Evidence-based Solution for the Healthcare Staffing Crisis
Tara Novosel
Millersville University
NURS478
Dr. Rotondo
September 25, 2022
Evidence-based Solution for the Healthcare Staffing Crisis
Nurse staffing levels are critical for promoting the quality of patient care, the long-term containment of costs, and improving healthcare outcomes. When staffing levels are appropriate, there are low mortality rates, a reduced length of patient stays at the hospital, and reducing the number of preventable events in hospitals, such as infections and falls. Unfortunately, there has been a shortage of nursing staff due to a lack of potential educators, a high turnover, and a lack of equitable distribution in the workforce. High turnover rates in the workforce are associated with burnout and stress, while the lack of potential educators leads to poor motivation and inexperienced nurses. This essay discusses the solutions to the shortage of staff in the healthcare crisis. The nurse staff shortage crisis can be resolved through communication, better leadership, promoting nursing education, new regulations and policies, and more nurse engagement.
Communication is crucial in ending the nurse staffing crisis because it helps improve the work environment. According to Haller et al., the American Nurse Credentialing Center developed the Magnet Recognition Program to improve the quality of nursing services and patient outcomes (2018). The program’s criteria included favorable patient outcomes, timely complaint resolution, job approval rates, and nurse involvement in data collection. The program used qualitative and quantitative methods to evaluate medical care and nursing services, offering channels for nurses to thrive through better work strategies. The program’s fundamental goal is to encourage open communication among nurses and other medical staff members, embracing better practices that will promote an efficient personnel mix and job satisfaction. Management policies related to the program promote hardworking nurses in a well-dispersed environment. Communication among nurses and their nurse leaders encourages independence, self-direction, and self-government because nurses have clear daily instructions on their work program. When nurses are in an environment where they can communicate openly, they are comfortable asking for opportunities to develop their careers and education for skilled development. The magnet program promotes a nurse-friendly work environment needed to attract more employees (Haller et al., 2018). Therefore, communication is crucial in reducing staffing shortages because open communication between nurses and their leaders promotes independence. Nurses have control over their patients and better relationships with them, skill development, and confidence in their daily role, leading to reduced turnover rates.
Better leadership qualities are another solution to the nursing shortage crisis. Many nurses demonstrate high absenteeism and turnover rates due to their leaders’ inability to cater to their needs. Organizational characteristics and leaders’ behavior significantly influence nurse shortages because of the relationship the two have. Leaders who empower nurses to use their skills, knowledge, and behavior help improve organizational commitment, the quality of care, and job satisfaction and help reduce the nursing shortage crisis. Leadership reflects influencing and controlling other people’s attitudes and behavior. In a nursing work environment, power is the ability to control, organize and attain resources, support, and information to achieve an organization’s goals (Mudallal et al., 2017). Nurse leaders who use their power poorly on their subordinates, such as assigning them too much work and failing to appreciate their efforts lead to burnout, contributing to the nursing crisis. Burnout is characterized by emotional exhaustion, where the nurses show low fatigue, hopelessness, and depression, and depersonalization, where they detach from caring for patients and following instructions. Another characteristic of burnout is low personal accomplishment, where the nurses view themselves as incompetent, inadequate, and unsuccessful. This consequently leads to low contributions to work, eventually quitting their jobs. Mudallal et al. conducted a cross-sectional correlational study to explore head nurses’ influence and their empowering behaviors on nurse burnout (2017). They concluded that nurse shortage in organizations could be reduced by nurse leaders enhancing the meaningfulness of their employees’ work, allowing them to participate in decision-making, expressing confidence in nurse performance, and facilitating nurses in attaining their goals.
The lack of nursing education has significantly contributed to the nursing staff shortage crisis. Nursing education aims to produce a nursing workforce that meets the population’s health needs in distributive, qualitative, and quantitative terms. Based on a study by Machitidze, gender issues affect the enrollment of nursing students, affecting the supply of nurses in healthcare systems (2017). For example, there are mistaken perceptions that women are better suited to caregiving, making recruiting male students challenging. Machitidze reviewed secondary research and descriptive analyses to determine how the lack of nurse education contributes to the shortage crisis. The article includes the Robert Wood Johnson Foundation example that supports nurses by investing in nurse programs such as leadership and mentoring (Machitidze, Nikoleishvili & Gogashvili, 2017). One of the forms of nurse education is changing nurse working processes, whereby, instead of assigning them time on administrative tasks, they are taught how to focus more on patients and improve care in their units. All public and private organizations should invest in nursing education because poorly trained nurses cause a staff shortage. The WHO’s report in 2022 showed that 7.2 million healthcare workers had a shortage of existing health needs. This makes them inefficient at their work, leading to nursing shortages. Therefore, to reduce the nurse shortage crisis, healthcare organizations should focus on training their leaders on delegating tasks to their subordinates to motivate them to care for their patients without burnout and a lack of motivation.
