Overview
The general occurrences in healthcare are closely related to trends in nursing. In some instances, trends can be closely related to each other. As it stands now, the United States is comprised of over 2.7 million nurses (Auerbach, Buerhaus & Staiger 2007, p.184). This implies that the healthcare working force is mainly made up of the nursing fraternity. Despite a large number of the nursing workforce, there is a growing trend in terms of the nursing shortfall. In other words, there is a sharp demographic challenge that is facing the nursing field due to the large number of patients who need care. Factors that have caused this shortage are not isolated at all. Some of the causes of this massive shortfall consist of a difficult working environment, poor management of the nursing staff, a dissipating workforce, and financial constraints. This essay offers a brief analysis of the trends in the management of nursing.
Trends
Although there is the rapid adoption of managed care in the management of public mental health, there are quite a several vivid trends that have emerged. Mental health systems are being privatized in various jurisdictions at the expense of patients who need the care. External corporations are making agreements with healthcare providers in a bid to capture the high-end consumer market in mental health. On the other hand, some jurisdictions have opted to retain the conventional techniques of managing mental health problems (Hromco, Moore & Nikkel 2003, p.502). At this point, it is crucial to mention that even nurses and other healthcare workers are sometimes affected by the risky experiences that they undergo. Eventually, they develop mental health complications.
Healthcare under the nursing fraternity is facing a gloomy future due to the demographic element of the aging nurses who are registered. For instance, less than ten percent of registered nurses are below 3 years (Tzeng & Yin 2009, p.22). This implies that the baby-boomer nurses are facing imminent retirement. In Canada, the trend is not promising at all. Currently, the country is lacking close to 100, 000 registered nurses, and the situation is expected to get worse as we approach the end of the second decade of this millennium (Tzeng & Yin 2009, p.20). This is purely a management challenge in the nursing profession and unless it is addressed in good time, the trend will jeopardize the entire healthcare sector
Nevertheless, there is no approach that can be completely accurate. Perhaps, the most crucial area that policymakers have emphasized is the formulation of a broad-based vision on the public health management of mental health. The vision should incorporate the goals and objectives to be achieved in providing mental health programs to the worst affected individuals or populations. The stakeholder groups should also be incorporated in the process of comprehensive planning. On the same note, the adopted goals and objectives can be reached using managed care.
In regards to the management of mental health, the most effective cutting edge that can be employed is the managed care system. Some of the core benefits of managed care include consumer protection, minimization of risks, and attainment of cost-efficiency. Therefore, effective management of mental health demands certain criteria. To begin with, the health systems that take care of mental health victims should be managed most effectively. As such, management qualities such as accountability and transparency should be exercised in the best way possible. Patients with gross mental disorders should be given priority when they seek healthcare services.
Higher paying jobs and decent working opportunities have compelled several registered nurses to depart the nursing profession. There was an approximated 500,000 registered nurses in the United States who had not been employed before the close of 2002 (Auerbach, Buerhaus & Staiger 2007, p.180). Worse still, the unemployment trend is still a major cause of concern within the nursing fraternity. It is common practice that inexperienced staff members usually replace nurses who have departed nursing leading to poor quality delivery of health services (Auerbach, Buerhaus & Staiger 2007, p.179). This is a management factor that has worsened the performance of the nursing profession for a long time. The nursing expertise has also suffered tragic loss bearing in mind that the newly graduated nurses can no longer enjoy the guidance of experienced nursing staff when they freshly join the profession. The nursing exodus since the onset of the new millennium has also been exacerbated by poor wages and a declining trend in job satisfaction (Tzeng & Yin 2009, p.22). A lower satisfaction level was accounted as one of the core reasons why nurses leave the profession according to the survey that was done in the year 2000 (Auerbach, Buerhaus & Staiger 2007, p.182). As already mentioned, the growth in wages earned by the nursing staff has been on the decline. For the past nine years or so, the purchasing power of registered nurses has not improved despite the move by the government to adjust inflation rates (Auerbach, Buerhaus & Staiger 2007, p.185).
In countries that have expansive and elaborate healthcare plans (such as the case of Medicaid in the United States), managed care can indeed assist in lowering the cost of heavy medical bills for patients with complicated mental health problems. However, quite a several weaknesses in the management of Medicaid and similar programs have been observed. For example, patients who are in dire need of mental health treatment can hardly secure such services fully due to the strict rationing program of the available funds. Despite this management challenge, the public mental health system has greatly lauded the part being played by Medicaid. The managed care system has not been thoroughly analyzed to provide a vivid picture of its strengths and weaknesses. Most forms of health insurance schemes have recorded immense success in the management of mental health. If financing and structures of healthcare organizations can be revamped, several positive impacts can be realized. Some of the achievements that can be readily realized include an improved focus on outcomes and accountability, increased flexibility in the delivery of healthcare services, access to a broad array of services, reduced instances of poor inpatient care, and expanded access to mental healthcare treatment for both nurses and other patients.
On the other hand, it is also worth mentioning that the individual nurses may fail to benefit from the positive impacts of managed care due to some reasons. To begin with, nurses may find it cumbersome to access high-quality care across several regions. Some jurisdictions are unable to handle the prospects of nursing care and therefore, nurses suffer in the same way as other patients. In addition, managed care has only been accessible to a small number of patients. As much as nurses can subscribe to the program, it may not be suitable for all the individual needs.
