Nursing Shortage
History and Current State
The stable work of the healthcare sector is one of the major determinants of the nation’s health. It is critical to guarantee that all individuals have access to care to manage their conditions. Furthermore, the challenges health workers face are becoming increasingly diverse each year, requiring greater effort to provide specialized, customized patient care. At the same time, the emergence of various problems undermines the sector’s readiness to respond to new problems and preserve high efficiency levels.
Addressing these issues and promoting positive change is a critical task today. Thus, the nursing shortage is a fundamental problem in the healthcare sector nowadays. The shortage of skilled and trained specialists affects all areas and worsens outcomes. For this reason, it is essential to find a solution and promote positive change within a sector. It would lead to higher patient satisfaction levels and treatment outcomes.
The nursing shortage problem is not new to healthcare; however, in recent years, especially after the COVID-19 pandemic, it has become especially topical. The high turnover rates and inability to retain workers mean that the healthcare sector faces challenges in providing quality patient care due to significant nurse losses (Soósová, 2021). Furthermore, the problem affects patients and puts them at risk, as it becomes more difficult to follow established protocols and care for them.
Patients suffer from missed care and the growing number of infections contracted in the hospital (Haddad et al., 2023). These consequences of the nursing shortage are critical, meaning that the problem is significant and requires immediate action. The question is also multifaceted, as it is associated with specialists’ well-being and their ability to perform their jobs and provide care. Thus, resolving the problem at the local level by promoting positive change within a single selected unit will lay the foundation for future, more substantial improvement.
Causes
Thus, the nursing shortage has a specific background that should be considered to design an effective solution. First, the lack of desire to continue working is associated with stress. Nurses experience extreme pressure, especially during the recent COVID-19 pandemic (Martin et al., 2023). As a result, they lose motivation to work and to deliver patient care. Second, around half of health workers experience burnout: 45% report physical exhaustion, and 51% admit mental health exhaustion (Lasater et al., 2021).
The problem of burnout is critical to the sector as it reduces productivity and increases the risk of mistakes. For nurses, it also means lower retention rates. The lack of security at the workplace and the fear of death are also among the reasons promoting the higher rates of nursing burnout (Tamata & Mohammadnezhad, 2023). As a result, the complex background of the problem influences the choice of methods that might help to address it.
Implications
In this way, recent data shows the scope and significance of the problem. The nursing shortage promotes numerous adverse effects on the healthcare sector, patients’ health, and units’ ability to treat clients and guarantee their recovery. For this reason, there is a need for an effective solution that will promote positive change within the discussed environment.
Practice Change Recommendation
The transformation should consider the primary causes of the problem, such as existing policies, burnout, stress, and a complex working environment. Further disregard of the problem will lead to the issue becoming increasingly complex and the need for additional resources and funding to address it. In this regard, discussing the nursing shortage and designing a local-level intervention to address it by engaging the most influential stakeholders and promoting reconsideration of staffing and nurse retention policies is critical.
Thus, the proposed change project focuses on transforming a specific acute care hospital with 300 beds. The nurses work in complex conditions with much pressure from various factors. These include the need to provide care for patients in complex situations, high burnout rates, safety concerns, and a lack of motivation, such as lower wages and limited career growth opportunities. The unit lacks nurses, which influences the results and the ability to provide patient care efficiently. For this reason, designing an intervention for the unit is critical as it would help to enhance outcomes and patient satisfaction.
Justification of Practice Change Recommendation
Consequences of Nursing Shortage
The scope of the nursing shortage and its adverse impacts make the need for practice change urgent. Its significance is evidenced by its effect on healthcare and associated factors. For instance, missed nursing care undermines nursing standards of practice and minimizes the chances of adequate treatment and patient safety (Imam et al., 2023). According to relevant statistics, such events are increasing; 60% are related to patient deaths, and 40% are linked to inappropriate pharmaceutical choices (Yoon et al., 2022). It means that the healthcare sector suffers from the problem, and the quality of care worsens.
Furthermore, the nursing shortage results in a significant reduction in the quality of care provided to various patient types. Treatment requirements are either partially or entirely unmet due to a shortage of nurses capable of providing specialized care (Haddad et al., 2023). Pressure ulcers, increased risk of health-associated infections, unexpected outcomes, and longer recovery times are often associated with the limited number of health workers who can provide the necessary care (Haddad et al., 2023).
