Nursing Shortage and Management Research Proposal Paper

Topic

Nursing Shortage and Management

 

Research Question

How could the healthcare industry address the nursing shortage and what is the importance of continuing professional development in the medical care system?

 

Purpose Statement

The purpose of this qualitative study is to investigate the underlying reasons behind the shortage in nurses and the subsequent implications for the profession in the future. It is also noteworthy to mention that undertaking this study is central to determine the future of the healthcare industry through analysis of different patterns and trends in order to present critical evaluation on how the industry could counteract the nursing shortage. The prevalence of shortage called for an effective nursing management as supplementary to combating the said shortage. This study intends to investigate the role of academia and healthcare institutions in effort to discover how they address the shortage and how they manage their nurses. Fifty health care professionals from different medical institutions will be surveyed. Questions will include explorations on how these institutions are recruiting nurses, what are their motivating schemas, what are the factors they perceived to be contributing to the shortage and how supply of nurses compensates with the demand.         

 

Problem Statement

There had been a report in October 2004 that approximately 72% of healthcare supervisors had experienced nursing shortage at their facilities. A separate report estimated that in the year 2000, approximately 30 states experienced a nursing shortage and that by the year 2020, 44 of the states would likely to experience further shortage along with the District of Columbia. There are also statistics that showed a significant reduction in the number of nursing school graduates (nursingshortageinfo.com). The problem lies on the serious implications the nursing shortage pose for the future. Nursing shortage is deemed to be a threat to care continuum. The worsening of the situation can be also viewed based on the facts that the nursing schools enrollment are declining, that many registered nurses are graduating at an average age of 31 and that half of the workforce is expected to retire in the next 15 years. Based on these facts, the predictability in lack of medical workforce is central to nursing education, retention, attraction and management.     

 

Significance of the Problem

There are many qualified applicants, however, space and finances hinder them to continue. Though it can be said that there is significance in the number of enrollees, still, there are limiting factors inherent in nursing programs. Nursing students are obstructed to pursue their studies mainly because of the lack of funding. These are evident in unaffordability of clinical facilities and laboratories and to compensate with the cost, nursing students are the ones who are shouldering the expenses. The number of nurses who leave their profession mainly due to retirement and job burn out are not complementary to the number of those who are entering nursing schools. Others chose to pursue professional practice outside the confines of hospitals. They prefer to work on much inviting environment like family clinics, care units and home. Creative staffing is not doing what is expected from it. Albeit the benefits, remuneration and reward, the shortage itself is compelling registered nurses whom are still practicing their profession to retire because of stress and anxiety the work brings.    

 

Focused Summary

‘States Tackle Nursing Shortage’ (Goodwin, 2002)

            The article discusses the core of the nursing shortage in the US, how the working conditions could be improved and the breadth of the prevalence of the condition in different states and internationally. Different standpoints are demonstrated as it consists of statements from registered nurses and the CEO of the American Organization of Nurse Executives. A survey made by the American Nurses Association revealed that 75% believed that the quality of their profession had declined and that 56% stated that their time for patients had decreased. As revealed, nurses were offered many different incentives that range from scholarships, loan programs, signing bonuses and increased salaries to further attract and retain registered nurses in the workplace. The article directly deals with the subject as it covers both nursing shortage and how different states are implementing various measures to fill positions.

 

‘Critical Long Hours’ (Price, 2002)

            The article gave informations on the reasons why many registered nurses are leaving the hospitals – health, age and workload. Hospitals are directly competing for nurses to address the inadequacy at their respective facilities. However, there are many rivals that these hospitals must face and these can all be seen inside the facilities. The extent of the shortage is more than combating the shortage itself but mainly stress that is brought by long hours of work and doing the works that is usually done by two to three people. This article is of particular importance since it provides insights on how nursing must be appropriately managed and it presents factors that must be at the core of every nursing management programs.

 

‘The shortage of registered nurses in monopsony’ (Chung-Cheng, 2002)

            The article makes use of two models – the Solow efficiency wage monopsony model and the job-hour model – in estimating the nursing supply and demand. The author states that one of the main reasons of nursing shortage in a small town is always monopsonic. The argument of Chung-Cheng is critical on hiring nurses based on the equilibrium wage he or she offered. This article is fundamental given that managing nurses incepts from sourcing them up to their retirement.

 

Literature Review

‘States Tackle Nursing Shortage’ (Goodwin, 2002)

            Goodwin directly reflects on the consequences of the nursing shortage today until 15 to 30 years from now whereby the maturing age would double and thus the need for medical care and nursing is expected to be doubled too. She made mention of the need for hospital restructuring in general, for the commitment of the young people and for general respect for the profession. Pam Thompson said that there is a need for a system-wide focus and how the provider should change the way they deliver care. To address the problem, states enacted different legislative plans including forgiving loans, boosting the state schools capacity to admit and train nurses, collecting data in state aid and regional workforce planning. To improve the work conditions, many nurses stated that they are dissatisfied with their jobs. Senator Bob Hagedorn of Colorado saw working conditions and forced overtime as the main reason for the decline. There are six states that limit or prohibit mandatory overtime. For example, Maryland legislature prohibits hospitals in requiring nurses to work on overtime.

            California has seen to be one of the most gaps between supply and demand of nursing professionals. The Workforce Investment Act purports funding standardization efforts and career ladder program for certified nurse assistants. California led the setting of minimum nurse-to-patient ratios in 1999. The legislation had established minimum staffing levels intended for registered nurses and licensed vocational nurses. Another alternative is directed on requiring hospitals and other medical institutions to develop their staffing plan ensure patient care continuum.

 

‘Critical Long Hours’ (Price, 2002)

            The key factors identified by Price are relative to the aging nursing population and the professional burn out. There are nurses that reached retirement and there are not enough people to replace them.  Since enrollments are down, some schools chose to close. The responsibility for nurse recruitment is fundamental on supporting the work life balance. Provided that hospitals had forced their nurses to work on overtime without prior notifications, they honed an uncomfortable environment implicitly. The shortage is also linked with unrealistic nurse workloads and thus they are forced to leave their careers.  Predictions are made that by 2020 half-million staff nurses would in inadequacy. The aging population aggravates the problem. The age and the shortage are at the extreme.    

 

‘The shortage of registered nurses in monopsony’ (Chung-Cheng, 2002)

            Monopsonists are likely to report vacancies. Provided that there is a significant level of monopsony power in nursing markets wherein one or few hospitals employ in the majority of registered nurses. Based on the two models, it is found that a monopsonist may not report vacancies as the labor market equilibrium in monopsony could likely to result in a state or excess labor supply. The reason for the nursing shortage is not only that monopsonist has the power over wages and the relative strengths of labor between supply and demand.     

 

References

 

Chung-Cheng, L. (2002). The Shortage of Registered Nurses in Monopsony: A New View from Efficiency Wage and Job-Hour Models. The American Economist, 46(1), 29+.

 

Goodwin, K. (2002, October-November). States Tackle the Nursing Shortage: The Lack of Qualified Nurses Is Reaching Epidemic Proportions. States, Universities and Hospitals All Are Trying to Do Something about It. State Legislatures, 28(9), 20+.

 

Nursing Shortage. Retrieved on 8 February 2008 from http://www.nursingshortageinfo.com/index.shtml.

 

Price, J. H. (2002, March 15). Long Hours, Burnout contribute to Nursing Shortage in Hospitals. The Washington Times, A01.

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