Current Issue in Nursing: Nursing Shortage
Nursing quality and adequate staffing are intertwined. Adequate levels of nurses, lower nurse to patient ratios, and also more highly trained nurses are associated with better health outcomes and lower mortality rates. But despite the fact that there is high demand for nurses, and also increased interest in entering this very exciting profession, retaining qualified nurses and recruiting new nurses is a struggle for many hospitals. Also, in a desire to cut costs, many institutions are often unwilling, despite evidence-based research supporting higher staffing ratios as leading to lower-cost and superior patient outcomes, to hire more nurses as healthcare staffing makes up as much as 40% of all intuitional operating costs (“Nursing Shortage,” 2019).

The attempt to cut costs by reducing staff levels reflects an unfortunately misguided view of the value of the nursing profession. It also reflects a misguided view of an aging patient population which increasingly consists of patients with multiple chronic conditions, many of which must be managed with long-term care and guidance. Nursing has gained respect a profession within the healthcare industry as a whole, as more nurses are performing functions once filled by physicians, but nurses must be treated with the respect they deserve in terms of reasonable patient loads and scheduling. Nurse leaders must offer realistic institutional approaches to circumvent burnout. This paper will attempt to address the causes of the nursing shortage, and also make suggestions for improving the problem. Nursing faculty shortages, an inability to admit all qualified candidates to nursing schools, combined with a dramatically expanded and diverse patient population with higher rates of chronic versus infectious diseases are all contributing to the need for more nurses, combined with quality of life issues for many nurses. There are also some positive societal shifts, such as an increase in the number of patients with health insurance, which still increases the patient load for nurses as a practical problem and must be addressed.

Synthesis of References

According to ANA Health Care Economist Peter McMenamin (2019), many nurses who deferred their retirement during the so-called Great Recession of 2008 have now finally started to retire; the Affordable Care Act (ACA) brought forth many new formerly uninsured individuals into the healthcare system as regular health consumers. There is a projected 15% job growth for nurses, a faster rate than all other occupations (Haddad & Toney-Butler, 2019). The population is aging, and older people require more healthcare, and have a higher rate of comorbidities. But the nursing profession is itself aging, and one-third of the current workforce of registered nurses will be eligible for retirement by 2029 (Haddad & Toney-Butler, 2019). It is vital that the profession take action in the here and now to supplant this deficit, so as the last of the Baby Boom generation of nurses retire, there is a new generation of qualified and trained nurses to rectify this threatened deficit.

McMenamin (2019) also notes that the nursing population is becoming more educated than it has been historically, with greater mastery of complex concepts like disease management and greater technical knowledge. This has resulted in advanced practice registered nurses (APRN)s practicing independently in many states, and more than half of all health insurers reimburse APRNs for independent practice (“ANA Health Care Economist Peter McMenamin on the Nursing Shortage Outlook,” 2019). But the demand for nursing education, particularly for graduate-level degrees, also means a subsequent demand for highly trained and qualified faculty, which is not itself being met. Lower faculty versus professional nursing salaries, a lack of interest in teaching versus practicing, and a number of other...…and less time spent with patients. This further compounds the level of stress experienced by nurses working on units, which them must work to compensate for the mistakes of others, and are (rightly) subjected to greater scrutiny because of higher rates of patient recidivism, poor follow-through on the part of patients regarding discharge orders, and lower rates of patient satisfaction.

The nursing shortage is a complex, multifactorial problem. But it is not an insurmountable one. Higher salaries for nursing faculty and incentives for nurses to teach at the undergraduate and graduate level are needed. It may also be necessary to allow qualified nurses with experience but without PhDs to teach certain classes. Universities must expand and fund their programs. Increasing online enrollment may be helpful in permitting nurses to increase their qualifications at minimal cost while still working full-time. Healthcare institutions must be willing to pay nurses commensurate with their experience and qualifications, and consider hiring nurses to undertake duties of leadership and primary care formerly assumed by physicians. Such leadership can be empowering to the status of nurses within healthcare, as well as reduce costs. There must also be a stress reduction program and a zero tolerance for harassment, as well as adequate staffing levels to minimize burnout and interpersonal friction.

Summary

The nursing shortage is a national crisis. It is a crisis for patients, whose care is compromised due to highly stressed healthcare workers. It is also a crisis for nurses who should not have to cope with bullying and punishingly long hours and caring for more patients than is feasible. The nursing profession offers a unique, holistic approach to patient care that can be highly beneficial, given the unique conditions and challenges of healthcare in America. But nurses must be equipped to leverage their expertise in a positive…