Registered Nurses in the United States

Registered nurses comprise the largest group of health care providers in the United States and around the world (STRUCTURED REVIEW OF LITERATURE). Nursing shortages and nurse turnover raters are becoming an increasing problem for health care administrators. These shortages are causing many hurdles in providing efficient and effective healthcare to patients. The current shortage of nurses in healthcare is due to many factors that are discussed in this paper. In 2001, there was a shortage of 126,000 registered nurses in hospitals and is expected to rise to 808,000 if changes are not made (HANSEN). Regardless, of the forces plummeting nurse retention rates, there must be some action taken to fill the vital roles nurses play in the healthcare system. In today's growing world, healthcare faces many challenges, both internally and externally. One of the most critical internal issues hospitals and clinics face is the shortage of nurses to carry out duties that range from documentation to various forms of patient care. The inability to increase nurse retention leads to problems for hospital administration, physicians, other nursing staff, and, most importantly, the patients in need. This paper discusses key factors associated with the growing nursing shortage and provides recommendations hospital administrators and managers can use to increase nurse retention and overcome the nursing shortage.

The demand for nurses is high and continuing to grow at a rapid rate. The U.S. Bureau of Labor Statistics projected a twenty six percent increase in registered nursing employment rates by 2020. A large chunk of the present nursing workforce is reaching retirement age. Current health care reforms and policies have increased access of health care for people. These factors alone have caused a greater need for more nurses in hospitals. This large demand for nurses cannot be met with the current supply of nurses present in the health care profession.

Quality of Life and Job Satisfaction

The working conditions registered nurses encounter is an important factor for them when making employment choices. Nurses complain of bad management, reduced roles in decision-making process with stagnate salaries, no room for advancement and harsh working environments. Additionally, alternate job opportunities; with better benefits and career development cause other nurses to leave their profession.

Retention

How shortages affect nurses

How shortages affect patients (quality of care is main focus for this section)

In most aspects of life the saying less is always more may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient's quality of life as well as nurses' satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low. Conversely this is affecting all patients' quality of care. As stated in the article, Addressing The Nurse Shortage To Improve The Quality Of Patient Care, According to an Institute of Medicine report, nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff.

The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to sixteen patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. In order for optimal patient care to be achieved nurses need to be inspired by their work and feel supported by the health care staff. Both patients and nurses deserve to be given the attention and support they need to thrive. It is imperative that the concerns of nurses are being heard and supported. Patients depend on all health care providers, but nurses are the backbone of patient care. Therefore acknowledging their needs should always be top priority.

Leadership and Management: Effective approaches

Nursing shortages and nurse turnover is a growing issue among the nursing profession. The main reason for this growing problem seems to be dissatisfaction among nurses with some aspect of their job. Nursing leaders and managers play a vital role in job satisfaction and ultimately nurse retention. In this section of the paper, I will identify the roles of nursing leaders and managers and examine the different approaches that each take to ensure job satisfaction among their staff and co-workers, as well as how they manage nursing shortages and nurse turnover.

In today's rapidly changing healthcare environment, it is important to develop strong, creative and effective nursing leaders. Leaders are those who possess certain characteristics such as motivation, commitment, autonomy, integrity, courage, initiative and the ability to handle stress (Huber, 2010). Good nursing leaders have the ability to encourage and inspire those around them to work as a team to achieve a common goal. Effective nursing leaders are respected and admired by their co-workers. They are able to think critically, set goals and have good communication skills which make those around them want to follow their lead. Nursing leaders do more than just delegate, dictate and direct. Leaders help others achieve their highest potential (ANA, 2014). Just like nursing leaders, nursing managers are equally as important to the nursing profession. The role of nursing managers is not only to promote and deliver safe, quality nursing care but also to facilitate and manage the environment of the health care setting.

The hospital needs to strive for a culture that is focused on working together as a team and provide a positive work health care setting for all employees. The hospital should strive for shared governance health care system, where nurses are also able to provide input in the decision-making process providing effective communication. The culture of the hospital should strive for effective conflict resolution strategies. Nurse leaders and managers need to build positive work relationships with nursing staff. Management should be approachable and easy to discuss work issues with. They should convey their thoughts and requests in a nonjudgmental, nonthreatening manner by creating a shared vision to handle issues. Management needs to have knowledge of the work environment and ensure their staff is well taken care of. Work fatigue can be limited through better scheduling, limiting the nurse-to-patient ratio, sufficient staffing, and promoting team work. The workplace environment needs to be friendly and have zero tolerance for work place abuse. Salary and benefits packages can be assessed through benchmarking information of other similar hospital nearby to ensure competitive salary and benefits packages. Workplace incentives can boost morale and increase job satisfaction. The hospital can offer longer better orientation, training, and mentoring programs to ensure new employees gain insight and knowledge of how the hospital operates. Nursing leaders and managers need to use positive reinforcement to boost morale and job performance of the staff. Executives need to go through annual training to learn and reinforce skills including business planning, budgeting, conflict resolution, communication and negotiating skills, leadership, communication and relationship building, professionalism, and knowledge of the healthcare environment (Wolper 310).

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