Literature Review on the Nursing Problem
In Montour, Baumann and Blythe (2009) view, there is a large gap between what nurses do and the perceived work by the public. This has been identified as a fundamental factor that causes the shortage. The profession does not have specify the roles which nurses play, which is why within the healthcare sector, nurses are indulged in diverse roles and not compensated for. Goodin (2003) noted that, within any profession, there is a need to have well outlined policies and structures that guide the profession. Within the health sectors, Barnett and Narudin (2010) identified in their study that nurses are shifting their goals and careers because they believe to be exploited in the profession yet enjoying lower returns. The pressure mounts on the nurses, and they seek for greener fields in other professions and this has been established as causing a massive migration of nurses to other professions including teaching and self-employment.
Montour, Baumann and Blythe (2009) noted in the context of the nursing shortage that poor work conditions have been resulting to high rates of turnover among the nurses. The work conditions have deteriorated over time forcing many nurses to reconsider a career in other professions and quitting healthcare. In US health policy experts as well as, advocates have warned that possible increase of strikes from the nurses will be massive in future administrators don't seek solutions to the identified poor working conditions in many hospitals (Buchan & Aiken, 2008). The strikes exacerbate and many nurses give up the profession leading to a threat of severe shortage. Barnett and Narudin (2010) noted that, among cardinal healthcare institutions, administrations have cut down the staff and force the nurses to work overtime yet without returns. Protocols in these hospitals have also led the nurses to believe that their life in healthcare provisions is at risk.
The sector does not provide ample protection in the nursing tasks which is a threat to the well being of the nurses. Such poor conditions have lowered the credibility of the profession and thus many nurses quit which is why the shortage is exacerbating (Huber, 2010). The policies also guiding the nursing sector have also been inefficient in increasing the pay for the nurses which is why low salaries are still an issue that is identified as a cause of the high turnover rate among the nurses.
Goodin (2003) is of the view that complexity of health care and advanced technology in nursing practices has resulted to lower capacity of the nurses to play their roles effectively. The nurses feel emaciated and without the skills required to facilitate various tasks in the profession because they have not been trained on the same. The challenge exacerbates because the health care institutions have ignored efforts to appraise the nurses and capacitate them so that they can handle the technological developments (Montour, Baumann & Blythe, 2009). The few available, skilled nurses who have the capacity of using the new technologies are inadequate to cover the healthcare needs in the respective healthcare institutions.
The current nursing shortage has also been prospected to worsen in the future as globally, the aging population continues to drive the demand for healthcare services high and yet many committed nurses are approaching the retirement age (Goodin, 2003). The younger generation of nurses has developed negative attitudes regarding the profession which has resulted to their neglect of trying their career advancement in this field. It is apparent that healthcare provision in the next few years will be a Herculean challenge especially bearing the fact that the nursing shortage is still an issue.
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Montour, Baumann & Blythe, (2009) (2008)illustrates that, five years ago, the Center for Health Affairs, which was looking into the nursing shortage problem, did marvellously in addressing the growing shortage. A career shadowing program was in this case the ideal strategy which the group worked out and implemented (Montour, Baumann & Blythe, 2009). This involves allowing high-school students to experience the profession by interacting with other professionals in the healthcare sector and within the practical workplace setting. In a successful strategy, in Ohio at least 1,762 students were indulged and the results were positive since over 1026 students later joined the nursing profession (Goodin, 2003). This recomendation has been passed across borders and Huber (2010) in a study on solutions to nursing problem brought out the real picture as one of the most successful strategies.
Facilitating clinical placements is also an ideal strategy advisable for countries facing severe nursing shortage. An impediment to develop a higher capacity of programs in the nursing field is the administration of site placements for nursing professionals. In response to such a problem, healthcare institutions need nursing education partnerships that would help in implementing an online placement program for nurses. Such strategy would also help in establishing appropriate training of nurses and capacitating them to handle advances in technology within their practice. Clinical placements are ideal in exposing the nurses and building their experience in respective fields while helping them to overcome the challenges they face in the context of working out different tasks.
Another ideal strategy that would cut down the shortage of nurses across the globe is concentrating on building on own nurses and retaining them (Buchan & Aiken, 2008). A good approach in this is to recruit baccalaureate and master's-prepared staff into a faculty program which will provide ample training at prepare them as finished products to be recruited in the nursing field (Huber, 2010). Orientation into the clinical faculty is ideal in this context, and this will develop their capacity to play the role as nurses successfully. The idea is to assist them to grow in the profession and ultimately make nursing their career of choice (Barnett & Narudin, 2010). When such decisions would be made by a good number of students, it would work well to the advantage of the profession with a good number of nurses adding to the already retained a number in an effort to solve the existent shortage problem.
It would also be advisable for regions facing a nursing shortage to increase the supply of nursing faculty using tax credits. An outstanding example is in the US where three bills have been passed to enable the creation of a refundable tax credit for all nurses in the registered nurses category (Montour, Baumann and Blythe, 2009). This is an incentive that would have revered and positive impact in the context of retaining the nurses in the profession (Huber, 2010). In the same line of argument, exempting taxes from the personal income of the full-time registered nurses would work well to boost their salaries and motivate the nurses to maintain their positions therefore, working positively to reducing the exacerbating shortage.
