Nursing is a friendly profession that is considered the "front line" in all health care organizations. Nurses role is very essential in meeting the organizational goals and in providing safe and effective care. Any defect in this "front line" will affect the entire organization (Booth, 2002). Nursing Shortage is a phenomenon that has been existing since many years ago mainly after the world war two and its increasing with time. Nursing shortage is a global problem that is turning into crises in some countries and it's considered as an imbalance between the supply and the demand (Sullivan , 2002). This shortage can be defined as a:" Dangerous lack of skilled registered nurses who are needed to care for individual patients and the population as a whole"(Fagin , Maraldo & Mason, 2007. P, 12) Nursing shortage is crucial issue because of its negative impact on health care services in every corner all over the world and it needs immediate interventions from all the society sectors. Too many factors or causes are contributing to this issue, and many solutions have been initiated to solve out this problem (Booth, 2002).
The purpose of this written assignment is to identify what is nursing shortage and retention. This will be done through identifying, the origination of this issue, types of shortage, factors contributing to shortage, strategies of recruitment and retention and its relation to shortage, what contexts and events shaped this issue and what are some of the beliefs and assumptions that are influencing this issue?
Types of nursing shortage:
Mainly nursing shortage were divided in to four types according to the cause of the shortage. As stated by Fagin , Maraldo & Mason, (2007), shortage can be divided into : "a willing nurse shortage", when the needed nurses to provide the care is not founded, simply it's the lack of skilled nurse to fill the job vacancy. The second type is: "A funding or perceived funding shortage", in which the nurse is available and willing to work, but the fund is not existing (financial wise).The third one is:" A shortage of understanding that nurses are needed to deliver care", referred to decrease in the awareness of the nursing roles. The fourth and last one is "A nurse education and empowerment shortage", when the nurse is placed in apposition of taking care for highly critical cases without getting a sufficient education and training in that filed. All those types of shortage will lead to global nursing shortage (Fagin , Maraldo & Mason, 2007).
Nursing shortage in UAE:
Nursing shortage is exiting in UAE due to many reasons. According to Haddad ( 2006) only 3% of the nurses are citizen and the rest are immigrants. Even though nurses are employed from different countries but still shortage is exiting. Factors decreasing the involvement of Emirate into nursing is the fact of the low income for the nurses compared to other carriers, no enough schools for teaching and the rapid economical change of the country and the strict culture and believes adding to that the common picture about nurses in Arabic countries. All those factor are considered barriers to increase the nationals in nursing. Programs and researches are conducted now a days to attract the nationals to join this profession.
Factors contributing to global nursing shortage:
How can a health care organization function effectively with high standard outcome without having the adequate supply of the front-line staff? Taking into consideration that professional nurses playing a major role in shaping the organization itself .Many factors has been identified as causes of nursing shortage and failing in retaining nurses amongst health care organizations all over the world. The fact that nursing has strong relationship with women's movements, 90% of the nurses are females, nursing called "women work", and the failing in attracting male to this profession can be considered as contributing factors to the shortage.(Sullivan , 2002) .
This shortage was discovered upon the World War II after they found that the females are more attracted toward many other fields rather that nursing, and that was due to the high technology that was newly introduced to our world. Considering the highly sophisticated, new diagnoses and more complicated cases that appeared after that war. The rapid increasing of this complicated cases with time required higher number of skilled and qualified nurses to deliver the highly standard care. That explains the meaning of imbalance between the demand ( bed side demands) and the supply ( licensed, skilled and qualified nurses). Adding to that decreasing enrollment or joining nursing schools mainly due to cultural, social, and physiological determinants and the fact of aging of the skilled and qualified nurses that is also affecting this issue (Huber, 2002).
It was found that immigration also plays role in developing that shortage, there were a study done that showed each two new nurses recruited in U.K will be followed by one certified nurse immigrated outside the country. Immigration occurs due to better offers, future plan or other personal causes. Despite of the causes of immigration, it's considered as contributing factors to shortage. As the nurses are the first in contact with the patients, the violence risk is high against nurses and that might cause feeling of insecurity and it will be ended by burnout leading to shortage ( Feldman, 2003).Weak leadership skills, poor management styles, and constant resistance to changing culture were other factor leading to the same problem. work environments are affecting this phenomena in which less resources and greater demand will lead to increase the stress level and will cause dissatisfaction leading increasing the number of burnout and decreasing the retention. (Rosseter, 2009)
Recruitment and Retention:
It is very crucial to recruit and got the ability to retain those qualified nurses in order to achieve highly standard quality of care. Some strategies have been used globally for recruiting and retaining nurses to increase the interest in nursing as profession. Recruitment refers to" the process of attracting, screening, and selecting qualified people for a job at an organization or firm"(Lee, 2005.p108). These strategies differs from one place to another due do organization cultures, policy and socio- economical status. The goal behind the recruitment strategy is to provide the best offers to attract nurses and at the same time to ensure retaining them after they will be trained, involved in continues education programs, become skilled, experts and qualified during their employment period. One example of recruitment strategies was considering the different needs of different generations, by doing that personal needs will be prioritized so attraction takes place. Committees were formed in some countries called nurse recruitment and retention committee to help in overcoming these crises.(Scanlon,2002) & (Lee, 2005)
Retention is a complex process; it needs strong leadership and management skills and qualification .Retention focuses on retaining those who still didn't leave the organization and to encourage the ones who left the career to join it again. It reflects the need of the organization to know what attract and motivates the staff to stay and to function adequately (Rosenkoe & Nardi, 2007). Nurses who are well supported by the organizational administration, challenged, got the opportunity to improve and to grow in their career, not overloaded due to the availability of adequate number of qualified nurses, supported by expert leaderships and managers, have the right to be a decision maker will stay in the organization, they won't burnout. For those satisfied nurses the provided quality of care will be highly standardized. Retaining staff is important step because of many reason one of them is cost effective, working on retained nurses helps the organization in saving the skills, the effort of training the new employee and also maintaining the quality of care served. Having the appropriate strategies for recruitment and retention will impact positively in solving out the shortage phenomena (Buchan & Calman, 2004).
