Nursing Shortage - Part 1

By Author: Sherry Roberts
Total Articles: 99
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Introduction
Adequate human resources for health in all medical professionals play a crucial role in the enhancement of efficiency, equity as well as delivery of quality of care. Nurses are mandated to carry out important purposes in the health industry including tending to the sick, assisting physicians in the discharge of medical operations such as surgeries, counseling patients about their health, enhancing processes throughout the care system, provision of medical prescriptions as well as prevention of medical errors. However, various challenges are in the forefront hindering the delivery of these services efficiently by nurses. One of the significant challenges facing the healthcare sector is the shortage of nurses all around the globe. Nursing shortage all around the world is caused by different factors that including increased aging of registered nurses and the effect of nurse educators as discussed in the following sections.
1. Aging of registered nurses
Today, the majority of the nursing workforce in the healthcare organizations is older than 45 years. According to research done in 2013 by the National ...
... Council of State Boards f Nursing and the Forum of State Nursing Workforce Centers, approximately 55 percent of the RN workforce is either age 50 or above (American Association of Colleges of Nursing [AACN], (2014). As this nursing personnel continues to age, they move to lighter jobs such as working in pharmacies, in physicians’ offices, outpatient settings or retire when they attain the retirement age. Future projections in the healthcare sector estimate that over 1 million registered nurses will attain the retirement age with the next 10 to 15 years, since the average RN population is 47.0 years old, up slightly from 46.8 in the year 2004. These factors, therefore, contribute significantly to nurses’ shortage in all medical institutions, thus causing an adverse implication to the objectives of health provision.
In 10 years between 2010 and 2020, it is estimated that the number of nursing staff that will leave the office each year due to retirement or turnover factors will be 40 000 to about 80, 000. In the US, the driving force of nursing shortage is the aging of the Baby Boomer generation. America has more citizens above the age of 65 today compared to any other time in history. It is estimated that the US population of senior citizens will increase by 75 percent to 69 million between 2010 and 2030, and by the year 2050 will have increased to an estimated 88.5 million (Grant, 2016). As more people continue to age, the nursing workforce in the country is also aging, and it is estimated that approximately one-third of the current nursing workforce will retire in the next 10 to 15 years. Also as more people attain the age of 65 and older, the demand for healthcare services also increase due to common health conditions affecting the elderly such as chronic diseases (Carnevale, Smith & Gulish, 2015).
The increased numbers of aging RN workforce are as a result of various factors. These factors include a significant decline in the number of nursing school graduates, a higher average age of graduates who are awarded nursing degrees and also that most of the RN nurses are the older individuals and that this pool of licenses nurses is the one that is favorable for employment. In the past 15 years, there has also been a dramatic decline in the number of students enrolling in nursing schools; hence contributing to a shortage of new graduates in the profession.
The aging workforce in an organization also gets associated with several issues that take place and increase the probability of a skilled nurse retiring. These factors include tiredness, exhaustion and chronic pain that are major stressors to the aging personnel who have been dealing with increasing pressure because of low energy levels, high work demands, and nursing shortages.
As the US population and the baby-boomers-generation reach the age of 60 and above, the ratio of nurses in the healthcare sector to the elderly population will decrease by an average of 40 percent between the year 2010 and 2020 (Cox, Willis & Coustasse, 2014). This decrease is attributed to the growing American population and the decreasing nursing population due to a wide range of issues including the retirement of nursing staff. The ratio of baby boomers aging from age 50 to 65 to a population age of 85 and older will decrease from 11 to 1 in 1996 to approximately 4 to 1 by 2050. With the changing population and a majority of American citizens turning 60 by the year 2020, it is essential that changes take place so as to effectively aid and assist the new demographic in the country that will have more long-term conditions than ever before.
Impact of aging nursing workforce
The aging nursing workforce will lead to a higher nursing shortage which is in turn associated with high patient mortality rates. Also, when nurses retire there is increased expense and draining of financial assets for all the positions they occupied within the facility. In the United States, the estimated cost per vacant nursing position is between 10, 000 to 60, 000 dollars depending on the specificity of nursing position (Cox, Willis & Coustasse, 2014).
Strategies of addressing the Aging Nursing Workforce
Various strategies would be implemented to assist to address the aging nursing workforce, and eventually solving the nursing shortage. Several nursing schools have come up with initiatives that seek to address the shortage of RNs and also nursing educators. For instance, the University of Wisconsin (UW) provided 3.2 million dollars for nurses for Winscoin initiative in which it aimed at providing fellowships and loan forgiveness for students in the nursing faculty. Also, other nursing schools are forming strategic partnerships as well as seeking private support so as to continue with their studies. Private organizations such as Johnson & Johnson have sustained a multimedia initiative called Campaign for Nursing’s Future in which they advocate for pursuing careers in nursing as well as polish the image of nursing so as to attract more young people into the field. Other strategies employed by governments to solve the nursing workforce shortage as a result of aging and retiring nurses is to encourage them to remain in the workforce even after they have attained the retirement age (Kwok, Bates & Ng, 2016).
2. The effect of nurse educators
