Nursing Shortage and How It Affects Patient Safety

Nursing Shortage and How It Affects Patient Safety
Student’s Name
Institutional Affiliation
Nursing Shortage and How It Affects Patient Safety
Introduction
The shortage of nurses in healthcare facilities presented as the nurse-patient ratio is primary among the challenges facing healthcare presently. The amount of work that nurses have to endure directly affects the quality of care and patient safety by extension. A high nurse-patient ratio has been linked to adverse outcomes, including burnout among nurses, increased stress among nurses, decline in the possibility of survival among patients in intensive care, and increased patient mortality. Conversely, there is published evidence indicating that low nurse-patient ratios lead to better patient outcomes. Hence, the PICOT statement for this presentation asks: among nurses with chronic burnout, what would enhance nurse retention strategies be compared to increasing nurse enrollment to address the nursing shortage challenges affecting the US healthcare facilities in the next ten years?
Problem Statement
There is an increasing challenge of nursing shortage in most healthcare facilities. In the US, registered nurses are the largest group of healthcare professionals. This number stems from the multiple roles, including caring for the patients, developing ideal clinical settings, and disseminating information that nurses must execute to ensure proper operations in healthcare settings. Despite the high number of nurses employed presently, the NSI report indicates that the vacancy for registered nurses continues to rise and stands at 7.2% presently (Tang et al., 2018). There is a possibility that the US will find it challenging to match the demand for registered nurses in the future. That is because the healthcare setting is facing a new strain of challenges. For instance, there is an increase in the aging population numbers. Bearing that the aging population needs more attention from healthcare professionals considering their unique health challenges, the nation will struggle to match the demands. Soon, even more, nurses will be needed to care for and educate patients suffering from chronic conditions. It is also worth remarking that a complete implementation of a healthcare policy such as the Affordable Care Act (ACA) should steer more challenges to healthcare facilities. ACA has opened avenues for more people to access health insurance and stay eligible for quality healthcare services (Tang et al., 2018), and as such changes occur, nurse shortages increase. Unfortunately, not many efforts have been put to address the shortages, which has led to the emergence of the recoil effects. Part of the challenge stems from the understanding that healthcare facilities are not ready to approach the issue with the vigor that it demands. As a result, stakeholders in healthcare must endure the impacts such as poor staffing, burnout among nurses, increased stress among nurses, a decline in the possibility of survival among patients in intensive care, and increased patient mortality. Therefore, proactive measures must be taken to deal with nursing shortages.
Organizational Culture and Readiness
Readiness for a change from an organizational perspective stems from multiple factors. Organizational culture is one of those prospects that bear influence on the change process considerably. Healthcare organizations have a primary role in addressing nurse shortages stemming from their culture and readiness to address the challenge. Superficially, organizational culture marks the practices, expectations, and values that guide activities within specific organizations. In addressing the nursing shortage, healthcare organizations must begin by assessing their practices, expectations, and values and gauging them against their resources. From such an analysis, the organizations should be ready to implement newer strategies in taming nursing shortages. Based on how organizations define their cultures, they should understand the most appropriate option between retaining nurses and opting for a larger influx from the learning institutions.
There are multiple reasons why organizational culture remains a vital tool in the change process. Primarily, the culture defines the internal and external identity of the organization. Culture contains attributes that best describe the organization. Factors such as teamwork, good work-life balance, or creativity at the workplace all stem from the influence of organizational culture. The values portrayed in the organizational culture define its image in how it interacts with its internal and external stakeholders. Presently, even healthcare facilities prosper based on the image that they showcase. A healthcare facility that showcases an image of an organization that understands the plight of nurses and addresses the identified challenges appeals to more nurses. Similarly, an organizational culture that encourages efficiency and acceptable workload on employees could reduce employee turnover rates and encourage even more employees to join the ranks of such an organization.
Organizational culture also remains the anchor of a healthcare organization’s vision and mission statements, thereby making it vital to the change process. Presently, healthcare facilities operate within the confines of a specific mission and vision statement (Harrison et al., 2021). A mission statement is a declaration that states the purpose of the existence of an organization. If the organization has a mission to offer healthcare services, it ensures that it offers those services effectively. A mission statement is a tool of performance measurement for an organization. That is, a healthcare facility would appreciate or stay ready for change upon realizing that it is performing below the expectations of its mission statement. Conversely, a vision statement guides an organization on its future expectations. To healthcare facilities, the vision statements stem from the need to deliver the best possible patient outcomes. Therefore, an organizational culture anchored on the vision statement will always be ready to make changes, especially after realizing that their present operations are limiting their trajectory towards achieving the vision statement.
