Global Nursing Shortage and Strategies for Recruitment and Retention
Proficient, self-assured, and regulated health personnel are a vital part of the society's health and well-being. Today, we are experiencing an incomparable global nursing shortage. "Recent statistics indicate a growing attrition rate among nursing students and suggest that between 30% and 61% of new nursing graduates report an intention to leave the profession within the first year of professional practice" (Price, 2009, p.12). This statistic is even more worrying, given that the nursing shortage is likely to augment over the next Decade. The current and budding shortage of nurses is a global apprehension. In addition, nursing recruitment and retention are recognized national and international priorities. Global nursing shortage coupled with elderly nursing employees has placed considerable strain on the government to execute strategies to meet upcoming nursing demands as well as build up strategies to cope crisis.
The subject of scarce human resources for health care delivery is both a universal and a local issue. " Shortage will reach crisis proportions by 2015 when there will be a 20% shortage of available nurses five years later, in 2020, estimates project the shortage to grow to 29% " (Andrews & Dziegielewski, 2005, p.288). The future of nursing will lie in the capability to hire and maintain the next generation to the profession. The aim of this essay is, to analyze the global nursing shortage and strategies for recruitment and retention. This paper explores the current nursing shortage and discusses how to create work environment that promote job satisfaction and retention.
Origin of Issue
World War II dramatically changed the way that medical care was provided. These advances and the remarkable increase in the number of hospitals resulting from the growth prompted again combined to create a shortage (Andrews, 2005). The demand for nurses is first recognize by high school counselors and employment agencies (Catalano, 2009). Additionally, Hirschfeld (2009) pointed that Long Term Care (LTC) needs are increasing in the developing world. By 2050, one of every five members of the working population in China will require daily help. A major reason for the steep increase in LTC needs is an aging population. Furthermore, Holloway, Bake, & Lumby (2009) noted that growing consumer expectations are strong drivers of an amplified demand for health care services.
Nursing Shortage Worldwide
The World Health Report in 2006 showed an anticipated deficiency of approximately 4.3 million nurses, midwives, physicians, and support workers worldwide. Stames & Kremer (2007) detected that in years past; the nursing shortage was attributable to diminished enrollment. Consequence of transformation in the workplace is a chief source of disappointment in the nursing workforce, correlated with poor retention rates that contribute to current nursing shortages (Andrews & Dziegielewski, 2005; Forsyth & McKenzie, 2006; Holloway et al. 2009). According to Oulton (2006), there are both delivering and demand issues. The augmented demand is due to increased acuity of care, new infectious diseases, aging inhabitants, globalization, rising private sector, elevated public trust in nurses and decreased supply of nurses. More to the point is aging nursing workforce bring upped in different studies (Andrews & Dziegielewski, 2005; Carver & Candelal, 2008; Catalano, 2009; Drury, Francis, & Champman, 2009; El-Haddad, 2006; Forsyth & McKenzie, 2006; Stames & Kremer, 2007). One more rationale for increased demand for nurse is increased population (Chitty, 2005). Additionally, poor retention rates in both developed and developing countries interrelated to low levels of employment fulfillment (Andrews & Dziegielewski, 2005; Carver & Candelal, 2008; Drury et al.2009; Forsyth & McKenzie, 2006), lack of gratitude by superiors and colleagues (Drury et al.2009; Forsyth & McKenzie, 2006; Oulton, 2006), and diminishing salaries (Drury et al.2009; El-Haddad, 2006; Forsyth & McKenzie, 2006; Oulton, 2006; Upenieks,2005).
