The nursing shortage has been recognized in state, national and global level. It happens in nursing literature, nursing learning institutions and in healthcare institutions. Although there is the nursing shortage, it is different from what has been there in the 1980s in three significant ways. The difference is seen in ageing nurses, universal labour workforce scarcity and the international nature of nursing deficiency (Nevidjon & Erickson, 2001). The nursing shortage began in the 1990s, and it continues to date, and there is a forecast that it will worsen in the coming years (Buerhaus, Staiger, & Auerback, 2000). According to these authors, they predicted that there would be an increase in the number of registered nurses in the future by 23% and it will grow at a very high speed than other medical professions. AACN also anticipates that there will be more than 114000 registered nursing positions unfilled and the trend continues to date (AACN, 1998). Also, there is also a forecast that the nursing workforce is likely to go down as a result of retiring of baby one boomers and the decrease in the number of young nurses to occupy the vacant positions left by retirees (Buerhaus & Auerbach, 2000).
There is the shortage of nurses in the USA especially in Florida which results from the increase in the rate of RN turnover. Other factors cause nursing shortages and the include the increase in the number of sick people which reduces nurse to patient ratio (Tieman 2001). The poor working condition for nurses also discourages people from different parts of the World to prefer working in the USA as a nurse of getting trained as a nurse in fear of lousy working condition (Texas Nurses Association, 2000). Low wage rate discourages nurses to work as a nurse in the USA, and therefore most people leave the nursing profession to another field with a better wage rate (FHA, 2001a, 2001b, 2002). The reported problems cause a reduction in the number of people getting trained as nurses for fear of facing harsh working condition. As a result, the number of nurses required to take care of patients in different hospitals declines thus experiencing 12.9% nursing shortage (Chun, 2002) especially in Florida. The introduction of managed care has affected the distribution of nurses in several ways. In 1997, the Federal Government introduced balanced Act which reduces the number of money hospitals get annually (Curtin, 1994). Because of low hospital payment and a reduction in Medicare and Medicaid reimbursements, healthcare settings cannot use higher operating costs (Ayala & Fries, 1993) which results into a decrease in wage rate for nurses. There were some periods when various health centers shut down beds, fire other nurses and ensure that they increase outpatient services. Restructuring of different healthcare settings also impacted the working condition of RN and reduced the number of nurses in hospitals (Rosenthal, 1996). Most hospitals incur a higher cost of hiring registered nurses as they are the majority of healthcare officers. They represent 23% of healthcare officers thus require the highest labour cost to maintain (AHA, 1996-97). It is, therefore, less costly to use unregistered nurses and reduce the number of registered nurses in every hospital as a way of increasing cost effectiveness (Aiken & Anderson, 1996). This restructuring strategies removes the skill mix required of registered nurses, reduce the number of costly RNs and allow hospitals to have less expensive healthcare officers to take care of patients. As a result, managed care operations therefore increases job insecurity especially in nursing profession. Some RNs have to lose their jobs because of downsizing, amalgamation, acquisition and cutbacks. As a result, the remaining nurses have a heavier workload which they would spread to other nurses when they are more. The number of unqualified nurse also increases in most hospitals which therefore place available nurses is a tough situation to take care of patients with different health conditions (Florida Hospital Association, 2000). The restructuring process of hospitals in USA, different nurses become dissatisfied with their work hence raise their complaints in social media and public media to air their concerns (McEachern and Ventura, 1995).
Justification of the Problem
In the period when there are nursing shortage, there are very few nurses available for various health caters to hire. It was also tough to retain a few nurses that accepted to work in hospitals. RN switch to other professions because there is an increase in the workload, poor working conditions and low wage rate. These conditions are attributed by lower remunerations, small number of RN in various hospitals and a higher patient to nursing ratio. These critical issues are determined to cause problem associated with hiring and RN retention in multiple hospitals in USA (National League of Nursing, 2001). Workload to hospital staffs, the issues in patient care and high operating cost of hospitals are evident. According to ANA, the decline in the number of nurses is as a result of poor working condition and contribute to low-quality patient care in hospitals in USA in general. Because of the low supply of RNs and demand for the available nurses, there is significant requirement to hire and retain few nurses for healthcare organizations to offer high excellence patient care. In order to eliminate all the healthcare crises, it is vital to develop strategies that can be used to ensure that different hospitals are able and capable to recruit more NRs and retain the existing nurses. The improvement of the working condition of nurses, enhancing their remuneration and reduction in their workload through the implementation of healthcare technology can solve the problems of deteriorating nursing staff (Tieman, 2001). The USA has a decline in consumer confidence and expectation in the safety in healthcare settings and therefore they have a feeling that they are under siege. Although this problem was first observed in the USA, it has spread in other nations.
This research paper is designed to determine why RNs accepts to leave their jobs as a nurse to other professions. It also seeks to establish the reason as to why RNs go their jobs and create public awareness so that the Government of different nations can develop strategies that hospitals can use to hire and retain nurses. It is essential to conduct a research on nursing shortage and its effect on RN turnover in order to discover the problem leading to a nursing shortage and the possible solutions to address such issues. This kind of research is vital in building literature on the effect of the nursing shortage. Data collected in this study will be used in an understanding working condition of nurses and reward systems so that the Government reviews their health policies to ensure nurses work in a good work environment.
The primary research objective is to determine the reason why there is the nursing shortage in the USA. It also seeks to establish:
Demographic characteristics of registered nurses who leave their jobs for other professions
The factors that contribute to the nursing shortage in the USA
The relationship between reasons for nurses leaving their jobs and their demographic qualities
In this research, the questions provided seek to provide solutions as to why most hospitals in USA experience nursing shortage. It will allow the researcher to explore the reasons why most hospitals in the USA have low RNs as compared to other nations. The questions relate to working condition, low remunerations and poor working conditions that registered Nurses in USA face as opposed to others in countries like the UK and Canada.
What are the reasons that nurses give for switching to other professions?
What are the demographic qualities of RNs who leave jobs for other professions?
Who is currently used to replace RNs in most hospitals in the US?
What are the association between the reasons provided by the research participants and their demographic characteristics?
1. H0: Demographic characteristics cause the nursing shortage in the USA
H1: Demographic characteristics do not cause the nursing shortage
2. H0: Factors like remuneration, nurse-patient ratio, work environment and work burden are the reason that makes nurses leave their profession for other professions
H1: Factors like remuneration, nurse-patient ratio, work environment and work burden are not the reason that makes nurses leave their profession for other professions
3. H0: Demographic characteristics are related to reasons for the departure of nurses to other professions
H1: Demographic characteristics are NOT related to reasons for the departure of nurses to other professions
This research is limited by the RNs who have shown that they have left their work other jobs of different occupations within a period of four years from 2013 to 2017. The researcher also experienced problems with missing data because there were other research participants who did not fully complete their survey questions. There were other problems which were caused by the self-reporting of data and as a result, it led to poor response validity (Norwood, 2000). Finally, research bias was also reported during the research. Some researcher assumed other RNs but only concentrated their attention on others and this limited the quantity and quality of data collected for this research study.
Review of Literature
This is a critical section here the researcher discusses matters relating to nursing shortages. It uses past literature which has a proper explanation on hospital RNS turnovers, policies that are aimed at addressing nursing shortages and educational issues that affect RNs distribution. The researcher explored Roy's adaptation mod...
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