Short Staffing Research Paper

The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.

Orderly Staffing Inc. focuses on the recruitment of Speech and Language Pathologist for school districts. Orderly Staffing Inc. is the primary employer of the Speech and Language Pathologist, working on payroll, benefits, and continued support. Orderly Staffing Inc. will match Speech and Language Pathologist to school districts, help with contract negotiations and future position vacancies.

Dr. Linda Aiken is the leading researcher in nursing staffing rates within the United States (Kerfoot & Douglas, 2013). She suggests that each state follows California’s example of conducting research to determine a minimum staffing ratio and making it a law (Kerfoot & Douglas, 2013). The California legislation enhanced nurse staffing in hospitals across the state and improved the patient care results of millions of patients (Kerfoot & Douglas, 2013). After the bill went into effect, job satisfaction increased, and the nursing shortage ended (Kerfoot & Douglas, 2013).

The nursing shortage has been influenced by the aging workforce, shortage of nursing faculty, professional alternatives, poor working conditions and poor nursing image. By 2020, there will be an increase in demand for registered nurses (RNs) due to the increase need for healthcare services to meet the needs of the baby boom generation (Keenan & Kennedy, 2003). It is estimated that the nursing shortage will range from 400,000 to 808,000 full-time equivalents (FTE) RNs. The nursing shortage has impacted the intensive care units (ICU), medical surgical units and operating rooms (Keenan & Kennedy).

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

The third challenge our healthcare system faces is the shortage of nurses. Part of this shortage is due to the lack of infrastructure. In the academic year of 2010-2011, 67,563 qualified students were not admitted into nursing schools due to the lack of faculty, training facilities and other budget constraints. This is a clear indication that unless there is improvement in the infrastructure, such as state and national funding, that there could possibly be a collapse in the nursing educational system (Dunham, 2009).

The institutions began redesigning staffing schedules and care plans for clients to accommodate the decreased need (Institute of Medicine Staff, Davis, Sloan, & Wunderlich, 1996, p. 94). Most institutions restructured trying to reduce operating costs by changing work methods and roles of the staff. Between 1981 and 1993, full-time-equivalent (FTE) nursing staff declined by more than 7 percent nationally after adjusting for client days and case-mix complexity (Aiken, Sochalski, & Anderson, 1996, pp. 88-92). These changes were done without regard to better client outcomes, thus producing the current need for change.

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.

The shortage of registered nurses (RNs) in the United States has been a cyclical topic dating back to the 1960s. Only recently have employers in certain regions of the nation stated a decline in the demand for RNs. Consequently, according to the American Association of Colleges of Nursing’s (American Association of Colleges of Nursing [AACN], 2014) report on 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, American nursing schools denied admission to 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. The reported decrease in job availability and rejected admissions has left many individuals to question if the nursing shortage still exists. On the other hand, some

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

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

Improving education and training is one of the strategies to address nursing shortage. Increase in federal funding to compensate current faculties and graduate students faculty is essential in addressing the issues. This will decrease vacancy rates and help to improve workload. Development of a program among regional and statewide nursing schools is another factor to consider. This promotes joint efforts with faculties allowing them to make use of resources efficiently which also assist in students nurse advancement. Moreover, it

214) “The ACA and the need for APRNs, nurse faculty, and nurse researchers would have increased dramatically under any scenario.” (L R Cronenwett [RWJF Iniative on the Future of Nursing], 2010, table 1). “Not only must schools of nursing build their capacity to prepare more students. Nursing need to focus on fundamental improvements in the delivery of nursing care to improve patient safety and quality is key.” (IOM, 2010, p. 208)

The supply of nurses is not sufficient to meet the current demand, and the shortage is projected to grow further as future demand increases. Most corresponding factors that are affecting the supply of nurses are also impacting the quantity of nurse educators. Therefore, the understaffing of nursing educators is also impacting the amount of nursing students available.

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.