Solving the Nurses Shortage using Technology and Excellent Leadership
The shortage of nurses is not a new issue, but it is one that is becoming increasingly more serious. Some, such as Cox, Willis and Coustasse (2014) who delivered a paper at the Business and Health Administration Association (BHAA) conference, have even considered the shortage of nurses as an epidemic in the United States because of its negative implications on healthcare organizations and the healthcare delivery system altogether (Cox, Willis, & Coustasse, 2014). Not having enough nurses means that nurses are unable to deliver as high of quality care as they would like to. Safety is another issue when there are not enough nurses, and safety in the workplace is a factor in nurse retention. According to Lawati, Dennis, and Abdulhadi (2018) of BMC Family Practice, healthcare organizations attempt to maintain a culture of safety, but with issues like a nurse shortage, the perception of safety may not remain (Lawati, Dennis, & Abdulhadi, 2018). Improving the perception of safety in healthcare organizations means ensuring that there are enough nurses on staff to meet the needs of the patients they care for and to maintain safety for patients and for nurses.
Description of National Healthcare Issue: Shortage of Nurses
The nursing shortage has been looming for years. However, as more and more Baby Boomers age and the need for nurses grows, the shortage is becoming even more immediate. Haddad and Toney-Butler (2019) of Stat Pearls say that there are approximately 29 million nurses and midwives in the world. About 3.9 million of them are in the United States. Another one million nurses will be needed by 2020. Until 2022, nursing will be the most in-demand job in the United States, and the U.S. Bureau of Labor Statistics estimates another 11 million nurses are needed to avoid having even worse shortages (Haddad & Toney-Butler, 2019). Those shortages are caused by nurses who quit their jobs. Stress and burnout is one primary reason nurses quit their jobs, so reducing that stress would reduce the burnout and the nursing turnovers.
At the organization where I work, there is a serious nurses shortage. It has led to many negative outcomes. Several problems exist among the nurses on staff such as accusations of bullying, misunderstandings between the newer nurses and those who have been in the organization for many years, and fear of violence from patients. The nurses currently on staff often must work longer shifts and take extra shifts, which does not help matters. Stimpfel, Sloane and Aiken (2012) of Health Affairs explain, “When long shifts are combined with overtime, shifts that rotate between day and night duty, and consecutive shifts, nurses are at risk for fatigue and burnout, which may compromise patient care (Stimpfel, Sloane, & Aiken, 2012, p. 2501). The fatigue and burnout adds to the other issues. Burnout leads to nurses quitting their jobs, and when the healthcare organization is already short of nurses, this just leads to more problems. It also leads to patient safety issues including medication errors. This does not look good for the healthcare organization and their reputation may suffer because of it.
Summary of Articles
Violence is an ongoing issue for nurses. There is always a chance of being assaulted by a patient, and there seems to be a growing incident of violence and bullying among healthcare staff. Armmer (2017) of Administrative Sciences says one reason for the perception of increased bullying is the generation gap among nurses. Some nurses are Baby Boomers who can be “characterized as nurses who are committed to the place where they work; who value promotions, titles and recognitions. Generation X nurses are characterized as viewing a job as temporary; are motivated by continuing education, training and income. Loyalty and pension plans are not motivating factors for the Generation X nurse” (Armmer, 2017, p. 3). These types of differences may cause conflict among the members of the different generations who work together as nursing staff. Armmer (2017) goes on to explain that Generation X nurses are likely to change jobs frequently and prefer to be mentored, while Millennial generation nurses have multi-tasking abilities, accept technology and have never lived without computers. They will be loyal to the organization that pays the most money, gives them the best schedule and the latest in technological gadgets. Generation Y nurses may have more than one job at a time, and do not like to accept additional responsibility (Armmer, 2017, p. 3). Armmer (2017) says that understanding these characteristics about the different generations of nurses can help to reduce perceived bullying and conflicts and reduce stress and burnout.
Armmer (2017) also cites the American Association of Critical Care Nurses which has identified eight standards for a healthy working environment including: authentic leadership, skilled communication, true collaboration, appropriate staffing, meaningful recognition, effective decision making, genuine teamwork, and physical and psychological safety (Armmer, 2017, p. 4). Unhealthy work environments are those that include abusive behavior, disrespect, lack of trust, refusal to change, poor communication and poor leadership that lacks vision (Armmer, 2017, p. 4).
Cohen (2019) of Modern Healthcare uses a different approach to strategizing about how to retain nurses and prevent shortages in nurses. Cohen (2019) says that technology is the key. For instance, she says that nurses should be recruited in the forums they use such a social media. “Social media and job recruitment platforms have become major sources of information for nurses looking for jobs” (Cohen, 2019). Cohen (2019) also believes that using communication technology is the way to keep nurses happier in their jobs. For instance, using electronic scheduling tools allows nurses to sign up for individual shifts that they are qualified to cover and trade shifts with other nurses online or on their phones. This allows the nurses themselves to control their work-life balance and manage the burnout better for themselves (Cohen, 2019). In the same vein, healthcare organizations can use analytics to better figure out scheduling needs by using artificial intelligence software to predict volume and admission based on historical patient volume data (Cohen, 2019). This way enough nurses are scheduled, but not too many.
Summary of Strategies
Cohen (2019) and Armmer (2017) have different strategies aimed at fixing the nursing shortage. Armmer (2017) sees leadership as crucial and interventions to reduce or eliminate violence and bullying toward nurses. This, she feels, is becoming pervasive and may be caused by the differences in generations among nurses. Cohen (2019) sees the solution to the nursing shortage in the use of communication technologies designed to address scheduling and recruiting, which will not only make life easier for nurses and healthcare organizations, but will also provide nurses with the ability to control their lives better and control the stress that leads to burnout.
Both of these ideas can be combined. Having visionary leadership and a better understanding of generational differences will help to ease tension among the staff. Using electronics can help nurses have better control of their work schedules and their work-life balance. Other efforts that could help the organization for which I work include better pay and the establishment of floating pools of nurses who are on-call whenever a nurse needs time off or when there are shortages.
Conclusion
The problem of nurse shortages is significant; however, the shortages can be solved. It will take a combination of solutions including having better leadership, using communication technologies and better incentives. With these types of strategies, the healthcare organization that employs will be able to keep the nurses who they have already hired and hire several new ones to prevent the shortage.
References
Armmer, F. (2017). An inductive discussion of the interrelationships between nursing shortage, horizontal violence, generational diversity, and healthy work environments. Administrative Sciences, 7(4), 1-7. Retrieved from https://www.mdpi.com/2076-3387...
Cohen, J. (2019). Tech helping to alleviate nurse shortage, experience gaps. Modern Healthcare, 49(32).
Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Business and Health Adminstration Association (BHAA) (pp. 1-12). Chicago: Marshall Digital Scholar. Retrieved from http://mds.marshall.edu/cgi/vi...
Haddad, L., & Toney-Butler, T. (2019). Nursing Shortage. In StatPearls [Internet]. Treasure Island, GL: Sat Pearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/b...
Lawati, M. H., Dennis, S. S., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: a systematic review. BMC Family Practice, 19(1), 1-12. Retrieved from https://bmcfampract.biomedcent...
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501-2509. Retrieved from https://www.healthaffairs.org/...
