Nurse Staffing Challenge in Hospitals
It is known that hospitals which operate using insufficient number of nursing staffs have a high record of poor patients’ outcomes. It has also been determined that increasing the staffing levels in most public facilities is not an easy task despite the fact that the patient outcome is known to be poor. The low staffing levels in hospitals is due to the high number of patients who are current always seeking for comprehensive medical care and the wide gap that exists between the open positions in health care sector and the number of registered nurses who are available to take up these positions. An average vacancy rate of about 13% has been identified.
These are findings of research projects funded by AHRQ and other additional research projects that are aimed at describing the existing nurse staffing levels in relation to the adverse or undesirable patient outcomes that are witnessed (“Hospital Nurse Staffing and Quality of Care | AHRQ Archive”, 2016). The valuable information from the findings are very important for decision makers to help them in making adjustments to improve on the current staffing levels to increase the number of those that are recruited. This will be aimed at improving on the quality of services offered and strengthening the nurse satisfaction when they are introduced to simplified working conditions where they are not overworked.
In another source, it is described that attempts to reconstruct the nursing workforce which is currently impending is a major threat towards that overall emergency preparedness in the nation. Emergency responses in the current times rely on services that are delivered by nurses who are always not sufficient. It is indicated that the United States has to come up with ways through which the nursing staffing levels will be improved to make sure that the state is always capable of handling emergencies cases which can come up at any one time. It is for this purpose that a robust nursing team is required in hospitals to facilitate effective response to health emergency cases at any one time. Long-term projections have indicated that the supply of Registered Nurses will not be able to attend to the demands that the hospitals will present in a manner that high-quality care will be ensure . It is indicated that the United States currently has a shortage of more than 120,000 nurses and this figures is projected to reach 250,000 by 2025 (“Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy”, 2016). This is a big challenge considering that the population is aging a demand for health services will increase. The status will worse when it will be determined that the hospital will not be able to respond fully using the available nurses.
A current trend has being indicated where hospitals are replacing Registered Nurses with licensed practical nurses in a way to reduce the amount of money that is used to support the nursing profession. This is a changing mix that has not only affected the working standards of nurses but has resulted into lowered quality of health services that are available at any one time to the members of the community. In Alberta, the hourly rate of practical nurses is about 21$ to $28 while that of Registered nurses is determined to be $32 to $43. They are interested in profit maximization without considering the effects that are felt by members of the community when they are served by low qualified personnel whereas the government can afford to employ qualified nurses to deliver quality services. The growth rate of Licensed Practical Nurse in Canada stands at 5 % for the last five years while that of Registered Nurses is indicated to be 6% (Karen Born, 2013). This is a major problem that affects acute hospitals where specialized services are greatly required based on the fact that intensive treatment procedures are involved. The complexity of procedures in these facilities requires that qualified nurses be used and this is determined by the level of training of the nurses and the experience they have. There thus exists a major gap when it comes to the quality of services that are offered by the licensed practical nurses in public health centers and what is being offered by private nurses who are by now operating on a private basis after they lost their jobs to the practical nurses. There are those who intentionally withdrew their services in the public sector and are currently operating on their own due to the poor payment systems and terms that were offered by the government. This has since created a scenario where the members of the community have to spend more when seeking quality medical services meant to accurately offer treatment to certain medical conditions which require interventions by qualified personnel. There is a possibility that those involved in the changing mix in the nursing profession are not aware of the extreme challenges which are being experienced. The missed understanding can only be addressed through detailed and dedicated research studies that they will be informed of the adverse effects allowing them to make timely changes to avoid things getting worse. The government, which is the primary source of funds in public facilities, will always undermine efforts by other parties that try to exposes its weakness, and this is a major challenge that research programs aimed at exposing trends in nursing profession about what the government is facing. The findings generated from this research will always face a lot of rejection and the implementation of the proposed changes will always be delayed or prolonged. This is the reason as to why it takes long for the public health facilities to make improvements in certain areas that are indeed observed to affect the process of service delivery after some revelations presented by the various research projects done in the past. Long-lasting solutions in the nursing profession can only be found if only the government and stakeholders involved change their focus to not only aim at profit maximization but have a major goal of improving the health care sector as whole, ranging from the professionals available and the systems that are involved.