Ways to Solve Nursing Shortage:
Improving the nurses' number and overcoming this crisis needs specific strategies .Many ways has been created in order to decrease the nurses' burnout and overcome the shortage. The working hours in the hospitals were increased, as one way to solve the shortage ,but this has brought another issue which is patient safety as it might be at risk. The second one was to send all those chronically ill patients with stable conditions home and to be followed their in order to decrease the hospital load (Chagutura & Vllabhaneni ,2005). Another way to solve the shortage is collaborative practice system in which PN (practitioner nurses) were introduced in order to decrease the load of the RN (Registered Nurse) by that the rate of retaining nurses increases (Schueller, 2003). Creating environment called rewarding environment that empowers the staff can also help by increasing the interest and decreasing the risk for burnout (lovell, 2006).
Technology can be considered effective in facilitating the work and decreasing the stress and the load if its introduced correctly, used efficiently and if the staff got adequate training and competencies in using that technology (equipment).On the other hand it can be a source of stress if it was not introduced appropriately because the nurses might feel that it's a barrier to accomplish the job perfectly. Economical determinant also can play role in overcoming the shortage, having high basic salaries added to the benefits and allowance might motivate specific personals to join the nursing school. The shortage itself impacted on attracting people by that there will be vacancies due to the shortage that is still existing (Jhonson, 2006).
In conclusion , nursing shortage is a challenge that all the nurses are facing all over the world. Many factors have been identified as a source of the problem, by knowing the cause it should be easier to find the solution to this phenomena. Emphasis on creating effective strategies in retaining and recruiting nurses should take place for the purpose of overcoming this issue. With regardless to the nursing shortage all the nurses should do their best and they should follow the highly recommended standards in providing their care for the best of the patients as they are our priority.
- Booth, R. (2002). The nursing shortage: a worldwide problem. University of Alabama school of nursing,10 (3), 793-803.
- Buchan, J,. & Calman, L,. (2004). The global nursing shortage of registered nurses: an overview of issues and action. International council of nursing, 9(2),65-80.
- Chaguturu, S., & Vallabhaneni, S.(2005).Adding and abetting- nursing crises at home and abroad. policy & politics of nursing practice, 353(17), 1761-1763.
- Fagin, C., Maraldo, P., & Mason, D.(2007).What is nursing shortage and why dose it exist?. The center of nursing advocacy, 3(2), 12-20.
- Feldman, H.(2003).The nursing shortage: strategies for recruitment and retention in clinical practice and education (1st ed). Springer publishing company inc: United stat
- Lee, T. (2005). Nursing recruitment and retention for senior adult. Tidewater Jewish Foundation, 6(3), 105-110.
- Haddad, M. (2006) Nursing in the United Arab Emirates: an historical background . 53,289. 284.
- Huber, D.(2006).Leadership and nursing care management (3rd ed). Elsevier: Philadelphia.
- Johnson, W.(2006). Addressing nursing shortage: staff nursing workforce centers collect and assess data needed for policy change. Charting nursing future journal, 6(2), 150-158.
- Lovell,V. (2006). Solving the nursing shortage through higher wages .institution of women's policy research, 4(17),4-32.
- Resenkoetter, M,. & Nardi, D,.(2007).Global nursing and health. Journal of trans-cultural nursing, 7(9), 305-315.
- Rosseter, R. (2009). Nursing Shortage Fact. American association of colleges of nursing, 23(1), 23-28.
- Scanlon, W.(2001).recruitment and retention of nurses and nurses aids is a growing concerns.GAO,4(1), 750-785.
- Schueller, J.( 2003). Collaborative practice for the RN and the LPN. Regional medical journal, 10 (7), 1-14.
- Sullivan, E. (2002).Nursing and feminism: An uneasy alliance. Elsevier science, 18(4), 21-26.