New policies and regulations are solutions to the staff nursing shortages. According to a study by Mehdaova, if government policies remain in place for a long time, they apply downward pressure on the workforce, perpetuating the nurse shortage (2017). Policies and regulations are crucial for healthcare organizations because they define the rules they should follow without oppression. However, since leaders establish most regulations and policies, they fail to acknowledge all the challenges that nurses at the lower level deal with. For example, most organizations prioritize patient performance over the total number of nurses assigned to patients and the roles they can perform on each. Such roles contribute to nursing shortages because of the feeling that they are not appreciated at the workplace and allowed to make decisions. To resolve this, nurses must be part of the decision-making process through communication (Mehdaova, 2017). This is achievable by having a board representative who discusses matters with the nurses before board meetings and aids in ensuring that nurses’ rights and needs are met in their respective institutions.
Additionally, increasing employee engagement will reduce the nursing staff crisis in the healthcare system. Nurses have a passion for caring for their patients, and encountering an unfriendly environment makes it difficult to accomplish tasks, leading them to quit their jobs. High turnover rates are a disadvantage for patients and healthcare institutions because it is expensive to hire new employees and take care of patients with infections or falls resulting from a low nurse population. In 2016, Tullar et al. conducted a study to determine whether the participants in engagement programs are less likely by participants to quit their jobs. The participants were nurses and nurse assistants recruited to be a part of a program that aided employees in finding more connection and meaning to their work. The study’s findings were that the participants in the engagement programs were less likely to leave the hospital than the non-participants. Therefore, when nurses are more involved with the activities in their workplace, they are less likely to experience the need to quit their job, resolving the shortage crisis (Tullar et al., 2016). The most common forms of employee engagement in the healthcare setting are assigning nurses challenging tasks that encourage critical thinking or consulting them before making any changes that may affect their functioning. For example, engaging patients entails informing them of a strategy to cut off the budget, which gives them adequate time to readjust to the new changes and appreciate that they are a part of the hospital because leaders trust them. Staff engagement lowers the nurse staffing shortage crisis because nurses are unlikely to quit their jobs when they feel appreciated and valued at the workplace.
Interview Summary and Results
The interviewee was Julia Stover, RN BSN, an Infusion Room Practice Site Manager at the Penn State Health Cancer Center. Stover has experience in nursing and nursing leadership, having been in the profession for 25 years. She has worked at Penn State Health for over five years in different roles; she has been a bedside nurse in hematology/oncology and a coordinator of a bone marrow transplant, and she has been in her current profession for the last three years. The interviewer addresses the nurse shortage after the COVID-19 crisis and the problems that arose, such as burnout, stress, and changing careers. Since the interviewee has not experienced nurse shortages in her unit during the pandemic, she offers insight into how to maintain optimum nurse staff quantities under pressure. However, in other departments, she had witnessed the negative effects of inadequate staffing, such as misplacing doctors’ orders, leading to poor patient outcomes. Her unit has retained 21 of the total 39 nurses for over five years. She suggested ways to prevent burnout and staff turnover: proper leadership and leadership styles, communication, and emotional and psychological support. She trusts her team to complete tasks individually and encourages them to ask questions at any time, and through the hospital, she ensures the nurses get emotional and psychological support services when they are overwhelmed or stressed.
Recommendations for the Crisis
Nurse leaders have a crucial role in promoting nurse communication, eventually resolving the nursing staff shortage crisis. Proper communication should begin at the orientation phase, helping the newly employed nurse to become comfortable with the new working environment. Communication entails the nurses having regular meetings with nurse leaders, who inform them of any changes in their respective departments and the changes they need to make to adapt. For example, an effective leader must communicate if there are changes in the nurse-patient schedule due to a shortage. Informing the nurses on time allows them to adapt to their environment without confusion and hurry. Proper communication makes the nurses feel valued and appreciated in their work, and working in an orderly environment is motivating, reducing the staffing crisis.
Nurse leaders must also strive to have leadership qualities and a style that motivates nurses in their work, preventing burnout and eventual nurse shortage. A nurse leader must be approachable and empathetic and recognize their team’s hard work. Nurse leaders must establish a comfortable environment with their subordinates, encouraging conversations on different topics. When nurses are confident that they can have transparent conversations with their leaders and supervisors, they tell them when they feel overwhelmed and are experiencing burnout. An approachable leader also significantly reduces conflict and stress among hospital staff (Xu, 2017). Conflict arises when nurses feel isolated without a leader to turn to for questions or work issues leading to conflict. An empathetic nurse will also prevent burnout and absenteeism, solving the shortage crisis. Empathy allows the nurse leader to consider the nurses’ feelings as though they were her own and ensure they do not assign tasks they would be unable to complete themselves. When nurse leader is empathetic, they understand the causes of burnout among their employees, leading to them making changes such as hiring more staff or increasing rest time for their nurses. An effective nurse leader must also recognize when their team has made an effort, leading to positive results. When staff is rewarded for their hard work, they are encouraged to work more because they know the stress they experience has rewards. Leaders who reward employees encourage their retention, solving the shortage crisis.
