Introduction of the Problem The American Association of Colleges of Nursing released an estimated report early this year on nursing shortage in America. The report issued by Health Affairs, Dr. David I. Auerbach stated that the number will rise to 340,000 by the year 2020, and the increase of shortage (by three times) in registered nurses will be experienced by the fifty states of America until 2015 (AACN). In a report made by U. S. Department of Health and Human Services noted the causes of shortage for registered nurses.
According to the report, there are three reasons for this, to wit: (1) the growth and aging of the population, (2) greater need for high-quality healthcare, and (3) registered nurses of America are facing retirement. In addition to this, the American Association of Colleges of Nursing presented contributing factors to the problem. First, the enrollment of nursing remains stagnant and projected that it will not grow within the next more years.
Next, there is also shortage of faculty members, clinical sites, classroom space, and even budget in order to operate nursing school; third, the students enrolling the nursing course have an average age of 46. 8. ; the growth in number of registered nurses is very slow; seventy-five percent of registered nurses experience job burnout and dissatisfaction; and many others. Dana Weinberg cited that “the worst nursing shortage in our nation’s history necessitated the unprecedented restructuring in the health care industry” (Weinberg, 2003) which has affected the performance of the nurses.
The restructuring resulted to the merger of Beth Israel Hospital and the Deaconess nursing service, which created enormous problems for the nurses. Weinberg said, “Restructuring undermined the elements that had made the different models of nursing practice successful on each campus prior to the merger and diminished nurses’ ability to plan, implement, and evaluate care for the patients” (Weinberg, 2003).
The nursing shortage created a serious problem of understaffing that resulted to work overload, which contributed to the causes of error in giving medication. Jacqueline Byers and Susan V. White pointed out that understaffing refers to “a situation of in adequate human resources allocation in which the workload or the nature of the work exceeds the number and/or abilities of the available staff” (Byers, 2004; White, 2004).
Byers and White cited surveys of nurses report that workloads are unmanageable, and that patient care quality is suffering. Byers and White pointed out a report by the Joint Commission on Accreditation of Health Care Organization in 2002 entitled Health Care at the Crossroads, which confirm understaffing as a significant source of medical error. The report stated that understaffing causes work overload, which creates conditions of slips, mistakes, and rule violations. Byers and White cited:
Studies find that lower RN/patients ratios, licensed nurse level, and RN/nurse or licensed nurse/nurse ratios are associated with higher institutional rates of complications, falls, failure to rescue , medication errors, mortality, nosocomial infections, patient/family complaints, and skin breakdown” (Byers, 2003; White 2004 p. 197). In a separate report on nursing shortage prepared by the New York State Education Department to New York State Board of Regents in April 2001, there state that in that year, about 92% of NYS hospitals have reported vacant registered nurse positions that causes a big impact in most hospitals.
In that report, it stated that due to nursing shortage, some hospitals in New York have been forced to close some of their departments, such as Ellis Hospitals and John Hopkins Hospital. This case presented a bigger risk on the health of people. Referring to this William Charney emphasized that “a nursing shortage means less nursing time for each patient and conditions that jeopardize safe patient care” (Charney, 2004).
Charney noted that hospitals with turnover rates of less than 12% had lower death rates; patients in hospitals with fewer intensive care nurses were more likely to have longer stays and postoperative complications: and that higher nurse staffing ratios correlated with 12% to 39% reduction in certain adverse outcome. Definition of the Problem Nursing shortage is defined as “the demand and need for Registered Nurses’ services greater than the supply of Registered Nurses who are qualified, available and willing to do the work (Turner, cited ANA, 2002).
Mireille Kingma explained the term as demand and need; demand in economic term, is “the amount of a service that consumers would be willing to acquire at a given price; and, need is a “subjective judgment about the ideal amount of a product or service that should be available regardless of the price” (Kingma, 2006). Meaning of nursing in the context of consumers it means ‘demand,’ while, in the context of professional association or health planner, that is ‘need. ’ However, in today’s issue on nursing shortage, demand is the most appropriate term to use.