Research Paper on Issue of Shortage of Nurses in the Health Care System

1. Introduction

1.1. The Problem

As the need and push for accessible, quality, cost-effective, and patient-centered care continues, the demand for trained and experienced nurses also increases hence creating the problem of nursing shortage. Some of the major causes of this public health issue have been identified in previous studies as salary problems, poor workforce planning, the poor image of the nursing profession, the aging RN workforce, lack of experience, insufficient staffing, declining enrolment of skilled nurses, and the changing patient demographics and needs.

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1.2. The significance of the problem

The issue of shortage of nurses in the health care system is important enough to warrant a change mainly because it has negative implications for patient care outcomes. That is, the lack of adequate nurses to provide or deliver care in healthcare facilities contributes to poor patient care outcomes, such as increased length of patient hospital stays, the overall quality of patient care, and high hospital-related mortality.

1.2.1. Scholarly reference #1

McKechnie, T. (2016). Call for nurses: The multi-dimensional manifestation of the nursingshortage on patient care. QiHi Journal of Healthcare Improvement and Patient Safety, 2, 1-51.2.2. Scholarly reference #2

Feldkamp, J.K. (2009)./ Implications of an endless nursing shortage. Caring for the Ages, 10 (1). Retrieved from https://www.caringfortheages.com/article/S1526-4114 (09)60024-X/fulltext?code=carage-site

1.2.3. Scholarly reference #3

Buerhaus, P.I., Donelan, K., Ulrich, B.T., Norman, L., DesRoches, C., & Dittus, R. (2008). Impact of the nurse shortage on hospital patient care: a comparative perspective. Health Affairs, 26 (3). Retrieved from https://www.healthaffairs.org/doi/full/10.1377/hlthaff.26.3.853

2. Review of Literature

2.1. Research reference #1

Aiken, L.H., Cheung, R.B., & Olds, D.M. (2009). Education policy initiatives to address thenurse shortage in the United States. Health Affairs, 28(4). Retrieved from https://www.healthaffairs.org/doi/10.1377/hlthaff.28.4.w646

Aiken, Cheung, and Olds (2009) conducted a qualitative study to investigate the effectiveness of some of the education policy initiatives that may be used to address the problem of nursing shortages. The population studied was nurses enrolled in various nursing schools and those already practicing in different healthcare settings. Their finding was that there is a need for Medicare funding or support for graduate nursing education to increase enrolment rates

2.2. Research reference #2

Gess, E., Manojlovich, M., & Warner, S. (2008). An evidence-based protocol for nurseretention. The Journal of Nursing Administration, 38(10), 441-447

In their quantitative study, Gess, Manojlov, and Warner (2008) examined some of the innovative approaches for reducing nurse turnover and shortage, such as rewarding or recognizing nursing staff, improving communication, and facilitating nurse autonomy. They found these methods to be effective. The study population consisted of practicing nurses in a selected hospital setting.

2.3. Research reference #3

McLean, L., Hassmiller, S., Shauffer, F., Rohrbaugh, K., Collier, T., & Fairman, J. (2014).Scale, causes, and implications of the primary care nursing shortage. Annual Review of Public Health, 35, 443-457

In a qualitative study, McLean et al. (2014) investigated the scope, contributing factors, and impacts of the shortage of primary care nurses and the possible solutions. The population studied was primary care workforce in US hospital.

2.4. Research reference #4

Buchan, J., & Aiken, L. (2008). Solving nursing shortages: A common priority. Journal of Clinical Nurse, 17 (24), 3262-3268

Buchan and Aiken (2008) in a comparative, quantitative study examined the global health challenge posed by the shortage of nurses and ways of addressing this problem. The population studied was practicing nurses in a Japanese hospital.

2.5. Research article #5

Seo, S., Spetz, J. (2014). Demand for temporary agency nurses and nursing shortages. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 1(1). doi: https://doi.org/10.1177/0046958013516583

This article presents the findings of a quantitative study by Seo and Spetz (2014) in which they investigated how the issue of nursing shortages may be addressed through the employment of temporary agency nurses. They analyzed 1993-2002 data from the Office of Statewide Health Planning and Development (OSHPD) in California indicating nurse shortages. The population under study was nurses at the OSHPD Hospital.

3. Synthesis of the Evidence

3.1. Summary of potential actions

From the review of evidence from the available literature, some of the potential actions to address the issue of nursing shortages include increasing nursing education funding, improving nurse retention through organizational programs, enhancing the recruitment of new nurses, workforce building strategies, and using interprofessional teams, task shifting. Other actions to resolve this problem as evidenced by literature would be increasing nurse pay, advocating for relevant legislation, improving the image of nursing, and exploring nurse recruitment or detainment mechanisms.

3.2. Recommendations to improve on the problem

Improving and funding nurse education at all levels and supporting legislation on nurse shortages compared in that both will help establish proper standards for evaluating nurses and hence ensuring that more nurses transit from graduate school to the market. However, they are also different in that improved funding for nurse education will only increase the number of practice nurses but not their professional experience while a piece of legislation will set certain thresholds for practice nurses. Further, nurse recruitment and retention programs and the employment of temporary nurses are different in that nurse retention programs will have a long-term positive impact on nursing shortages while the employment of agency nurses is a short-term solution to the problem

3.3. Best action for the organization

The best cause of action for my organization is to adopt staff development and nurse recruitment or retention strategies such as reward systems and the creation of conducive work environments that will help reduce turnover rates. The recommended plan is thus for the organization to focus on improving the working conditions of nurses to motivate them.

4. Suggested Courses of Action

4.1. Restatement of action

The action I would want to occur is the adoption of nurse recruitment and retention strategies that focus on improving and developing the skills of nurses and motivating them to perform.

4.2. Implementation of the change

This change will be implemented by involving all the relevant stakeholders in the organization, availing necessary resources, monitoring the implemented change, and providing feedback on its progress.

4.3. Leadership strategy

To guide the change process, the leadership strategy that will be adopted is the investment in people. Through this strategy, an organizational leader entrusts every member of the organization with the responsibility of ensuring that change implementation process is successful by providing them with relevant resources and autonomy.

4.4. Who, what, when, and where?

The change implementation process will be led by all members of the organization in various healthcare settings, such as ambulatory care.

5. Summary or Conclusion

5.1. Main ideas and arguments

As is evident, the shortage of nurses is a serious concern for the health care system due to its adverse impacts on patient outcomes such as safety, quality of care, and overall health. From the literature review, it is clear that nurse shortages in hospitals can be addressed through strategies such as effective staffing techniques, appropriate nurse recruitment, and retention programs, nurse education support programs, and providing better pay and working conditions for nurses to reduce intention to leave the nursing profession.