HOW NURSES CAN STOP THE NURSING SHORTAGE

An article by HSM Group Ltd. states (as cited in Spetz & Given, 2003, para. 1) “estimates of average nurse vacancy rates at hospitals range from 10.2 percent to 13 percent, with one in seven hospitals reporting more than 20 percent.” The Bureau of Health Professions predicts the nursing shortage to worsen within the next twenty years; by 2020 there will be a projected shortage of 800,000 nurses (as cited in Spetz & Given, 2003, para. 2). Because the nursing shortage has been linked to negative patient outcomes and high rates of nurse burnout, nurses have the responsibility as members within a discipline to partner with other professionals in the health care industry to alleviate the nursing shortage by reaching out to youth to promote a positive image of nursing, increase graduation rates of licensed nurses, and increase job satisfaction.
The need for educated nurses is expanding due to a variety of factors including: increasingly risky and complicated work, an aging workforce, invariable financial benefits, increasing work alternatives, and inadequate new nurses entering the field (Stedmen & Nolan, 2007). In addition, some individuals do not rand nursing as high as other professions and are being discouraged from pursuing nursing by their elders (Cohen et al., 2006). Considering that “up to 50% of the current U.S. nursing workforce will reach retirement age by 2020” ( Cohen et al., 2006, para. 3), it is time to start generating changes in several areas of the nursing continuum.
As role models, nurses need to take action to educate the youth of society about the nursing profession. Several authors have noted that “encouraging children to enter nursing should begin during the pre-school and elementary school years because changing children’s perceptions of nursing has been shown to affect their choices of college and careers” (Cohen et al., 2006, para. 7). Programs specifically designed toward the youth should be established like the “Kids Into Health Careers (KIHC) Initiative”. According to the U.S. Department of Health and Human Services, Health Resources and Services Administration, and Bureau of Health Professions (as cited in Cohen et al., 2006) it was created to convey to youth that job opportunities in health care do exist, qualifying for these jobs is an attainable and gratifying goal, financial aid is available, and health care work fills a critical need in medically underserved communities where people are not receiving health care. These types of programs can be launched at health fairs and career days at the local schools. An increase in knowledge and preparation gained in elementary, junior high, and high school about nursing will increase the likelihood that youth will choose nursing as a major in college.
Once a student has chosen the major of nursing, he or she may run into more tribulations before they obtain a nursing degree. In a study done by Paolucci (as cited in Spetz & Given, 2003, para. 25) it is reported that “numerous nursing programs have been forced to reduce admissions because of lack of faculty, and future faculty retirements are likely to make the problem worse”. The average salary for a staff nurse in the United States for 2007 is $59.061 and the average salary for nursing faculty is $62,734, with a difference of only about $3,600 according to hotjobs.com. This seems unjust due to the fact that staff nurses usually hold an associate’s or bachelor’s degree, while the faculty member holds a master’s or Ph.D. The nursing educators need to demand the salary they deserve with the support of unions or groups that they form independently so that the number of admitted applicants can increase. If the shortage is considered to be a crisis, support from the state and federal governments should be increased to meet the needs of educators. Other organizations could also help finance programs. In an article by Rapaport (as cited in Spetz & Given, 2003, para. 25) it is stated that “hospitals are also funding nursing education slots directly, thus enabling cash-strapped programs to expand.”
While nursing programs need money to expand, the nurses who are already in practice are being recruited with benefits packages that include items such as paid leave, health insurance, retirement plans, education benefits, child care, and more (Spetz & Adams, 2006). However, Spence, Laschinger and Finegan (2005) state recruitment and retention of nurses will benefit most from approaches that generate work atmospheres that manifest justice, trust, and respect and thus will reinforce professional nursing practice. The goal is for the organization to value the nurses enough to allow open communication facilitating a mutual respect. In a study done by Laschinger (as cited in Spence Laschinger & Finegan, 2005, para. 8), she found that “only 38.3% of staff nurses felt they received the respect they deserved from their managers.” This absence of respect will only harbor mistrust and lack of commitment thus leading to job dissatisfaction. A relatively new concept to assist with current dissatisfaction is coaching. Coaching is an anonymous two person communication system to help employees make their concerns known and find means to work through them (Stedman & Nolan, 2007). This conflict resolution system may help solve problems by compromise rather than employees simply quitting because of dissatisfaction. Coaches are registered nurses from human resources who are good listeners, experienced in conflict resolution, and are familiar with the hospital’s benefits and policies; they ensure focus on the future, generate strategies and solutions, create a trusting environment, and are not judgmental (Stedman & Nolan, 2007). If the hospital implements a program directed toward employee satisfaction and it works, the employed nurses will likely have an increased feeling of respect and value that will renew their commitment to the hospital and to nursing as a profession.
The quality and availability of healthcare is a growing problem in recent years as a result of a chronic nursing shortage. As members within this professional community, nurses are responsible for finding a resolution for this dilemma. Educating the youth is crucial because they are the individuals that will be entering the workforce whether it is in nursing or not. Lobbying for more college funding is essential so that the faculty can be compensated justly and the programs can accept as many qualified applicants as possible. The last step is to promote workplace satisfaction by demanding the respect and compromise nurses deserve through programs like coaching so recruiting and retention rates rise. Because the nursing shortage is so complex, it is going to take a collaboration of disciplines and several multifaceted strategies to end it. However, since the deficit is a direct nursing problem, nurses need to be on the forefront of new implementations.

