The national healthcare issue that this writer has chosen for analysis is the registered nursing (RN) shortage. This is not an acute issue, but rather a chronic issue that is be exacerbated through the current pandemic and staff burnout. The RN shortage is only expected to worsen with the aging Baby Boomer population and their increasing need for healthcare, with an estimated 82 million U.S. residents being over the age of 65 by the year 2030 (American Association of Colleges of Nursing (AACN), 2020). The problem is compounded with the struggles of nursing schools across the country to increase capacity to meet the current demand. The Bureau of Labor Statistics listed Registered Nursing as one of the top growth occupations through the year 2029, with an estimated growth from 3 million RNs in 2019 to 3.3 million RNs in 2029, a growth of seven percent. There is also expected to be 175,900 RN openings each year through 2029, with the aging workforce retiring and members leaving the workforce. As one can see, the issue of RN shortage is an expansive one and will not be solved overnight.
One cause of the RN shortage is the inability of nursing schools to increase capacity to meet the demands. In an AACN survey between 2019 and 2020, over 80,000 qualified applicants were turned away from baccalaureate and graduate nursing programs due to an insufficient number of faculty, clinical sites, classroom space, and clinical preceptors, in additional to budget restraints (AACN, 2020). Positively, there was a 5.1% enrollment increase in entry-level baccalaureate nursing programs in 2019, although this increase is will not be enough to meet the demand of nursing services, such as nursing faculty, researchers, and primary care providers.
Another cause of the RN shortage is burnout. Coined by Fredudenberger in 1970â€™s, burnout is a psychological syndrome which is a result from a delayed response to chronic interpersonal stressors from the work environment (de Oliveria et al., 2021). Burnout syndrome (BS) can be characterized by emotional exhaustion, depersonalization, feelings of cynicism, detachment from work, senses of ineffectiveness, and lack of accomplishment. The condition is so prevalent, it has been added to the eleventh revision of the International Classification of Diseases (ICD-11). Compared to other healthcare workers, nurses have a higher rate of BS due to a nurseâ€™s responsibilities and high work demand. Half of the current nursing workforce is experiencing BS, which can lead job dysfunction, is risky to the patients, and can lead to personal consequences for the nurse (Kelly et al., 2020). Burnout, besides causing an interruption in patient care, also leads to a significant financial cost, which is estimated at between $11,000 and $90,000 per nurse, with $8.5 million in wider costs, this includes unfilled vacancies, patient deferment, training and orientations. Recent studies have confirmed that up to one third of nurses leave their positions within the first two years of employment, this equates to a national turnover rate of 18%. With this, the causes of the RN shortage need to be investigated and addressed in order to prevent more serious complications later.
The RN shortage has impacted this writerâ€™s work section substantially. This writerâ€™s organization has approximately 100 RN positions open, some of which have been posted for over a year. The current COVID-19 pandemic has led to some nurses retiring early, either due to health reasons, such as immunocompromised staff members, RNs have also left bedside care for remote nursing positions or quit due to being burned out. This has led to a shortage of staff at the bedside, often leading to nurses having to care for additional patients. My organization responded by hiring many traveling nurses, some floors are staffed about 50/50 with permeant and traveling staff. This created a divide among hospital staff, because traveling staff nurses are paid more than permeant RNs. This caused some nurses to leave their permeant positions to become a traveling nurse. This writerâ€™s organization responded by offering bonuses to work extra shifts and provided two cost of living rases and a merit raise. This eased the tensions among staff members, but the hospital still employees many traveling nurses to cover the vacancies created by permeant staff members leaving. Ultimately, these bandages placed over the problem will fall apart and the nursing staff will again be strained to care for the increasing number of sick patients. Increasing the number of nurses in the work force should be one of the top priorities in the United States in order to address the needs of the increasing sick and aging population.
American Association of Colleges of Nursing. (2020). Fact sheet: Nursing shortage. https://www.aacnnursing.org/Portals/42/News/Factsheets/Nursing-Shortage-Factsheet.pdf
de Oliveira, D. G., Reis, A., Franco, I., & Braga, A. L. (2021). Exploring global research trends in burnout among nursing professionals: A bibliometric analysis. Healthcare 2021, 9(1680).
Kelly, L. A., Gee, P. M., & Butler, R. J. (2020). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(2021), 96-102.
The healthcare profession is very broad and it is growing technologically at a very fast rate to meet the demands of the fast-growing worldâ€™s population as well. There are so many problems that the healthcare profession face today. The most critical is the shortage of staff. Nurses make up a very important part of the healthcare profession and if there is a shortage in staff (nurses) then the problem is critical.
In order to address the problem of nursing shortage, more nurses need to be trained in schools and must pass the license exams before they can practice as a nurse. Only a few students go through this process as a whole lot of students drop out of school. As a result of this nursing shortage remains a prominent problem which leads to burn-out. Most nurses leave the work during one year of employment due to burn-out (Marshall & Broome, 2021). Action is required to keep nurses at work in order to solve the problem of burn-out in nurses.
Â Shortage in staff in nursing (nursing shortage) has been going on for long time worldwide. Just as earlier discussed above, there are many factors that lead to this nursing shortage. Nurse burn-out is one major problem due to high patient-to -nurse ratios. This also leads decreased job satisfaction and performance and this also decreases the safety of patients (Bakhamis et al., 2019). The National Academy of Medicine states that 35% of doctors and nurses suffer burn-out symptoms (Sofer, 2020).
In my own opinion, nursing shortage is not only lack or shortage in staff. it also entails high patient-nurse ratio. Â In my place of work, (hospital), the nurse -patient ratio is 1:10. Me alone having 10 patients during shift makes me feel dissatisfied as a nurse and this discourages me a whole lot. I do not render good quality care because of the workload being heavy and the patients are not satisfied either. This has made me question my decision of being a nurse. â€œDo I really want to continue working like this?â€™â€™ did I choose the right profession?â€™â€™ But I have passion for this profession, reason I am pursing the masterâ€™s program. During the pandemic, (COVID breakout), my unit became a medical surgical unit and the nurse patient ratio was 1: 5 which was way better than 1:10. This is because there was support from other departments such as the Lab, and the hospital partnered with mental health department which provided counselling to patients and nurses which was very helpful. This has helped the hospital to have a high nurse turn over due to the counselling and partnership with the mental health companies. The hospital actually has recruited so many nurses since the pandemic broke out but still working on the strategies to keep the nurses including increase in salaries which is very encouraging as well.
Bakhamis, L., Paul, Smith, H., & Coustasse, A. (2019). Still an Epidemic. The Health Care manager, 38(1), 3-10.
Marshall, E.S., & Broome, M. (2021). Transformational leadership in nursing: from expert clinician to influential leader. Springer Publishing Company LLC
Sofer, D. (2020). Restoring a Burned -Out Workforce. AJN American Journal of Nursing, 120(2) 16-17.