nursing shortage essay example

Nursing Shortage Problem Problem Solution Essay

Introduction, method of obtaining necessary approval, detailed explanation of proposed solution, rationale for selecting proposed solution, description of implementation logistics, resources required for implementation.

Nursing shortage is a problem that is encountered by most of the healthcare providing institutions in many nations. It refers to a state where nursing professionals’ demand is higher than the number that is supplied to an institution. The role of nurses in health institutions is vital and cannot be assumed. This is because of crucial services they offer to patients.

It is through nurses that clients gain or lose trust of health services provided by any health institution. This means that the services of nurses is so crucial that anything that may hinder or make them compromise safety of patients should be eradicated. However, it is equally important to ensure that nurses’ workload is not too much for them to bear.

This is to mean that for delivery of effective health care to patients, the right number of nurses should always be maintained in an organization. Just like in many countries, in United States, only the registered and licensed nurses can offer health care services in healthcare institutions. Currently the State is facing a problem of nursing shortage.

There is a rising demand for nurses in many health institutions in United State, an issue that require to be addressed. Failure to address this issue in time may make nurses to compromise health status of patients in many hospitals. Several factors have led to shortage of nurses across nations. These factors include education systems that do not favor enrollment of nursing as a career and governmental or organization’s policy among others.

The organization’ leadership

To win approval of organization’s leadership in addressing the issue require presentation of health facts related to nursing shortage in the institution. The statistics of health status and provision and its relationship of nursing shortage in the organization can provide a valid basis for the management to raise concern and approve the proposal.

These statistics will provide the recommended workforce for each nurse. It will equally show the effects of shortage of nurses in this organization in relation to the workload of each nurse. This information will convince the organization’s leadership as to why they need to approve the proposal.

Fellow staff members

One of the best ways to get support and approval from fellow staff member is by unveiling the truth of the matter in this organization. This can be done by asking them some relevant questions concerning their workload in general and the effectiveness of the services they render to patients. By doing so, the staff will be a position to get the facts.

The organization may for example reflect on the ratio of patients that die to the ratio of those that survive in every 500 patients. In 2005, out of every 500 patients, only five would die and 495 patients would survive in this firm. Since the shortage of nurses’ problem arose, the healthcare is deteriorating each year. In the year 2010, out of every 500 patients, statistics show that 10 patients died and 490 survived.

It also shows that the workload for each nurse has tremendously increased with the increase of overtime working hours and the quality of services provided has generally decreased to a point of making many clients to lose trust with the services rendered by this firm. This is a clear indicator of how nursing shortage problem has affected the institution and why there is a need of fellow staff members to approve and provide necessary support towards the proposal.

Description of Current Problem, Issue, or Deficit Requiring a Change

The policy of every health care organization should be drawn with a lot of consideration on issues that arise on daily basis and several other possible factors should as well be keenly considered. According to the policy of this organization, it is stated that a specific number of new nurses should be employed every financial year.

However, this policy did not consider cases that arise and cause shortage of nurses in the institution, hence, affects the quality of health provision in this institution. Some of these cases include death of some of the nurses, transfers, firing and aging cases of others.

All these cases constantly occur in this institution with no replacement of such nurses until another financial year. This leads to continuous shortage of nurses in this organization, a deficit that is not covered even by the subsequent employment of nurses, as the number employed does not include those fired, dead, transferred, or aged.

To solve the problem of shortage of nurses in this institution, there is a need for leadership management to revise the policy and make any necessary adjustments. In this policy, the recommended workload for each nurse should be clearly defined and followed strictly.

The issue of employing nurses at the end of every financial year also requires some adjustments. It should allow a room for frequent replacement of the nurses that die, those transferred, aging and those that are fired within the course of the year. This way, the organization will be in a position to solve the problem of shortage of nurses and avoid overworking them for provision of quality healthcare services to its clients.

Having enough nurses will also help the management monitor carefully the work of every nurse. This is because the management can be able to assign nurses to various and specific wards or other areas for easy monitoring.

Selecting the proposed solution was because it is the only way to provide a lasting solution to nursing shortage, improve the deteriorating healthcare in this institution, and hence restore the lost trust of clients with the organization. It will also reduce relieve nurses from being overworked to enable them deliver efficient and effective healthcare services to the patients.

By so doing, health safety of patients will not be compromised. Mortality rate will reduce greatly as nurses will be enough to attend to every patient at a convenient time and in an effective manner. The module clearly describes the problem of nursing shortage. It states how this problem affects the general population in United States.

It explains some of the factors that lead to nursing shortage that needs to be addressed to solve this problem. In addition to enhancing favorable education system to nursing, the module states what nursing administration and policy makers have to do in addressing the issue of nursing shortage in United States.

The article explains that that the aging nurses reduces the total workforce each year. This means that there is need for an organization to replace constantly the aging nurses to avoid insufficiency of nurses in a medical institution.

The implementation of the change and its integration to the organizational structure should be implemented as soon as the report is approved. The integration can be done by making necessary amendments to the organizational structure and hiring the needed number of nurses to meet the demanded number. Both the top management and the middle level management will spearhead the whole implementation process.

They are in the best position of initiating change in this organization, train the incoming and the continuing nursing staff and to ensure that the implementation process is has taken place successfully and suits well in the culture and workflow of the organization. It is also important for the management of this organization to collaborate with policy makers and other health providers in amendment of any unfavorable nursing policies.

The main resources in the implementation of this proposal are finances and the human resource. Funds will aid in publishing the materials for advertisement on recruitment of nurses. These materials may include posters, pamphlets among others. Finances will also help the organization to use like television media for wide spread of the information on the same in order to have many nurses getting the information for application.

Human resource is needed in the form of the interviewing panel to choose the most qualified and competent team for nursing positions. In carrying out the interview, funds will be required in providing the necessary materials for the same. Funds will also be needed to print and make copies to enhance the training sessions for the successfully recruited nurses and for other necessities in incorporation of the change in the work structure of this organization.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2023, December 21). Nursing Shortage Problem. https://ivypanda.com/essays/nursing-shortage/

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Bibliography

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• How We Approve Others
• Nursing Workload and Patient Safety
• Nurse Staffing Ratios Bills and Laws in California
• Affordable Care Act and Nursing Shortage
• Nursing Shortage Issue and Recommendations
• A Nursing Shortage Article by Marc et al.
• Healthcare Staff Shortage Trend from a Nursing Perspective
• Nursing Shortage in the United States
• The Issues of Staffing in Hospitals and the Shortage of Nurses
• Nursing Shortage: As Serious As It Is Publicized?
• Caring in Nursing
• Philosophy of Nursing Science Associated with Hemodialysis and Cardiac Issues
• Nursing Philosophy: Relativism, Obscurantism, and Nihilism
• Post Modernism and Nursing Science
• Addressing the Nurse Shortage

What’s Really Behind the Nursing Shortage? 1,500 Nurses Share Their Stories

• Survey Results
• What Is the Nursing Shortage?
• Reasons Nurses Quit
• Hope For the Future
• What Nurses Need Now
• How to Take Action

Winner of the Gold Award for the Digital Health Awards, Best Media/Publications Article, Spring 2022

Update 10/10/2022

The findings of  Nurse.org's 2021 State of Nursing Survey revealed some harsh truths about the profession but also spoke to the strength, perseverance, and passion that nurses have for their work. Nurse.org has relaunched the State of Nursing survey in 2022 with the aim to capture a complete picture of the true state of the profession - from how nurses feel about work, how nurses are being treated, how nurses feel about the future of nursing, nurse's mental wellbeing and what nurses think needs to change within the profession. Take the survey now (it takes less than 10 minutes.)

