Nursing Shortage Of Maryland And How Does It Effect Healthcare

Nursing shortages have always occurred in cycles. Recently, the shortage has become worse due to the implications of managed care as a way of controlling escalating health care costs. While the shortage did ease some during the recession of 2009, there is still a shortage in some areas of the country (Cherry & Jacob, 2014). Increased student enrollments and government policies have helped with the shortage, but the occupational outlook for nursing jobs is expected to grow faster than any other occupation through 2018. So it is essential that the supply of nurses increases to keep up with the demand. The current shortage is due to several factors. First, new nurses are needed to replace “baby boomers” who will be retiring in the near future. Second, as the population ages, there will be a demand for more healthcare, leading to a demand for more nurses. Third, new advances in patient care will lead to more people in the healthcare system needing more specialized care, and lastly, the affordable care act places a large emphasis on preventive care, leading to more people desiring wellness visits (Cherry & Jacob, 2014). Finally, according to Dall’Ora, Chiara, Griffiths, Peter, Ball, Jane, Simon, Michael Aiken, Linda H. (2015), “shifts lasting 12 hours or longer were associated with a 40 percent greater level of job dissatisfaction and a 31 percent higher risk of planning to quit. Job satisfaction and burnout in the nursing workforce are global

Nursing care was unscientific and consisted of assisting patients with usual body functions; and was typically administered by women of a religious order or by women who by nature of their lifestyle frequented hospitals. Hospital care was for the poor and destitute; since home based medical care was better than risking additional infections in the dirty, crowded, and disease-ridden hospitals. During the typhus epidemic of 1852, hospital staff and patients suffered the greatest morbidity and mortality. (Ranade , 199817-19)

Current internal and external hospital stressors are impacting NCs nursing shortage. With the release of many reports from different sources suggesting a change is needed. Most have been accurate in their projections; however, the struggle continues. Strong implications for the direction the crisis is heading, from campaign research to thesis and dissertations, written by professional groups and organizations add credibility to the cause; however, the shortage remains. Although some would argue that job satisfaction has no bearing on the nursing shortage and more pressing problems are prevalent; for example, the ageing population, undereducated nurses, patient safety and more positive patient outcomes; therefore, this paper highlights suggestions for change, with a concentration on nursing dissatisfaction and the nursing shortage.

It is no secret that the United States is currently experiencing a shortage of nurses . “The U.S. Department of Labor, Bureau of Labor Statistics ( 2009 ) estimated that more than one million new and replacement nurses will be needed by 2018 to meet the increased demands of the health care workforce” (). The stressful conditions under which nurses work, due in part to the nursing shortage, are among the risk factors that contribute to nurses’ abuse of illicit drugs and alcohol. Nurses are unique in that they work in an environment where they not only have access to controlled substances, but also are exposed to critically ill patients, traumatic situations, death and dying, the stress of which can increase the risk of substance abuse. (Epstein, Burns, & Conlon, 2010). Unfortunately, it is the patient that suffers the most.

The shortage of nurses in the United States has been discussed often and has been fully reported in the media over the past several decades. There have been reports of shortages so critical that they actually have become "…a national security concern" (Nelson, 2002). Moreover, the reasons for the shortages and potential solutions for this crisis are extremely well covered in the scholarly literature. In this paper, an article in the peer-reviewed Health Marketing Quarterly points to how the nursing shortage can be addressed using marketing strategies. In addition, other scholarly articles will be reviewed in order to address the challenges and consequences that could result if this crisis is not addressed immediately.

The United States healthcare industry faces many challenges everyday, such as the rising cost of care, medical errors, access and quality problems etc. Within the next few years, the United States will experience a shortage of Register Nurses (RNs). “Registered Nurses are considered one of the largest health professions in the health care industry. The Nurses duty is to provide direct patient care and can be done in a hospital, public health facility, nursing home and many other different settings. Other services included are patient education on disease prevention, administering treatments and promoting a healthy lifestyle.” ("The Future of the Nursing Workforce: National- and State- Level Projections 2012-2025”) The shortage will occur due to Baby Boomers aging and the demand for health care will dramatically rise. With the baby boomers aging, Registered Nurses are at the top of the list for demand in health care. Unfortunately the supply and demand does not meet. “According to the Bureau of Labor Statistics’ Employment Projections 2012-2022 released in December 2013, RNs will increase of about 526,800 within that time frame but will still have job openings of 1.05 million by 2020)”("Nursing Shortage") Indicating that there is no growth between 2012- 2022. There are multiple factors to this shortage and one of them is that nursing schools across the nation are struggling to increase the capacity of students to meet the rising demand. Considering the fact

In 1960, Virginia Avenel Henderson a nurse and a theorist in the same time, defined nursing, “the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible”. It is a noble function and to be fulfilled at the highest levels, it takes time, patience and the devotion. When the number of people given this care is much lower than that of people who must receive the care, then a crisis occurs. The phenomenon is acute not only in America but all around the world. Even if the nursing is considered a meaningful work, the country is facing a nursing shortage that grows more with each passing year. Nursing shortages in America affect all parts of the health care delivery system.

