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The problem of shortages in nursing and among nurse practitioners has been discussed by the public, the media, policymakers, and nurse practitioners for more than ten years now. Although particular solutions were suggested, it does not seem that they have influenced the issue positively or brought improvements into it. Therefore, it is necessary to analyze the problem and present other solutions.
Analysis
The shortage of the nursing workforce is ongoing; it began approximately in 2000-2001 and had reached its peak in 2002 (Ritter, 2011). In 2005, the shortage increased up to 10% or 218000 nurses (Ritter, 2011). As the Baby Boomer generation ages, it is expected that more senior citizens will be in need of nurses and their help. Nevertheless, the shortage is anticipated to continue, and, by 2020, it will grow up to 29% of all nurses in the United States (Ritter, 2011). This shortage is directly linked to the costs that hospitals have to endure, because if a medical facility does not have enough nursing practitioners or registered nurses, those of them who are employed have to face burnout and exhaustion, therefore increasing the amount of mistakes made during treatment (Ritter, 2011). However, newly graduated nurses have difficulty in becoming employed.
Solutions
Unhealthy work environment has an adverse impact on nurses, causing stress and burnout. Nurse-physician communication needs to be improved; inadequate staffing and poor care environment directly contribute to shortage and stress among nurses. Shared decision-making, recognition of nurses contribution, encouragement of development would help nurses perceive their work as more meaningful. Moreover, employment of professional, highly educated nurses would also contribute to reducing stress and poor communication among medical staff in hospitals.
Background
The Patient Protection and Affordable Care Act was implemented to increase the number of trainees and bring new practitioners into the field. One of the primary policies that addresses the shortage of primary care practitioners, including nurses, was increased funding for loan forgiveness for clinicians willing to work in underserved areas , as it could attract new professionals into the areas where shortage was inevitable (Carrier, Yee, & Stark, 2011, p. 2). Nevertheless, while the Act also aimed to increase access to care for citizens, it provoked a growing need for nursing practitioners throughout the country. Moreover, this need is not expected to decrease in the next decades.
Structures Involved
As it can be seen, the president and the Senate have the jurisdiction over the problem. However, local governments can also contribute to the issue, including the Department of Health of the state. The town council can also provide or suggest strategies that will address the problem. At last, hospitals have the right to introduce policies and changes that can affect nurses as well.
Stakeholders
The primary stakeholders are nurse practitioners and hospital administration who can provide information about issues nurses have to face, as well as solutions to these issues. Patients are interested in an effective delivery of care and professional nurses because shortages can have an impact on their health. Therefore, these stakeholders can address the problem too, pointing out that nurses shortage results in higher costs and medical errors. Local governments are interested in reducing the rates of medical errors and mistakes in cities and the state; they can also provide funding, necessary for successful implementation of proposed policies.
Inherent Values
The inherent values of the nursing include professionalism, dignity, dedication, commitment, responsibility, and interest in new knowledge and development (Scully, 2014). Willingness to help others and the attitude towards the world, the work, patients, and routine are also significant.
Resources/Power Bases
As the demand for nurses grows, more workforce is needed. Universities and colleges are capable of providing new trainees and nursing practitioners; a significant amount of nurses comes from abroad (Littlejohn, Campbell, Collins-McNeil, & Khayile, 2012). However, changes in macroeconomic policies, as well as in funding of health sector and health care, are needed. Adequate funding is expected to decrease the shortage (Littlejohn et al., 2012).
There are five bases of power: coercive (force), reward (positive/negative reward), legitimate (elected/authority), referent (affiliation), and expert (experience/knowledge) (GarcÃa & Sánchez, 2011). Coercive power is the one that should not be used to resolve the issue as it could create more stress, decrease motivation, and lead to even bigger rates of shortage among nurses. Other powers, when combined, can provide an effective leadership model for nurses.
Plan of Action
It is important to stress the speed of shortage and how it affects the medical treatment throughout the country. After that, a policy that will improve communication and work environment, working conditions, and staffing of hospitals needs to be presented. This policy should also address the difficulties of employment for graduated nurses. The policy can be submitted to the hospital administration for review, and then to the town council to discuss the funding. If it is approved, data needs to be gathered during its implementation to understand whether it was effective and what other changes can be suggested. If the policy is proven successful, it can be implemented on a state level. It is possible to assume that the results of the policy will differ, depending on the state, its financial policies, other issues in health care, and other policies that concern nursing practice.
References
Carrier, E. R., Yee, T., & Stark, L. B. (2011). Matching supply to demand: Addressing the US primary care workforce shortage. Looking Ahead, 5(4), 1-7.
GarcÃa, I., & Sánchez, E. (2011). Relationship between nurses leadership styles and power bases. Revista Latino-Americana de Enfermagem, 17(3), 295-301.
Littlejohn, L., Campbell, J., Collins-McNeil, J., & Khayile, T. (2012). Nursing shortage: A comparative analysis. International Journal of Nursing, 1(1), 22-27.
Ritter, D. (2011). The relationship between healthy work environments and retention of nurses in a hospital setting. Journal of Nursing Management, 19(1), 27-32.
Scully, N. J. (2014). Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444.
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