>> Take Nurse.org's NEW 2022 "State of Nursing Survey" and let your voice be heard about issues in nursing that matter most. 

January 26, 2022

If the past two years have taught the world anything, it's that nurses are NOT okay. The truth is that despite the 7 pm cheers, the commercials thanking nurses for their dedication and selflessness, and the free food from major retailers – the overwhelming majority of nurses are burnt out, underpaid, overworked, and underappreciated.  

With millions of nurses worldwide, Nurse.org wanted to truly understand the current state of nursing and give nurses a voice to share their thoughts, feelings, and apprehensions about the nursing profession. We surveyed nearly 1,500 nurses to find out how they felt about the past year and get to the real reasons behind the nursing shortage . The responses were heartbreaking, but not without hope.  

What We Found: Nurses Are Struggling

Nurses are struggling. Regardless of practice specialty, age, or state of practice – the answers were all the same. Nurses, NPs, and APRNs are all struggling and need help.  

Only 12% of the nurses surveyed are happy where they are and interestingly, 36% would like to stay in their current positions but changes would need to be made for that to happen. Nurses report wanting safe staffing, safer patient ratio assignments, and increased pay in order to stay in their current roles.  

Nurses didn’t hold back when discussing their feelings regarding the current state of nursing:  

• 87% feel burnt out 
• 84% are frustrated with administrators 
• 84% feel they are underpaid 
• 83% feel their mental health has suffered 
• 77% feel unsupported at work 
• 61% feel unappreciated 
• 60% have felt uncomfortable having to work outside of their comfort zone in the past year 
• 58% of nurses have felt frustrated with their patients 
• 58% of nurses have felt unsafe at work in the past year 

The numbers don’t lie. It’s astounding that a profession continually recognized for its compassion, strength, and resilience is suffering . And the suffering is universal.  

One nurse responded with the following, “I have been an RN for 34 years and in my specialty of nursing for 31 years and I am burned out.” 

What Is the Nursing Shortage and Why is it Happening?

You’ve likely heard about the nursing shortage, but what does that mean and why is it happening? 

According to the U.S. Bureau of Labor Statistics (BLS) , the employment of registered nurses is projected to grow 9% from 2020 to 2030.  Approximately 194,500 openings for registered nurses are projected each year, on average, over the decade. However, this number was projected prior to the pandemic, and before the mass exodus of bedside clinical nurses. As a result, it’s likely substantially lower than what the real demand for nurses will look like.

The American Nurses Association (ANA) reports that the increased need for nurses spans beyond the current pandemic. In fact, they sent a letter to the U.S. Department of Health and Human Services (HHS) on September 1, 2021, urging the country to declare the current and unsustainable nurse staffing shortage to be a national crisis. 

The ANA attributes the needs for thousands of nurses to the following:  

• The Affordable Care Act made access to health care services possible for more people
• Increased focus “primary care, prevention, wellness, and chronic disease management” 
• Aging baby-boomer population
• Growing interest in community-based care

Why Are Nurses Really Leaving The Bedside? 

However, those stats don’t address some of the systemic issues nurses face every day, particularly in the midst of a pandemic. That’s why we asked nurses why they are really leaving the bedside.

What we heard is that, overwhelmingly, the number one reason nurses want to leave the bedside is because of unsafe staffing ratios. This leads to a never-ending cycle of shortages: nurses face unsafe staffing ratios so they decide to leave the bedside, this results in even fewer nurses available to care for patients, so the downward cycle continues.

Essentially, nurses are dealing with an increased workload with fewer resources. Typically, pre-covid ICU nurses would experience a 1:1 or 2:1 patient-to-nurse ratio. Now ICU nurses throughout the country are experiencing a 3:1 or 4:1 patient-to-nurse ratio which exacerbates staff burnout and unsafe nursing practices.  

One nurse reported, “With increased patient census, staffing ratios are very unsafe especially with high acuity patients. Having 4+ critically ill patients not only puts licenses at risk but the patients do not benefit at all. We’re just running around doing tasks, not providing adequate care.”

Unsafe Staffing Ratios Are Just Part of the Problem

While a big piece of the puzzle, unsafe staffing issues are, unfortunately, one part of a long list of issues plaguing nurses today. 

 Nurses are leaving the bedside because of issues like: 

• Inadequate staffing ratios 
• Not getting equal pay for equal experience 
• Not receiving hazard pay during a pandemic 
• Not having adequate back up 
• An inability to take breaks, sick days, or even turn down extra shifts 

To learn more about the nursing shortage and learn ways you can get involved, check out the full report here . 

Despite All This, Nurses Still Have Hope

70% of nurses still think that nursing is a great career and 64% still think that new nurses should join the profession. 

“If you’re a student considering becoming a nurse, please know that you are not walking into a doomed profession. You will never meet anyone who is more determined, more resourceful, or more ready to jump in and lend a helping hand than a nurse." 

--– Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org

If you’re a nurse, you know that nursing isn’t just a profession, it’s a calling. It’s devastating to see that so many nurses are suffering in their quest to heal and give care, but it’s heartening to know they are not without hope. 

What Nurses Need Now 

If you’re a nurse, know that your job is simply to put yourself first. If we want to solve the nursing shortage (and we do!), it can't happen without nurses recognizing that they are NOT the problem. 

"The problem is not with nurses or nursing; the problem is that nurses have been so busy taking care of others that no one has taken care of them. And we’re here to change that--and by entering the nursing profession, you will be part of the solution too”

 – Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org 

The truth is nurses need a lot more to be incentivized to stay practicing clinically at the bedside. Nurses reported needing:  

• Higher pay 
• Safe nurse-to-patient ratios 
• Hazard pay 
• REAL mental health resources 
• Adequate staff support 
• Support programs for new nurses

4 Ways to Support Nurses and Take Action

While we may not be able to make this change at an individual level, collectively, we can amplify the voice of nurses and shed some light on the issues that they are facing every day. Together, we have the power to create meaningful, lasting change for current and future nurses.  Here's how to get involved: 

1. Sign the Pledge

Sign the pledge seen below and encourage your friends & colleagues to do the same. While you’re at it, print it out and post it in your break room. 

2. Spread the Word 

Change can’t happen unless we get the word out about what’s really going on. Share what you’ve heard and what you’ve experienced, and encourage others to do the same. 

3. Contact Your Elected Officials 

It’s time for elected officials to stand up for nurses. Write them a letter. Call their office. Demand change for nurses. Click here to get the contact information for your local and state Officials. 

4. Download and Share the Report

Get even more in-depth insights into what’s going on with the state of nursing and the issues that nurses face today, click here to download the full State of Nursing report or read about the best and worst specialties for nurses during COVID . 

“If you are a current nurse considering leaving the profession, be assured that you are not alone in your struggles. If all you’ve had the energy for is keeping your head down and getting through your shifts, sleeping, and getting up to do it all over again, know that you are doing enough. It’s not your responsibility to solve the nursing shortage.” 

– Nurse Alice Benjamin, MSN, APRN, ACNS-BC, FNP-C, CCRN, CEN, CV-BC, Chief Nursing Officer and Correspondent at Nurse.org 

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Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

Plus, get exclusive access to discounts for nurses, stay informed on the latest nurse news, and learn how to take the next steps in your career.

