Oct 23, 2020 in Research Proposal
Research Proposal about Nursing Workforce

Abstract

Shortage of nurses is a common negative phenomenon for hospitals in the country. Stakeholders in the nursing profession have predicted that this shortage will continue if proper interventions are not made. Traditional methods that different hospitals have applied in employment and sustaining nurses have proven to have limited success. There are several factors that leading to shortage of nurses. One of the main factors contributing to this shortage is the fact that the nursing workforce is aging. There is also low employment with the global nature of lack of skilled labor. However, there are some interventions that hospitals can apply to reduce nursing shortages in the labor force. Current paper proposes on some of the ideas and solutions that the hospitals can apply to reduce these shortages. It gives examples from hospitals in the United States and recommends on the most effective methods of intervention.

Executive Summary

Renfrey Memorial Hospital is a regional hospital with 200 beds that is situated in the Midwest. It has been in operation for 32 years. The hospital is currently encountering a problem with retention of the nursing staff. About 68% of the nursing staff is over 45 years old, thus, approaching retirement. Recently, the hospital carried out a survey which showed that most of the nurses find the work physically demanding. Nurses also reported that the work was taking much of their time and was emotionally exhausting. Some of the nurses also noted that they were already engaged in taking care of their parents at home in addition to the workload at Renfrey. The hospital has reported an exodus of the nursing staff especially in the past two rears. This has forced the hospital to employ temporary staff from a nursing agency, which, in turn, has drastically increased the costs of running the hospital. It has also negatively affected performance of the hospital according to patient service reports. The shortage also makes the nursing recruitment process difficult. Thus, the hospital must come up with ways to curb this problem otherwise it may face the risk of closure.

The problems that the hospital faces are not solely a nursing issue. It calls for collaborative efforts among all the nursing leaders not only in the hospital, but also in the region around it. This is also undertaking that requires interventions from those in the education sector, the media, the society as well as the healthcare executives and the government. The hospital can apply different interventions from those applied by other hospitals in the area to ensure that it would be able to manage the problem before it escalates. There are also changes in the society on patient care and its environment. There has been decrease in hospital stays with preference to home stays which leaves the nursing shortage unmet. At Renfrey Memorial Hospital, the analysis indicates that the level of expertise is the main cause of the problem as well as the working conditions for nurses. This calls for appropriate measures to be undertaken which will increase the number of nurses joining the hospital and improve the working conditions for the nurses.

Nursing Proposal

Introduction

Insufficient number of nurses in hospitals compromises patient safety as well as general quality of healthcare. The nurses are also overwhelmed by the amount of work that they have to handle daily in order to cater for the lost time. The ratio of patient to nurse increases which leads to job burnout and frustration and accounts for high turnover in the nursing profession. Inadequate supply of nurses plays a key role in negative patient outcomes leading to higher mortality rates due to risks as well as longer stays in hospitals. This does not mean that hospitals are helpless in times of nursing shortages. They can undertake different measures which have been found to produce positive results (Jenkins 2009). The thesis statement of this paper is: employers can curb nurse shortages by supporting nursing education as well as changing the working environment for the nurses. The proposal uses evidence-based research in an attempt to prove the thesis statement.

Available Solutions

There is a number of interventions that other hospitals in the country have applied to curb nurse shortages. One of the main solutions has been applied in the state of Maryland. Healthcare organizations have joined together to come up with methods on how to curb these shortages. These hospitals have come up with the strategies to enhance the nursing image in the state. Rather than competing for the current nursing population in the area, healthcare institutions have approached the society with campaigns for nurses. They have combined their resources through different initiatives to encourage young people in the society to join the field of nursing (Yett 2008). The most recent initiative involved the University Of Maryland School Of Nursing. This institution has proved to be a great partner with other public relations firms in the state to encourage people to join nursing school. These public relations firms were pioneered by healthcare institutions in the state. The approach has gone a long way in encouraging young people to join the field of nursing. Within last two years, partnership with Gilden Advertising, an organization which donates to support the marketing plan for the nursing profession has greatly contributed to increasing the population of nurses.

Boston State Hospital has come up with a method to encourage students to join the nursing profession. This has assisted the hospitals to curb the shortage challenge. The hospital organized several projects through the federal government in Boston High School. These projects were aimed at fostering and maintaining students interests in nursing. The project was a huge success. During the two following years, students continued to join nursing colleges in the state. Therefore, this project has proved to be sound for nursing departments in different hospitals to engage in order to promote their future nursing population. Such programs encourage students in middle and high schools to join the nursing profession and aim at sponsoring students through nursing college (The Subcommittee on Health 2001). After the students have completed their nursing courses, they can join the hospitals which sponsored their programs and pay back the college funds as they earn.

The other strategy aims specifically at retaining the nurse population in hospitals. The program was applied by hospitals in Orlando, Florida, which also experienced a great nurse shortage. due to poor retention of nursed by hospitals in the area. The solution was found through changes of healthcare executives. The new healthcare executives included nurse leaders with strong employee valuing skills. In hospitals in the region, the Human Resource departments collaborate closely with the nursing executives to handle the nursing workforce. This provides a forum for executive decision-making procedures which facilitate executive decision-making as a team. The nurses now feel valued in their workplaces. This way, hospitals are able to maintain their nursing population. During a period characterized by a shortage of nurses, healthcare facilities focus entirely on competing for new nurses and pay much less attention to already hired personnel, which in its turn, causes further shortages. Thus, the hospitals should learn to appreciate their workforce which will encourage others to join them.

