Nurses are a critical part of healthcare and make up the largest population in the healthcare profession. The shortage of nurses in the United States has become critical. It is projected that there would be a national nursing shortage of 260,000 to 1,000,000 registered nurse jobs in 2015 (Monahan, 2015). In the United States, the nursing profession continues to face shortages because of lack of potential educators, high turnover, an ageing workforce, regulatory and policy issues. The numerous factors leading the nursing shortage are many and issues of concern. Some of the potential causes of nursing shortages in the United States are exploring below.
Causes of Nursing Shortage
Recruitment of Students
For decades, enrolment in schools of nursing has been decreasing. Nursing school enrolment is not growing fast enough to meet the projected demand for registered nurses. Nursing schools are not keeping pace. Despite having more nurse graduate now than there has ever been, the current nursing staff is not enough to address the shortage. Due to lack of space in the nursing program, many qualified nursing applicants are being turned away. One main reason is that institutions are finding it difficult to teach the curriculum those who are qualified or have a high credential to teach nursing often opt for higher paying positions.
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High Turnover
High nurses turnover rates are affecting nurses access to health care. As cited in the American Association of Colleges of Nursing (AACN) Fact Sheet (2019), “ Dr. Christine T. Kovner and colleagues found that 13% of newly licensed RNs had changed principal jobs after one year, and 37% reported that they felt ready to change jobs.” A study conducted by Akhtar, Haider, Aamir, and Hamid (2016) found the numerous reasons nurses leave their positions to move to other organizations, leave to pursue new careers or alternative areas of practice. Some of the reasons included lack of professional stimulation, a diminished sense of value within the organization, and lack of appreciation from superiors.
Ageing Workforce
The nursing workforce is ageing just like the population they serve. There are currently about one million RN older than 50 years (Grant, 2016). This means that one-third of the current nursing workforce could be at a retiring age in the next 10 to 15 years. The retiring workforce presents numerous other problems, training more nurses with fewer resources. According to Cooley & DeGagne (2016), the shortage of nurses the nursing faculty are experiencing leads to enrolment limitations, which limits the number of nurses an institution can generate. Apart from generating fewer students, decreased and limited amount of faculty also causes a decline in the overall quality of the program and classes.
The Aging Population
Our ageing population requires more nursing professionals, even without older nurses retiring. According to the population report released by Vincent and Velkoff (2010), it is projected more Americans, approximately 88.5 million, will be over the age of 65. The increase in the ageing population means an increase in the demand for nursing services. Therefore, healthcare offerings must grow to meet this new demand.
Regulatory and Policy Issues
There are numerous regulatory and policy issues which are exacerbating the nursing shortage. Some of these regulatory and policy issues include state and federal law, regulation by accreditation organizations, requirements from reimbursement government or private organizations, and licensure and nursing acts (Nevidjon & Erickson, 2001). Some issues are factors creating barriers to recruiting nurses and others are causing nurses to leave the profession. In all sectors of patient care delivery, nurses have raised concerns regarding the amount and complexity of paperwork that has resulted from a multitude of actions by regulatory agencies as well as the reimbursement industry. Due to paperwork, nurses are spending less time with patients and as a result, causing dissatisfaction among nurses who want to interact with patients and may lead to nurses leaving direct care positions, especially in acute care settings.
Steps to take to Address the Nursing Shortage
Bolster the Nursing Education Infrastructure
The shortage of nurse workforce in the United States is mirrored by a corresponding shortage of nursing facilities. Given the increase in faculty shortage, it is clear that nursing shortages will become worse in the future. Federal funding of nursing education is modest. In order to provide an opportunity for skill building in a real clinical setting, structured postgraduate training programs ought to be put in place for nurses.
Empowerment
When providing the best and safest care to the patients, nursing facilities and organization ought to be creative in meeting the needs of nurses. In order to rejuvenate and sustain the nursing workforce, it is necessary for organizations to create an environment that empowers and motivates nurses. “ Empowerment in autonomy in staffing ratio decisions taking into consideration high volume and acuity levels will lead to less burnout, and strong desire to leave the workforce” (Haddad & Toney-Butler, 2019). Organizations need to endorse programs that provide superior nursing processes as well as a high level of safety, quality and patent satisfaction. By creating an atmosphere where nurses are appreciated as well as given room to grow their hospital management team will ensure that most of the nursing workforce is retained while also attracting new talent.