Moreover, declining interest in a nursing calling because of escalating job opportunities for women outside of the health care field (Andrews & Dziegielewski, 2005; El-Haddad, 2006; Upenieks, 2005) pooled with faculty deficiency to practice nurses to edify in an academic setting (Andrews & Dziegielewski, 2005) and fewer opportunities for enduring education of RNs (Catalano, 2009; Forsyth & McKenzie, 2006). Furthermore, work-related hassle is another variable regarding health and safety experience, job-related injury, sickness and burnout (Andrews & Dziegielewski, 2005; Oulton, 2006; Stames & Kremer, 2007) .Besides , unfavorable work settings, inadequate support staff, hostility leads to physically exhausted and emotionally drained ,to end with poor retention (Drury et al.2009; Forsyth & McKenzie, 2006; Oulton, 2006; Stames & Kremer, 2007; Upenieks, 2005). The exacerbating fact is Holloway et al. (2009) inadequate workforce preparation, along with poor recruitment and allocation strategies. Additionally, childcare troubling issues (Forsyth & McKenzie, 2006), community influences (Andrews & Dziegielewski, 2005), and uneven relationships with physicians, downsizing and re-engineering have taken an immense toll on the health care. Drury et al. (2009) mention that stumpy retention because of nominal mentoring, shift work, restricted autonomy, and lack of prearranged career paths.
Strategies for resolution of the issue
According to the United States Department of HRSA Report, the country will be short of about 1 million nurses by the year 2020 (Carver & Candelal, 2008).The ongoing shortage and large employee turnover rates specify that recruitment and retention are only part of the solution. Reorganizing the work setting to bring about increased nursing job satisfaction is a vital solution for today's critical nursing shortage. Moreover, (Carver & Candelal, 2008; Flynn & Mickeown, 2009; Holloway et al, 2009;Oulton, 2006) observed that graduate nurses salaries need to be considered when inquiring why school leavers are not captivated to nursing. Strategies that can assist keep nurses in the workforce by flexible working hours (Andrews & Dziegielewski, 2005; Drury et al, 2009; Upenieks, 2005), enhanced professional development opportunities (Andrews & Dziegielewski, 2005; Catalano, 2009; Drury et al, 2009; Oulton, 2006). Several studies conducted by different researchers (Andrews & Dziegielewski, 2005; Carver & Candelal, 2008; Drury et al,2009; Holloway et al,2009; Hessler & Ritchie,2005; Oulton, 2006; Stames & Kremer, 2007; Upenieks, 2005) emphasize that Employers need to frequently revisit the remuneration packages available to their workers and think innovatively about competitive ways to formulate the benefits is more enviable.
Moreover, recruitment and retention strategies should dynamically engage nursing mentors, peers, and role models within the process. Ensure access to a sound orientation and mentoring.
(Drury et al, 2009; Oulton, 2006; Price, 2009; Stames & Kremer, 2007). Additionally, (Andrews & Dziegielewski, 2005; Hessler & Ritchie, 2005) believe that, at minimum, an official or casual guidance program will aid retain and recruit individuals. A study by (Oulton, 2006; Upenieks, 2005) states that had better work environment persuade the arrival of nurses who are not presently working. Improved salaries, benefits, and student allowances to draw and keep students. Nurses crave to be valued and appreciated .Acknowledgment and remuneration for their competencies, problem-solving skills, challenged appropriately. Creating those environment need not be expensive and will go a long way to resolving the nursing shortage (Carver & Candelal, 2008; Hessler & Ritchie, 2005; Forsyth & McKenzie, 2006; Oulton, 2006; Upenieks, 2005; Stames & Kremer, 2007).
Upenieks (2005, p.25) " Local initiatives might consist of offering referral bonuses, working collaboratively with nursing schools as primary clinical site rotations, hiring new graduate nurses, establishing residency Programs, targeting more males for the field, and having clinical nurses visit high schools to increase students' interest in the health care field" . Nursing shortage issues should address through a collaborative approach that includes government policy and marketing an optimistic picture of nurses as professional and autonomous health care team members. The nursing shortage issues need to be tackled internationally Drury et al. (2009). Besides, decreased turnover is organizational commitment Carver & Candelal (2008). Patent career development pathways, perfect problem definition is crucial to formulate clear alternatives or options for nursing workforce issues. According to Andrews and Dziegielewski (2005), a study conducted by the Robert Woods Johnson Foundation suggested decreased workloads, more support staff, empowered management, active response to staff concerns, increased salaries, support for improved nurse-physician relationships, improved on the job orientation and paid continuing education should improve the retention rate.