The other strategy to manage nurse shortages is identification of benefits that would favor different nurses in a particular work setting. This strategy was especially successful during a nurse shortage in New York hospitals. In that particular case healthcare providers employed a committee to find out the needs of nurses. Meanwhile, the nurses came up with their own solutions on how to curb the shortage (McGee 2005). They were able to identify the benefits that would attract other nurses and maintain the current situation. It was found out that benefits such as salaries, autonomy, schedule, professional respect as well as credibility were the main causes of nurse shortages. During a nurse shortage, it is important to interview the nurses individually rather than through unions. This would show personal areas of satisfaction and dissatisfaction individually rather than as a group. Every employee is important in an organization and should have an opportunity to air their views. This will create a healthy working environment for everyone, thus, reducing the shortages (Yett 2008).

Another main solution to fight shortage of nurses regards administration of hospitals. Nurse shortages can be due to lack of proper administrative structure which does not support professional development of the nurses already in profession. This was the case in Denver General Hospital. The population of nurses included those who had worked in the hospitals for ten or more years without a chance to learn new and innovative healthcare methods. The solution came with the change of administration of medical facility (Simoens &Vellenueve 2005). The new administration invested heavily in training of the remaining population of nurses after the exodus of most of the nursing population. The hospital brought in temporary staff to take care of patients during training of the permanent ones. This proved to be profitable in the long run since the nurses enjoyed the new methods and at the same time coped with the increase in patients population by being able to provide quality medical care to their patients.

The first solution entails changing the general perception of the society about the nursing profession. The solution involves all the stakeholders in the healthcare enterprise.. The target population of this approach is the young people in schools who are waiting to join colleges. The hospital administration is to pioneer the program through seeking funding from other stakeholders such as donors. The accounting department in healthcare enterprise should then account for the funds in order to create a viable program. Further, human resource departments are designed accountable for implementation of the program. The criteria of success in this case would be the number of young people who joined the profession (Simoens & Vellenueve 2005).

The other solution involves departmental change in hospitals. The pioneers of this approach will be the management of healthcare facilities since they are responsible for setting up the structure of operations in the industry. The approach begins with hospital administration making the necessary changes for the top executives. The top officials in any organization are responsible for any major structural change (Jenkins 2009). The human resource department is also a major player in this case as it is responsible for the workforce in the hospital. Hence, it should come up with ways to support the changes and assist the workforce adopt appropriate measures where necessary. The third party players such as the donors and the society should also assist the hospital in adapting to these changes by assisting when called for. Finally, the process is not possible without support of the general patient population, since the patients are the main reason why the departmental changes are made.

Recommendations

While seeking for the best solution that Renfrey Memorial Hospital should adopt to reduce the nurse shortage, one should consider several factors. These factors include: the financial impact on the hospital as well as adaptability of the human resource management groups. It should also be taken into account that different interpersonal dynamics of the hospital personnel may arise from the solution of choice. Factors such as the cultural shift and change of management are also crucial in choosing the most effective solution. The first step in ensuring that the hospital comes up with the most appropriate solution in solving the nurse shortage is the short run (The Subcommittee on Health 2001). It is evident that the hospital is facing a crisis which threatens the quality of patient care. Therefore, providing patient care would be possible through introduction of temporary nurses to support the small number that is available. The hospital should make sure that they outsource labor with nursing skills as soon as possible to ensure that the nurses that remain are not overwhelmed by work.

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Though, introduction of a temporary workforce is not a lasting solution. The second step would be to consider the interpersonal dynamics of the hospital personnel as well as the working conditions in the facility. This is crucial in determining the main problem facing the hospital. It would also give the nurses a chance to come up with solutions themselves or air their concerns. Through the human resource management the hospital should select a few independent evaluators to interview the nurses and determine the cause of problems. Independent means that the evaluators should not be part of the hospital crew in order to have an unbiased opinion towards the working conditions of the nurses. The hospital administration should then analyze the findings of the evaluation team taking into consideration all the views of both the temporary as well as the permanent nurses. This will render a chance to make departmental changes both in the short and the long run andenable the administration to make an informed decision on the cultural shift, financial or departmental changes (Jenkins 2009).

The final step towards achieving the targeted nurse population would be to invest in constant supply of nurses. This approach will appear to be especially effective in the long run. The hospital cannot depend entirely on the use of temporary employment. Therefore, hospital administration should liaise with other hospitals and health organizations to encourage the society to join the nursing profession. They should also establish benefits for nurses who work in the hospital through improvement in the working conditions. This would also be the chance to invest in education of the older nurse population. Learning new methods of patient care would ensure that the does not overwhelm them. This means that the hospital has to come up with a strategic financial resource plan to enable the above measures to be undertaken.

Conclusion

Nursing profession requires skills which could be gained in a nursing college. In their turn, healthcare administrators should provide good working conditions for the nurses in order to retain them in hospitals. Quality patient care is the objective for every hospital in the country. There are examples of different methods ranging from education to working conditions applied by hospitals in the country in order to curb the problem. Therefore, proposal proves the thesis statement that employers can curb nurse shortages by supporting nursing education as well as changing the working environment for the nurses. Thus, the proposal is viable to undertake a research on in order to find a solution to nurse shortages in Renfrey Memorial Hospital.

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