In this way, the statistics show that the nursing shortage is a critical issue that negatively affects the quality of patient care and the sector’s overall performance. Existing policies might cause it, barriers to training and enrollment, high stress and burnout rates, and a lack of perspectives or payment (Tamata & Mohammadnezhad, 2023). The problem is systemic and should be addressed by finding practical solutions.
Benefits of Shared Governance Models
Fostering a positive work environment might help address the nursing shortage. It might be achieved by introducing a shared governance model and integrating it into the acute care hospital’s work. The framework implies shared decision-making between the nurses and nurse leaders (McKnight & Moore, 2024). They can discuss areas such as resource allocation, evidence-based projects, staffing, schedules, rewards, and task distribution (McKnight & Moore, 2024).
The existing research shows that shared governance models enhance nurses’ buy-in and lead to higher satisfaction levels (McKnight & Moore, 2024). Moreover, it fosters a positive working environment, which is essential for addressing the nursing shortage, providing optimal patient care, and retaining health workers (Maassen et al., 2021). The discussed issue is a multi-faceted problem, meaning its addressing requires complex solutions (Peters, 2023). The shared government meets this criterion by giving nurses the authority to resolve problems that affect their satisfaction and to avoid conflicts.
The shared governance model also effectively reduces tensions between all health workers. Thus, there is a direct correlation between healthy teamwork and a positive workplace climate (Bragadóttir et al., 2023). It means that by switching to this practice, it is possible to create more powerful teams and improve care quality. Additionally, involvement in decision-making may influence nurses’ intention to stay (Al Yahyaei et al., 2022).
Another critical factor is that shared governance positively influences nurses’ career motivation, which is necessary for their retention. Therefore, providing access to professional development opportunities is important for nurses’ satisfaction (Razai et al., 2023). This suggests the framework may be effective in making the work more attractive to nurses and motivating them to engage in new projects.
Altogether, the existing literature supports the use of shared governance as a solution to the nursing shortage. The model effectively promotes positive change within a unit by reconsidering the nature of relations among the main stakeholders. In traditional settings, nurses are in a vulnerable position. They have to perform their jobs and face many stressors and risks. These include low wages, poor schedules, threats to their health, and workplace conflicts.
However, with the new model, nurses are given the authority to discuss and resolve the most essential issues affecting their performance and their desire to continue working. As a result, it leads to higher retention rates, better performance, and patient satisfaction. The shared governance model might also be a beneficial solution for the acute healthcare setting. It would improve teamwork during complex cases, reducing the risk of mistakes and, as a result, managing burnout rates.
In this way, it is possible to admit that the shift to the shared governance model might be an appropriate solution to the nursing shortage. It would lead to improved staffing, conflict resolution, and scheduling, and help to cultivate a positive working environment within a unit. As a result, health workers will feel motivated and less stressed, which is vital, as this is one of the root causes of low retention rates. Implementing this measure will require gathering support from the main stakeholders and altering the existing policies.
Reference List
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Bragadóttir, H., Kalisch, B. J., Flygenring, B. G., & Tryggvadóttir, G. B. (2023). The relationship of nursing teamwork and job satisfaction in hospitals. SAGE Open Nursing, 9.
Haddad, L., Annamaraju. P., & Toney-Butler, T. (2023). Nursing shortage. StatPearls.
Imam, A., Obiesie, S., Gathara, D., Aluvaala, J., Maina, M., & English, M. (2023). Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review. Human Resource for Health, 21(19).
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McKnight, H., & Moore. S. (2024). Nursing shared governance. StatPearls.
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Soósová, M. S. (2021). Association between nurses’ burnout, hospital patient safety climate and quality of nursing care. The Central European Journal of Nursing and Midwifery, 12.
Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247–1257.
Yoon, S., Cho, S. I., Shin, S., Lee, W., Ko, Y., Moon, J. Y., & Lee, H. J. (2022). An analysis of judicial cases concerning analgesic-related medication errors in the republic of Korea. Journal of Patient Safety, 18(2).