A large section of scholars and intellectuals within the disciplines related to both health care and nursing, a majority of opinion shapers and even the ordinary members of the society converge within their patterns of thought that the issue of brain drain is one of the major 21st-century trends that cannot be overlooked. While this trend within the larger healthcare sector is currently manifested in nearly all the developed societies, players and stakeholders within the industry agree that the trend is most predominant within the United States society. Various reasons have been given as a response to this particular paradigm shift. This paper purposes to explore those reasons. Additional effort will be directed towards exploring issues related to leadership with a special emphasis on the challenges facing leadership within the 21st century.
Remuneration
While the reasons that push nurses out of their countries and attracting them to the United States are numerous as already stated above, the issue of compensation is the most profound. According to Kline (2003), nursing as a profession, like the rest of the other careers needs to be properly rewarded if the quality of the profession is to be maintained. The scholar argues that this is largely lacking in many countries especially the developing countries in African societies and those in the Asian sub-continent and parts of South America. Considering that training within the health care discipline takes many years compared to other disciplines provided in institutions of higher learning, it is only reasonable that such great lengths of time factored in the attainment of the resultant skills be met with reasonable forms of rewards that apparently lack in the affected countries and societies such as the ones already stated. However, despite the presence of such types of challenges in such countries and societies, a total paradigm shift exists within the United States health care system. Johnson (2005), opines that apart from rewarding its nurses with financial forms of remuneration that are comparatively higher than the rest of the countries including those in other developed countries in Europe, the United States, has put in place policies that ensure that nurses receive other forms of rewards for their services. These include proper housing, insurance benefits, vacation, and retirement packages that are commensurate with the amount of time spent in acquiring nursing skills in addition to the hard work involved. It is important to note that these forms of rewards are non-existent in many countries especially those in developing societies such as Africa, the middle east and those within the Asian sub-continent which play a significant part in channeling their nurses towards the united states employment market.
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Facilities, Equipment, and Professionalism
Buchan (2000) argues that some of the reasons that make nurses leave their countries for the United States revolve around matters related to ensuring the professionalism of the discipline. In this context, the scholar argues that nursing is a professional career that best functions within a specific spectrum of logic. As such, certain variables make the profession what it is, without which, the profession loses its meaning. Such variables include facilities and equipment that lack in most countries that are abandoned by nurses who relocate to the United States. There are various reasons in this regard. First is the very fact that proper conduct of nursing practice cannot take place manually in the absence of facilities such as buildings that shelter both the nurses and the patients during dispensing of health care and beyond health care providers such as housing facilities. Secondly is the fact that certain nursing procedures cannot be effectively carried out without the involvement of particular tools and equipment. In the latter category, it becomes an exercise in futility for a nurse to perform a nursing procedure in the absence of reliance on special tools and equipment especially in medical cases involving complex multiple ailments and diagnosis in addition to certain emergency cases. It is worth noting that the variables mentioned here, largely lack in the countries affected by the problem of nursing brain drain, but exist within the United States health care. While the reasons for these particular states of events are numerous, the key among them is the existence of proper policies and leadership within the United States health care system. Thus, the United States has the upper hand regarding nursing staff attraction and retention as opposed to the other affected countries where such policies are non-existent, weak or dysfunctional.
21st Century Leadership Challenges
Studies conducted on leadership challenges within the 21st century indicate that such problems are numerous. However, despite being many, the paper will not make an attempt at dissecting all of them for reasons such as variations in their general applicability and weightiness regarding contemporary relevance. As such, the following will be explored;
Meeting Expectations for Increased Productivity Within Budgetary Constraints
This stands out as one the most dominant challenges within the nursing sector in the 21st century. As already discussed above, remuneration, equipment, and facilities are some of the problems facing the nursing industry. This in effect means interference in the level of productivity within the nursing sector due to the presence of a direct correlation between productivity in the sector, and the existence of reasonable financial resources. Moreover, given that the nursing profession falls under biological sciences, the need for continuing and constant research on matters related to the profession cannot be overlooked (Houston, 2013). This presents a leadership challenge since leaders within the sector expect an increased level of productivity from nurses in the presence of huge budgetary constraints, a development that hampers productivity on the part of the nurses in forms of morale, motivation, and impediments on finances needed for the purchase of equipment and the conduct of research.
Positioning Nursing to Influence Decision Making in Organizational and Health Policy
This kind of challenge manifests itself in the grand scheme of things. In this case, nursing as a profession has been short changed by other professions within the larger health care sector, with the culprit profession here being that of medicine. As such, major players in the healthcare sector accord relatively higher importance to professions such as medicine in matters related to decision making in health and organizational policy, often at the expense of the nursing profession despite all of them falling under similar sector (Houston, 2013).
Striking A Balance Between Technology and Interpersonal Relationships to Deliver Best Care
The advent of technology within the 21st century has brought its forms of challenges regarding leadership within the nursing profession. At the moment, nearly every aspect of life within the society has a relation to technology in one way or the other. This ranges from the modes of communication such as mobile phones, computers, and machines. The flipside of all this is that the formerly existing interpersonal relationship has been challenged, thus by extension affecting the manner in which the profession of nursing is carried out (Houston, 2013). In terms of leadership, this means the dilution of the effect that leadership used to have on the nursing staff, especially the effect between the upper echelon and the lower echelon of the nursing community.
Planning for Succession and Mentoring Young Nurse Leaders
Apart from the above challenges, planning for succession and mentoring of young nurse leaders is also one of the major leadership challenges that the nursing profession faces in the 21st century. The reasons here are two-fold; the first is that individuals occupying the positions of leadership within the nursing fraternity are reluctant to give up the positions they hold to the younger generation for personal reasons of self-centeredness (Houston, 2013). The second reason is that there is an existing vacuum of leadership as a majority of the young nurses prefer to stick to their professional career of nursing at the expense of engagement in leadership or leadership related matters.
In conclusion, the reality that the immigration of nurses to the United States, especially those from the third world and underdeveloped countries, remain a fact that is most likely to stay as long as the reasons for this kind of brain drain continues to exist and leadership within the affected countries continue to face challenges such as those presented in the paper
References
Buchan, J. (2000). Nursing brain drain. Nursing Standard , 15 (4), 22-23.
Huston, Carol J. Professional Issues in Nursing: Challenges and Opportunities, 3rd Edition . Lippincott Williams & Wilkins, 03/2013. VitalBook file.
Johnson, J. (2005). Stopping Africa's medical brain drain. BMJ: British Medical Journal , 331 (7507), 2.
Kline, D. S. (2003). Push and pull factors in international nurse migration. Journal of nursing scholarship , 35 (2), 107-111.