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Guest Essay

Nurses Deserve Better. So Do Their Patients.

By Linda H. Aiken

Dr. Aiken is a professor of nursing and sociology and the founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

The Covid-19 pandemic exposed strengths in the nation’s health care system — one of the greatest being our awesome nurses. But it also exposed many weaknesses, foremost among them being chronic nurse understaffing in hospitals , nursing homes and schools .

More nurses died of job-related Covid than any other type of health care worker. The more than 1,140 U.S. nurses who lost their lives in the first year of the pandemic knew the risks to themselves and their families. And yet they stayed in harm’s way. They cared for their fallen co-workers. They went to New York from around the country to fight on the front lines in the first Covid surge. Nurses from Northwell Health in New York returned that support by deploying to the Henry Ford Health System in Detroit in December when a surge occurred there.

We celebrate nurses now. We call them heroes. But if we value their sacrifices and want them to be there when we need them, we must prevent a return to the poor prepandemic working conditions that led to high nurse burnout and turnover rates even before Covid.

As a nurse with extensive clinical experience in hospitals, I found it nearly impossible to guarantee safe, effective and humane care to my patients. And so I established the world’s leading research center on nursing outcomes to understand the causes of nurse understaffing in the United States and abroad and to find solutions to the problem.

The United States has a robust supply of nurses . And there is no evidence that recruits to nursing have been deterred by Covid. To the contrary, applications to nursing schools increased during the pandemic.

Death, Through a Nurse’s Eyes

A short film offering a firsthand perspective of the brutality of the pandemic inside a covid-19 i.c.u..

I was looking through the window of a Covid I.C.U. And that’s when I realized I might see someone die. I didn’t even know who she was. But I was filled with immense grief as she edged closer to death by the hour. What I didn’t know yet was that by the time I left just two days later, at least three patients would be dead. The vaccine offers hope, but the sad truth is that the virus continues its brutal slaughter in I.C.U.s like this one in Phoenix, Ariz. The only people allowed in are health care workers. They’re overworked and underpaid in a deluged hospital. I wanted to know what it is like for them now, after a year of witnessing so much death. Eager to show us their daily reality, two nurses wore cameras so that for the first time we could see the I.C.U. through their eyes. “Unless you’re actually in there, you have no idea. Nobody can ever even imagine what goes on in there.” [MUSIC PLAYING] This I.C.U. contains 11 of the hospital’s sickest Covid patients. Most of them are in their 40s and 50s. And they are all on death’s door. It’s an incredibly depressing place. I blurred the patients faces to protect their privacy. But I also worried that blurring would rob them of their humanity. The family of this patient, the one who is rapidly declining, allowed her face to be shown. And they readily told me about her. Her name is Ana Maria Aragon. She’s a school administrator and a 65-year-old grandmother. Sara Reynolds, the nurse in charge of this I.C.U., organized a video call with Ana’s family to give them a chance to be with her just in case she didn’t make it. “It just breaks my heart when I hear families saying goodbye.” You might expect the doctors to be running the show. But it is really the nurses who are providing the vast majority of the care. “We do everything. We give them baths every night.” “Rubbing lotion on their feet.” “Shave the guys’ faces.” “Cleaning somebody up that had a bowel movement. It doesn’t even register as something gross.” “Look, I walk into the room. I say, hey, sounds like you have Covid. And I might order a chest X-ray. I might order blood work. I might order catheters. All that stuff is done by the nurse. I may have spent 10 minutes. The nurse might spend seven or eight hours actually in the room, caring for them. Let’s say there was a day that nurses didn’t come to the hospital. It’s like, why are you even opening?” “Ibuprofen.” 12-hour-plus shifts, isolated in this windowless room, these nurses survive by taking care of each other. “Aww, thank you.” And by finding small doses of levity. [MUSIC - JAMES BAY, “LET IT GO”] “(SINGING) Wrong. Breeze.” “I’m getting older now, and there’s all these new young nurses coming out. And I feel like a mom to all of them. Morgan, she’s got big aspirations. She loves to snowboard, and she’s so smart. And Deb, Deb’s just— she’s funny.” “I tease her all the time. I can tell her to do anything, and she’ll just do it because I think she’s scared of me because I just always say, make sure you have no wrinkles in those sheets.” The patients spend most of their time on their stomachs because it makes it easier to breathe. But the nurses have to turn them often to prevent pressure sores. There was one woman in her 50s who was so critical that this simple procedure risked killing her. “Even just turning them on their side, their blood pressure will drop. Their oxygen levels will drop.” “Her heart had actually stopped the day before. And so the concern was if it was going to make her heart stop again.” “Then come over. Push.” “We were all watching the monitors.” “I felt relieved like, whew, we did it.” Arizona’s a notoriously anti-mask state. And it faced a huge post-holiday surge in Covid cases. In January, the month I was there, Arizona had the highest rate of Covid in the world. As a result, I.C.U.s like this one have too many patients and not enough nurses. “Because they’re so critical, they need continuous monitoring, sometimes just one nurse to one patient with normally what we have is two patients to one nurse. But there definitely are times when we’re super stretched and have to have a three-to-one assignment.” A nurse shortage has plagued hospitals over the past year. To help, traveler nurses have had to fly into hotspots. Others have been forced out of retirement. Especially strained are poorer hospitals like Valleywise, which serves a low-income, predominantly Latino community. “Many of our patients are uninsured. Some of them have Medicaid, which pays something but unfortunately not enough.” This means they simply can’t compete with wealthier hospitals for nurses. “There is a bidding war. The average nurse here, give or take, makes about $35 an hour. Other hospitals, a short mile or two away, might pay them $100.” “We lost a lot of staff because they took the travel contracts. How can you blame them? It’s sometimes a once-in-a-lifetime opportunity to make a lot of money.” “Every single day I’m off, I get a call or a text. ‘Hey, we desperately need help. We need nurses. Can you come in?’” This nursing shortage isn’t just about numbers. “Physically it’s exhausting. We’re just running. We don’t have time to eat or drink or use the restroom.” “They have kids at home, doing online school. And I think, gosh, they haven’t even been able to check on their kids to see how they’re doing.” “My days off, I spend sleeping half the day because you’re exhausted. And eating because we don’t get to eat here often.” Nurses have been proud to be ranked the most trusted profession in America for nearly two decades. But during Covid, many worry they aren’t able to uphold the standards that earned them such respect. “I can’t give the quality of care that I normally would give.” “It’s absolutely dangerous.” “That’s demoralizing because we care. We’re nurses. It’s our DNA.” Ana had been in the hospital for over a month. Her family told me she was born in Mexico. She came to the States 34 years ago, first working in the fields before eventually landing her dream job in education. She’s beloved at her school. Former students often stop her in town and excitedly shout, Miss Anita. She was very cautious about Covid. She demanded her family always wear a mask and yelled at them to stay home. Yet, tragically, she somehow still caught it. “She had been declining over the course of several days. It’s a picture we have seen far too often that we know, this one is going to be coming soon.” Because there is no cure for Covid, the staff can only do so much. Once all the ventilator settings and the medications are maxed out, keeping a patient alive will only do more harm than good. So Ana’s family was forced to make a tough decision. “And I talked to family and let them know that we have offered her, we have given, we have done everything that we can, there’s nothing more that we can do. The family made the decision to move to comfort care.” “If I’m there while someone’s passing, I always hold their hand. I don’t want somebody to die alone. That’s something that brings me peace.” “Thank you.” “Thank you.” “Dance floor is packed. People hugging, holding hands, and almost no one wearing a face mask.” “I think like many health care workers, I’m angry a lot. And my faith in humanity has dwindled.” “How can you think this isn’t a real thing? How can you think that it’s not a big deal?” “Free your face. Free your face.” Arizona Gov. Doug Ducey has advocated for personal responsibility over mask mandates even though he’s been photographed maskless at a gathering and his son posted a video of a crowded dance party. “Even on the outside, they go, I don’t care. I’m not wearing a mask. I’m not getting the vaccine. That’s bullshit. The second they come into the hospital, they want to be saved. Never do they say, ‘I made the decision. I’m accepting this. Don’t do anything, doctor.’” Half a million people in this country have died from Covid. Many have been in I.C.U.s with nurses, not family members holding patients’ hands. “I always wonder, are they still going to be there when I get to work? It’s on my mind when I get home. Are they going to make it through the night? There’s one that I can think of right now.” One patient in his late 50s was so critical that he required constant supervision. Each of his breaths looked painful. “There was one day that he was kind of— he was looking a little bit better. And so he was able to shake his head and smile. And we set up a video call for him. And it was just the sweetest thing ever. I could hear his little grandson— he was probably 4 years old or so. And I saw him on the screen, too. And he was just jumping up and down, so excited. ‘You’re doing it, Grandpa. You’re doing it. We love you. Look at you. You’re getting better.’ It just broke my heart. It broke my heart. He’s one that I don’t think is going to be there when I get back on Sunday.” But I’d already been told something Sara hadn’t. The patient’s family had decided to take him off life support. “Yesterday they did? Oh. And I just think of his little grandson. And ‘you’re doing it, Grandpa. You’re doing it.’” He wasn’t the only patient who didn’t make it. When I went back to the hospital, I noticed that the bed of the patient I’d seen get flipped over was empty. My heart sank. I knew this meant she’d passed away. “What’s sad is when I go back, those beds will be full. They’ll have somebody else there just as sick with another long stretch of a few weeks ahead of them before it’s time for their family to make that decision.” I’d never before seen someone die. And even though I didn’t know these people, witnessing their deaths left me sleepless, exhausted, and depressed. It’s unfathomable to me that these nurses have gone through that every single week, sometimes every single day for an entire year. I assumed the nurses must block out all the deaths to be able to keep going, but they don’t. They grieve every single one. “I’ve always loved being a nurse. It’s what I’ve always wanted to do. And these last couple months, it’s definitely made me question my career choice.” And what makes their situation so tragic is that many of these nurses hide their trauma, leaving them feeling isolated and alone. “We’re the only ones that know what we’re going through. I don’t really want to tell my family about everything because I don’t want them to feel the same emotions that I feel. I don’t want them to know that I carry that burden when it— that it is a lot. I’m Mom. I’m strong. I can do anything. And I don’t want them to see that.” Leadership in the pandemic hasn’t come from elected officials or spiritual guides but from a group that is underpaid, overworked and considered secondary, even in their own workplaces. As so many others have dropped the ball, nurses have worked tirelessly out of the spotlight to save lives, often showing more concern for their patients than for themselves. I worry their trauma will persist long after we re-emerge from hibernation. Covid’s legacy will include a mass PTSD on a scale not felt since World War II. This burden should not be ignored. “Thank you. Thank you. I feel, yeah. And you’re all amazing.” [MUSIC PLAYING]