The Nursing Profession has been experiencing shortages for many years. The pattern seems to be repetitive, high demand for nurses followed by phases of downsizing with a surplus of nurses. The earlier years of the nursing shortage was short compared to today’s current nursing shortage. The nursing shortage exist globally and in all nursing areas. There are several factors that are the cause of the nursing shortage of today as well in years past.

Due to the current worldwide nursing shortage, delegation is an essential aspect of the nursing profession. Delegation provides a way in which professionals can assign other employees tasks both to decrease workload and increase satisfactory patient care. However, many individuals within the healthcare system, including myself, do not fully understand the concept or importance of delegation. After doing my research, I have gained a new perspective of delegation, and some of the issues involved. There are many actions being taking to educate students as well as professionals of the true meaning of delegation and what all it entails.

We hear nurse’s talk about how rewarding their profession is but what they seldom talk about is how it can be very challenging as well. There seems to be many issues existing in the nursing profession. One of the most affective issues in nursing is the decreasing number of staff nurses. With inadequate staffing, nurses are demanded to have more responsibilities thus causing more stress on the nurse. This increase in responsibility causes nurses to neglect many aspects of their patients’ care. Patient care is suffering from the shortage of nurses as there is an increase in adverse patient outcomes due to the shortage. Also, there is evidence that there is a positive relationship between the number of staff and the effectiveness of their teamwork. The more staff available the more likely nurses will work together as a team. A new act is being implemented to help with the nursing shortage. This act is called the National Nursing Shortage Reform and Patient Advocacy Act. The purpose of this paper is to discuss the issue of nursing shortage and how the National Nursing Shortage Reform and Patient Advocacy Act is an example of evidence-based practice.

The nursing shortage is no longer a projected problem in the healthcare industry in the United States, this problem is present and is not phasing out anytime soon. Addressing this challenge would improve job satisfaction, reduce burnout in the profession and ultimately improve retention.

In 1873 there were four hospitals with a school of nursing with in them. These hospitals were the New England Hospital for Women and Children; Massachusetts General Hospital; New Haven Hospital; and Bellevue Hospital.( 1996.Nursing. Dictionary of American History) The number of hospitals and hospital with nursing schools inside of them increased, because the hospitals soon found that the mortality and morbidity decreased with improved nursing care.( Nursing. Dictionary of American History) The shaping and molding of the nursing profession made the hospitals that we know today to be possible. In the 1860’s and 1870’s more Americans went to the hospitals for treatment because of the emphasis on hospital cleanliness, and the professional nurse.( Kellison, Kimberly. 1997-1998) Mary Eliza Mahoney became the first black graduate nurse in 1879.( Hine, Darlene,C., 1996) From 1893 to 1900 the number of nursing schools inside hospitals increased 225 to 432, and the number of hospitals increased from 178 to over 4000.( 1996.Nursing. Dictionary of American History) Nursing became considerably more popular and “by 1920, 54,953 women were in nursing

through the wound care being performed and missed a major step in caring for that patient, leading to infection. The effect of increased nurses to patients has been shown many times to improve patients’ outcome.

The ongoing instability evidenced from the high mobility of qualified nurses in the nursing workforce has raised many questions about the issue of nursing shortage and nurse turnover (Gates & Jones, 2007). The paper below discusses the issues of nursing shortage and nurse turnover. The paper also describes how leaders as well as managers in the nursing fraternity and other leaders can resolve those problems effectively and the different applicable principles, skills, roles of the leader, and theories of leadership and management.

Modern nursing is a rewarding, but challenging, career choice. The modern nurse's role is not limited only to assist the doctor in procedures, however. Instead, the contemporary nursing professional takes on a partnership role with both the doctor and patient as advocate caregiver, teacher, researcher, counselor, and case manager. The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the client's dignity. In order for a nurse to be an effective caregiver, the patient must be treated in a holistic manner. Within the subject of nursing, there are often times in which different aspects of the practice must be analyzed by using primary research from other scholars. Nursing scholarship is vital to the profession, as we have seen, in order for the modern nurse to remain current with scholarship and practice. At the very core of this paradigm, though, is the manner in which the blend of art and science in nursing will be expressed to others, to the next generation, and through pedagogical theory (Alligood & Tomey, 2002). To do this, however, requires a new approach to the paradigm of nursing leadership strategic thinking, planning and action and above all appropriate integration of a more holistic and multidisciplinary approach to professional nursing.