When reaching out to the Medical field for any type of health issues the patient expects the unsurpassed quality of care possible, but how is that possible in today’s society if we have a labor and skill shortage within our healthcare systems? The shortage of labor and skills are a compliance issue that are frequently happening. These shortages range from anything in between certified nursing assistants to doctors. The labor and skill shortage within the hospital systems across the nation oppose a threat to the patients. The patients can be put into safety hazards which then can worsen their care causing the hospital more money, one of the reasons for hospitals not hiring more staff to have safer nurse to patient ratios is because hospitals would have to pay more staff. If having patients fall out of bed due to not having adequate staff is costing hospitals more money, why wouldn’t they rather spend the extra money to hire more staff instead of eating the cost of patients falling. It would be a win-win situation, less patient falls and nurses working in more suitable working conditions. The shortage puts the staff in safety risk also due to their work conditions not being up to the safest factors. While working in the hospital patient safety was something that was always preached, but how do you keep patients safe and tend to all of their needs while having 8-10 patients to tend to a day? Having 8-10 patients a day allows for staff to get the job done, just getting the job doesn’t always mean that it’s done right putting patients at risk for injury. People will continue to need hospitals for their health needs, so if the labor and skill shortage is not corrected patient care within hospital systems will keep declining.
The history with labor and skill shortage dates to as early as 1915 (Zurn, Poz, Stillwell, Adams, 2004). That was when the first nursing shortages were reported in hospitals in the United States and continues to be a concern to this day. According to (Zurn, Poz, Stillwell, Adams, 2004) a skill imbalance occurs when the quantity of a given skill supplied by the workforce and the quantity demanded by employers diverge at the existing market conditions. The labor market supplies and demands for occupations, which continues to fluctuate continuously. It is clear these issues will not be resolved anytime soon since they still oppose a threat to our hospital systems. I believe within todays day in age it is possible to fix this shortage, but it will take time to learn how to fix it. I also believe that by lowering nurse to patient ratio the turning over rate for staffing in a hospital will be much lower due to working conditions being much less stressful. That staff in hospitals are overworked due to shortage of nurses and certified nursing assistants causing staff to be burnt out on their work. This is also causing a decline in patient care throughout our healthcare system. You could argue that this hasn’t been a problem that has been talked about a lot until recently when laws started taking place in California, which could make you wonder if this is the reason other states are starting to talk about the shortage. Another reason the healthcare system is starting to talk about labor shortage and patient care is due to the number of nurses who are leaving their jobs because they are unhappy and burnt out. The people who are monitoring patient care are most likely trying to plan ahead in different states besides California for the shortage coming.
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This compliance has been somewhat successful in parts of the United States. In California they have laws to help with the shortage of nursing staff, but it is currently the only state with these sort of laws (Zurn, Poz, Stillwell, Adams, 2004). According to (Zurn, Poz, Stillwell, Adams, 2004) there has been short-term and long-term solutions for these shortages. A short-term solution would be filling immediate vacancies including increasing salaries, using temporary staff, or offering sign on bonuses. Long term solutions are creating more sustained growing in the nurse workforce include providing financial support for nursing education and changing nurses work environments. Experts in (Zurn, Poz, Stillwell, Adams, 2004) stated that typical short-term solutions will likely not solve the long-term shortage. These solutions are advertised by a large majority of any health care setting seeking employees, but it is clear they are not keeping the employees they are attracting. The focus should primarily be on the long-term solutions if they want to this fix to be permanent. The nursing shortage is predicted to keep growing higher as the years go on. According to (Grant 2016) By 2025, the shortfall is expected to be “more than twice as large as any nurse shortage experienced since the introduction of Medicare and Medicaid in the mid-1960s. By 2025 the patient population will be much larger and will be more in need of nursing care in facilities. The patient population is also living a lot longer, but that doesn’t mean that they are healthy. “As the population ages, demand for health-care services will soar. About 80 percent of older adults have at least one chronic condition, and 68 percent have at least two, according to the National Council on Aging. A USA Today analysis of Medicare data revealed that two-thirds of traditional Medicare beneficiaries older than 65 have multiple chronic conditions, a number that will only continue to climb.” (Grant 2016)
To understand this shortage the reason behind it happening needs to be known. According to (Public Health Industry, 2018) some of the factors contributing the shortage is the aging population generating a greater need for care, an aging health care workforce retiring many workers, increases in chronic disease, and limited capacity of education programs. A press release by AAMCNEWS in 2017 states that the population of Americans aged 65 and older will have increased 55 percent by 2030. The same press release stated approximately one million registered nurses are over the age of 50. Most of those nurses entered the workforce prior to the 1970s meaning that about a third of the nursing workforce will retire in the next 10 to 15 years. With that many nurses retiring, it leads a huge shortage for the new nurses that continue to graduate from nursing programs, but even those new nurses are outnumbered with patients due to the limited capacity of education programs. Just in 2012 nearly 80,000 qualified applicants were turned away from nursing schools because of limited capacity. This is an issue because how are we to fix this shortage if we are turning away that many applicants due to limited capacity. Another reason for the nursing shortage could be from nursing burnout. According (Haddad, Toney-Butler, 2019) the national average for turnover rates for registers nurses is 8.8% to 37.0% depending on geographic location and nursing specialty. The reason for these nursing burnouts is the fact that nursing graduates start working right after graduation only to find out the profession is not what they thought it would be. This could be from being understaffed, the work environment, or even bad management. These are just few of the reasons for these shortages, but with the right long-term goals these shortages can be resolved. Many could argue that nurses should know what they are getting into because of the fact that they do clinicals in nursing homes and hospitals, they should be prepared right? That isn’t the case most of the time, many times when you are clinicals you are limited on what you can do and what you experience at the time due to only being there for a short amount of time. Most nurses work twelve-hour shifts and most clinicals are only an eight-hour day with you rotating to different floors throughout the week. I don’t believe that nursing students get enough time on one floor to get familiar with what actually goes on day to day in a hospital or nursing home.