Nevertheless, we find ourselves too often with a shortage of nursing care. Many decades of research reveal two major reasons: First, poor working conditions, including not enough permanent employer-funded positions for nurses in hospitals, nursing homes and schools. And second, the failure of states to enact policies that establish and enforce safe nurse staffing; enable nurses to practice where they are needed, which is often across state borders; and modernize nurse licensing rules so that nurses can use their full education and expertise.

Training more nurses cannot solve these problems. But more responsible management practices in health care, along with better state policies, could.

Not only are states not requiring safe nurse staffing, but individuals also do not have the information and tools they need to pick hospitals and nursing homes based on nurse staffing or to advocate better staffing at their hospitals and nursing homes.

Ninety percent of the public in a recent Harris Poll agreed that hospitals and nursing homes should be required to meet safe nurse staffing standards. But powerful industry stakeholders — such as hospital and nursing home organizations and, often, medical societies — are strongly opposed and usually defeat legislation.

The New York State Legislature is the first in the postpandemic era to fail to approve proposed safe nurse staffing standards for hospitals. The legislature passed a bill that did not require safe nursing ratios, opting instead for internal committees at hospitals to oversee nursing and patient safety. This happened despite compelling evidence that the legislation would have resulted in more than 4,370 fewer deaths and saved more than $720 million over a two-year study period through shorter hospital stays.

What are the solutions? While there are some actions the federal government could take, the states have most of the power because of their licensing authority over occupations and facilities. The hospital and nursing home industries have long failed to police their members to remove the risk of nurse understaffing. So states should set meaningful safe nurse staffing standards, following the example of California, where hospital nurses cannot care for more than five adult patients at a time outside of intensive care. State policies are tremendously influential in health care delivery and deserve greater public attention and advocacy, as they are also ripe for exploitation by special interests.

In states with restrictive nurse licensing rules, many governors used their emergency powers during Covid surges to waive restrictions. If they were not needed during a national medical emergency, why are they needed at all?

Still, the federal government has a role to play: It should require hospitals to report patient-to-nurse staffing ratios on the Medicare Hospital Compare website, because transparency motivates improvement. The federal government could incentivize the states to pass model nurse practice acts.

We need influential champions taking on special interests so that states will make policy changes that are in the public’s interest. AARP is using its clout to advocate nurse-friendly policies. But health insurers and companies such as CVS, Walgreens and Walmart that provide health care have been on the sidelines.

While we long to go back to pre-Covid life, returning to chronic nurse understaffing in hospitals, nursing homes and schools would be a big mistake. We owe nurses and ourselves better health care resources. The so-called nurse shortage has become an excuse for not doing more to make health care safe, effective and patient-centered. State legislators must do their job. Health care leaders must fund enough positions for nurses and create reasonable working conditions so that nurses will be there to care for us all.

Linda H. Aiken is a professor of nursing and sociology and the founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

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An earlier version of this article misstated the status of legislation on nurse staffing standards in New York State. The bill passed without setting minimum nursing ratios; it did not fail to pass.

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Addressing the Nursing Shortage in the United States: An Interview with Dr. Peter Buerhaus

The nursing shortage in the United States has reached a crisis point. Hospitals that have been overwhelmed by patients with COVID-19 face an additional challenge because nurses have decided to no longer work in hospital care, have gone to work in temporary positions, or have left the workforce altogether. To understand this problem better, Dr. David Baker, Editor-in-Chief for The Joint Commission Journal on Quality and Patient Safety , interviewed Dr. Peter Buerhaus on January 27, 2022. Dr. Buerhaus is a professor in the College of Nursing at Montana State University and director of the Center for Interdisciplinary Health Workforce Studies. He's one of the leading authorities in the country on the nursing and physician workforces in the United States. Dr. Buerhaus is both a nurse and a health care economist, so he brings a unique perspective and experience to his work in this area.

