Lack Of Motivation And Job Satisfaction

In Australia a recent report has projected that by the year 2025 there will be a shortfall of 109,000 nurses (Health Workforce Australia, 2012). However, in developing countries, such as Malawi, the nursing shortage has reached dangerous proportions and currently stands at a quarter of the minimum level considered adequate by the World Health Organization (2014). Research by Chimwaza and colleagues (2014) details recent nurse to patient densities in Malawi are 0.343 per 1,000 population compared to Australia’s figures of 15.4 nurses per 1,000 population (Nursing and Midwifery Board of Australia, 2015). Poor working conditions and insufficient salaries, especially in more remote areas, are major factors which impact Malawi’s ability to meet the minimum recommended nurse/patient ratios (Global Fund Observer, 2014). The effects to nursing cannot be underestimated, impacting on the quality of care, and majorly effecting nurses morale and professional pride. Nursing performance is adversely affected due to the excess workload this shortage imposes, hindering the ability to provide the minimum level of health care to patients. Gorman & Hohmuth-Lemonick (2009) stated that nurses are often left to work alone, in highly stressful situations. They have also reported that Malawi’s national guidelines are two nurses per shift on labour and delivery wards, but due to the nursing shortage, one nurse per shift is often the

With the existing trend of shortages in healthcare providers and professionals, the recruitment and retention of this type of staff in a rural area may

The challenges associated with the HRM i.e. human resource management includes the distribution and composition of health care work force. In addition to this, the issues related to the training of the work force are also a challenge for the human resource management. The relocation of the health workers is also a great concern. Moreover, the degree of economic development is also a great challenge that negatively impacts the level of performance shown by a health care organization. These challenges must be addressed properly in order to have an effective health care delivery anywhere in the world.

The most challenging area Mrs. Dukes faces is staffing. For a well- developed health care system, sufficient, highly motivated and skillful employees are essential components (Saleem, 2015). It is important that we remember people are the most important and valuable asset of an organization. Every position is an important position and it takes skillful and effective people to fill those spots. “Staffing is the managerial function concerned with the procurement and maintenance of human resources” (Dunn, 2010). Having the right staff members is key in running an organization. If you hire individuals who are

Training is imperative. There has to be a shift in the orientation of the healthcare personnel. Extensive direction is required through in-service and basic training. The perception of their role as simply delivering government health programs needs to be changed to being agents of health development. They need to be sensitive to the local needs. In addition to technical skills, they will need social skills to negotiate with other sectors, and communication skills for organization and empowerment of communities.

This paper will discuss staffing shortages and how they can be unethical. It will discuss the sound leadership principles that were used in a past experience. It will also discuss three strategies to address the issue in the interest of the patient. Lastly it will discuss how this issue impacts nursing practice.

Retention can be done by enticing the employees with an attractive remuneration; • An innovative training and education can be used to encourage efficiency in delivery of health services. Such training is to be accompanied by real training models to ensure quality qualification; • Offering education scholarships for students in health services so as to increase the number of experts. Scholarships to countries that offer a better quality of health training can help improve the quality of delivery of health services; • Training more people to offer supplementary or basic care for instance midwifery services; and • Funding more training programs for health personnel for example the Aboriginal and Torres Strait Islander Health Workforce Training Package. The following strategies address the issue of reforming the health workforce: • Establishment of an official body to oversee health education for instance a National Health and Education Training Council.

Globally, the demand for education is higher than what can be supplied. When it comes to healthcare education and professionals, there is a “global imbalance”. In 2013, the World Health Organization (WHO), stated that we are short of 7.2 million health workers, and this number is expected to nearly double to 12.9 million by 2035. The WHO cited the age of the health workforce, lack of youth filling healthcare jobs, inadequate training, and that “internal and international migration of health workers is also exacerbating regional imbalances”. Furthermore, several journals and organizations, including the WHO, New England Journal of Medicine (NEJM), Health Volunteers Overseas, Human Resources for Health, and Routledge International Handbook of Medical Education, have all stated that the global healthcare work imbalance is a global crisis, all suggesting different paths to reduce the current imbalance.

More than a quarter of the world’s countries do not have enough health care workers. The world needs 4 million new health workers to address global workforce shortages. The urgency to address the health care worker crisis is a challenge for all high-, middle- and low -income countries alike. Health care worker shortages affect Germany and the USA, just like they affect India or Uganda. Western countries ‘import’ workers from developing countries, because they are also short of trained health workers. Aging populations are exacerbating the problem (Global Health Workforce Alliance, 2013).

All across the globe, there are people in need of the care and knowledge that health care professionals provide. Given so, it should come as no surprise that there is a very high demand for health care providers internationally. The recruitment and retention of health care employees is vital to the success and growth of the health care industry. That is why it is so important that health care facilities provide excellent work conditions, as well as competitive wages and reasonable work hours, for their employees.

There is a critical gap between the demand for health care personnel and the supply of their services. This is an acute issue facing the citizens, governments and policy makers internationally and could have dire consequences if the situation is not dealt with the urgency and importance it demands. There are a myriad of factors causing this shortage in health care personnel. It ranges from migration of trained personnel from developing countries to developed countries to being over-worked to inadequate healthcare management. The reasons for migration range vary from lack of stability and safety of living conditions to a dearth of adequate training opportunities for healthcare personnel.

A continuous concern that continues to present itself within the healthcare environment is adequate staffing on nursing units. Most hospital organizations try their very best to accommodate staffing needs, though many units remain understaffed for an unspecified amount of time. Inadequate staffing can negatively affect patient outcomes, lead to nurse burnout, and decrease patient satisfaction scores. Combating this issue will require a great deal of effort, as many geographical face nursing shortages when seeking new graduates and qualified candidates. Employees may begin to feel that they are unable to pursue personal goals within a healthcare organization, due to inability to transfer as a result of staffing shortages. This often results in nursing seeking employment or career advancement outside of the organization or geographical area, which further intensifies ramification associated with inadequate staffing.

Demographic trends, While the population has grown from10.6 million in 1990, to approximately 17 million the Malawi health system has struggled to maintain and provide adequate health care to the people

Another challenge affecting the human resources for health in Malawi is shortage as a result of migration of professional health workers to management related work or positions(9). Medical doctors and state registered nurses are being promoted to take up managerial positions either in government or working in Non-Governmental Organisations (21). Malawi has successfully managed to address the challenge of brain drain to other countries by implementing incentives but continues to struggle with migration within the country whereby health workers are moving from bed-side patient care to managerial positions. Some health workers especially nurses are pursuing careers other than nursing(4). The MoH should consider establishing positions that will make these health workers to still remain in hospitals providing patient care. There is need to develop a clear career pathway so that staff trained in health management should be allocated to the managerial posts while health workers remain with patients. Furthermore, the ministry should be vigilant in reinforcing the agreements within the MOUs with the NGOs on the health worker recruitments from the public sector(10).

A number of studies have analysed that KHWIS consists of health workforce supply and distribution of four health professional councils. These are the Nursing Council of Kenya, the Kenya Medical Laboratory Technicians, Clinical Officers Council and the Kenya Medical Practitioners and Dentists Broad as can be seen from in Figure 3 (Kenya Health Workforce, 2010; Ministry of Medical Services, 2011). In 2010, KHWIS has collected all of health care workers in the public sector from every province to the deployment database in chief nursing officer, clinical officer, medical service and laboratory officer. Besides, KHWIS expanded also to collect health workforce data in private sectors (Kenya Health Workforce, 2010; National Academies, 2011; Emory School of Nursing, 2010).