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Staffing shortages in nursing
Literature review on staff shortages in nursing
Nursing shortage issue
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Nurses are considered as the largest population of professionals in the health care systems. The nursing population currently confronts sever shortages especially of younger and RNs nurses that could threaten the quality of care and patients’ safety, nurses’ job satisfaction, and organizational productivity. According to Flinkman and others’ fact that “Most countries within the Organization for Economic Cooperation and Development (OECD) have reported a nursing shortage, which is predicted to get worse because the current nursing population is aging”. Even nursing education institutions could not fill healthcare organizations demands of graduated nurses because they also suffer from shortages of nursing faculty (Erlen, 2004).
This issue
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The economists like March & Simon in 1958, Burton & Parker in 1969, Stoikov & Raimon in 1968, and Pencavel in 1970, explained the turnover from the perspective rational decision-making based on cost/benefit analysis (Stags & Dunton, 2012). Nonetheless, their description of turnover was too narrow. They additionally ignored explanation of the turnover process (Rodger, Griffeth, Peter, & Hom, 2004). While, sociologists focusing on work structure, and psychologists like Lyons in 1968 and Farris in 1971, pointing to employee anticipations and behavioral commitment (Stags & Dunton, 2012). Whereas, nursing turnover researchers have utilized all three views but more emphasize on work environment and psychological aspects (Stags & Dunton, 2012).
Turnover Process Models
Nursing turnover is phenomenon that directly affects nursing practice and patient health status. However, the factors surrounding this phenomenon are complex interrelated. But, the traditional research on nursing turnover essentially has concentrated on job attitudes, specifically negative attitudes as the primary cause for turnover. Lately proposed models are extension or modification of the early models that presented as the backbone of the contemporary turnover theory ( Battistelli, et al., 2012) . There are five turnover theoretical models that have shaped the research on turnover
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Those researchers addressed turnover as related to behaviors rather than a separate phenomenon, which failed in explaining turnover adequately. Some described the turnover process while others shown the relationship of turnover with others variables.
These newly models includes others factors beside work attitudes as causes of employee turnover. The causes of nursing shortages and high turnover rate are divided to three categories. First is the work status and work environment including safety and unit size, workplace stress, workplace location, leadership style and other organizational factors (Currie & Carr Hill, 2012). The second factor associated with personal reasons encompassing home and family, age and generation related, value and morals, and career opportunities and professional development. Final factors related to economic
Nursing Shortage is a problem we all should be aware of. There are many factors that may lead to a nursing shortage, such as having stressful and unsafe working environments, and our nurses are being overworked. This is a problem we should be aware of because it is affecting the patient care. Nurses would not have enough time to stay with a patient if they have more patients to worry about. Nurses play a big role in our hospitals and communities, “Nurses play significant roles in hospitals, clinics and private practices. They make up the biggest health care occupation in the United States. Nursing job duties include communicating between patients and doctors, caring for patients, administering medicine and supervising nurses' aides”(study).
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
Dawson, Roche, Homer, and Duffield (2014), presented a qualitative design to reveal nurses’ experiences and perceptions of turnover in Australian hospitals and to identify strategies that will improve nurse retention, performance and job satisfaction. They analyzed 362 nurses from a national survey of nurses from medical-surgical units across 3 Australian states. The results found that key factors affecting nurse turnover were limited career opportunities, poor support, a lack of recognition and negative staff attitudes. These issues caused nurses to feel undervalued and disempowered. At the conclusion of this survey, it was shown that nursing turnover can be influenced by the experiences of nurses and positive steps need to be made to improve workplace conditions and nurse retention. Several studies were performed and it was found that participants highlighted the need for a quality preceptorship program for new nurses. Improving job performance and workplace conditions can reduce high turnover rates.
There are various issues that arise with having a shortage among nurses in the hospital setting. Scientists have found that nursing shortages can lead to both complications during a patient’s hospital stay and in some cases patient mortality. This is due to the fact that nurses are unable to focus on proper care for each individual patient’s needs.
According to ANA “the nursing shortage affords opportunities, but there are consequences, too” (Nursing Shortage, n.d, para 4). ANA points out the negative effects of nursing shortage as medication errors, mistakes, fatigue, injury to nurses, job dissatisfaction and as a result patient quality care suffers.
Several other causes have been attributed to the nursing shortage. An increase in the number of nurses is needed. Sadly, there is little increase in compensation for nurses. In addition to no growth in pay, the level of stress, responsibility, and demand nurses is increasing. Unfortunately, patients are the ones who suffer. When a hospital does not have the proper nursing staff to care for patients, it results in poor patient safety and patient outcomes (Buerhaus, Donelan, Ulrich, Norman, DesRoches, & Dittus, 2007). Nursing salaries compared to other professions has remained stagnant. For example, a registered
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
According to Canadian Nurses Association(2009), human health resources have stated that by the end of 2011 Canada will experience shortage of 78 000 registered Nurses (RN) and shortage of 113 000 nurses by the end of 2016. Globally there will be shortage of 4.3 million health care workers. It was also shown that approximately 38% of new graduate nurses leave their workforce within the first year of employment (Lavoie-Tremblay, Wright, Desforges, Gelinas, Drevniok & Marchionni, 2008). According to registered Nurses Association of Ontario (2011), full time positions of RN dropped to 57.9 % in 2010 from 58.9% in 2009. With the current trend it is expected that the Canadian Nursing shortage will increase significantly. In order to understand nursing shortage and improve the future of the workforce, it is important to determine and treat the root cause of the problem. Through the use of professional practice model and fish bone diagram this essay will identify the major root cause of the problem.