Dr. David Baker: The COVID-19 pandemic has been devastating in so many ways, but one of the most profound negative consequences has been the strain that it's placed on nurses. How is the pandemic affecting the current nursing supply?

Dr. Peter Buerhaus: Let me just begin by noting that as of today, there have been about 72 million reported cases COVID in the United States, and 872,000 people have died from the disease. Nurses have tried to care for these patients, they've done their best to try to save them, and they have to live with the emotion of having lost a patient. At the same time, nurses have helped save tens of thousands of lives. So I'm just glad we are having this conversation.

I'd like to start with a 40,000-foot-level look at this. The nursing workforce is composed of about 3.5 million registered nurses who are working on a full-time basis and then another roughly 400,000 who are working on a part-time basis. So there's a lot of nurses in the country. About a million RNs are working in inpatient care units, and about a third of those are working in ICUs and emergency departments. We were all shocked at how rapidly that demand for care increased for nurses with the education, the skills, and clinical experience needed to take care of so many very critically ill patients.

Now if we get down closer to ground level, I think the pandemic has decreased the supply of nurses, and it's come about in several different ways. Some nurses have become ill with COVID-19 themselves, and they aren't in the workforce while they're waiting to get cleared, or they've left permanently as a result of having COVID. Others are not in the workforce because they don't want to increase their risk of exposure to the disease and give it to their families. Others aren't in the workforce due to vaccination requirement policies and their beliefs about vaccination. Some nurses are not in the workforce because they are taking care of parents or in-laws, they're raising children and providing home schooling. And some RNs have retired sooner than they had planned. For the first time in 10 years, we saw an overall drop in employment among RNs, LPNs, and nursing assistants about five or seven months into the COVID pandemic.

Dr. David Baker: So, do you think that this is going to have a lasting effect? What do you see coming in the next decade for the nursing supply?

Dr. Peter Buerhaus: Just recently, our team, using data through 2019 just before the COVID pandemic began, we estimated the RN workforce would grow by about one million, reaching 4.5 million in 2030. So this is really good news because these projections take into account the retirement of an estimated 640,000 baby boom RNs who are expected to retire by the end of the decade. We'll be able to replace those RNs and add another million. Now that's the good news. But what concerns me are, are factors that affect entry into the workforce and exit out of the workforce.

We don't know this, but the pandemic could speed up and condense the time for RNs who were planning to retire over the decade and maybe move that up closer. So we could have an accelerated rate of retirement in the next couple of years. We could also see the pandemic leading to younger and middle-aged RNs withdrawing from the labor market for the reasons that I just described.

And depending on the magnitude and timing of these sort of reactions, the exit from the workforce in coming years could disrupt labor markets and have real consequences for employment. They could aggravate shortages or even create new shortages—that's the exit side. The entrance into the labor market is also something I'm concerned about. If the pandemic decreases people's interest in becoming a nurse, this would lead to decreased enrollment in the nursing education programs, and decreased graduations, and ultimately less entry into the nursing workforce.

Decreased entry would have a significant impact on the future, and more so than the retirements. Now if both of these occur, both the exit from retirements and withdrawal of existing nurses and decreasing entrants due to loss of interest in becoming a nurse, then we're setting up the potential for very large and persistent shortages. We would be in big trouble. We would see hospital operations and health care systems being deeply affected, and this would harm patients and harm those nurses who remain in the workforce.

Dr. David Baker: So how can we put the nursing supply on a more stable footing going forward? You've talked about these different factors increasing the supply as well as the exodus of nurses. How do we address those two factors?

Dr. Peter Buerhaus: In the first place, I would suggest that we start to get control of the messaging of nurses and of hospitals. And by that, I mean that I believe that way too much of the current imagery, the tweeting media coverage, the social messaging about nurses and about hospitals is, frankly, just dreadful. It emphasizes unprecedented shortages, their negative effects, and that hospitals are to blame. And I think if we don't counterbalance these negative messages with positive portrayals of nurses, we risk decreasing entry into nursing education programs and not growing the nursing workforce over the decade.

I want to take us back to the 1990s, because there's history that has relevance here. Back in the 1990s, nurses protested vigorously and persistently throughout the country over how hospitals were coping with the growth of HMOs and managed care. The media reported on this extensively, and the imagery that the public saw was very negative. And not surprisingly, interest in nursing as a career dropped over the next six years, and the number of RNs graduating from nursing education programs decreased substantially.

In 1995, we graduated 97,000 RNs each year. But by 2000, we were graduating 30,000 fewer RNs. So this effect of decreasing interest showed up quickly and by the late '90s and early 2000s, we were having a large national shortage of registered nurses. The American Hospital Association reported about 125,000 vacant positions for nurses in 2001. Now that was the last large national shortage of RNs in this country. Now, we need to learn from that experience and start controlling the message about nurses and hospitals. We need to rebalance and put forth more positive portrayals of nurses, or else we could risk repeating the 1990s drop in interest in nursing and in enrollment and graduations.

And I think this is a shared responsibility. Nurses have to take ownership on this, our leadership has to, professional associations, educators, certainly the media, social media, and unions. We need to grow the workforce, so we've got to rebalance current messages.

The second area is to come to a deeper awareness of the implications of the withdrawal from the workforce of our retiring baby boom generation. We've retired about half of the 1.2 million RNs born in the baby boom generation, and over this next decade were going to see the remainder of that generation leave the workforce. And when they do leave, these nurses take with them decades’ worth of knowledge, experience, leadership, and mentorship of younger nurses.

I think our hospitals and other institutions really need to ascertain how many RNs are expected to retire and identify the nursing units, the departments, the patient populations that could be most affected by this retirement. Share that information with hospital leaders, with physicians and other clinicians who could be affected, and seek their involvement in helping to mitigate some of the potential harmful consequences with this.

I think there will be some baby boomers who we want to remain in the workforce longer. Is there something that can be done to engage them, to keep them in so that they would delay their retirement? I think we also want to focus in on bringing the older, soon-to-be-retiring nurses together with younger nurses to impart the knowledge and skills, particularly for taking care of patients with COVID or working in specialty units.

Dr. David Baker: Thanks Peter. You talked about the importance of messaging and controlling the messaging. Is that possible? Last week the New York Times published a video editorial by Lucy Ken and Jonah Kessel about the nursing shortage in hospitals that had nurses talking about these really horrible experiences that they had. It claimed that the most important root cause is chronic under-staffing leading to nurse burnout. So how do we control the messaging in this environment where social media is going to fan the flames of these concerns?

Dr. Peter Buerhaus: I think that there could be discussion among the major health care associations, provider associations, delivery of care associations, payer associations, educators, nurses themselves, about how resources could be pulled together to finance a campaign that brings forward positive images of nurses.

Dr. David Baker: So if part of the solution is increasing salaries for nurses, who should pay? How should those payments flow? I think it will be very difficult for hospitals to increase the salary for nurses without increased pay from payers. How should that be dealt with yet?

Dr. Peter Buerhaus: It strikes me that this is in society's interest that government and payers step up. And I don't think hospitals have the resources or all the resources needed to economically recognize nurses, so I do believe there is a role for government to provide resources specifically earmarked for nurses.

I'm reminded that when the government passed Medicare in 1965, Medicare paid hospitals extra to cover the cost of hiring more nurses needed to care for the influx of older patients. So I think there is a precedent for a step-up by the federal and state governments.

