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Kayo Estes
NURS 211
Cherry and Jacob (2014) argued that periods of long term nursing shortages have been
one of the complex issues in health care. This paper will support their argument demonstrating
that there have been shortages in the past, that there are current shortages, and that it is predicted
that there will be future nursing shortages as well. It will also be shown that having a shortage of
nurses creates ethical dilemmas for the nursing profession and the patients for whom they care.
This discussion will finally address the role of the nurse in improving client centered care in the
According to Rich and Nugent (2010), the nursing population is getting older and many
older nurses will retire in the next 10 to 15 years (p. 228-229). With older nurses retiring, there
would need to be younger nurses being graduated into the workforce in adequate numbers to
replace those older retiring nurses. To look at an older, but representative, statistic created back
in 2004, 83.2 % of Registered Nurses (RNs) were then working in their professions. Of that 83.2
%, only 8.1 % were under the age of thirty. A casual look at this statistic shows that the 8.1 % of
RNs under thirty who represent approximately ten years of RNs being graduated into the
workforce cannot replace the 75.1 % of RNs working after age thirty in the approximate forty
It is well understood that as the population ages the individual health care needs increase.
The baby boomer generation is moving into old age adding to the numbers in need of additional
health care. Because of technological advances, increased trends toward preventive care, and
an aging US population, the demand for nurses is expected to grow 23 % by 2016 (Rich &
Nugent, 2010, p. 229). But as the demand for nurses grows, the Health Resources and Services
NURSING SHORTAGE ISSUES 3
Administration suggested, the availability of new graduates to meet the projected demand is
The shortage of nurses affects both the quality of patient care and the lives and working
environment of the nurses themselves. Regarding patient care, Needleman et al. noted that when
hospital staffing has a shortage of nurses, there are more reported cases of pneumonia,
gastrointestinal bleeding, urinary tract infections, and the length of patients hospital stay is
increased (as cited in Duvall & Andrews, 2010, p. 313). American Nurses Association (2011)
mentioned that nursing shortage is related to increased risks of patient complications and
mortality rates. Specifically, patients mortality risk was up 2 % while a shift was being staffed
by fewer than the recommended number of nurses. In addition, the mortality of patients
expanded by 4 % when the patient was in an environment of lots of discharges, admissions, and
Such shortages affect the nurses themselves. Buerhaus et al. reported that, when polled,
most RNs (79 %) felt that the quality of care was significantly impacted when there was a
nursing shortage. This loss of quality was most evident in the ability to keep the patient/nurse
environment safe, to be able to find complications early, and to get to spend quality nurse to
Aiken et al. demonstrated how the nursing shortage also has a cascading effect on its own
problem of to few nurses (as cited in Duvall & Andrews, 2010, p. 313). When even one patient
is added to a nurses patient load, it was found there was a 23% increase in burnout and a 15%
increase in job dissatisfaction. So, the condition of to few nurses even caused more nurses to
leave the nursing workforce, exacerbating the already difficult problem of nursing shortage.
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Certainly, patients are the center of health care. To enhance patient centered care as it
relates to the issues of nursing shortage that were discussed above, what would the professional
Zolnierek and Steckel (2010) argued nurses are the final contact point with the patient in
a line of forwarded information and directives. This position ensures that the nurse will be the
one to actualize all mistakes and misinformation that may have been picked up in this
communication line. So, this position is most critical in that, here, the nurse can screen out and
protect against misinformation and/or mistaken directives being actually performed on the
patient. In taking this role seriously, the nurse must first be skilled at identifying the areas of
concern and quickly identifying the specific problem. By having this skill, the nurse makes an
opportunity to effectively correct the possible error and to enhance the safety of the patient.
Obviously, during periods of nursing shortages, these skills are most important. Zolnierek and
Steckel (2010) also suggested a commitment to a culture of safety and a positive nursing
practice environment is the most important strategy in the health care organization (p. 264).
Alternative staffing like using more licensed vocational nurses and respiratory therapist,
floating staff, mobilizing managers and other nondirect care nurses, and controlling demand are
helpful examples of organizational strategies to effectively preserve a safe environment for the
Conclusion
There are many factors that cause nursing shortage. Some of them are the aging nursing
population, the aging baby boomer population, and decrease in new nursing students. Nursing
shortage directly affects nurses in their work environment by having each nurse assume more
NURSING SHORTAGE ISSUES 5
responsibility and greater workload. The result is burnout causing them to leave the workplace.
Of course, the issues affect the quality of patient care increasing risks of complications and
mortality. The issues are serious and complicated, and have been for a long period. From
understanding and analyzing the issues, effective strategies and ideas could be developed to
enhance patient centered care. In any work environment, the professional nurse must understand
References
American Nurses Association. (2011, June). Understanding the nursing shortage and what it
Cherry, B., & Jacob, S. R. (2014). Contemporary nursing: issues, trends, & management.
Duvall, J. J., & Andrews, D. R. (2010). Using a structured review of the literature to identify
key factors associated with the current nursing shortage. Journal of Professional
Rich, K. L., & Nugent, K. E. (2010). A United States perspective on the challenges in nursing
Zolnierek, C. D., & Steckel, C. M. (2010). Negotiating safety when staffing falls short. Critical
http://dx.doi.org/10.1016/j.ccell.2010.03.014
NURSING SHORTAGE ISSUES