Healthcare Issue: Nursing Shortage
Abstract
In this paper, the writer examines the nursing shortage by identifying the strengths, weaknesses, opportunities, and threats that necessitate the need for an effective and practical approach. The text’s literature review highlights renowned scholars’ views on the state of the issue in different parts of the world and advises on how nurse leaders can solve it. The segment on the implementation plan features a change theory that offers an informed perspective of the most appropriate evidence-based practices and recommendations for nursing shortages. However, the researcher pinpoints specific barriers facing the implementation plan, and how expert nurses can use the plan’s strengths to minimize the magnitude of the problem. The paper evaluates detailed statistics and factors facilitating nurse shortage and shows how one can use informatics and technology to improve job satisfaction and increase nurse retention. Other strategies focus on inter-professional collaboration practices and certain resistance management tools in enhancing nurses’ role in curbing the issue.
Table of Contents
Abstract
Introduction
SWOT Analysis
Literature Review
Implementation Plan and Method for Change Initiation
Strengths and Barriers in Promoting the Implementation Plan
Role of Informatics, Technology, and Interprofessional Collaboration in Improving Quality
Conclusion
References
The United States healthcare workforce has been in the spotlight during and after the COVID-19 pandemic. This phenomenon highlighted nurses’ critical role in the country’s healthcare system. However, it has also amplified how the nursing shortage has significantly swamped hospitals across America. Numerous factors affect this nationwide issue, including high turnover rates, burnout, and the reduced number of experienced personnel. According to the World Health Statistics Report, the United States has 3.9 million nurses and midwives. The American Nurses Association (ANA) adds that the nation will need more than one million registered nurses (RNs) by 2030 to meet its healthcare demands. This problem calls for an effective literature review of credible, peer-reviewed articles on the subject and an implementation plan for change. This essay examines the state of nursing shortage in the United States, proposes an implementation plan for quality improvement, and suggests how technology and interprofessional collaboration can aid in the change process.
SWOT Analysis
Strengths
Internal factors of the healthcare industry reflect the strengths associated with initiating a change that addresses the nursing shortage in the United States. Firstly, the changing structure will transform work processes and internal policies in the primary setting. It will increase the areas of specialization, such as in the Intensive Care Unit (ICU), trauma, and cardiac care, among others (Tappen et al., 2017). In addition, it will contribute to establishing a novice nurse residency, nurse union, and enhanced collective bargaining agreement programs. Another strength of initiating change is that it will provide resources for further research. Another example of these strengths is that it will enable nurses to identify and treat underlying psychological issues due to burnout.
Weaknesses
Tappen et al. (2017) identified various weaknesses in creating change and eradicating nurse shortages worldwide. The magnitude and complexity of the applicability of the change process determine the extent to which other defects would affect the initiation of this plan. Buerhaus (2021) asserts that the leading nurse must effectively educate other nurses to improve their understanding and commitment to the cause. Other weaknesses include scarce resources, stakeholder resistance, and other technical issues that may arise at the implementation stage (Ladd et al., 2020). Additionally, an unstable leadership system at the facility will most likely increase the severity of these barriers.
Opportunities
The opportunities that would result from initiating this change will significantly impact the healthcare industry’s external factors. According to Buerhaus (2021), successfully repressing nurse shortage will enhance collaborative programs in the nursing practice. Moreover, the change plan will necessitate using information technology to allow nurses to simplify their duties in critical care units. Tappen et al. (2017) add that the change could increase preceptor and required mentorship programs in the healthcare system. Therefore, the change plan will ensure continuous care and thoughtful scheduling, especially in providing new access to care through the Affordable Care Act.
Threats
Buerhaus (2021) asserts that specific threats can prevent the implementation of the change plan. Firstly, the solution will increase the risk of burnout because nurses will be forced to work extra hours in intense shifts. This immediate threat is related to the notion that the plan will increase payroll costs when the country and the world face a shrinking economy and revenue. In addition, the change process will introduce new graduates with less experience while causing low staff compensation (Ladd et al., 2020). This phenomenon might develop a chain that would be problematic to the healthcare industry as it will exhibit high employee turnover and other issues.