There is also a need to invest in training nurses within their profession. Increasing government funding to support training of nurses is ideal at all levels because this would work positively in guaranteeing that the nurses feel comfortable within their workplaces (Montour, Baumann & Blythe, 2009). Acts and policies as passed by the respective governments need to be oriented to finding solutions to the nursing shortage and thus should have all strategies applied to cater for the welfare of the nurses (Buchan & Aiken, 2008). Lower salaries are also noted as a cause of the dissatisfaction among nurses within the broad profession. It would also be ideal to look into the loan forgiveness strategy as one of the best approaches of motivating the professionals into the nursing field. It is an ideal incentive that would work positively to retaining the nurses and welcoming new people in the field especially fresh students after graduating in the nursing profession.
Challenges and barriers in implementing the changes
However, there are numerous challenges noted, which bring down all efforts meant to solve the nursing shortage issue. Brain drain is one of the biggest challenges among many nations. The worse situation where nursing shortage has hit extremes is the developing countries. On the same note, these regions are ranked as with the highest number of the populations seeking for healthcare services. Even with an effort by the government all initiatives, to retain the nurses in the profession, it is apparent that brain drain is eminent across the regions. In the third quarter of year 2004, Ohio hospitals reports revealed that they had a total of 767 vacant positions almost 6.9 percent of the workers within the hospital which resulted to high turnover rates (Goodin, 2003). The nurses have identified green pastures across the borders, which are deemed as well paying, and promising (Montour, Baumann & Blythe, 2009). Thereffore, even with the efforts such as an introduction of incentives and other strategies to retain the nurses, the global market still poses a barrier to these efforts.
Huber (2010) also noted that nurse empowerment shortage is a massive barrier to the implementation of solutions for nursing shortage. It has been identified that, in many situations, governments have concentrated on recruiting more nurses and not empowerment. Even with the identified solutions such as career shadowing and facilitating clinical placements, the fact holds that these nurses are still inexperienced in handling and carrying out some tasks. Technology advancement especially the introduction of new equipments continues to pose as a challenge among the nurses and making them uncomfortable in the profession (Barnett & Narudin, 2010). The nurses feel emaciated as noted in the discussion on barriers and therefore, they are not motivated on the grounds of working within the nursing profession.
Inadequate resources have also been a monumental challenge in establishing solutions for nursing shortage. The challenge presents itself in the context that there are inadequate funds, which the institutions can use to train and empower the nurses (Montour, Baumann and Blythe, 2009). This leads to inefficient training, which does not solve the incompetence of nursing in handling technological advancements and other developments in the nursing field which demand ample training.
How to overcome barriers and Implement Changes.
Overcoming the barriers and challenges, which engulf the solutions for nursing shortage is itself a challenge. However, it is possible to overcome the barriers through strategizing appropriately. Government support and subsidies need to be in the limelight to solve the inadequate funds barrier. The incentives are a terrific solution to many healthcare facilities that have low capacity of training their employees (Huber, 2010). These institutions at least will provide basic training to the nurses and the funds will also help in hiring trained professionals to indulge the nurses within the institution in training. The challenge also might exacerbate with the inability to sustain the subsidies. Therefore, the respective governments' needs to think globally and outsource funds which will boost the budget meant for subsidies provisions.
Exchange programs have also been one of the best strategies that are assisting many healthcare institutions to overcome the inadequate funds barrier. With institutions not having adequate resources for training nurses and empowering them, exchange programs are cheap and efficient because they expose the nurses to other programs and in turn improve on their skills that are required within their profession (Barnett & Narudin, 2010).
The implementation of the identified or recommended changes within the institutions, appropriate steps are ideal (Goodin, 2003). The first step is to establish policies which will support the changes once they are implemented. These policies mark the beginning of a long journey in implementing changes. The policy agenda should be worked out to ensure that they retain the existing nurses and provide appealing conditions for the new comers (Goodin, 2003). In the implementation process, induction is an appropriate step that works out to attract nurses and develop in them, loyalty and a strong appeal to their career (Barnett & Narudin, 2010). Making the nursing career as much appealing as possible is the basis of implementing these changes and sustainability in the solutions implemented (Montour, Baumann & Blythe, 2009).
Global nursing shortage is a massive problem in the healthcare field. This has posed as a challenge to efficient healthcare provision and affected healthcare in general. A widespread shortage has loomed threatening provision of effective healthcare among the populations. The questioned posed for this research is what causes the shortage and the eminent solutions that could possibly solve the problem. This field of research has identified the problem of the nursing shortage and noted some of the causes, consequences and solutions to the same. Research in this area is paramount to help in handling nursing shortage and establishing long-term solutions. Further research is also required on the growing diversity within the nursing profession and how that is coming along in retaining the nurses. Globalization in this context is viewed as having a significant impact on the nursing profession, and this is an area that needs further research.
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