Another reason that America is experiencing labor shortage in hospitals is due to toxic nurse managers. I’m sure everyone has experienced a boss who blamed staff for mistakes that were happening, took credit for all accomplishments on the floor, and never listened to new ideas. During my time working at a hospital I had the pleasure of working with a nurse manager who was selfish and took credit for all of the nurse’s accomplishments and was never open to new ideas that could help with patient satisfaction. That’s our main goal when working in a hospital is to have great patient satisfaction numbers, so why wasn’t he open to new ideas? Having a nurse manager who is open to new ideas and gives their staff credit for their accomplishments is crucial patient care and keeping your nursing staff around. “Effective hospital leadership at the executive level as well as at the unit level is crucial in today’s unstable economic environment. Studies have identified a significant relationship between effective leadership and job satisfaction (Laschinger, & Finnegan, 2005; Upenieks, 2003; Wilson, 2005), commitment (McGuire, & Kennerly, 2006) and intent to stay (Force, 2005; Johnson, & Rea, 2009). Each of these outcomes contributes to a healthy and productive work environment according to the RN nurse journal. If your nurse manager is so bad, then why don’t you just ignore it and just try to do your work the best you can? By being around negative people, it can change your attitude towards your patients, and you can start to slack due to not caring, because your manager doesn’t acknowledge your accomplishments.
In my own opinion I believe these shortages continue to be a problem. I have experienced these firsthand as I am certified nursing assistant (CNA). I worked in all types of healthcare settings, but the worst experience I had was in short term facilities such as a hospital and a rehabilitation to home facility. These types of healthcare settings patients demand more as they are just freshly out of procedures or just experiencing pain and not knowing how to manage it. People now of days are used to everything being at the tip of their fingers and that’s not the case in healthcare. It can be one nurse to 8 to 10 patients, and with that ratio it makes it hard for those patients to get what they want on demand as they wish to have. If you aren’t in the healthcare field you may not think that 8 to 10 patients are a lot, but when you are doing everything for those 8 to 10 patients it can be a lot to handle. From doing med passes on time to getting people to the bathroom in a timely manner depends on the number of patients you have. Not doing these things in a timely matter means patient care numbers will go down. Hospitals and facilities depend on these numbers to stay high because they want to be able to make money. I have also felt the nursing burnout feeling, I felt over worked for such little pay. I even stepped away from nursing for about six months to realize if I wanted to continue down that career path. I have decided to stay within the health care field to help patients and hope one day we won’t be overworked and underpaid. “A 2014 survey of more than 3,300 nurses found that they were stressed, overworked, underappreciated, and underutilized. Of those nurses surveyed by the Vickie Milazzo Institute in Houston, 64 percent said they rarely get seven to eight hours of sleep per night. Another 31 percent said they get enough sleep just two to three nights a week.” (Fischer 2016). My goal is help in the process of ending the shortage of the health care employees and make sure that nurses are able to live a happy and healthy lifestyle.
The labor and skills shortage within the United States has clearly been an issue for quite some time. These shortages are even happening to our higher ups such as doctors due to the limited capacity within programs that schools offer. This issue is not just putting the patients in harm’s way, but also the staff that provides the care. If the shortage is not fixed the care will only go down will for the patients and we will continue to lose great nurses due to being overworked and getting burnt out on their job. I believe in today’s day of age it is possible to come up with an end to this shortage. Healthcare shouldn’t just be about money like it is today, it should be about giving out the great care that we would want to receive if we were in our patient’s situation.
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