The Impact of Nursing Shortage on Morbidity and Mortality Rates

Abstract

The following paper discusses the seriousness of the nursing shortage problem in the US and, in the state of New Jersey, in particular. The state is expected to occupy third place, after California and Texas, in terms of insufficient nursing staff by 2030. Besides, there will be a substantial difference between the supply and demand for the nurses in NJ. Different indicators cause such a critical situation in the state, including the lack of nursing faculty, higher nurses’ burnout rates, turnover rates, and aging populations. Nursing shortage among healthcare organizations has severe implications for patient care. Hence, it can lead to the emergence of various diseases, infections, overcrowded emergency rooms, and extended treatment. There is a direct connection between high nursing shortage and mortality and morbidity rates. It is essential to integrate measures and strategies to combat the issue.

The Impact of Nursing Shortage on Morbidity and Mortality Rates

Practical nursing plays a critical role in many aspects of a patient’s treatment and recovery. Various nursing practices highlight the significance of proper care that can lead to faster healing and better satisfaction among the patients. However, healthcare organizations can experience a shortage in nursing, which implies dramatic impacts. According to Fagerström, Kinnunen, and Saarela (2018), different researches revealed that “insufficient nurse staffing in hospital-based care negatively affects outcomes such as mortality, infections, and failures to rescue” (p. 1). Consequently, one can see that the nursing shortage can have severe consequences for the healthcare sector. The problem of insufficient nursing is present in different regions and is at critical rates in the state of New Jersey. The purpose of this paper is to investigate the nursing shortage issue in NJ and analyze its influence on morbidity and mortality rates within the state.

First, it is crucial to look at the situation with the nursing staff in New Jersey. The current situation is critical in the US, and the nursing shortage is getting worse annually, expecting more than one million registered vacancies for nurses by 2022 (Begley, 2019). The US Health Resources and Services Administration revealed that by 2030, New Jersey would occupy third place in the largest nursing shortage in the country (Mishkin, 2018). This projection represents a severe problem for the state’s healthcare industry and the overall health of the population. Thus, NJ will be the third after California and Texas, experiencing a shortage of around 11,000 nurses, according to the estimated demand and supply in 2030 (“The states with the largest,” 2020). Moreover, the projections show that, in NJ, in comparison to 2014, there will be around 20,000 new nursing positions in 2030 (“The states with the largest,” 2020). It is possible to say that the problem of nursing shortage imposes critical challenges in front of the state’s authorities.

Different reasons lie behind the issue of the nursing shortage around the country and, in NJ, in particular. The president of the New Jersey State Nurses Association stated that with a splash in the economy, more nurses start to retire in time, which becomes one of the causes of the shortage (Mishkin, 2018). Hence, the nurses do not recognize the need to put off their retirement and work longer years, which generates a higher number of professionals who leave the industry. Another issue in New Jersey and the whole country is the insufficiency for faculty to provide proper nursing education (Mishkin, 2018). The American Association of Colleges of Nursing stated that in 2017, almost 60,000 applications that were qualified were turned away (Mishkin, 2018). Therefore, nursing education institutions do not have enough human resources to accept a required number of potential nurses, which results in the inability to meet the demand rates.

Besides timely retirement and the lack of faculty to educate the nurses, other factors cause the nursing shortage in the US. Some of the issues include the aging workforce, nurse burnout, implying the fact that young professionals change their minds in terms of career, violence in healthcare settings, and technology (Haddad & Toney-Butler, 2019). Hence, the aging of the nursing workforce can be directly connected to the shortages in faculty. Nurses’ burnout can be referred to as another aspect related to the workload and stress. The study showed that burnout could have different dimensions, including depersonalization, emotional exhaustion, and reduced personal accomplishment, which also contributes to the nursing shortage (Wang, Liu, & Wang, 2015). The fact that it can be challenging for some of the nurses to adapt to new technological advancements and the presence of emotional insults in the workplace can also lead to nurses leaving their jobs. Consequently, one can see that various aspects cause the lack of registered nurses, leading to a substantial shortage with its severe effects.

The paragraphs above discuss the seriousness of the nursing shortage issue in NJ and the reasons behind it. Besides those aspects, it is essential to understand the impacts that insufficiency in nursing staff can have on the healthcare industry. Some of the adverse consequences include a longer stay in the hospital, higher rates of urinary tract infections, and cardiac arrests (McKechnie, 2016, p. 2). Thus, it is possible to say that some of the common outcomes in the healthcare organization that experiences a nursing shortage are represented in severe diseases and prolonged treatment. Another concern that hospitals with high nurses’ turnover rate face are economic implications. The systematic review revealed that the lack of nurses’ supply implies substantial costs for the organization, including the costs of “per nurse turnover” and hiring new nurses expenditures (Halter et al., 2017, art. 824). Therefore, besides having the consequences on the patients’ health and treatment duration, the insufficiency of nurses has economic implications represented in high operating costs.