UAE Nursing Shortage and Strategies
Approximately 3% of the UAE nursing workforce is at present nationals, which elucidates the UAE dependency on transient emigrant nurses. Several features may be contributing, in varying Degrees, to this dilemma. Claims that the great effort by nurses in the Middle East to attain professional status is intricate by the dependent position of the women. Enlisting from other Arab and foreign countries, generally from India and the Philippines, has rectified this shortage in the interim. Other contributing factors are the deviations in basic nursing programs and the lack of instructive resources in Arabic, the prosperous life style of UAE nationals, as well as the cultural norms and religious principles they reside. Establishment of the ENA together with membership of ICN in 2004 gave an immense boost to morale. As part of its strategic intentions, the ENA endeavors to enhance the icon of nursing in the UAE and to pick up the enrollment and maintenance of Emirati nationals into the nursing services. In this climate of global nursing shortage, the need to nationalize the nursing workforce in the UAE as well as in other Gulf States is vital (El-Haddad, 2006).
The hope of nursing will lounge in the aptitude to recruit and retain the next generation to the vocation. Much work needs to done regarding the recruitment and retention of new faculty to stick with the strong educational background of the profession of nursing. Oulton (2006, p.37) "There is many things that can be done to address the current crisis and avoid future ones. However, there is no magic bullet. It requires concerted action-a combination of strategies globally, nationally, regionally, and locally". An investigation of role modeling and mentorship, including peer mentorship, in relation to recruitment is an area for further Practical and research consideration.
- Andrews, D.R., & Dziegielewski, S. (2005). The nurse manager: job satisfaction, the nursing shortage, and Retention, Journal of Nursing Management, 13(1), 286-295.
- Carver, L., & Candelal, L. (2008). Attaining organizational commitment across different generations of nurses, Journal of Nursing Management, 16(1), 984-991.
- Catalano, T. (2009). Nursing Now! Today's Issues, Tomorrow's Trends. 5th edition. F.A. Davis Company. Philadelphia.
- Chitty, K.K. (2005). Professional Nursing Concept and Challenges. 4th edition. Saunders. Philadelphia.p. 97-100.
- Drury, Francis., & Champman. (2009). Where have all the young ones gone: implications for the nursing workforce. Journal of issues in nursing, 14 (1), 11.
- El-Haddad. (2006). Nursing in the United Arab Emirates: an historical background, International Nursing Review, 53(1), 284-289.
- Forsyth, S., & McKenzie, H. (2006). Nursing and Health Care Management and Policy: A comparative analysis of contemporary nurses' discontents [Electronic version]. Journal of Advanced Nursing, 56(2), 209- 216.
- Flynn, M., & Mickeown, M. (2009). Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix research, Journal of Nursing Management, 17(1), 759-766.
- Hessler, K., & Ritchie, H. (2005). Recruitment and Retention of Novice Faculty [Electronic version]. Journal of Nursing Education, 150-154.
- Holloway, K., Baker, F.J., & Lumby, J. (2009). Specialist Nursing Framework for New Zealand: A Missing Link in Workforce Planning, Policy, Politics, & Nursing Practice, 10(4) , 269- 275.
- Hirschfeld, M. (2009). Profession and Society: Accepting Responsibility for Long-Term Care-A Paradox in Times of a Global Nursing Shortage, Journal of Nursing Scholarship, 41(1), 104-111.
- Lynda, Hynes., & Teri, H.B. (2004). Nursing in Contemporary Society, Issues Trends and Transition.Boesce.Pearson.Newjersy.
- Oulton, J. (2006). The Global Nursing Shortage: An Overview of Issues and Actions, Policy, Politics, & Nursing Practice, 7(3), 34-39.
- Price, S. (2009). Becoming a nurse: a meta-study of early professional socialization and career choice in nursing. Journal of Advanced Nursing, 65(1), 11- 19.
- Stames, K., & Kremer, M. (2007). Education News: Recruitment and Retention Nurse Anesthesia Faculty: Issues and Strategies, AANA Journal, 75(1), 13-16.
- Upenieks, V. (2005). Recruitment and Retention Strategies: A Magnet Hospital Prevention Model, Medsurg Nursing, 21-29.