Nurses have not been given due attention in the management of their health statuses bearing in mind that accountability is lacking. There are myriads of policy dilemmas that have not been resolved. This situation can be improved by utilizing data obtained from the managed care program.
Workforce shortage among the nursing fraternity is a growing challenge across several jurisdictions. It is a trend that has negatively impacted nurses themselves since they are overworked and poorly paid in most instances. As already mentioned, demand for nursing care services has been on the increase for the past ten years. As a management problem, the available workforce is also poorly distributed across various locations. For instance, it would have been fair to distribute the nurses according to the healthcare needs of individual areas. The training needs for the nursing workforce is yet another deteriorating trend that has affected the performance of nurses. As a result, the workforce supply and the health standards of nurses are key problem areas that policymakers ought to address with speed.
The future development of the workforce among the nursing fraternity will be largely dependent on policy framework and formulation. Action plans must be drawn so that the nursing fraternity can indeed be made more robust in the coming 10-20 years. In the following section, various solutions have been proposed to address the trends in the nursing challenge in the future. In each of the solutions suggested, policy frameworks should provide the key guidelines.
First of all, a care management service that addresses specific issues affecting the nursing profession is crucial. If nurses are not taken care of in the best way possible, they will also not be in a position to advance the necessary care to the growing number of patients each year. A separate care management service for nurses will among other things, take part in policy formulation on matters affecting the profession. A long-term mistake has been witnessed when nursing issues are combined with those of other healthcare practitioners. Since the nursing profession forms the bulk of the workforce in the entire healthcare sector, it is only necessary for these professionals to be given due attention and not overlooked at all. In the case of managed care program, it would have been commendable for the nursing fraternity to be fashioned with a unique care program that relieves them from medical bills alongside their close family members. It is unfortunate to note that nurses have been treated as inhuman entities that do not need comprehensive healthcare services just like other patients.
An independent care service for nurses will also provide a platform through which nurses can air their views and concerns. This will facilitate immediate actions to be taken.
A very strong partnership will also be required across the board to establish a vibrant care service tailored toward the needs of nurses. This form of partnership will have to be derived from government agencies, non-governmental organizations, and other healthcare providers in the private sector. As it stands now, there are myriads of professional groups that can assist in policy formulation and the implementation phase of the nursing care programs meant for the nursing profession. It is still interesting to note that a national training plan that targets the nursing fraternity is possible under this program. Even though all the practicing nurses have been trained in their respective fields of care, it is still not enough to continue practicing without additional capacity building regularly. In the next 10-20 years, the nursing demands in terms of the ability to perform myriads of duties will increase. Unless nurses are re-trained and their healthcare delivery capacities boosted, it will be critically impossible to push the nursing agenda in the right direction.
The Medicare benefits schedule ought to be part and parcel of benefits that nurses enjoy while still in service. However, it is disheartening to observe that several countries have not worked out plans for evaluating the needs of the nursing staff. Perhaps, for regions that have comprehensive insurance healthcare packages for nurses, it will be necessary to put in place legislations that support various beneficial medical schemes. A collaborative approach is required so that the nursing fraternity can fully benefit from various medical schemes.
There is a sharp and growing disparity between nurses who practice in rural and urban setups. In most instances, nurses in rural settings are hoodwinked with meager benefits in form of hardship allowances and other fringe benefits. It is not just enough to offer hardship allowances for nurses working under difficult conditions (Connolly & Jones 2003, p.207). The allowance awarded to such nursing staff should be compatible with the internationally adopted guidelines. When nurses are posted in difficult working environments, they also risk their lives greatly. There are instances when these nurses are subjected to war-torn working environments and as such, they need to be protected. It may not be a smooth journey for nurses deployed in rural setups or perilous working environments. Therefore, conclusive legislation regarding the overall working conditions of nurses as well as the accompanying benefits must be put in place to minimize the chances of job tolerance and eventual withdrawal from the profession.
There are reduced admissions in the nursing profession compared to the way it used to be some years back. For example, between 1995 and 2000, about a 26 percent decline in the new graduate RNs was recorded (Tzeng & Yin 2009, p.19). The educational pipeline does not currently hold enough nursing students who can adequately replace those going for retirement (Tzeng & Yin 2009, p.20). When prospective nursing students eventually make a decision to step out of the profession; it creates a very bad picture of the future of this fraternity.
In conclusion, it is highly recommended that a special nursing care service should be set up so that nurses can access a viable platform through all their concerns can be addressed adequately. In the past, the needs of individual nursing practitioners were not addressed with a lot of concern largely because nursing was perceived as a subsidiary profession in healthcare delivery. Unless a robust reform agenda is put in place, individual nurses will continue to face difficult times.
References
Auerbach, D.I., Buerhaus, P.I. & Staiger, D.O 2007, “TRENDS: Better Late Than Never: Workforce Supply Implications Of Later Entry Into Nursing”, Health Affairs, vol. 26, no. 1, pp. 178-185.
Connolly, M. & Jones, N 2003, “Constructing management practice in the new public management: The case of mental health managers”, Health Services Management Research, vol. 16, no. 3, pp. 203-210.
Hromco, J.G., Moore, M.W. & Nikkel, R.E 2003, “How Managed Care Has Affected Mental Health Case Management Activities, Caseloads, and Tenure”, Community mental health journal, vol. 39, no. 6, pp. 501-509. 285.
Tzeng, H. & Yin, C 2009, “Historical Trends in Human Resource Issues of Hospital Nursing in the Past Generation”, Nursing Economics, vol. 27, no. 1, pp. 19-25.