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Global Nursing Shortage and Strategies for Recruitment and Retention
Nursing is a dynamic profession. Constant changes occurring both internally and externally to the profession, nursing exists because of the needs and demands of society. One major problem facing present day nursing is shortage of Nurses. The causes of nursing shortage are complex. The demand for nurses directly correlates to the demand for health care services. The world's elderly population is expanding rapidly, and the average age of nurses is also rising (Hessler, 2005). Now the situation is serious. Demand for nurses continuous to grow. The United States, United Kingdom, Australia, Canada and other countries have an aging nursing work force caring for increasing numbers of elderly people. The challenge is how to replace the many nurses. Today's global nursing shortage is having an adverse impact on health systems around the world. By reviewing the recent literature based on evidence this paper is trying to analyse the issue of nursing shortage worldwide. A nursing shortage is not an organizational challenge; it has a major negative impact on health care. Failure to deal with a nursing shortage which is local, regional, national or global is likely to lead to failure to maintain or improve health care (Carney, 2005).
The Impact of Nursing shortage
Nursing shortage is worldwide. The amount of nursing responsibilities has increased like prevention of infection, electronic documentation and maintenance of patient safety. The impact of nursing shortage has many effects such as increase patient nurses work load, increase the risk for error and increase the risk of hospital acquired infections, more death, increase risk of occupation injury and exposure. As a result of the volume and acuity of patients, things are being missed (Gullette, 2005). Every day we are reminded that there are no enough nurses around the globe. Most countries have an aging and growing population. So demand for nurses goes up. Besides, because of physical demands of the job, there is a limited ability to function that cause people to exit out of the work force generally in the mid fifties. An aging work force is one of the biggest contributors to the expected shortage (Cohen et al., 2006).
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The number of younger nurses coming in is not nearly enough to replace the older retiring nurses. One of the reasons for that is poor perception of nursing profession among people. There was a public perception that nursing was a really bad job. It was paid poorly, work was difficult and young people were not being encouraged to study nursing. Now the interest in nursing profession has increased. The lack of nursing faculty and clinical rotation sites is limiting enrollment at nursing schools. The demand for nurses has grown very high because the government has prioritized health care. The number of nursing jobs has grown faster than the number of nurses coming into the system (Price, 2009).
Lack of job satisfaction is the most cited reason for staff turnover (Andrews, 2005). Job stress and work place tension are common in health care. The key is how they are managed. The nurse manager should be engaged in the human relations variables of the work place, they should have at least one basic human resources class. The elimination of nursing shortage is very important. Various studies and data collection have shown that the shortage has forced high patient to nurse staffing ratios, which further complicates crisis by creating burn out and Job dissatisfaction (Gulatte, 2005). Overtime is dangerous and should never be mandated, mandatory overtime is common in hospitals around the world because of nursing shortages. In addition to interfering with decision making, fatigue could potentially affect the physical well being of nurses. Having no time to recover from workplace stress can lead to human error relatively easy. Andrews (2005) states that the over worked and overburdened nurses are more prone to committing medical errors, which is further complicated by increased patient morbidity and mortality. These events deeply affect patient safety, thus put in danger the reputation of all nurses, and ultimately affect the entire health care delivery system.
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Aside from the financial impact of the nurse staff turnover, there is a negative effect on the staff involved in the orientation of the new member. Staff left behind may be working longer hours and take on increased patient assignments to fill the vacancy. Agency nurses maybe employed as a quick fix. These temporary nurses are not familiar with the patient population and may not possess the same level of skills as the organization staff. Nurses must also work together to find creative approaches to resolve current problems that drive so many colleagues from the field and discourage others from entering it (Cohen et al., 2006).
Retention and Recruitment
Retention and recruitment are very important responses to a long term solution to the nursing shortage. The impact of nursing shortage crisis, in combination with the high patient acuity is a vital concern for any nursing administrative team specifically related to balancing staffing needs with patient needs (Rudel, 2009). Increase enrollments schools will provide more graduates in the future. Encourage people to select nursing as a career choice and promote the profession. Many activities during the nurses work period take unnecessary time. The technology, although available is not being used. A variety of factors influence the retention of nurses in adult care settings, including work satisfaction, group unity, job stress, work schedule, age and experience in nursing care related to job satisfaction (Hessler, 2005). People need to be recruited into nursing and faculties need to be available for studies. Practice settings and school of nursing to combine to produce new nursing graduates adequately prepared to do the role of a professional nurse. The nursing shortage is sparked by a multitude of factors such as aging nursing pool, fewer women choosing nursing as a career. To meet this challenge, health care employers have initiated multiple strategies, from foreign nurse recruitment and sign on bonuses to creative benefit packages. Employment agencies need to focus on making the nursing profession more attractive to both younger and older generations (Roberts, 2006).
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Creating a culture of retention is one key strategy to decrease nurse turnover and cost. Once recruited, greater emphasis must be placed on retention (Roberts, 2006). The American Nurses Association staffing survey (2004) reported that 75% nurses felt that the quality of patient care had decreased over the past two-three years and 56% feel that they did not have adequate time to perform patient care because of staff shortage in hospitals (Andrews, 2005). To retain qualified nurses and to remain competitive in a changing labour market, employers need to improve personal policies and benefits, provide opportunities for career advancement, lifelong learning and flexible work schedules (Aiken, 2009). Offer encouragement, praise and recognition making employees feel that they are valued by the organization often revealed as one of the highest reason for retention. Compensation and benefits also play a major role in retention of nurses. Creating an organizational culture of nurse retention is crucial to reducing vacancies in health care organizations. High nursing staff turnover and low entry of nurses into the workplace adversely affect both the health care organization and patient outcomes.
Impact of Global Recruitment
Countries that send their nurses abroad experience a shortage and strain their own health care system. The work force has become much more global and there are attractive offers around the world. The nurses are also leaving because they are attracted by other opportunities. The migration of highly skilled workers from less developed nations to industrialized nations is an inevitable part of the process of globalization and has positive and negative aspects (Hein, 2001). Nurse migration affects different countries in different ways. Advantages often include the individuals who move and the source, or home, country that receives capital in the form of remittances from these who have moved. At the same time, major disadvantages occur when the country fails to deliver vital services in local communities.Global Nursing Shortage 6
The Nursing shortage is significant. Hospitals with high patient to nurse ratio negatively impact patient mortality. The future of nursing lies in the ability to recruit and retain the next generation to the profession. A deepening nursing shortage combined with an aging RN work force indicates that urgent efforts to be made to address nursing retention as well as the productivity of those nurses who work at the bed side. Nurse leaders must place additional efforts on changes needed to improve the hospital workplace environment to decrease job stress, improve nurse's ability to provide quality care, and assure the health and safety of nurses. Reducing job stress and providing adequate staffing so quality of care can be provided will enhance job satisfaction which will also encourage nurses to stay at the bed side. Improved work environment may delay older RN's retirement from the work force. To assure quality of care for hospitalized patients and adequate and productive work force is critical. The health of our health care system depends on nurses. Share a responsibility to promote nursing profession. Successful solving of nursing shortage requires work from the highest national level to work with individual nurses.
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