Leadership is the ultimate aspect of organizational culture that should influence the change process. Organizational leaders understand their facilities regarding their present capabilities and future expectations (Harrison et al., 2021). Such leaders can determine the strategies to explore to achieve the best outcomes for their healthcare facilities in a change process. One of the initiatives that leaders can undertake to ensure a smooth transition during a change process is instilling inter-professional collaboration or teamwork. Healthcare organizations motivate employees to perform both individually and collectively to achieve the best patient outcomes. Individually, healthcare professionals must be skilled and knowledgeable enough to execute their duties, including diagnoses, treatment, or general patient care (Sollazzo & Esposito, 2020). Remarkably, it takes the intervention of leaders for healthcare organizations to master optimum inter-professional collaboration. Through teams, leaders can give directions and assess the scope of changes collectively. Such inputs limit conflicts or resistance at the implementation of change. Leaders also nurture employees’ perceptions (Harrison et al., 2021). A good leader should have a visionary understanding of the organization. Such insight can be employed to educate employees about the organization’s position, especially when it comes to delivering visionary clinical environment changes. The other leadership roles that impact the change process include setting goals for the organization and communicating the entire change process to the stakeholders of such organizations. Organizations intending to make changes can barely consider their position as ready without proper leadership inputs to fuel the change process.
Organizational Readiness Tool
Assessing an organization’s readiness for a particular change is a key prospect in the change implementation phase in most public health interventions. Stakeholders within a particular healthcare setting must adhere to readiness elements before they are subjected to the change itself (Sollazzo & Esposito, 2020). Readiness for change is defined as the extent to which stakeholders or members of an organization are prepared behaviorally and psychologically for a particular change initiative. An organization is better positioned with the change initiative if the members are ready in all the measurement matrices. The Ready, Set, Change online decision support tool is one of the most common tools in assessing the organization’s readiness for a particular change (Harrison et al., 2021). This tool embeds its inputs on a framework that focuses on readiness for change as preparedness by the organization and the individual in a range of readiness areas for the change process to be successful.
There are four readiness areas that the online tool assesses to determine the preparedness of an organization and its employees for the change process. The first readiness area is the individual psychological factors. Individuals who are poised to feel the impacts of a change must be prepared psychologically to stand a chance of accepting the suggested changes (Davey et al., 2019). One of the areas that change managers must assess is the beliefs of the members. Every change process should concur with the beliefs of most individuals in the organization. Resistance to change stems from a lack of congruence between individual beliefs and the changes that the organization intends to implement. The second change area includes individual structural factors. Structural factors such as skills, ability, and knowledge play a significant role in defining the acceptability or resistance to the change process (Sollazzo & Esposito, 2020). The third area of assessment is the organizational psychological factors. An organization must have a belief system embedded in its culture, which supports the projected change. For instance, an organization is barely ready for changes if its cultural attributes do not support the proposed change. Ultimately, an organization must be ready through its structural factors. Factors such as personnel, policy, communication channels, and resources play a primary role in implementing the change. For instance, it remains challenging for a healthcare organization to employ more nurses without the financial resources.
My current organization is mildly ready for the changes that are likely to eliminate nursing shortages within its operational settings. In the first readiness area, every nurse is prepared for a change that will reduce their workload in the facility (Davey et al., 2019). Other healthcare professionals are also motivated for such a change that should redefine workload in the facility. On individual structural factors, nurses are prepared through their skills, knowledge, and ability to accept changes within the personnel ranks. The current professionals understand the interpersonal and even communication skills needed to accommodate more workmates besides manifesting the knowledge and abilities to execute their jobs efficiently. In the third area of readiness, the organization shows commitment towards instilling the changes. Factors such as the organizational culture and structure point to a workplace setting motivate to give their nurses the necessary workload (Tang et al., 2018). However, the organization is not entirely ready to commit all the structural factors. Principally, recruiting more nurses requires financial resources, which has impeded implementing the changes. Perhaps, initiating cheaper and long-lasting strategic approaches in addressing the shortage of nurses is a necessity.
Literature Review
Strategic Options
Addressing the shortage of nurses and its impacts on patient safety is a debate that has attracted multiple scholarly inputs. Presently, there are only a few strategies that such facilities can employ to address the issue. Primary among the strategies would be implementing an aggressive retention strategy (Baker, 2016). With such a strategy, healthcare organizations will employ nurses and create a valid workplace environment for them. Part of the inputs includes implementing proper performance appraisal protocols. Unfortunately, high turnover rates inhibit healthcare facilities from aggressively executing their roles. Further, healthcare facilities are faced with poorly constructed clinical settings that do not attract more nurses and bureaucracy that inhibit operational efficiency (American Association of Colleges of Nursing, 2017). Exploring an intensive employee retaining strategy focuses on factors such as abolishing low salaries, encouraging nurses to obtain higher levels of education, filling open faculty roles, and addressing the retirement slots (De Oliveira et al., 2019). However, this strategy is expensive and requires the healthcare facility to invest intensively individually to stand a chance of success. While intensive retraining of nurses could solve the problem in the short term, healthcare facilities do not have the resources to sustain it, especially with the increasing demand for healthcare services.
A more appropriate strategy in addressing the nurse shortages is thr...