Dr. David Baker: Peter, you've been studying the nursing workforce for a long time. How does the current situation compare to these past crises that you've seen? Is this crisis unique? Are there basic forces that led to the shortages in the past that are being repeated now? Or is this something really fundamentally different today?

Dr. Peter Buerhaus: I think the first thing I would say is, in the years leading up to the pandemic from, say, 2010 to 2020, we were seeing about 70,000 baby boom RNs retiring each year from the workforce. Well, some of these baby boom RNs worked in ICUs, in emergency departments, in critical care units, and in other units that were later transformed to care for COVID patients. Now in some hospitals, this retirement was already causing shortages of nurses in the very units that would then suddenly become under siege by the rapid admission and very ill COVID patients.

Second, I think a unique aspect of the current situation concerns the rapid growth in the number of RNs becoming nurse practitioners, and this has really accelerated over the past 10 years. We've done some research on this and it turns out that the numbers of nurses who have left the workforce to become nurse practitioners led to a withdrawal of about 80,000 fewer RNs between 2010 and 2017. I expect that during 2018 and '19 there were continued losses from the nursing workforce as RNs continued to become NPs

Dr. David Baker: Peter, while we're working on long-term solutions, health care organizations and the staff that work in them have to get through today, and tomorrow, and the months to come. What's your advice on how leaders can help get through the challenges that they face today?

Dr. Peter Buerhaus: I think that in the short run as we are hopefully seeing the current variant, Omicron, spiking and hopefully receding over the next several months. We just have to get through it. We've just got to come to work each day, and we need to help one another, support each other, understand each other, and be kind to ourselves and to others. We're all in it together, and we just have to persevere. But I also think that it would be helpful to anticipate that there will be a time when COVID becomes more in our rearview mirror, we can get back on our feet, we can take some deep breaths.

And at that time, I would hope that hospitals and other care delivery organizations and nurses could come together in a very meaningful way and reflect on what's happened over the past couple of years, discuss what things really worked well, what was the process that led to good decisions, what didn't work, what have we learned about ourselves clinically and personally and organizationally, what are our strengths and weaknesses, an honest assessment. I believe that nurses and hospital leaders all want to get back to some sort of normal. But I don't think we want to go back to a normal that also included things that weren't working. We want to go forward forging a new normal.

I think we really need to reset that relationship, and do it in a way that's mutually beneficial and aimed at a better future for both nurses and hospitals, and of course that benefits the patients that we together serve. If we're going to purposely take the time to reset this relationship, it can be helpful, if organizations could survey their nursing staff and others and ask both questions that were negative and positive, get the full understanding, assess what nurses know, what their knowledge is—there may be some inaccuracies or misperception. What are their attitudes? Take the temperature on both nurses’ and leadership's willingness to change, their willingness to engage, and in listening to each other, and in building a new path forward, to jointly grasp the fuller situation and learn from it.

Dr. David Baker: Great. Well, thank you so much for taking the time to talk with me today. It's really been a pleasure. I really value the comments that you've given us today.

Dr. Peter Buerhaus: Well, thank you, David. I am so thrilled and glad that you took the time, and hopefully there'll be some benefit for nurses and hospitals as a consequence.

This interview transcript has been edited for length. The video interview is available at https://player.vimeo.com/progressive_redirect/playback/678918045/rendition/1080p?loc=external&signature=b5091feabb76a9d59d7c536fbb4b9ab064299f2165d8032aaff22b89fba3e536 .

Acknowledgments

Acknowledgment.

The author thanks Dr. Peter Buerhaus for his interview responses and valuable contribution to this publication.

The Issue of a Nursing Shortage

Nurses play a significant role in health care because they are the intermediaries between patients and professional physicians and doctors. The nursing shortage is a significant problem that has led to reduced chances of achieving global health care objectives, especially in healthcare-associated infections and diseases. Health care leaders have continued to experience challenges in nursing recruitment and retaining processes due to economic factors such as a reduced supply of professional nurses and reduced institutional funding. This essay will examine the issue of a nursing shortage, parties involved, market forces influencing the issue, demand and supply of nursing, influence of the affordable care act, and how improvements can be made. Due to the nursing shortage, the nursing field has been clouded with low-quality care and reduced patient safety, which leads to the negative patient and organizational outcomes.

Introduction

Population health and universal coverage, and equitable access to quality care are dependent on having a vibrant workforce in health care facilities. The global demand for health care providers is expected to rise in the US, and demand for RNs is expected to surge to meet the needs of patients. The new RNs are needed to replace that elderly workforce and meet the growing demands of people searching for health care. The challenge that faces the nursing field is that there have been shortages in the workforce. The current workforce is overwhelmed by the rising demands which need their services. Nurses comprise half of the global workforce, and shortages are a significant concern in the healthcare sector. The shortage of nurses in the world is a topic of interest across the medical field, and it is prudent to address the issue and come up with solutions to policy and resource allocation.

Literature Review

The nursing shortage is a critical issue because it leads to a negative patient and organizational outcomes. In the US, it is projected that nursing supply will experience up to 1million shortages regarding registered nurse jobs by 2025, and demand is projected to increase, influencing employment rates to have a 19% increase (Mehdaova, 2017). This growth in nursing employment rate will be higher than the average growth experienced in other occupations.

There has been a growing demand for nurses to cater to increased chronic health conditions such as dementia, obesity, diabetes, and arthritis. Additionally, the demand for nurses is growing due to the increased number of people who can access health care services due to the affordable health care act. The federal government has continued to improve health care access through health insurance reforms, which have enhanced the capacity of patients to pay hospital bills without pressuring health care facilities budgets. Nurses are needed to satisfy the demand to enhance fast patient discharge to improve health care outcomes.

The aging population is increasing rapidly, which has led to increased numbers of nursing homes. Baby boomers have increased in number, with most ranging in the 65-year-old and above gap, making them legible for Medicare. Aged people may prefer staying at home or in nursing homes, and they need to be cared for. The continued increase of baby boomers into Medicare will impact the program’s sustainability. Meeting the health care needs of the aging population will increase the pressure of health care spending due to increased recruitment of nurses, setting up facilities, and retaining nurses.

This health care pressure is likely to affect nurses’ attitudes, self-perception, competence, and performance. Practicing nurses will have to improve their attitudes and collaborate towards effective performance for improved patient and organizational outcomes. Nurse Managers are required to have an understanding of expense to revenue ratio and other metrics that influence operational performance. Nurse leaders need to guide the processes of change to make recruiting, retaining, and performance efficient.

Nurses are also aging, and the US currently experiences increased retirement of nurses due to old age. In 2013, a report by the National Council of State Boards of Nursing stated that 55% of the registered nurses in the US were above 50 (Snavely 2016). Even though many graduates are presumed to replace the retired nurses, it is not sure that the fresh graduates will fill the gap. Even if the fresh graduates replace the retired nurses, there still is a deficit of nursing professionals considering most retired nurses add up to the growing number of aging individuals in need of nursing care.

The economic perspective of nursing shortage demonstrates that supply factors drive the issue. The issue is complex because it cannot be solved in the short term due to the dynamics of having to educate thousands of individuals while the demands are steadily increasing. Addressing past economic problems has entailed relocation coverage, sign-on bonuses, and new premium packages. These solutions can only temporarily address some of the factors associated with the nursing shortage, such as job satisfaction. The solutions can only redistribute nursing supply based on the merits of priorities. Creating a more sustainable nursing supply requires long-term strategic planning. Some nurses have quit their jobs due to lack of job satisfaction, poor working conditions, and flawed work relations. Resolving such fundamental issues is the starting point of dealing with the nursing shortage. Nurses need to be valued, given a voice, provided with advanced training, and paid good salaries.

