Nursing shortage is a phenomenon that is affecting nurses and the provision of adequate patient care in today’s health care industry. Nursing shortage is said to occur when the demand for employment of nurses is far greater than the number of nurses willing to be employed at that time (Huber, 2010). According to the American Association of Colleges of Nursing (A. A. C. N. ), “the nursing shortage is expected to increase as baby boomers age, and the need for health care increases” (A. A. C. N. , 2013, Para 1).
In the United States, Registered Nurses (R. N.) make up the largest recorded working population of the health care profession, and the Bureau of Labor Statistics estimates that 2. 7 percent of the workforce comprises of nurses compared to 3. 6 percent in the last 6 years (A. A. C. N. , 2013). This decrease is attributed to the current shortage and high turnover of nurses. This current trend in the nursing profession has a great effect on the provision of health care because it has reduced the quality of care of patients, increased accidents amongst patients, absenteeism rates and staffing among others.
The purpose of this paper is to discuss the causes of nurse turnover and shortage, find out ways nurse leaders and managers may resolve this problem, and also to discuss the writer’s own personal and professional philosophy of nursing regarding this issue. Nursing shortage is also evident by the reduction in the availability of new nurses, inadequate staffing to meet the high demanding in patients’ needs, to mention but a few. Healthcare organizations need regular, dependable, highly efficient and fully involved staff to provide excellent patient care at all levels.
Therefore nursing leaders and managers are highly depended upon in changing this current trend of shortage and turnover of nurses affecting the healthcare profession (Hunt, 2009). Nurses’ turnover on the other hand is described as the loss of a nursing employee as a result of transfer, termination, or resignation (Huber, 2010. Pg. 598). It is also estimated that healthcare organizations lose about $300,000 every year as result of turnover of nurses (Hunt, 2009).
The major causes of nursing turnover include increased work load on the unit, poor leadership style, lack of role clarity, non-recognition for good performances, contributions and capabilities, poor communication on the side of leaders and managers concerning critical issues that affects working in the units, lack of career opportunity and advancement, lack of team work, tight work schedule and inflexibility that does not match job needs, job that is too physically demanding, to mention but a few (Hunts, 2009).
Nurse turnovers have been noted to increase when there are nursing shortages, and they have both economic and non-economic impacts. However there are solutions that when applied may reduce such impacts such as increasing educational and community outreach programs to increase awareness of nursing as a possible profession, providing educational re-imbursement to help existing employees obtain nursing degrees, increasing compensation and benefits, supporting flexible scheduling, and job sharing (Hunts, 2009). The behaviors of the nurse managers / leaders play a major role in the retention of nurses in a healthcare organization.
They are responsible for hiring applicants and maintaining staff retention. These behaviors include encouraging staff to lifelong learning; inspiring staff education efforts like the tuition reimbursement, make sure staff has access to education and training opportunities, enabling high quality of staff recruitment and selection, and mentoring professional development amongst employees (Huber, 2010). The role of the nurse leader is to influence people to achieve goals. In case of nurse shortage and nurse turnover, the activity of the leader becomes more important.
The leader creates and communicates a sense of purpose, discovers new ways to hire and retain nurses. The nurse manager on the other hand integrates and coordinates resources by developing staff friendly schedules, ensure that there are adequate staff on the floors at all times, make decisions that benefit the team, and delegate tasks (Hunts, 2009). The leader motivates the nursing staff, builds trust and sustains commitment; helps develop leaders while the manager makes sure that the workload is not too heavy as this increases the stress level of staff, and result in staff turnover (Huber, 2010).
Furthermore the nurse managers need to be physically present in the unit at all times to provide support and assistance in times of need, and effort should also be made in hiring adequate and appropriate mix of RNs and assistive personnel (Huber, 2010). Leadership at all levels must come together to combat these problems, while offering long lasting solutions to attract people into nursing. The profession must be communicated as a positive, satisfying, and inspiring career. “Nursing must provide for a balanced work life, offer leadership opportunities in which nurses may hone their management skills, and create
an environment in which young nurses may plan to move toward higher pay and better hours” (Huber, 2010, p587). The writer’s own personal and professional philosophy in approaching nurses’ shortage and turnover is provision of enough working staff on the units, and this can only be achieved by hiring nurses to fill up the vacant position. Careful attention should also be paid to workload, because this is one of the main reasons for nurse turnover. Nursing leaders and managers should be more empathic towards the plight of their staff; this shows the staff that someone cares.
The work environment should be transformed by providing capable, top-level nursing leadership and understanding nursing supervision all through the organization; involving nurses in decisions that are related to patient care ; re-designing nurses work spaces to be more ergonomic and less physically demanding. “A culture of safety should be created; limiting nurses work hours; promote safe staffing levels; offering flexible work schedules and employment opportunities such as job sharing; and improving nurses wages” (Jones & Gates, 2007).
When the leadership, management and staff works together, a lot of goals can be achieved. In conclusion, nurses play a major role in improving the financial capability in a healthcare organization. Therefore health care organizations should work together with nurse managers and leaders, in utilizing the solutions to resolve this growing trend of nurses’ turnover and shortage that is plaguing the nation’s health system, and impeding the ability of nurses to provide adequate care of their patients.
- American Association of Colleges of Nursing (2013): Strategies to Reverse the New Nursing Shortage. Retrieved on October 6, 2013 from http://www. aacn. nche. edu/publications/position/tri-council-shortage
- Huber, D. (2010): Leadership and Nursing Care Management (4th ed. ). Saunders Elsevier Hunt, S. (2009): Nursing Turnover: Costs, Causes, & Solutions. Retrieved on October 6, 2013 from http://uexcel. com/resources/articles/NursingTurnover. pdf
- Jones, C. , Gates, M. , (September 30, 2007) “The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention” OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 4. DOI: 10. 3912/OJIN. Vol12No03Man04