Nursing Shortage and Nurse Turn-over.
Nurses form an essential part of the healthcare system to ensure the patients receive quality and safe care. This is translated from their skills, advanced knowledge as well as interventions and compassion towards their role in healthcare. For this trend of service to continue, there is need of maintenance between demand and supply at equilibrium. Nurses’ shortage, as well as high turn-over rate, leads to disequilibrium which does affect not only the healthcare system but also the entire nation’s economic health. This can be managed and mitigated by the interventions and various approaches that are given to the nurse shortage and turn over and factors supporting the nurses’ leaders and managers which forms the focus of this article.
In various care centres, the nurse managers need to focus significantly on the supply of qualified registered nurses at all levels by not only attracting the new nurses but also retaining them in their new areas of practice. Nursing leadership need to embrace an open system of enhancing professional development via advanced education of their staff. According to Zinn et al., (2012) the educational restrictions that exist in the nursing profession acts as a demotivation to individuals that would wish to enter the profession. For those who have entered the profession, they are pushed to the wall leading to a premature exit from the profession to pursue their further studies. This leads to high turnover is such environment which seems to be unfavourable. The turnover rate gets higher if the restrictions continue to exist hence the need to embrace educational development which has the potential of accommodating the nursing staff.
Nurse retention can be achieved by creating a conducive environment for the nurses that will see them work efficiently with fewer stressors and disruptions. Zinn et al., 2012 reiterates that a work environment that has disruptive behaviours such humiliations, demeaning treatment, passive-aggressive behaviours and violence among the staffs act as a facilitating factor to nurse leaving their positions and roles since it is not conducive for working. The nurse managers can apply the leadership styles to guide their operations and guide conflicts of common interest among the staffs. For instance, democratic style of leadership can guide the needs of common interest among the staff while laissez-faire style can guide experienced nurses to undertake their duties without guidance. In such instances, violence and solutions to various issues can be assorted to make the surrounding favourable for the staff.
There is also need to adopt the nurse residency programs that are geared towards increasing retention and reduce the turnover. With the program in place, the graduate nurse will be able to have resources and equipment that they require to offer their services. Similar to the correction of the disruptive behaviours, the residency program leads to a supportive environment to the nurse by enabling professional development and allowing retention to address the nursing shortage. Through the program, proper orientation and mentorship provided to the new graduates improve their skills and knowledge hence increasing their confidence and competencies in the care provision.
On the other hand, the nursing leaders and other stakeholders need to provide constant recognition to the nursing profession such as appreciation to the nurse managers and the frontline health workers. Gelinas recognises that the increased professional recognition only exists during the time of scarcity (2017). This calls for the nursing leadership and management to give it a continuous focus that may make the profession lucrative and attractive to throughout to boost its working force. The recognition can further be achieved via the creation of clinical ladders that will see experience and levels of education being rewarded. This can also take the form of advanced practices roles, versatile staffing systems and shared governance structure. These demonstrate incased celebration and acknowledgement of the high professional performance.
Furthermore, the nurse managers need to design the working systems to ensure the professional nurses are only tasked with licensed duties that provide right persons perform right duties. The designing and implementation of the healthcare system to ensure right functions are performed by right individuals will not only be a critical mission to improve the quality of care but will also be part of the solution that will overcome the shortage among the nurses that usually come about with burden of undertaking unlicensed duties (Gelinas, 2017). The scrapping of unauthorized duties translated to reduced tasks for nurse leading to increased demand hence reduced shortage.
As per the personal and professional philosophy of nursing, the patient requires the nursing services to get back to normalcy. Hence, the nurse needs to be available to provide quality, safe and continuous comprehensive nursing care until the patient can get back to their normal lives. In line with this belief, the nurse residence program fits to ensure its achievement. This is so because, during the program, both the new graduates and the experienced nurses are available to the patient hence providing continuous care despite the learning bit. At the same time, the nurse is being orinte3d, indoctrinated and educated which all lead to improvement of knowledge, skills and experience hence enabling provision of quality and safe care. All in all, the environment provided to the nurse is favourable to allow smooth transition hence enabling the nurse to be retained leading to a solution to the existing nurse shortage and turn over that comes with poor adaptation to the environment as well as culture shock among the new graduates.
In funding various sectors to alleviate the nurse’s shortage and turnover, there is need to redirect the funding meant for the diploma nursing programs by the secretary of Health and Human Services to aid the nurse residency programs (Snavely, 2016). This should take place in rural areas and the critical access areas where the demand for nurses is high creating a shortage. Besides, the medical covers from the centres of Medicare and Medicaid services need to fund the development and implementation of the residency programs. This move will enhance and promote the care provided to their contributors and lure more to insure their health with their services hence a mutual benefit.
Both the state and the federal government need to allocate substantial funding directed toward the salaries, remunerations, incentives and resources through the healthcare departments that are used by the nursing staffs (Blumenthal, Abrams, & Nuzum, 2015). Sufficient allocation will act as hygiene factors which will facilitate the working environment to be supportive. This will lead to the motivation of the staff and enable retention.
Indeed, the nurse shortage and the nurse turnover can be related to the poor working environment that makes it unfavourable to stay, poor transition from graduate nurse to the time of practice, burdening of the nurses with unlicensed duties as well as restriction of professional development within the profession. The nurse leaders need to approach these challenges by making the environment conducive and attractive by adopting the residency program, allowing advanced education within the staff as well as rewarding and enabling recognition of better performances. This can be realized by the support of various organizations in term of funding for instance diversion of funds to the residency programs as well as funding of the program by the insurance covers. The stage and the federal government can also increase the allocation of funds to meet the salaries and resources need to make the nurses work environment favourable to attract and retain its staff.
References:
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years.
Gelinas, L. (2017). Advantages of a nursing shortage. American Nurse Today, 12(7), 4.
Hunt, D. (2014). Does value congruence between nurses and supervisors effect job satisfaction
and turnover?. Journal of nursing management, 22(5), 572-582.
Purdy, E., Macintosh, N., Miguel, M., & Mitchell, T. (2014). What Management Qualities Affect
Nurse Turnover on An Inpatient Unit?.
Snavely, T. M. (2016). Data Watch. A Brief Economic Analysis of the Looming Nursing
Shortage In the United States. Nursing Economic$, 34(2), 98-100.
Zinn, J. L., Guglielmi, C. L., Davis, P. P., & Moses, C. (2012). Addressing the nursing shortage:
the need for nurse residency programs. AORN Journal, 96(6), 652-657. doi:10.1016/j.aorn.2012.09.011