Another critical point of the nursing shortage is its influence on mortality rates. One of the studies found out that “a low number of registered nurses and nursing support staffing were associated with increased mortality” (Needleman, Liu, Shang, Larson, & Stone, 2020, p. 10). Hence, the nursing shortage represents a risk for the patients in terms of survival rates. It is crucial to mention that one of the reasons that lead to higher mortality also lies in the shortage of nursing professionals. The insufficiency of registered nurses leads to emergency room overcrowding, which, in turn, results in deaths, additional procedures required for the patients, and permanent disability (“The nursing shortage,” 2019). Therefore, the nursing shortage has undeniable adverse effects on patient care and mortality.

It is also crucial to observe the statistics associated with the lack of nursing professionals in the hospitals and mortality rates. An increase by one registered nurse per 1000 days led to more than 4% decrease in inpatient mortality (“The nursing shortage,” 2019). At the same time, the individuals in intensive care units with low nursing staff levels experienced an average increase in mortality by 4.5% (“The nursing shortage,” 2019). Thus, the numbers show that a higher presence of registered nurses in the hospital units leads to lower mortality rates. However, the current situation is characterized by a substantial nursing shortage, as discussed above, which implies an adverse impact on mortality and morbidity rates among inpatients.

One of the paragraphs above discusses the state of things with nursing supply in New Jersey, and it is critical to understand the details of the issue. New Jersey Collaborating Center for Nurses issued a policy analysis connected to the measures that can be taken to improve primary care. The report states that the barriers for advanced practice nurses (APN), aging population, and the lack of APNs represent some of the factors that negatively influence the access to affordable primary care (“Policy analysis,” 2019). One should say that decreased access to the required care and treatment implies dramatic consequences described in one of the sections above, such as various diseases, infections, and death. Thus, the situation with nursing professionals in the state of New Jersey is critical, imposing numerous challenges and problems for the future of the healthcare industry in the region.

The issue of insufficient nursing staff requires careful consideration and the integration of improvement measures. Some of the strategies that can address the shortage involve offering higher wages for the nurses and seasonal hiring of the professionals providing temporary jobs during busy times (“The nursing shortage,” 2019). The incentive of higher payment can be efficient for the nurses who leave their jobs due to dissatisfaction with the reward for their responsibilities. Today, around half of the registered nurses report being satisfied with their payment (“The nursing shortage,” 2019). Moreover, providing additional training and education for nursing professionals is beneficial. It can also serve as an encouragement to pursue this career and generate a higher number of specialists (“The nursing shortage,” 2019). In such a way, it is essential to encourage professionals and those who see nursing education to be successful with various incentives and useful nursing programs.

It was mentioned above that one of the reasons behind a substantial nursing shortage is the insufficient number of faculty staff to educate the nurses. Proper education is integral to the nursing career, and with a difficult situation in New Jersey, the state’s authorities should address the issue of nursing schools and colleges. As of 2019, NJ had around 9000 student nurses, among which approximately 2000 were freshmen (“New Jersey’s best,” 2020). It is suggested that to meet the demand of nurses within the next couple of years, the number of student nurses needs to be three times higher (“New Jersey’s best,” 2020). Consequently, the nursing education institutions have to provide more opportunities for prospective students, increase the possibilities of financial aid, and offer more incentives that will generate a higher number of qualified applicants.

In conclusion, the issue of nursing shortage represents severe risks for the healthcare industry in New Jersey. Various factors influence the current and predicted lack of registered nurses within the state. Among those reasons, there are insufficient faculty staff, an aging population, nurse burnout, and others. Nursing shortage can have critical effects on patient care, such as the emergence of numerous disease and infections, longer treatment periods, and substantial financial losses. One of the essential outcomes of insufficient nursing staff is the increased rate of mortality among inpatients. Consequently, New Jersey is facing a severe problem of deteriorated patient care and a higher number of deaths among patients if the situation would not change. It is essential to implement various incentives and introduce new educational programs to attract more professionals and encourage more nurses to keep their jobs. The state’s authorities are working on improving the situation and combating the nursing shortage problem.

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