Employee turnover represents a practical problem to an organization in terms of loss of talent and additional recruitment and training cost. Only a few studies have explored the effects on intention to leave (i.e. Daily & Kirk 1992) . Therefore, the underlying process through with organizational perception leads to employee turnover remain largely unknown. I am not going to consider gender, age or race in this study. I am not going to consider individual employee titles. I am not going to study samples of over 60 people. I am not going to divide HR non-exempt employees by individual HR departments.
The study of employee voluntary turnover is an important organizational issue that has received great attention for many decades. According to Mobley (1982), when an employee decides to leave, many effects can occur to the organization and to employees. Researchers studying turnover have identified a vast number of variables scattered throughout the turnover and work attitude literature (Griffeth, Hom & Gaertner, 2000; Maertz, & Griffeth, 2004). According to Steel (2002), most of the qualitatively relevant core models focused on job attitudes as the main reason for leaving, and were based on March and Simon’s model (1958) that dissatisfaction ultimately influences employee turnover (Mobley, 1977). However, although job satisfaction (JS) is a key predictor of employee turnover (Mossholder, Settoon, & Henagan, 2005), Griffeth and colleagues (2000) sustained that the strength of the relationship between satisfaction and turnover was weak. Previously, Judge (1993) argued that the relationship between satisfaction and turnover could be mediated by one or more variables. Furthermore, Mathieu and Zajac (1990) sustained that the dominant view on voluntary turnover assumed that satisfaction influences commitment and that organizational commitment mediates the effect of satisfaction on turnover intention. In particular, Mathieu and Zajac (1990) argued that “the most common use of organizational commitment in causal models mediated the influences of personal characteristics and work experiences on employee turnover processes” (p. 188). According to Wagner’s meta-analysis (2007), all three components of commitment influenced turnover and were negatively correlated with both turnover intention and voluntary turnover. However, although the corr...
The inadequate number of skilled trained nurses is a universal phenomenon. The shortage of nurses has raised many healthcare delivery burdens worldwide. Known earlier studies reported that fewer qualified school leavers chose to be trained as nurses (Knox, Irving & Gharrity, 2001; Fonza & Tulker-Allen, 2007; Zysberg & Zisberg, 2008). In our local context, registered nurses form the bulk in the forefront workforce of our Singapore healthcare system, thus training ample number of registered nurses is a concern for the local healthcare structure. This continued trend of failing to attract an acceptable amount of trainees in the nursing profession indicates that an imbalance still appear between what retaining and deserting factors of the profession. Hence, it is also important for the hospitals to understand factors which impact nurses’ decision to leave the nursing profession (Ng & Tan, 2010). Retention of nurses working in acute hospital settings and specialized areas such as psychiatric wards is crucial and it can be accomplished by establishing that nurses find satisfaction with their work environment (Murrels et al. 2005). Despite the fact that a number of comprehensive research regarding nurse job satisfaction has been done, large numbers of nurses still experiencing high level of job dissatisfaction at their workplace (Manojlovich & Spence Laschinger 2002, Ma et.al. 2003).
Healthcare is facing a nursing shortage that will challenge the delivery of medical care throughout the United States and worldwide. The current registered nurse (RN) shortage is predicted to increase over the next 20 years due to the imminent retirement of the Baby Boomer generation (Griffith, 2012). The nursing profession faces difficulties attracting new nurses and retaining the existing workforce. Many factors, including poor retention rates within the profession, contribute to this problem (Gambino, 2010). Unfortunately, often due to the lack of financial resources, many of the changes suggested to encourage retention are difficult, even impossible to achieve.
Tett, R. P. & Meyer, J. P. 1993, ‘Job satisfaction, organizational commitment, turnover intention, and turnover: path analyses based on meta-analytic findings’, Personnel Psychology, vol. 46, no. 2, pp. 259-293
Financial issues within a business are another reason for employee turnover. Both are affected by the financial situation in which a company is placed by its management or leadership. When a company has a low turnover is considered a safe business, financially and culturally is a business that does not have any major issues affecting the overall wellbeing of the staff or of the finances of the business. Managing turnover can be a very delicate process. Voluntary Turnover is when the individual’s choice of resigning from their position, involuntary is when the business decides that the employee is no longer an asset to the company, and is discharged from their duties.... ...
(Beecroft, Dorey, & Wenten, 2008). Nurse turnover in the first year of practice ranges between