The nursing problem that will be addressed is that of staff shortage. The nursing shortage is a problem that occurs across the world. Nurses form the most significant proportion of the healthcare system and have a critical role in providing direct care to the patient. Considering the vital role that nurses play in the healthcare system, it remains fundamental to assess how the shortage affects the quality of patient care. Research has shown that the nursing shortage has far-reaching consequences on the level of job satisfaction and stress. Hellerawa & De Alwis, (2015) noted that nursing shortage is defined as “An overarching imbalance of supplying and demand attributed to demographics, qualifications, availability and willingness to do the work” (75). The World Health Organization (WHO) 2013 report estimates that there are about 29 million nurses and midwives globally (Haddad & Toney-Butler, 2018). In the United States, nursing shortage remains a significant issue with the Bureau of Labor Statistics estimating that a further 1.1 million new nurses are required to avoid the shortage (Haddad & Toney-Butler, 2018). Solving the problem of shortage would be in tandem with Accurate Healthcare mission, vision, and values as well as relevant professional standards. The nursing profession continues to face widespread shortage due to high turnover, lack of potential educators, and the inequitable workforce distribution. Therefore, solutions should be tied to these identified aspects.
The scope of the Problem
The nursing shortage is a problem that continues to affect many departments and units across the US. One of the most affected units is the pediatric nurse. Statistics have placed the current growth prospects of pediatric nurses at only 19% (Ball, Doyle, & Oocumma, 2015). It, therefore, means that the shortage issue will likely have far-reaching consequences on the overall health of the children. With the increase in birth rates remaining high, there is a need to ensure that more pediatric nurses are trained to combat the growing morbidity and mortality rates. Several factors could be attributed to the pediatric nurse shortage in the country. The first reason to explain the shortage of pediatric nurses in the country is the growing demand for professionals. The recent increase in birth rates experienced across the country has meant that the existing number of pediatric nurses fails to meet the growing demands. The experience needed for pediatric nurses sometimes makes it difficult for individuals to qualify for the position. Working in the pediatric intensive care unit requires a vast experience of two years. Pediatric nurses who work in the community require an advanced practice that goes beyond the traditional Bachelor of Science in nursing (Shelton, 2003). Therefore, the change should focus on increasing the number of nursing professions in this critical department in a bid to enhance childhood health and prevent rates of mortality.
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Accurate Healthcare
The change must also be in line with the Accurate Healthcare mission, vision, and goals. The mission of Accurate Healthcare is to provide the highest quality of healthcare to patients in various medical settings. It also ensures that healthcare staffing solutions meet both the needs of the provider and the patient. Overall, its main aim is to improve healthcare by creating enabling conditions for the professionals which in turn enables them to provide the much-needed healthcare to the patients. Patients will only receive accurate healthcare needs if all the necessary resources are present. Out of the resources, human resources are probably the most significant. Shortage of nursing has direct implications on the patients because it increases the workload of the remaining nurses hence impacting their productivity. Research has also shown that the shortage of nurses is a major contributor to the high turnover rates experienced in the profession. It can also lead to fatigue and conflict among nurses. All these have a counterproductive effect that could easily cause the work of the nurses to deviate from the Accurate Healthcare provisions.
Change Models
Several change models can be used in solving the nursing shortage problem in the pediatric unit. The first approach is known as Kurt Lewin's change theory. The theory is known to apply in three primary circumstances including where radical change is needed, where minimal disruptions of operations are required, and where change needs to be permanently adopted. It follows a three-step model including unfreezing, freezing, and refreezing (Hayes, 2018). In unfreezing, the hospital will identify the need for new staff nursing officers after inefficiency in work, reported turnover rates, and fatigue among the nurses. Through unfreezing, the hospital will show the determination and readiness to change the situation. The next step is called the change process where individuals will need to conduct the implementation process. Here, the hospital will need to set aside more funds to employ new workers and train the existing ones to better handling pediatric issues. Lastly, the refreezing will aim at making this part of the organizational culture by completely solving the problem.
