Factors Contribute to the Nursing Shortage in Texas

Factors Contribute to the Nursing Shortage in Texas Introduction Nursing is one of the most honorable professions and nurses are the true care givers and the backbone of our health care system. s the largest healthcare occupation! registered nurses

held about 2." million #obs in 2$$% & 'ureau of (abor! 2$$)* . +mployment of registered nurses is expected to gro, by 22 percent from 2$$% to 2$1%! much faster as compared to all other health care professions & 'ureau of (abor! 2$$)*. -ro,th ,ill be driven by advanced technology in patient care! ,hich allo,s for a greater number of health problems to be treated and by an increasing importance on preventive care. .n the /nited States and other industriali0ed countries! #ust as the population of older and sicker people is about to explode! ,e have a ma#or shortage of nurses in Texas. Discussion +ven though the nursing profession is in demand! more than 12 percent of 3Ns reported that they changed positions or employers due to ,orkplace issues4 or chose another profession for improved pay or benefits &/. S. 5epartment! 2$1$*. 6hy are so many skilled 3Ns dropping out of health care7s largest profession8 6hat factors contribute to the nursing shortage in Texas8 These are some of the 9uestions that arise in the ,orld of health care. :any factors contribute to the current nursing shortage in Texas! including healthcare cost budgeting! an aging ,ork force! shortage of faculty nursing! heavy ,ork load! rising legal responsibilities! occupational health risks! troubled ,orkplace relationship bet,een 3Ns and physician! and inade9uate long term pay incentives. (ack of 9ualified nurses has been present in the health care system for so long that

the term nursing shortage has become a truism.

Factors Contribute to the Nursing Shortage in Texas The origins of the current nursing shortage can be traced directly back to the implementation of managed care in the 1))$s as a method of controlling health care costs &;uston! 2$$"*. Some nursing positions ,ere actually cut due to the demands of managed care! ,hich had curtailed public and private sector insurance reimbursement rates and placed many hospitals and care facilities in difficult financial positions. ;ealth care facilities that tried to cut costs hired fe,er expensive 3Ns in favor of less expensive personnel. .n short! this do,nsi0ing

and shortsightedness concerning the employment and retention contributed to the beginning of a severe shortage of 3Ns in many health care settings by the late 1))$s &;uston! 2$$"*. Nursing shortages are not ne, < they have been cyclical in the profession for years4 ho,ever the current shortage may be more critical than any previous shortage. The graying of the merican population is going to have a tremendous impact on the health care industry. There ,ill be a substantial increase in the number of geriatric patients! and they ,ill also have increased needs for multilevel health care &Fox! = brahamson! 2$$)*. >recisely! more people ,ill need health care compared to previous years but very fe, people ,ill be ,illing to ,ork as a nurse in health care. There has been a significant decline in students enrolling in nursing school due to faculty shortage. ccording to CN7s report on 2$$)?2$1$ +nrollment and -raduations in

'accalaureate and -raduate >rograms in Nursing! /.S. nursing schools turned a,ay @A!))1 9ualified applicants from baccalaureate and graduate nursing programs in 2$$) due to insufficient number of faculty! clinical sites! classroom space! clinical preceptors! and budget constraints &Fact sheet! 2$1$*. .n the last fe, years! interest in nursing has increased to some extent! due to a ,eak /.S. economy! combined ,ith a gro,ing a,areness that nursing offers plentiful! diverse positions ,ith the chance to better lives! and pay that is good relative to the

Factors Contribute to the Nursing Shortage in Texas amount of formal training re9uired. /nfortunately! a critical nursing faculty shortage driven by inade9uate financial support has hampered efforts to train sufficient numbers of nurses4 nursing schools have turned a,ay or ,aitlisted many 9ualified applicants &Fox! = brahamson! 2$$)*. nother limiting factor is the access to clinical sites. ;ospitals are making it increasingly difficult to get students into the various units for clinical practices. The decline is further compounded by the aging of nurse educators. ccording to