Similarly, the most effective leadership style that suits nurses and their subordinates is democratic leadership. A democratic leader is open with their staff and includes them in making decisions. Staff that operates under a democratic leader have expectations and responsibilities for which they are held accountable. A democratic nurse leader also values relationships, focusing on quality improvement instead of staff mistakes (Al Rahbi, Khalid & Khan, 2017). Democratic leadership minimizes nurse shortage because employees feel more valued and trusted enough to have tasks delegated to them. Therefore, nurse leaders must be democratic and trust their employees’ abilities, which minimizes turnover rates and absenteeism.
Also, when nurse leaders educate their staff as a strategy to reduce turnover rates, they should focus on career development and advancement because it also increases nurse engagement. When nurses are in an environment where they are guaranteed to rise on their career ladder, they are less likely to quit their jobs. Thus, nurse leaders in various institutions should establish mentorship programs and initiatives that help nurses acquire more workplace responsibilities (Bindon, 2017). For example, leaders can provide weekly newsletters containing educative content. Since nurses are too busy to have training sessions, reading the newsletters offers step-by-step guidance on how nurses can increase their responsibilities at work. Nurses then put them into practice in their daily activities, promoting career growth. When nurses are in the midst of career development and taking up more responsibility, they are less likely to record high absenteeism rates.
In summary, the nurse shortage nursing crisis can be resolved through communication, better leadership qualities, and styles, promoting nursing education, new regulations and policies, and more nurse engagement. Communication should be open to promote independence, control over patients, and better relationships with them, leading to reduced turnover rates. With better leadership qualities, nurse leaders can enhance the meaningfulness of their employees’ work, allow them to make decisions, express confidence in nurse performance, and aid nurses in attaining their goals. Nursing education aims to produce a nursing workforce that meets the population’s health needs in distributive, qualitative, and quantitative terms. It involves training leaders to delegate tasks to their subordinates in a manner that leaves them motivated to care for their patients without stress and burnout. Policies and regulations are crucial for healthcare organizations because they define the rules they should follow without oppression. Lastly, employee engagement lowers the nurse staffing shortage crisis because nurses are unlikely to quit their jobs when they feel appreciated and valued at the workplace.
References
Al Rahbi, D., Khalid, K., & Khan, M. (2017). The effects of leadership styles on team motivation. Academy of Strategic Management Journal, 16(2), 1–14. https://www.academia.edu/download/57425577/THE_EFFECT_OF_LEADERSHIP_STYLES_ON_TEAMS.pdf
Bindon, S. L. (2017). Professional development strategies to enhance nurses’ knowledge and maintain a safe practice. AORN Journal, 106(2), 99-110. https://www.sciencedirect.com/science/article/pii/S0001209217305410
Haller, K., Berends, W., & Skillin, P. (2018). ORGANIZATIONAL CULTURE AND NURSING PRACTICE: THE MAGNET RECOGNITION PROGRAM ® AS A FRAMEWORK FOR POSITIVE CHANGE. Revista Médica Clínica Las Condes, 29(3), 328–335. https://doi.org/10.1016/j.rmclc.2018.03.005
Mehdaova, E. M. (2017). Strategies to Overcome the Nursing Shortage. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=5933&context=dissertation
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54(1), 004695801772494. https://doi.org/10.1177/0046958017724944
Nikoleishvili, E. (2021). Factors Affecting Nurses’ Shortage – Literature Review. American Journal of Biomedical Science & Research, 13(1), 66–67. https://doi.org/10.34297/ajbsr.2021.13.001833
Tullar, J. M., Amick, B. C., Brewer, S., Diamond, P. M., Kelder, S. H., & Mikhail, O. (2016). Improve employee engagement to retain your workforce. Health Care Management Review, 41(4), 316–324. https://www.jstor.org/stable/48516231
Xu, J. H. (2017). Leadership theory in clinical practice. Chinese Nursing Research, 4(4), 155–157. https://www.sciencedirect.com/science/article/pii/S2095771817300944
Use the paper above that has been completed for the information needed for the infographic
Part 4 — Infographic Visual Presentation of the Challenges (10 pts) This visual needs to be used to educate your classmates and will be shared in one of the discussion posts. It should include the following:
2pts = Visually Appealing/Use color/pictures or Icons to represent content
2pts = Covers the Challenge in Healthcare (as per the interview or podcast of the nurse leader)
2pts = Supported by Evidence Based Literature/research
2pts = Includes supporting data/graphs/numbers to show why it is a healthcare challenge
2pts= Title, Student’s name, Grammar, Spelling, APA format for references