a. Intervention 1- Encouraging children to pursue nursing.
i. Disadvantage 1- Knowledge deficit related to day to day work of the registered nurse.
The choice to pursue nursing can occur at a young age. However, if children do not have correct information about the nursing profession, they will not be able to make a solid choice on which educational path to follow when they choose their major in college. Education programs and job fairs can help close this gap however children need to see nurses actually doing their job. In a study done by Stevens and Walker (as cited in Yeager & Cheever, 2007) they found that high school seniors did not know that nurses engage in high-technology work, direct programs, or held leadership positions even after a nurse came to their career day at school. This is a knowledge deficit that can be altered with the utilization of job shadowing and having hospitals host job fairs and camps for the youth.
ii. Disadvantage 2- Discrimination related to gender of nurses
With just of fraction of the registered nursing work force consisting of men, job fair and career day nurses are no longer targeting girls as their main focus for recruiting nurses; nevertheless the youth of America still think that nursing is a woman’s job. In a recent study, students were most likely to consider that “women are better suited” to a career in nursing by up to 16 percent as compared to other occupations (Seago, J.A. et al., 2006). This is a discrimination and knowledge deficit problem that can be easily addressed. Stevens and Walker found that this sort of discrimination didn’t hold true in children who knew a nurse personally; in fact, knowing a nurse personally was positively associated with pursuing a career in nursing (as cited in Yeager & Cheever, 2007).
b. Intervention 2- Obtain funding to expand nursing programs
ii. Disadvantage 1- Financial deficit among state and federal governments
The nursing shortage has not only hit hospital nursing positions, it has greatly effected the faculty nursing positions at the university and college levels. This is crucial because nursing programs need to increase the number of graduating registered nurses to meet the demand for nurses in each pathway of the profession (Spetz & Given, 2003). Due to most RN education programs being in publicly funded colleges and universities, particularly community colleges, government support is going to be required in order to accomplish the expansion of many programs. However, current state and federal budgets are preventing them from expanding the programs as much as necessary (Spetz & Given, 2003). Spetz and Given state that even with the support of unions and organizations, the budget for nursing will most likely not change (2003).
ii. Disadvantage 2- Knowledge deficit related to “lack of vision”
Hospitals are an important asset to nursing programs. They allow a place for hands on practice and staffing to guide students through the learning process without the school paying for additional faculty. Several hospitals have stepped forward and become active participants with their local colleges according to the article by Henderson and Hassmiller Hospitals and Philanthropy as Partners in Funding Nursing Education (2007). Conversely, others have shown less determination due to lack of vision, lack of funding, and a desire to “go it alone and do it the way they’ve always done” (Henderson & Hassmiller, 2007). With government funding that has nearly vanished hospitals need to be convinced that according to the Robert Wood Johnson Foundation (as cited in Henderson & Hassmiller, 2007, para. 8) “nursing shortage problems are beyond the control of any one institution, so partnerships are the only way we will arrive at solutions.”

REFERENCES
Cohen, R., Burns, K., Frank-Stromborg, M., Flanagan, J., Askins, D.L., & Ehrlich-Jones, L. (2006). The kids into health careers (KIHC) initiative: Innovative approaches to help solve the nursing shortage. Journal of Nursing Education, 45(5), 186-. Retrieved April 13, 2007, from ProQuest database.
Henderson, T.M., & Hassmiller, S.B. (2007). Hospitals and philanthropy in funding nursing education. Nursing Economics, 25(2), 95-. Retrieved October 23, 2007, from ProQuest database.
Seago, J.A., Spetz, J., Alvarado, A., Keane, D., et al. (2006). The nursing shortage: Is it really about image? Journal of Healthcare Management, 51(2), 96-. Retrieved October 23, 2007, from ProQuest database.
Spence Laschinger, H.K., & Finegan, J. (2005). Using empowerment to build trust and respect in the workplace: A strategy for addressing the nursing shortage. Nursing Economics, 23(1), 6-. Retrieved April 13, 2007, from ProQuest database.
Spetz, J., & Adams, S. (2006). How can employment-based benefits help the nursing shortage? Health Affairs, 25(1), 212-. Retrieved April 13, 2007, from ProQuest database.
Spetz, J., & Given, R. (2003). The future of the nursing shortage: Will wage increases close the gap? Health Affairs, 22(6), 199-. Retrieved January 7, 2007, from ProQuest database.
Stedman, M.E., & Nolan, T.L., Jr. (2007). Coaching: A different approach to the nursing dilemma. Nursing Administration Quarterly, 31, 43-49. Retrieved January 19, 2007, from Epanded Academic ASAP.
Yeager, S.T., & Cheever, K.H. (2007). A residential nursing camp program: Effects on adolescent attitudes toward nursing careers. Journal of Nursing Education, 46(10), 452-. Retrieved October 23, 2007, from ProQuest database.