Other than Kurt Lewin's change theory, the Nudge theoretical model could also apply in this case. Rather than providing the steps required to manage change, it outlines several tactics and mindsets that could be used to frame a change. The theory requires the leaders to clearly define their changes and consider them from the employee’s point of view (Hayes, 2018). It also calls for the listening of feedbacks and maintaining momentums with the short-term objectives. The Nudge theoretical model would, therefore, require the management to outline the need for the change which is to provide effective healthcare in the pediatric unit. Most importantly, it will take feedback from the preexisting nursing officers by assessing the perspectives, beliefs, and experiences.
Steps for Change
Based on the theoretical models, several steps could be used to realize change and provide solutions to the problem of nursing shortage in the pediatric unit. The backbone of the process will involve assessing the demand and supply dynamics of the nurses in this particular field. The demand represents the number of patients in the pediatric wing that require the services of the nurses on a daily basis. Secondly, the supply will assess the number of nurses that the hospital has to deal with particular issues. The solution will be achieved by matching both the demand and supply (Ball, Doyle, & Oocumma, 2015). Using Kurt Lewin's model of change, the hospital will need to unfreeze by appreciating the shortage and assessing the implications it has since had on the service delivery. Once the hospital management and the nurses themselves are aware of the problem, the process of change will begin. When conducting the change, several dynamics touching on the economy of the hospitals will come to play. Examples include the financial capacity of the hospital, remuneration policies, and any other incentive.
The hospital must first revise its employment policies in regards to the benefits to enable it to attract better professionals to deal with the problem in the unit. The hospital, through the nursing head of the unit, will advertise for vacant positions, conduct interviews, and employment thereafter. The change will have been implemented through the recruitment of new staff members that will assist the unit to deal with the health problems arising from the shortage. The next step will be the unfreezing stage. This is probably the most critical stage because it ensures that the change process is permanent by including it as part of the organizational culture. The first step will be to leverage a reward system that will keep the nurses attracted to the job. Secondly, the hospital can sponsor some of its nursing staff members to acquire specialization in the area of pediatric care which will assist the problem internally. The care setting will need to invest more in its human resources (Ball, Doyle, & Oocumma, 2015). Meeting the goals of Accurate Healthcare will only succeed when consideration is placed on the nurses and how best they can meet the needs of the patient.
The Nudge theoretical model will also provide basic tenets that will assist in the process of change. Two crucial aspects will be of use to the change process. First, it emphasizes the clear definition of goals. Once the nursing shortage has been identified, the unit and the hospital at large must focus on the priorities such as recruitment, remuneration, and further education, all of which must be outlined as objectives. Secondly, the theory emphasizes the need to collect feedback from the employees. When the nurses are given a chance to explain the problem from their perspectives and points of view, implementation could be easier and more effective.
Conclusion
Nursing remains one of the most significant professions in the medical field. Despite their importance, the profession continues to grapple with problems of shortages thereby deviating from meeting their professional goals such as those outlined in the Accurate Healthcare. Out of the many nursing departments and units, the pediatric department is one of the most affected based on its huge demand for care. Using theoretical foundations such as the Lewin's change model and the Nudge theory, change will be implemented. Improving such a situation requires a revolution on the recruitment and retention policies and a culture that appreciates the internal development of human resources.
References
Ball, K., Doyle, D., & Oocumma, N. I. (2015). Nursing shortages in the OR: solutions for new models of education. AORN Journal, 101(1), 115-136.
Haddad, L. M., & Toney-Butler, T. J. (2018). Nursing shortage. https://www.ncbi.nlm.nih.gov/books/NBK493175/
Hayes, J. (2018). The theory and practice of change management. Palgrave.
Hellerawa, K. S. S. M., & De Alwis, C. A. (2015). The nursing shortage impact on job outcome (the case in Sri Lanka). Journal of Competitiveness, 7(3), 75-94.
Shelton, D. (2003). The nursing shortage: Its impact on the care of children. Newborn and infant nursing reviews, 3(1), 27-31.
