live for a little longer. This causes patients to be sicker, thus having nurses looking after sicker patients for longer hours causing more stress and burnout that decreases how alert they are and how effective their jobs are done.
When a patient needs extended care the nurse has to take up more time on that one patient thus not allowing them to have a heavy workload. This is hard though because there aren’t enough nurses. The patients, being society, then do not receive the care they need and deserve. Sometimes this causes a longer hospital stay because of infections that can be caught in the hospital if infection control is not strictly followed, which takes a lot of time. Also health teaching takes a lot of time and it is a daily thing done with every patient to get them ready to go home.
If this is not done they either cant go home right away or they go home and end up having to come right Shortage 10 back because they get sick again ( Williams, Stotts, Jacob, Stegbauer, Roussel, & Carter, 2006). This shortage of nurses has causes some parts of the hospitals to close such as parts of the surgical floors because there just isn’t the nurses to look after the patients. This then causes a back up in surgery and doctors trying to get their patients sent home as soon as possible to move new patients in.
If the beds are not available, then patients can not have surgery as there is no one where to put them, so surgeries have to be cancelled till further notice. This has a huge effect on society and what they need health wise. Not only this but due to a lack of beds when emergency patients come in and have to be admitted, some times there is no beds available but they are not stable enough to be sent home. They end up having to stay in the emergency waiting in a room until a bed come available. This effects society by putting longer waits in the emergency department to see a doctor (M.
Lougas, personal communication, March 6, 2008). Did you know that 30,000 students were not able to enter nursing programs in just 2005 alone. This was due to there not being enough faculty and clinical placement settling, and limited classroom space. The average professor age is between 48-57 years. They are all starting to retire and there is no one to fill their places. Clinical placements are hard to find as there are not enough nurses to do there work plus teach students, as well as the high work load causing stress, a lot of nurses feel they don’t have time.
Limited classroom space is causes by more institutes but not enough educators so only a certain amount of students can be accepted, as a professor can only teach so many students ( Zbierajewski, Kachmarik, O’Dell, 2007). Shortage 11 Conclusion The research didn’t need to be done to know there is a nursing shortage. The public already knows the major issue of the nursing shortage and how it effects a lot of the healthcare system. It has been announced and everyone has been made aware. It effects the public in so many ways and it needs to reversed or at least slowed down.
The shortage is due to a lot things that are fixable and can be worked on to slow the shortage down. Patient care is not as efficient and effective as it needs to be to reach safety standards, and mortality rates are higher. Healthcare communication, critical thinking, teamwork and problem solving are all decreased because of the shortage and it only causes more issues. In the future I suggest first of all something be done about the nursing faculty issue as once that is fixed more nursing students can get excepted a year and more graduates a year into the work field.
This fixes on small problem that makes a huge difference. The second I would want done is funding from the government for the institutions and for the healthcare system. Third I would want communication and teamwork gaps filled and nurses feelings better about their work place and who they work with, thus making the job less stressful. Last but not least I would like wages and extra classes and courses to be thought about and considered. Over all there are a lot of changes to happen but just one change can make such a huge difference in the problem, If someone will just step forward.