CNBs report the median age of a nurse faculty member is @1 years old &Fact sheet! 2$1$*. The experts indicate that the average age of a nurse in the /nited States is no, over A" years. The nursing ,orkforce is rapidly aging! and too fe, ne, young nurses are being trained due to faculty shortage & llen! 2$$%*. The recent increase interest in nursing in the /.S. has not been sufficient to end the shortage. The /.S. continues to face an aging nursing ,orkforce and an explosion in the need for skilled nursing! as the baby boom generation starts to retire &Fox! = brahamson! 2$$)*. Traditionally! people choose to become nurses because they ,ant to care for people ,ho are ill! in#ured! or unable to care for themselves. /nfortunately! no, a nurse7s day is spent ,ith more time documenting than caring for the patient. 5ocumentation is time consuming and frustrating for many nurses. To comply ,ithin the internal policies and external regulatory re9uirements! nurses spend an estimated 22C of ,ork time documenting the care that they provide &Co,en! = :oorehead! 2$1$*. 5ue to large volume of documentation! the nursing ,orkload increases and the efficiency decreases. 6hen nurses feel rushed! the first things that they do not get done are teaching and providing emotional support for patients and families. They should not be spending their time on unnecessary paper,ork and should have ancillary help to perform non nursing activities. .n fact! each hospital should establish a staffing system

Factors Contribute to the Nursing Shortage in Texas

that ensures a number of registered nurses on each shift and in each unit of the hospital to ensure appropriate staffing levels for patient care. The other area ,here health care institutions feel the cost of the 3N shortage is in la,suits and rising insurance costs. 5uring periods ,hen there is a shortage of 3Ns! the 9uality of health care decreases! clients become dissatisfied ,ith the care they are receiving! and serious mistakes are made in care! resulting in in#ury or death of clients. 6hen nurses go to ,ork in a hospital or other health care institution! they expect to confront a certain number of predictable risks &Co,en! = :oorehead! 2$1$*. They may in#ure their backs if they try to turn a patient ,ithout help! or lift a patient ,ho is fallen in the hospital bathroom. They may stick themselves ,ith an infected needle because another hospital ,orker has failed to dispose of it correctly. They may contract a ne, and mysterious disease like S 3S. They may be verbally or physically attacked by a mentally ill patient ,ho becomes violent or by a family member of a patient ,ho is frustrated ,ith an increasingly impersonal health care system. Through a variety of ,orkplace and legislative measures! nurses try to minimi0e these risks but still all these patterns of behavior make nursing a risky #ob. nother important factor is :5?3N relationship. Dn a daily basis! nurses ,ork ,ith physicians ,ho fail to communicate ,ith them about critical clinical issues. Some physicians rudely overrule nurse7s clinical concerns and sub#ect nurses to verbal abuse and humiliation &Co,en! = :oorehead! 2$1$*. .t can be challenging for some nurses to form collegial! mutually respectful relationships ,ith physicians. ;o,ever! these relationships are important4 positive nurse?doctor relationships correlate ,ith stronger nursing #ob satisfaction for better patient outcomes. Some nurses obviously rebel against this dynamic! some negotiate a partial rebellion!

Factors Contribute to the Nursing Shortage in Texas and some submit. 6hichever course they take! it affects their commitment to their profession. Thus! poor nurse?physician relationships have a serious impact on nurse retention. Conclusion 5espite the above efforts! it is no, pro#ected that if current trends continue the /nited States ,ill be short @%1!@$$ nurses by the year 2$1% & 'ureau of (abor! 2$$)*. .f the shortage continues as currently pro#ected! it ,ill have catastrophic effects on the everyday health of the nation and may severely hamper the nation7s ability to respond effectively to a mass casualty event.

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Factors Contribute to the Nursing Shortage in Texas 3eferences

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contributing factors! public policy implications. doiE 1$.1111F#.11AA? "1)%.2$$).$$1A).x ;uston! C H. &2$$"*. >rofessional issues in nursing ? challenges and opportunities. (ippincott 6illiams = 6ilkins /. S. 5epartment of ;ealth and ;uman Services! &2$1$*. The registered nurse population: findings from the 2008 national sample surve of registered nurses 3etrieved from httpEFFbhpr.hrsa.govFhealth,orkforceFrnsurveyF2$$%F

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