In yet another source, it is indicated that regulations behind the staffing ratios is an issue that needs to be addressed with a lot of considerations of the ever increasing number of patients that are always available at any one time seeking medical services. It should be understood that the population is continuously becoming aged and this presents a high demand for nursing services than before (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013). This is a call to the public health sector to make timely adjustments that will allow for recruitment of more registered nurses to increase the available ratios (DPE et al., 2016). The elderly population creates a delicate population that requires timely medical attention and swift interventions to be available at all times. Any delay in service delivery worsens their medical conditions, and this can only be achieved by increasing the number of nurses that are available in public health facilities. Mixed research studies have identified that public facilities are flooded with medical students who are used in most cases used to deal with the high number of patients. Fresh graduates end up taking roles in comprehensive care departments, and this is a threat to the quality of health care offered. This is because the government ends up posting few registered and experienced nurses to public facilities who end up taking up the management roles. It is for this reason that they are not directly involved in the patient analysis to decide on the suitable treatment options. They function to be consultants in the facilities making it hard for every patient to get the required therapeutic touch from them. Interns operate based on the operating procedures that are set by the management, and this makes it hard for identification of other factors behind a given medical issue (LAI, 2014). It is for this reason that health promotion is not efficient and re-occurrence of diseases remain to be high.
It is indicated in another source that there lacks the required nursing workforce to attend to complex medical conditions which require an experienced nurse to coordinate the process involved to incorporate all parties involved to favor the treatment and management of these conditions such dementia. The main problem is that the number of specialized nurses in acute hospitals is always limited as most of them have since turned to work on a private basis. It is identified that treatment of such complex medical conditions is always expensive especially when private nurses are used (“American Association of Colleges of Nursing | Nursing Shortage”, 2016). These are conditions that require a lot of input, and this is where professionals are required to make informed decisions that will decide the best treatment options that will offer solutions that will fully respond to these conditions that are not easy to treat and managed. The nurses that are always available at any one time are always limited and cannot sufficiently attend to the high numbers of patients requiring comprehensive care hence the patient outcome is low. This information can sufficiently convince health care stake holders that there is a gap that needs to be filled in acute hospitals especially in the recent times when cancer treatment and management is a big challenge.
Another source that gives a general insight to nursing profession indicates that there are some gaps in nursing profession which need to be addressed, and this will involve amendment of the available policies and standards. These changes will address the procedures through which nurses are selected to serve in public hospitals and the number of nurses that will be available in a given facility to attend to the high number of patients that is always on the increase in the recent times (International Journal of Nursing Studies, 2016). It is the role of the stakeholders in healthcare sectors to understand the currents trends that are associated with the aging population which is presenting a high demand for nursing services. It is the time that the government sets up strategies that will address the projected high demand for nursing services shortly. It is time to invest actively in medical education in the current times as this is the only way in which the number of trained and qualified nurses will be increased to improve the overall quality of health services offered. Those already trained should be encouraged on the importance of advancing their education to specialize in various fields as this will produce professionals to deal with the diverse medical needs of the community. Most important for the government is to ensure proper payment terms of nurses as this is the only way that the current shift from public to the private sector will be minimized. It is true to say that cost of nursing services will be reduced to affordable levels by increasing the number of registered nurses in the public sector.
It is identified that the low number of registered nurses leads to overworking which is a major problem in most public facilities where a single nurse is required to attend to a big number of patients at any one time. This is because the population is too high for the available nurses to cope up with (Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach, 2016). This has since resulted in the lack of specialized services in the nursing profession, and this has resulted in cases where a single nurse offers a lot of medical procedures in a general manner without considering the fact as to whether they are trained in that field or not. It becomes worse in those cases where urgent specialized services are required, and the right nurse cannot be reached. This is a negative occurrence in health care and has resulted in some cases where a patient dies even after receiving medication for some public facilities. Research projects using postmortem results have in certain cases proved those wrong procedures have in some cases led to the death of individual after wrong medication were offered. The wrong medication is attributed to the fact that the nurse involved did not follow the right procedures in determining the exact medical condition. Lack of the required expertise leads to selection and use of wrong medical procedures hence the medication that is offered is not the right one. The person develops additional complications which combine with the condition at hand leading to the death of the person. Death resulting from such a case is an indication that there is a missing gap in nursing profession where the required personnel are not available in certain cases.
References:
American Association of Colleges of Nursing | Nursing Shortage. (2016). Aacn.nche.edu.
Retrieved 27 September 2016, from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage
Ball, J., Murrells, T., Rafferty, A., Morrow, E., & Griffiths, P. (2013). ‘Care left undone’ during
nursing shifts: associations with workload and perceived quality of care. BMJ Qual Saf, 23(2), 116-125. http://dx.doi.org/10.1136/bmjqs-2012-001767
DPE, A., Message, P., Statement, D., Staff, D., AFL-CIO, D., & Unions, A. et al. (2016). Safe-
Staffing Ratios: Benefiting Nurses and Patients – DPEAFLCIO. DPEAFLCIO. Retrieved 26 September 2016, from http://dpeaflcio.org/programs-publications/issue-fact-sheets/safe-staffing-ratios-benefiting-nurses-and-patients/
Homes, I., Wunderlich, G., Sloan, F., & Davis, C. (2012). Staffing and Quality of Care in
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Hospital Nurse Staffing and Public Health Emergency Preparedness: Implications for Policy.
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