Literature Review
There is numerous published empirical research on the shortage of registered nurses. In a peer-reviewed quantitative cross-sectional study, Gaietto & Brooks (2019) assess the shortage of professional nephrology nurses in the dialysis setting. The study demonstrates that the nation’s healthcare system should prioritize recruiting more professionals into the nephrology specialty. Morioka et al.’s (2022) literature review support this notion with the disposition that there is a robust relationship between staffing levels and the quality of health outcomes in Japanese hospitals. The two studies indicate that more nurses yield better results in various departments of a healthcare setting. Tenorio et al. (2021) specify that additional nurses would help the industry reduce the length of hospital stay, increase job satisfaction, reduce post-operative complications, and improve morale. Another consistent thing among the three studies is that the nursing system requires an advanced design for handling patient needs and characteristics.
The three studies make practical and valuable suggestions and recommendations for addressing the nurse shortage in the United States and worldwide. Gaietto & Brooks (2019) state that nephrology nursing should create a strategy to educate effectively, train, and retain nephrology nurses. Further, leaders in the nephrology section should develop ways to bypass the stiff competition in recruiting new expert nurses and advanced degree holders in the specialty. Tenario et al. (2021) assert that the compensation rates, wages, and salaries should attract these talents. Conversely, employers and leaders must understand how to retain nurses in their positions. Morioka et al. (2022) demonstrate that besides cross-training and promotion, the government should consider allowing nurses to advance their education and work on special projects. The studies state that other ways of attracting and keeping nurses include availing the resources needed to conduct research and ensuring a favorable working environment and company culture (Scruth et al., 2018).
Implementation Plan and Method for Change Initiation
Nurse shortage alters the necessity for quality and safety in the healthcare industry. Several scholars have studied the relationship between nursing shortage and patient safety, including Bauerhaus’s (2021) assessment of how it decreases the quality of care. Nurse shortage is related to low patient satisfaction scores, high patient mortality, medication errors, and overcrowded emergency departments. For this reason, Gaietto & Brooks (2019) state that employers can increase nurse retention rates by increasing wages and offering training and education opportunities. In addition, healthcare employers should look for talent in minority groups to improve diversity in the work environment. Apart from seasonal hiring, another evidence-based strategy involves the government initiating relevant nursing programs (Saputri et al., 2021). Some important nursing programs include raising academic salaries and incentives for nurse educators and allocating more funds for nursing students to alleviate financial constraints (Sadler, 2021). Other practices involve enhancing distance learning and offering more frequent and advanced online learning programs to improve nurses’ commitment to education and practice.
Udod & Wagner (2018) provide insight into essential change theories that impact different nursing situations, including the three concepts of Kurt Lewin’s Change Theory. In this context, the driving forces behind nurse shortage include poor pay, inadequate training and education, poor job satisfaction, and lack of experience. According to Udad & Wagner (2018), the restraining factors that impede change include lack of planning, inadequate leadership support, resistance from staff, and lack of resources. However, as the theory denotes, one can achieve equilibrium by unfreezing, equivalent to meeting the employee factors contributing to the nursing shortage. A nurse leader can adopt a recommendation from Tenario et al. (2021) and learn more about how experience can be improved by learning more about employee demographics. This strategy enhances the movement stage by allowing the nursing staff to work with others to find common ground, such as the appropriate compensation amount (Saputri et al., 2021). Lastly, to establish and reinforce a new habit in the refreezing stage, one should assess how job satisfaction and increased retention impact patient safety and care quality.