Nursing shortage from an economic perspective

Nursing shortage draws from the economic factor of reduced supply amidst a sharp increase in health care demand. Based on economic principles, the nursing shortage is detrimental because it leads to ineffective and inefficient use of limited health care resources. Based on their professional positions as supplementary and complementary to physicians and doctors, nurses can provide less costly health care. The production process in health care requires the input of nurses to improve the utilization of resources to achieve reduced service costs. Nurses are involved in administration, policymaking, education, and research, and clinical practice. Therefore, nursing shortage reduces the ability of the health care sector to provide quality care, ensure equitable resource distribution, and integrate nursing-specific performance and quality of care measurement.

Major Parties Involved in Nursing Shortage

The major parties involving in the nursing shortage are the government and the employers. The government is a significant party in nursing shortage in addressing policies related to the supply of nurses, such as the nursing subsidies. The US government began a nursing subsidies program under the Nurse Student Loan Program, which has continued ever since. However, no significant changes have been made to the policy to ensure that the prevailing state of nursing subsidies is enhanced to suit the current nursing care demand. Nursing subsidies help nurses navigate the normal challenging labor market clouded with depressing compensation and wages below reasonable market value.

The nursing shortage does not just happen in the market economies, but it is created by the actions of the government and employers, which entail tampering with nursing supply and retaining mechanisms. The shortage of supply in the free market economies is, in this perspective, expected. Employers, including hospitals, pay nurses to meet organizational demands, increasing overtime and nursing shortage. Employers compete to retain nurses by increasing compensation rates and wages to attract and retain more nurses. When the shortage of nursing supply persists, wages continue to increase due to increased demand until a level is reached where nursing wages are competitive, just like other enviable occupations. This way, individuals get attracted to undertaking nursing courses and get into service. However, with the rapid demographic changes of aging populations, increased rate of chronic diseases such as obesity and diabetes, and increased healthcare-associated infections, the demand may never be fully met.

Market Forces that have an Impact on Nursing Shortage

The market forces of supply and demand have been at play in influencing nursing shortage and surplus in various instances. However, due to the increased need for quality health care, increased number of patients with health insurance increased infections and diseases, and an increase in the aging population, the force of demand is higher. The increase in health care demands has led to nursing shortage because the supply of registered nurses is affected by a factor such as reduced funding for nursing education and economic recessions. Therefore, instances of nursing surplus are rare even though there are years when nursing recruitment rates increase, but they cannot match the demand in the health care industry.

Economic recession is a factor that influences the supplies of nurses. During the onset of economic recession, nurses working part-time and nurses not working tend to find full-time jobs for financial security. Employers are usually ready to hire more nurses, which brings the supply and demand at equilibrium even though public institutions and may have limited ability to retain their workforce. However, when an economic recession ends, the nurses tend to leave their full-time jobs to continue with their pre-recession status. Therefore, the economic recession creates instability of nursing supply, which ends up causing a nursing shortage. The effects of nursing shortage can be a long term such as downsized workforce.

When nursing policymakers do not understand the market trends and the dynamism of a free market economy, they may make bad policies such as downsizing. Reversing such policies is expensive and time-consuming, and difficult. After an economic recession, if downsizing had been effected, the cost of attracting, recruiting, and retaining nurses is usually higher than cost saving in the short term. Effective nursing management supports its nursing workforce during economic downturns and motivates them by creating conducive working conditions to retain them.

Influence of Affordable Care Act on Nursing Shortage

The ACA has made access to health care access, which has increased the number of people who can access health care in the US. ACA covers many health problems, including chronic diseases such as dementia. The health cover has enlightened people about preventative health care, which has led to the development of health culture. These changes have increased the demand for quality health care and intervention practices to prevent health-associated infections and diseases. The ACA has led to the shift of focus on patient and organizational outcomes, pressuring nurses to provide adequate health care. The increased demand for health care services has opened the public’s eye to the nursing shortage issue. There is a growing demand for APNs and NPs for the health care sector to deal with complex emerging issues such as HCAIs and provide improved care.

The introduction of the ACA was done when the US was already experiencing a nursing shortage. What ACA did was increase the number of people eligible for health care access. It has made the nursing profession rise in preference among non-nurses. According to the US Bureau of Labor Statistics, the profession is projected to grow by 16% up to 2024 (Thompson 2017). The average salary for RNs is projected to have a steady increase since the introduction of ACA. According to the ANA, more RN jobs will be availed in the US by 2022, and employment opportunities for nurses will grow by 15% towards 2026 (Haddad et al. 2020). Even though the increased demand is favorable for RNs seeking employment, it may present negative outcomes.

The nursing shortage has led to long working hours for practicing nurses due to a high patient-to-nurse ratio. Cases of burnout reduced patient safety, and poor quality of health care are some of the negative consequences of increased demand and low supply of nurses. The ACA came along with incentives of making nursing education affordable in the US. The ACA is disbursing funding to the health care system in the US, including learning institutions. Advanced education programs for nursing for APNs, nurse-midwife programs, and NPs are funded to address the nursing shortage in the US.

Health Disparities Demonstrated in Nursing Shortage

Nursing shortage continues to be a significant problem even in advanced countries such as the US, which demonstrates health disparities for communities. Nurses work in health administration, environmental health, laboratory and education, and research. Nursing shortage presents health threats to individual families and communities. In the case of communities, nursing shortage impacts IPC practices such as immunization, home care, and herd protocols. The outcomes are usually the prevalence of infections and diseases such as asthma, pneumonia, HIV/AIDS, and dementia. These health disparities are further stirred by low-quality nursing care and reduced patient safety, which lead to increased mortality rates. Nursing shortage incapacitates the health care systems in the provision of preventative and curative health care.

Improvement of nursing shortage

The WHO has been instrumental in the improvement of nursing shortage in global markets such as the UK. The major focus in improving the issues has been the policies of employment and retention. The main argument in the change of focus to policymaking is that most countries make health care policies based on the linearity of nursing. The policies tend to oversimplify the reality of nursing supply and demand. Most countries have in the past focused on increasing the numbers of individuals entering nursing education, and they have failed in increasing the numbers of already trained RNs entering the labor market (Drennan & Ross 2019). The policies applied in this perspective are not favorable for filling the gaps in priority nursing areas with a history of human capital shortage, such as community health. The futile health care policies are coupled with insufficient healthcare-related infrastructure for nursing education, clinical practice, and weak nursing training regulation.

Health care policy reforms in countries such as the UK entail attending to supply and demand to increase nursing productivity. Utilizing the full extent of nursing care license is encouraged coupled with nursing shifts to reduce burnout and use technology to attend community health care. The policy also focuses on the supply of more nurses into the labor market through increased nursing education enrolments, efficient recruitment, and retention. The WHO has a global health care strategy of addressing nursing shortage similar to the one in the UK, where rural and remote areas prioritize nursing supply improvements. Rural populations are susceptible to health disparities such as healthcare-related infections and diseases, communicable diseases such as pneumonia, and nutrition needs. Therefore, ensuring a sufficient supply of nurses to these areas is significant in tackling the nursing shortage globally.

