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.
Nursing Shortage and Nurse Turn-Over Nursing shortage is one of the major issues in the health care organizations in United States and that results in decreased patient outcome and poor patient satisfaction. One of the main reasons for nursing shortage is aging work force. Nurses are the largest group of health care professionals in America, but majority of the nurses are close to retirement age. The nursing profession was very popular in 1960’s and 1970’s but currently there are different career opportunities available for women (Nevidjon & Erickson, 2001).
These newly presented career opportunities have an adverse impact on new nursing candidates. Another reason for the nursing shortage is the lack of nursing school faculties and there are many nursing faculties that do not have proper classroom, clinical sites, and preceptors. Nursing is a very tough job both physically and mentally because of stressful work environment and that can lead to nursing burnout. Nurses are very unhappy with their workplace because of poor management, excessive workload, and abuse from patients or patient’s family. According to Dr. Linda Aiken (as cited in Nevidjon & Erickson, 2001), nurses are dissatisfied with their workload which affects the patient safety. The nursing shortage mainly affects patient care that ends up in high mortality rate. Nurse turn-over is another major issue affecting the performance and profitability of health care organizations.
The financial cost of losing a single nurse has been calculated as equal to double the annual salary of a single nurse. Various studies reveal that each hospital in America is losing almost $300, 000 per year because of nurse turn-over. Nurse turn-over can negatively impact the ealth care system in many ways such as poor quality of patient care, increased medication error, hospital acquired infection, prolonged patient stay at hospital, and increased staffing cost. Many factors contribute to nurse turn-over such as workload, absence of career opportunities, poor work recognition, and lack of communication with management about issues (Hunt, 2009). Strategies for Nursing Shortage and Nurse Turn-Over Nursing shortage and nursing turn-over cannot be addressed through a single intervention because there are multiple reasons for the shortage and turn-over.
Nurse managers and leaders play a major role in solving this problem by different approaches. Many different strategies are available to address these issues and they are described as follows. Create a Healthy Workplace The main role of nurse manager is to create a healthy, pleasant, and productive work environment for the staff. A nurse manager should have a variety of skills to deal with diverse group of people to maintain a good work environment. Nurse manager can offer flexible work schedules to the staff because young workers prefer long shift like 12 hours and older workers prefer short shift like 8 hours.
Organization can provide attractive benefits such as health insurance, retirement plan, tuition reimbursement, and vacation based on years of service to the organization. Nurse manager should encourage nurses to go for higher education and allow them to change their position to prevent nursing burnout. Nurse manager can also upgrade the technology to reduce workload of the nurses such as technologies for lifting patients (stretcher bed), lift teams, bariatric equipments, transport teams and proper training for body balance.
Nursing job is very stressful so the managers should appreciate and award nurses for the work they do (Nevidjon & Erickson, 2001). Increase the Supply of Nurses To overcome nursing shortage, nurse managers and leaders can recruit increased number of nursing students to the nursing program. Nurse manager can organize community programs to create interest among young people towards nursing program and offer them scholarships. They can also arrange community outreach programs to encourage the people to know more about nursing and let them aware that nursing is a good profession.
Nurse manager can encourage the organization to lobby the law makers to permit hiring of nurses from abroad. These strategies can reduce the overall nursing shortage throughout the country by increasing the supply of nurses (Nevidjon & Erickson, 2001). Screening Out Job Candidate with Poor “Job Fit” One of the major factors of nursing turn-over is hiring candidates with unrealistic expectation about their responsibilities, requirements, and benefit of their job. Nurse managers can use a well-structured assessment tool to evaluate candidate’s interest in the job and communicate with them clearly about the expectation of the work.
Realistic job previews give candidates exposure to the requirements, benefits, and work duties of a job either by providing them with clear description of the job or through exposing them to the actual work environment. These previews have proven to be effective for reducing turn-over associated with poor fit related to job characteristics such schedules, pay rates, and job task (Hunt, 2009). Theories, Principles, and Skills in Nursing Management Nursing leaders should have certain skills and abilities to be effective in their work such as organizational management, communication, analysis/strategy, and creation/vision.
Nurse manager is critical to recruitment and retention efforts. Leaders should demonstrate honesty, integrity, and optimism. Nursing staff always wants good communicator who are receptive to others and who are motivational, approachable, fair, and empowering. Research shows that 84 percent of the nurses who left their job because of dissatisfaction with their nurse managers (Contino, 2004). System theory is applicable to nurse managers to allow them to make appropriate changes in the system to provide a good work environment for the nurses and to retain skilled nurses.
Nursing leaders should have a Trait theory approach that has mainly six skills such as vision, passion, trust, curiosity, integrity, and daring. Attitudinal leadership theory helps the leaders to maintain a good relationship with managers and with the staff (Huber, 2009). My Personal and Professional Philosophy My Personal and professional philosophy about nursing shortage and turn-over is to provide the nurses with a positive work environment. Managers have to be approachable and supportive for the staff because it is very difficult to work in a stressful environment.
Nurse managers should communicate with the staff regularly to know their issues and resolve those issues to make the staff comfortable at the work place. Nurses should be respected and treated as professionals at work and community. Organizations should design collaborative councils including all health care providers to improve mutual respect. Managers should involve all nurses in decision making and give them responsibilities to make them feel as part of the team. Conclusion Managers face a significant challenge about staffing in the active workforce.
To resolve this problem nurse manager has to create and maintain a positive work environment, bring new nursing candidates to the profession, and retain qualified nurses. Management of health care provider organizations should support the role of nursing leadership. The nurse manager’s position description should emphasize retention of staff at the front line of care delivery. Concurrent with providing nurse managers the tools to retain staff, nurse managers must also clearly understand their responsibility and accountability for nurse retention.