Strengths and Barriers in Promoting the Implementation Plan
Strengths
Implementing an effective change plan for nursing shortages presents an opportunity to provide safe patient care for all. A powerful and successful implementation plan allows nurses to influence the change and prepare for the shift. The strengths of such a model lie in recognizing the value of an increased number of nurses and its benefits to patients. Tappen et al. (2017) posit that nurses can use these strengths to realize the prevalence of leadership support and authority. In this case, effective leadership enables staff to interact and incorporate other efforts against the competitive pool of recruitment. In attempting to change the hospital culture, nurses can use the plan to strengthen employees’ persistence and improve their response to frequent monitoring (Nilsen et al., 2020). Moreover, the good results associated with the change model would reinforce a spirit of prosperity and motivate nurses to give their best at work.
Weaknesses
The main barrier to the implementation of a change plan has to do with the complexity of the change process. Full implementation of the measures for nursing shortage requires an extended effort. An unstable leadership system coupled with scarce resources makes it difficult to establish a massive change plan (Nilsen et al., 2020). In addition, a healthcare organization with competing demands and a notable resistance to change would be at a disadvantage because addressing the nursing shortage requires confidence in nurses’ roles and evaluations. However, there are specific ways nurses can overcome these barriers. These ways include excellent communication among staff and stakeholders and leadership pertaining to the change. Further, as Udod and Wagner (2018) demonstrate, nurses should fully understand the need for change and its effects. Additionally, one should involve all levels of nursing staff in addressing such a significant issue. Other evidence-based practices include embedding the change process in the hospital culture, adopting it as the new norm, and using resistance management tools such as ADKAR and Kubler Ross (Balluck et al., 2020).
Role of Informatics, Technology, and Interprofessional Collaboration in Improving Quality
Over the last three decades, technological advances have transformed the nursing landscape. Emerging recordkeeping, telehealth, and informatics technologies have significantly elevated patient satisfaction scores. Cohen (2019) states that since most recruitment processes occur online, nurses can use social media, email marketing, and website optimization to attract talent. From here, nursing staff can modify their informatics analytics to improve their chances of finding the right fit for the position at the specialty. Cohen (2019) states that this strategy has been a growing success at Emory University Hospital. According to Darvish (2014), nurses can pair their scheduling practices with technology and informatics to determine the number of patients admitted and those at the emergency department. These workload acuity utilities consider factors such as staff-to-patient ratios to manage staff and maintain patient safety effectively. In essence, informatics and technologies strive to streamline workflows, improve efficiency, and improve hospital quality.
Vital, collaborative nurses help one another embrace change, policies, and team-based and patient-centered protocols that seek to reduce nurse shortage. Busari et al. (2017) note that even when there are not enough professionals in the primary care setting, interprofessional collaboration ensures constant patient care and outcomes. For instance, after emergency surgery, a team of nurses take 12-hour shifts caring for him as the patient spends the whole day in the ICU. After this, another group transfers the patient to a cardiac unit where another team of rotating nurses attends to his needs before another hospitalist nurse makes rounds to check on their well-being. Ladd et al. (2020) state that collaboration eliminates issues related to nurse shortage, including medical errors. In addition, interprofessional collaboration ensures prompt attention to the patient, reduces inefficiencies, improves nurse relationships and job satisfaction, and reduces healthcare costs. Furthermore, informatics and technology can empower collaboration through communication technology and other mobile solutions in a world where nurses are more connected than ever.
Conclusion
This study’s components of a SWOT recognize the severity of the nursing shortage and the manner in which the proposed mechanism addresses the issue in detail. The literature review of the previously selected peer-reviewed sources shows the applicability of the implementation plan and the effectiveness of the change plan. Notable evidence-based practices concerning nurse shortage emphasize increasing nurses’ wages and compensation and providing nurses with training and education opportunities. Kurt Lewin’s Change Theory fosters the need for the government’s involvement in actualizing specific nurse programs, including alleviating financial pressures pertaining to nursing research. On the other hand, while the implementation plan will offer room for partnerships and positive workflow changes, it is pertinent to note that there might be unprecedented resistance among nurses and staff. Still, the essay suggests that the country’s healthcare system can utilize informatics, interprofessional collaboration, social media, email marketing, and website optimization to solve the issue.
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