Another critical factor contributing to nursing shortage around the globe is the inability to educate nurses (Lee, et. al, 2014). In 2009 approximately 29 percent of the people seeking for careers, 21 percent would consider pursuing nursing as their career profession with only one in 10 males viewing it as a possible career choice. However, back in 2006 nursing schools were forced to deny 41, 683 applicants the chance to join and pursue bachelorette degree in a nursing program because there was a lack of faculty. These applicants would have assisted to address the nursing workforce shortage in the future if they admitted for training as nursing students.
According to the American Association of Colleges of Nursing report, around 79, 659 qualified applicants of baccalaureate and graduate nursing programs were denied in the year 2012 due to challenges facing the nursing schools such as an inadequate number of faculty, clinical sites, classroom space, budget constraints and clinical preceptors (Grant, 2016). It is unfortunate that a country that is facing a severe nursing shortage is turning away a significant number of people seeking to pursue an education in a nursing program. The inadequate nursing faculty members are attributed to the increasing retirement or approaching retirement age of majority of the members thus posing a big challenge to the nursing schools. It is essential that at all times the nursing schools maintain critical student-to-teacher ratio so as to maintain quality education.
Nurse leaders recognize the strong connection between a culturally diverse nursing workforce and the ability to offer quality, culturally competent patient care. Therefore, there is a need for governments to encourage young people from minority groups such as African-American, Asian, Hispanic and Native American to pursue the nursing profession (American Association of Colleges of Nursing [AACN], 2015). Studies have shown that a diverse nursing workforce will be in a better position to serve the diverse needs of a very diverse patient population.
Impact on healthcare
The lack of nurse educators has an adverse impact on the healthcare sector because despite the strain of the nursing workforce today, the situation will lead to a severe shortage of nurses. For instance, without the nursing faculty needed to educate nurses’ in-state, all of Colorado’s hospitals will be forced to hire and compete nationally for around 3, 000 nurses per year, thus leading to high healthcare costs as well as limit health care capacity (Kowalski & Kelley, 2013). Shrinking the education resources in all states will give rise to few of any “surplus states” where the states facing shortage can go prospecting to recruit their much-needed faculty members and nursing staff.
Address to the issue of Nurse Educators
Nurses in all care facilities describe the need to have more nurses hired so as to ease the patient workload and relieve the strains of the day to day work within the healthcare system. So as to solve these challenges costs of training need to be reduced and also training needs to be available to more people who seek to pursue nursing or higher education and to reach the qualification levels desired by healthcare institutions. When more nurses attain the levels of education and experience required to provide proper care to patients, it will be almost impossible for health care facilities to hire nurses and not to pay them according to the levels appropriate for the positions. Possible solutions for this problem include increased education, increased availability of monetary incentives by healthcare organizations for education, legislation by state and federal government as well as the availability of web-based training for continuing medical education.
Individual care organizations have undertaken strategies to solve their problems of nursing workforce shortage and increasing concerns. One of the strategies employed by organizations is investing in career ladder programs, which allow the facility’s employees to gain skills and knowledge while “on the job progressively.” The primary objective of career ladder programs is to assist workers in advancing their careers by providing compensated education and training. The employees who take part in the programs get rewarded with more demanding tasks, higher income and also promotions to new positions such as from a licensed practical nurse to a registered nurse. In the short-term, the career ladder program is associated with benefits such as having a better trained and skilled workforce as well as improved retention of high-performing staff. In the long-term, the program assists hospitals and clinical centers to reduce the cost associated with high turnover, improve the delivery of patient care and also address projected shortages of particular nursing and allied health professions (Dill, Chuang & Morgan, 2014).
Another strategy used to address nursing shortage is to include public-private partnerships and incentives for nurses so as to become nurse educators. Johnson & Johnson have launched a multimedia campaign called the Campaign for Nursing’s Future in which they tout the benefits of pursuing a nursing career so as to convince more citizens to pursue a nursing program. Also, the American Nurses Association is lobbying for funds for Title VIII of the Public Health Service Act. The provision allows government grants for nursing schools for the advancement of educational programs, promoting diversity in nursing, and assisting to repay loans for nursing students who work in hospitals and clinical centers with critical shortages (Jones, 2017).
 
References
American Association of Colleges of Nursing [AACN] (2014). Nursing shortage fact sheet.Washington, D.C.: American Association of Colleges of Nursing.
Jones, S. (2017). Succession planning: Creating a case for hiring new graduates. Nursing Economic$, 35(2), 64-87.
Kowalski, K., & Kelley, B. M. (2013). What's the ROI for Resolving the Nursing Faculty Shortage?. Nursing Economic$, 31(2), 70-76. Ebscohost
Kwok, C., Bates, K. A., & Ng, E. S. (2016). Managing and sustaining an ageing nursing workforce: Identifying opportunities and best practices within collective agreements in Canada. Journal of Nursing Management, 24(4), 500-511. doi:10.1111/jonm.12350
Lee, T., Kang, K. H., Ko, Y. K., Cho, S. H., & Kim, E. Y. (2014). Issues and challenges of nurse workforce policy: A critical review and implication. Journal of Korean Academy of Nursing Administration, 20(1), 106-116. doi:10.11111/jkana.2014.20.1.106

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