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Providing High-Quality Care Despite Nursing Shortages

Introduction

Nurses play a crucial role in protecting public health, and it is impossible to imagine a hospital without them. Their duties include preventing illnesses, helping doctors manage patients’ physical needs, and treating some health conditions. Bedside nurses stand on the frontline and are always ready to provide immediate care to each patient. These days, healthcare systems around the world face the problem of the nursing shortage. Nurse staffing strongly influences the quality of care provided in hospitals, and the lack of a workforce is a challenge for hospital settings and the healthcare system in general. Hence, this problem calls for careful consideration and looking for solutions to maintain the quality of care on a high level.

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The Role of a Bedside Nurse

Bedside nurses are essential in all hospital settings, and some of their duties consist of taking and recording the vital signs of the patient, assessing their general health status, preparing patients for various procedures, and assisting physicians during operations. A common idea that bedside nursing is simple and does not require competencies appears to be false, as this profession implies possessing essential skills. A caregiver should have much medical knowledge and be able to perform certain procedures, such as drawing blood or giving a vaccination. Nowadays, nurses should know how to handle modern technological tools because they may need to fill out patient charts through an online database. It is also worth mentioning that, in many cases, nurses provide emotional support to the patient as it is a crucial part of the recovery process. As such, competent bedside nurses should also possess listening skills and be empathetic and patient.

Reasons for the Nursing Shortage

Nurses constitute a large part of the health personnel and perform some of the most difficult tasks. According to the World Health Statistics Report, there are about 29 million midwives and nurses in the world (Haddad et al., 2020). However, healthcare faces a shortage of nurses, which is a problem not only in the US but also in other countries around the world. According to the ANA, there will be more registered nurse jobs available through 2022 than any other position in America (Haddad et al., 2020). Some of the reasons for the shortages in the nursing profession include high turnover, lack of educators, and inequitable distribution of the workforce (Haddad et al., 2020). To deal with the problem, it is essential to consider its causes, thus, each of the possible reasons for medical staff shortage will be discussed below.

The aging population is one of the reasons there is a high demand for nurses. People nowadays tend to live longer, and the elderly demand special treatment (Haddad et al., 2020). For instance, the United States now has a higher number of Americans over the age of 65 than ever before (Haddad et al., 2020). Moreover, many diseases that were terminal earlier can be treated now with the help of modern technologies and medications. As a result, health settings need more nursing staff to take care of older patients.

At the same time, the nursing staff is also aging, causing a lack of workforce. According to Haddad et al. (2020), there are now about one million registered nurses older than 50 years. This means that a large proportion of nursing personnel will be at retirement age in the nearest future. Haddad et al. (2020) also state that “nursing faculty are experiencing a shortage, and this leads to enrollment limitations, limiting the number of nurses that a nursing school can generate.” This represents a problem of training nurses with limited resources, which leads to fewer students enrolled in the program and a decline in the quality of education. As a result, young people lose interest in this profession, choosing other, more promising careers.

The increasing age among nurses is connected with the unpopularity of the nursing profession. Medical students tend to get advanced degrees, and being a nurse at the bedside becomes regarded as a step in the career ladder, not as a destination. Marć et al. (2019) state that “the physical and mental burden and the lack of satisfactory salary often deter the graduates of nursing studies from entering the nursing profession” (p. 13). Young people become demotivated and decide to leave nursing or continue their studies to obtain higher degrees in medicine. Hence, this occupation becomes devalued and unpopular among medical workers, causing the undersupply of bedside nurses.

The lack of nurses is also connected with the general atmosphere in the healthcare setting. The profession of a bedside nurse implies working in a stressful environment and dealing with difficult cases. Caregivers employed in emergency and psychiatric departments are at higher risk of physical or emotional abuse because of the patient population. As a result, job satisfaction and work effort are affected negatively because emotional insults harm a nurse’s well-being (Haddad et al., 2020). Some of the nurses cannot bear such conditions and decide to leave their job.

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It is noteworthy that the level of the staff shortage depends on regions and areas of a country. According to Haddad et al. (2020), some regions in the United States have a sufficient number of nurses, while other areas struggle to fulfill the local population’s basic needs. The specialty of nursing can also influence the amount of staff shortage. Hence, labor and delivery, as well as critical care nurses, may be of higher demand compared to caregivers working in other hospital settings.

In light of recent events connected with the coronavirus pandemic, the lack of nursing personnel has become even more pronounced. As the patients with the COVID-19 were admitted to hospitals in large numbers, healthcare systems around the world faced the problem of an extreme shortage of medical staff. Because of nurses being treated as the “backbone” of any healthcare system, their lack turned out to be critical for acute hospital settings (Mudihanselage & Chamaru, 2015). The situation with the COVID-19 pandemic has shown that many countries are not ready to supply their hospitals with a sufficient amount of medical personnel and, in particular, nurses.

Solutions to the Problem

Understanding the causes of the issue helps to work out solutions to it. Taking into consideration the reasons for the nursing shortage described earlier, it is possible to state that this problem is multifaceted and requires a complex approach. One of the effective ways of dealing with medical staff shortages is the implementation of the nursing policy. Marć et al. (2019) propose a program that would improve working and employment conditions, implement mechanisms regulating salary, and provide the possibility of lifelong learning with the implementation of mobile and technological innovations. This program correlates with the reasons for undersupply of the medical staff and addresses each factor of the problem.