Schedule Flexibility
Given that nurses also have growing families and also want to further their education, organizations need to provide flexible schedules. When they are overworked, the nurses find it difficult to provide quality care. By providing flexible schedules to the nursing staff, organizations put the well-being of the nurses in mind as well as create a healthier work environment. This, in turn, help organization or hospitals retain their nurses.
Establish Financial Incentives for Investing in Nursing
Although it is very important to create a culture of nursing staff retention-based on better outcomes, higher profitability, lower costs, and lower turnover- there is a need for investment in hospitals to establish a new base of response capacity. New federal monies specifically targeted for nursing ought to be made available for hospitals to be able to invest in nurse as well as be able to resolve the problems that have resulted to the impending nurse staff crisis.
Nurse Residency Programs
Across the nation, there is growing popularity in nurse residency programs. Nurse residency programs give nursing graduates the chance to experience a specific hospital environment before being employed to work for a full-time position. This improves the transition into a nursing career. It also improves the retention of the nursing workforce.
Reflection on my Future Nursing Role amid Nursing Shortage
With ratios averaging one nurse to nine patient, one can see the impact of the nursing shortage. As a future nurse, I will be looking at the vital skills required in order to advance and pass my course as set out by my institution. As a nursing student, I believe this course will help me acquire the skills required for inter-professional practice. Amid the nursing shortage, I would be able to get employed very fast due to the high demand for nurses. Thus, I would be able to develop the competencies necessary for patient-centred care. I was surprised by the statistics to indicate the nursing shortage in the United States. I believe this information will help me strive hard so that I could join the nursing workforce in the future to help people.
The Role of Legislature Contributing to Safe Staffing during a Shortage
Safe staffing legislation aims to alleviate nurse shortage. Effective staffing results in better patient care as it can prevent nurse burnout. Many states are considering bills that would require organizations to maintain minimum nurse staffing levels. Utilizing the nursing staffing solution ensures that sufficient nurses are scheduled at peak patient times. Thus, safe staffing tools can help hospitals optimize the performance and productivity of their workforce while also ensuring that the health systems do no overspend on labour costs.
Safe staffing legislation would require hospitals to have a certain number of nurses during peak times. Although hospital fears that this would drain their resources, it would help them provide great patient care as well as ensure that there are enough nurses in health systems to provide care for each patient. “ Minimum nurse-patient ratios are essential to maintaining the hospital’s bottom line, even though hiring more nurses costs health systems in the short term” (Pasqual, 2016).
Conclusion
Nurses are a critical part of healthcare and make up the largest population in the healthcare profession. The shortage of nurses in the United States has become critical. The nursing profession continues to face shortages because of lack of potential educators, high turnover, ageing population, the ageing workforce, regulatory and policy issues. There is numerous step that can be taken to address the nursing shortage which includes bolstering the nursing education infrastructure, empowering the nursing workforce, proving flexible nursing schedules, establishing financial incentives for investing in nursing, and providing nurse residency programs.
References
Akhtar, C. S., Haider, M., Aamir, A., & Hamid, A. B. A. (2016). Work-life balance, job satisfaction and nurses retention: the moderating role of work volition. International Journal of Business Excellence, 10, 488-501.
American Association of Colleges of Nursing (AACN). (2019). Nursing Shortage. [Online]. Available at: https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage . Accessed 6 th May 2019.
Monahan, J. C. (2015). A student nurse experience of an intervention that addresses the perioperative nursing shortage. Journal of Perioperative Practice , 25, 230-234.
Nevidjon, B., Erickson, J. (2001). The Nursing Shortage: Solutions for the Short and Long Term. Online Journal of Issues in Nursing . Vol. 6 No. 1, Manuscript 4. Available: http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/workforce/NursingShortage/Resources/NursingShortageSolutions.html . Accessed 6 th May 2019.
Pasqual, L. (2016). Safe Staffing Legislation Aims to Alleviate Nurse Shortage. [Online]. Available at: https://www.apihealthcare.com/blog/healthcare-staffing-best-practices/safe-staffing-legislation-aims-to-alleviate-nurse-shortage . Accessed 6 th May 2019.
Vincent, G., & Velkoff, V. (2010). The Next Four Decades: The Older Population in the United States: 2010 to 2050. [Online]. Available: https://www.census.gov/prod/2010pubs/p25-1138.pdf . Accessed 6 th May 2019.
