Introduction
Inadequate staffing and training of nurses is a serious problem that causes nursing shortage in health care organizations. Most health care facilities do not meet the recommended nursing staffing levels. It therefore becomes difficult to provide quality health care as there are fewer nurses in each section or to offer particular service. Lack of training affects supply of trained nurses to health care organizations, thus, contributing to nursing shortage in these organizations. The World Health Organization believes that health care organizations across the world still need about 4.3 million nurses, physicians as well as other hospital staff (Dugger, 2010).
Causes of poor training
The major reasons as to why some nurses may be poorly trained and equipped to deliver quality healthcare are the fewer nurse-training programmes, as well as, fewer qualified nursing educators to provide appropriate and standard training. This is because the demand for professional educators is growing faster than their supply. In addition, most institutions which provide nursing training do not have adequate resources to provide necessary and relevant training to nurses. Again, some health care organizations do not provide retraining opportunities and refresher courses to their nurses.
Causes of inadequate staffing of nurses
Declining interest in college students to pursue the nursing profession is a major factor which contributes to low staffing of nurses in some countries. For example, Netherlands had to hire 7,000 nurses from overseas in 2002 to fill the nursing gap that existed in the health care (Kline, 2003). According to Dugger (2006) some health care facilities in the US are currently pushing for the lowering of the restrictions that limit the number of foreign nurses which can be recruited by health care organizations. The deteriorating working conditions for nurses have discouraged the younger generation from pursuing nursing courses. Even the nurses themselves sometimes fail to recommend nursing profession to their children. In addition, there is increasing turnover in the nursing field leading to further low number of nurses available for employment.
Many hospitals, administrative institutions and other health care organizations still make cutting of costs as their major priority. Thus, they rarely consult their nurses on major improvements needed to increase the efficiency of the nurses in delivery of nursing care. Most health care facilities are run like business and therefore minimizing the cost is a major operating priority, thus, raising nurse-patients ratio is not given the much consideration it is supposed to be accorded.
Assessing causes of inadequate training and staffing of nurses
There are several ways of identifying poor training and inadequate staffing of nurses in a health care organization. However, the most appropriate would be to administer a questionnaire modified in such a way that it harnesses the view of all the stakeholders of the health care organization. The questionnaire should target to get the views of senior nurses, nurses-in-charge, the management, the ministry of health, and randomly selected patients and the public.
More data on the number of nurses who graduate from colleges and universities also have to be obtained from the ministry of health, and the American Association of Nurses. Data on the total number of nurses in the facility has to be obtained from the hospital management to compare it with the recommended number of nurses to identify the deficiency in staffing. Records of reported medical and treatment errors also have to be obtained to be used in analyzing the possibility of poor training or inadequate staffing.
The questionnaire has to explore the reasons for low staffing in the facility (from the management and the nurses in the facility); whether the patients feel they are receiving quality care, and why not, as well as, whether they feel this is related to poor training or low staffing. The ministry of health, the management and the nurses are the likely targets to provide the answer as to whether there is a training gap in the nurses. After that, we get the average number of reasons to make qualitative analysis.
Implications of poor training and staffing in healthcare organizations
Poor training of nurses leads to increase in risk for error during health care delivery process. This compromises patient safety and may worsen the condition of the patient or even lead to death of the patient. For example, poorly trained nurses or their subordinates may not be aware of the need to turn bedfast patients after every two hours. Such neglect may cause bedsores on the patient. It is also not uncommon for patients to lose appetite, however, in some cases; this could be a symptom of an illness. Poorly trained nurses may assume that such an instance in a patient is normal and therefore neglect to investigate the possibility of an illness in a patient. The Healthcare Packaging (2010) reports that insufficient staffing of nurse contributes about 68% of medical errors while poor training contributes about 56% of the same. In health care facilities which are understaffed, nurses perform their duties in fast-paced, complex as well as unpredictable settings; this puts patients’ lives at risk.
Inadequate staffing and training make the available nurses to be overloaded in their respective jobs as they are assigned many patients. Besides, they have to perform massive paperwork to meet the bureaucracies needed for billing purposes.
This means that low staffing in a health care facility increases the burden on the available nurses making the job to be stressful. Job stress coupled with other stressors may lead to cases of neglect by the nurse on those they provide health care to, especially in situations which require proper judgment or are stressful (Clegg, 2001). When certified nurses are given the responsibility to take of many resident patients, the patients are not likely to receive the care they are supposed to receive.
Inadequate staffing also has significant impact on health of nurses. Nurses who work in these understaffed health care facilities are more likely to suffer work-related stress. Work overload may cause psychometric disorders in the affected nurses. Such disorders include back pain, worry, resentment, forgetfulness, acidity, as well as, stiffness in shoulders plus neck (Kane, 2009). Moreover, poorly trained nurses may not have the proper understanding of how to deal with additional stress which may come from home-related or personal problems. This may lower their efficiency and increase their chances of making errors in their health care delivery. If such a problem is experienced consistently in the organization, the nurses are not likely to achieve job satisfaction, and worse still, it may contribute to job burnout.
Inadequate training and staffing in an organization may also increase losses to owners or managers and create bad reputation to the healthcare facility. Losses may result from lawsuits and claims of medical or treatment errors that occur during the health care delivery process. Stress due to work overload may increase injury claims as well as errors in patient treatments. Besides, nurses’ absenteeism due to chronic stress and sickness, as well as, turnover significantly increases the cost of their employment in the health care organization.
Conclusion
Poor training of nurses and inadequate staffing of healthcare facilities has been the major cause of nursing shortage in most countries across the globe. These cause difficult working conditions since it leads to low nurse-patient ratio. It is therefore important to find solution to avert the training and recruitment problems.
Reference List
Clegg, A. (2001). Occupational stress in nursing: A review of the literature. Journal of Nursing Management, 9:101–6
Dugger, C. W. (2010). U.S. plan to lure nurses may hurt poor nations. New York Times, Web.
Healthcare Packaging. (2010). Nurse medication errors and the role of packaging. Web.
Kane, P. P, 2009, Stress causing psychometric illness among nurses. Indian Journal of Occupational and Environmental Medicine, 13(1): 28-32.
Kline, D. S. (2003). Push and pull factors in international nurse migration. Journal of Nursing Scholarship, 35(2).