Recommendation

The nursing shortage is an issue whose application draws from economic principles of demand and supply. It is nearly impossible to bring demand and supply t equilibrium because there are factors that constantly influence the two market forces. However, the supply of nurses can be improved.

Allocating resources to all areas of the health care system can boost the nursing supply. For instance, in the US, the ACA started funding all nursing-related departments of the health care system, such as nursing education. Promoting the education and training of more professional nurses by resource allocation can stabilize the supply of nurses against the growing demand.

Creating policies that make it easy for fresh graduates to secure nursing jobs is essential to fill the gap left by retiring nurses. Graduates struggle to find nursing jobs when they are not well guided. There is a need to transition from college to labor efficient and effective to improve the nursing shortage.

Utilizing the resources available is an economic principle that needs to be fully undertaken to make nursing care efficient. It may take time to fill the existing gap caused by the nursing shortage. However, if each available nurse is trained on the efficient utilization of resources, the quality of health care and safety can improve. The demands of health care can be met at a reasonable level. Nurses can provide less costly and quality health care coupled with optimized patient safety, such as monitoring for patient falls more quickly than physicians and doctors.

Due to the nursing shortage, the nursing field has been clouded with low-quality care and reduced patient safety, which leads to a negative patient and organizational outcomes. Nurses contribute significantly in the health care sector, considering they are supplementary and complementary to physicians and doctors. Nurses make it easy for patients to access health care, even for the aged at home. The major market forces that influence nursing shortage are supply and demand, which are affected by changing economic trends such as a recession. The economic downturn is a double-edged sword in that it can lead to an increase or decrease in the supply of nurses. During a recession, nurses working part-time jobs and those not working may seek employment for financial security. After the economic recession, they may get back to their regular working schedules. Also, during a recession, health institutions may not retain their nurses, which may lead to a shortage. There is a need for health care policies to focus on increasing nursing supply to the labor market rather than maintaining the traditional perspective of training more nurses.

Drennan, V. M., & Ross, F. (2019). Global nurse shortages: The facts, the impact, and action for change.  British Medical Bulletin ,  130 (1), 25-37.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage.  StatPearls [Internet] .

Mehdaova, E. A. (2017). Strategies to overcome the nursing shortage.

Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States.  Nursing Economics ,  34 (2), 98-101.

Thompson, M. (2017). How the ACA Affects Nurses. Retrieved 10 May 2021, from https://nhcps.com/aca-affects-nurses/

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Nursing Home Abuse

This essay about the pervasive issue of nursing home abuse sheds light on the dark reality faced by vulnerable elderly individuals. From physical violence to emotional manipulation, neglect, and financial exploitation, the text explores the various forms of abuse within nursing homes. It emphasizes the systemic failures and societal attitudes that contribute to this epidemic and calls for comprehensive reforms to ensure the dignity and well-being of seniors in care facilities.

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In the quiet corners of society, away from the bustling streets and the glare of the public eye, lies a disturbing reality: nursing home abuse. It’s a dark underbelly of eldercare, where vulnerability meets cruelty, and trust is betrayed. Behind closed doors, within the walls meant to provide comfort and care, some of society’s most vulnerable individuals suffer in silence. Nursing home abuse is a pervasive issue that spans geographical boundaries, socio-economic classes, and cultural divides. From physical violence to emotional manipulation, neglect, and financial exploitation, the spectrum of abuse in nursing homes is both extensive and deeply troubling.

Imagine a place meant to be a sanctuary for those in their twilight years, where they are supposed to find solace, support, and safety. Instead, it becomes a nightmare—an environment tainted by fear, humiliation, and despair. The elderly residents, often frail and dependent on others for their most basic needs, become victims of those entrusted with their care. Caregivers, who are meant to be their advocates, become perpetrators of abuse, preying on the very individuals they are supposed to protect.

Physical abuse in nursing homes manifests in various forms—bruises, broken bones, and unexplained injuries. These wounds tell stories of violence inflicted upon defenseless seniors, whose cries for help often go unheard. The perpetrators, whether overwhelmed by stress, lacking empathy, or harboring malicious intent, subject the elderly to pain and suffering, stripping them of their dignity and autonomy.

Equally insidious is emotional abuse, which leaves scars that may not be visible to the naked eye but are no less damaging. Seniors enduring emotional abuse suffer from verbal insults, threats, and manipulation that chip away at their sense of self-worth and worthiness of care. They may be subjected to ridicule, belittlement, or isolation, leaving them feeling abandoned and alone in their time of need.

Neglect is another form of abuse rampant in nursing homes, where residents are deprived of essential care and attention. Basic necessities such as food, water, and medication may be withheld, exacerbating existing health conditions and jeopardizing their well-being. Neglect can also extend to personal hygiene, leading to infections, bedsores, and other preventable ailments that compound the residents’ suffering.

Financial exploitation adds another layer of vulnerability to the plight of nursing home residents. Trusted caregivers may exploit their positions to siphon off the elderly’s savings, manipulate their financial affairs, or coerce them into signing over assets. The financial repercussions of such exploitation can be devastating, leaving seniors destitute and without resources to support themselves or secure proper care.

The prevalence of nursing home abuse underscores systemic failures within the eldercare industry, from inadequate staffing levels and lack of oversight to insufficient training and accountability. Despite regulatory measures aimed at safeguarding residents, enforcement mechanisms often fall short, allowing abuse to persist with impunity. Moreover, societal attitudes towards aging and the elderly contribute to a culture of neglect and indifference, further marginalizing those in nursing home settings.

Addressing nursing home abuse requires a multi-faceted approach that encompasses legislative reforms, enhanced regulatory scrutiny, and cultural shifts in attitudes towards aging and eldercare. Strengthening legal protections for nursing home residents, increasing transparency in reporting abuse, and implementing robust oversight mechanisms are essential steps towards combating this pervasive issue.

Additionally, investing in caregiver training programs, promoting elder abuse awareness campaigns, and fostering a culture of respect and empathy towards the elderly are crucial in fostering environments where abuse is not tolerated. Empowering residents with knowledge of their rights and avenues for recourse is equally important in giving them a voice and agency in their own care.

As a society, we must confront the uncomfortable truths about nursing home abuse and acknowledge our collective responsibility to protect the most vulnerable among us. Every senior deserves to age with dignity, respect, and compassion, free from the specter of abuse and neglect. Only through concerted efforts to address the root causes of nursing home abuse can we ensure that our elderly loved ones receive the care and respect they rightfully deserve.

In the shadows of nursing homes across the globe, the silent cries of abused seniors echo, pleading for justice and recognition. It’s time to break the silence, shine a light on this epidemic, and hold perpetrators accountable for their actions. The measure of a society’s humanity is reflected in how it treats its most vulnerable members. Let us rise to the challenge and create a world where nursing homes are havens of compassion and care, not breeding grounds for abuse and suffering.

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Home — Essay Samples — Nursing & Health — Nursing — Nursing Shortage And The Future Of The Profession

Nursing Shortage and The Future of The Profession

• Categories: Nurse Nursing

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Words: 1887 |

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Published: Dec 16, 2021

Words: 1887 | Pages: 4 | 10 min read

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The problem identified, strategies to eliminate the nursing shortage, the impact of the nursing shortage on quality of care, qsen competencies applied to chosen problem, strategy number one, strategy number two, strategy number three, qsen competency number one, qsen competency number two.

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