First of all, it is crucial to make the profession of a bedside nurse attractive to medical students. It has already been mentioned that the nursing profession is devalued nowadays, and students tend to choose other career prospects. Hence, a new policy should encourage undergraduates to enroll in nursing courses and continue studies in this field. One of the crucial factors influencing the popularity of a profession is the salary. As such, governments should work up and implement mechanisms, ensuring salary corresponding to the type of work and qualifications (Marć et al., 2019). This measure could stimulate students to pursue a degree in nursing and make this profession more prestigious.

Grants may also help encourage more nursery school graduates to take up the profession, serving as an incentive for them. For instance, the Polish government was considering launching a grant program for nurses in October 2018 (Marć et al., 2019). Students were promised to receive about 150 dollars a month for two years, and the only condition was to start working as a nurse at a public medical facility (Marć et al., 2019). All in all, if bedside nursing becomes a well-paid profession, more students will undertake nursing studies, reducing the level of the staff shortage.

In addressing the issue of aging nursing staff, it would be beneficial to introduce employment support programs. This could assist currently employed nurses who approach retirement age and sustain employment balance while facing no possibility of staff renewal (Marć et al., 2019). These programs should provide not only financial but also educational support. Professional requirements continue increasing with time, irrespective of the nurse’s age, and it is important to help senior workers to improve their knowledge in this field and acquire the necessary skills. Furthermore, the experience of some countries has already shown that nursing education should be imperative and result in training at a graduate level in key healthcare specializations that have faced a shortage (Marć et al., 2019). A common requirement in many states is that a qualified nurse must have a bachelor’s degree, and further training is also welcomed. Hence, implementing nurse education policies will lead to a higher number of professional personnel and ensure high-quality care at the bedside.

Furthermore, a new program should improve the working conditions of nurses. In this respect, the United States can serve as an example of the right policy. The American government offers nurses high bonuses, free housing, covers tuition fees to ensure the continuation of studies, bears the cost of the move, and even pays school fees for the nurse’s children (Marć et al., 2019). Other countries also address this problem and take action to improve the working conditions of caregivers. Several countries of South Africa that want their nurses to work in the provinces guarantee accommodation and higher salaries (Marć et al., 2019). Japan also supports nurses in getting the necessary education, and employees with a higher level of education get larger salaries (Marć et al., 2019). As one can see from the examples mentioned above, the lack of nursing staff is a worldwide issue, and different countries implement different policies in dealing with it.

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A supportive work environment can also be effective in dealing with staff shortages. Lack of support from colleagues and management is regarded as one of the reasons for burnout and a high turnover in hospitals. It should be noted that this problem may be even more prominent in settings that face violent behavior from patients and deaths (Gohar et al., 2020). In this respect, bedside nurses receive the hardest blow as they often work in acute care settings dealing with difficult cases and having close contact with patients. In such conditions, nurses require moral assistance from their colleagues and employers, and its absence may lead to resignation. Thus, the creation of a friendly and supportive atmosphere at work could decrease the number of bedside nurses leaving their positions and lower the level of staff shortage.

New technologies can also help solve the problem. Telemedicine is an alternative method of monitoring and treating patients. According to Canfield and Galvin (2018), “telehealth includes all health services provided using telecommunications technology, including the transmission of images, remote monitoring, and medical call centers” (e1). This technology allows physicians, nurse practitioners, and nurses to provide care for patients without personal presence. The researchers have shown that tele-ICU presence increases the number of positive outcomes and improves the perception of support at the bedside (Canfield & Galvin, 2018). This system is designed to alert medical staff about changes in a patient’s condition, allowing them to assess the patient’s status and identify potential health issues remotely (Canfield & Galvin, 2018). The use of telemedicine in hospitals can help provide high-quality care at the bedside in conditions of personnel shortages.

Conclusion

Nurses play an important role in all healthcare systems, and their shortage exerts a negative impact on the quality of care provided in hospitals. The lack of nursing personnel is a global problem that has multiple reasons. To address this issue and work out solutions, it is essential to consider potential causes. The problem of staff shortage is complex and calls for integrated measures, such as improving working conditions, creating a supportive atmosphere, and raising salaries.

References

Canfield, C., & Galvin, S. (2018). Bedside nurse acceptance of intensive care unit telemedicine presence. Critical Care Nurse, 38(6), e1-e4.

Gohar, B., Larivière, M., & Nowrouzi-Kia, B. (2020). Sickness absence in healthcare workers during the COVID-19 pandemic. Occupational Medicine, 70(5), 338-342.

Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2020). Nursing shortage. StatPearls Publishing. Web.

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage–a prospect of global and local policies. International Nursing Review, 66(1), 9-16.

Mudihanselage, H. S. S. S., & Chamaru, A. A. A. (2015). The nursing shortage impact on job outcome (the case in Sri Lanka). Journal of Competitiveness, 7(3). Web.

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