Over the course of the semester, we have spent time discussing how to attempt to solve complex problems. We learned the importance of being a generalist from the book Range by David Epstein. We learned the importance of being aware of source biases and self-biases. We learned different tactics and approaches to solve complex problems. For our final project in First Year Seminar, I was asked to explore a complex problem that interested me. I decided to explore something that has to do with my major as I am a nursing student. Have you ever gone to a hospital and had to wait a long time just to be seen? Well, this is due to a nursing shortage that is only getting worse year after year. Why is there such a shortage of nurses and how is this affecting patients?
This topic is personally relevant because this topic has been something that I have been curious about ever since I decided I wanted to be a nurse. The stress that these nurses go through due to the shortage is something I will have to face in a few years if the problem does not get solved. Everyone always tells me, “That’s a great career choice, we need nurses,” but why do we need them? Why is there such a shortage? According to the Bureau of Labor Statistics’ Employment Projections from 2016 to 2026, Registered Nursing is one of the top occupations expected to have a job increasement. The number of RNs in the health field is expected to increase about 15% from 2016 to 2026, growing from 2.9 million to 3.4 million. There will also be a need for about 203,700 more nurses every year as people retire and new positions are created.
You might be wondering, why are nurses important? Nurses are one of the most trusted professionals and hold the healthcare industry together. Most people can say that they have had to go to the hospital whether it was for themselves or for a family member. Nurses are the people holding your hand at your most difficult times, giving you advice, and listening to you as a friend. They are the face that patients remember when they leave the hospital. Doctors come and go, but a nurse is always there. A nurse is not only a nurse, but a teacher, a friend, a counselor, and more. Nurses are not just nurses when they go to work, it is a lifestyle and character trait that they carry with them everywhere they go. They care for their patients greatly and want nothing but the best for them. However, when there is a shortage of nurses, they are not able to spend as much time with these patients, which can make a drastic change in the outcome of a patient.
Why is this a problem? Well, this shortage is putting patients at a high risk. Nurses are working very hard, especially because they are understaffed. They are tired and because of this, error occurs. Nurses are getting burnt out, giving patients the wrong medication, and not making it to patients in time, all resulting in injuries or death. When there are less nurses working in a health care facility, this means that nurses must work overtime and have to care for more patients at once. While trying to juggle responsibilities all while being tired, it is easy to mix up patients’ medications. A study showed that there has been a direct correlation with infections and understaffed units. Another study showed that when a nurse had one additional patient, it resulted in a 7% increase in the probability of failure to rescue. The nursing shortage can affect anyone who steps into a hospital, resulting in life or death situations. If this problem could be solved, it could benefit society at large. People would receive care faster and safer.
As the shortage of nurses only increases, so does the stress put on the nurses in the workforce. Nurses are working overtime while caring for a greater amount of patients. These workers are experiencing more stress, injuries, fatigue, and overall job dissatisfaction. Nurses are expected to work overtime, which can alter their whole day. A lot of nurses have families and other responsibilities that they have to worry about that are often put second due to having to stay overtime. Nurses are getting burned out because of this and it is resulting in making many mistakes. Should these nurses be held accountable for these mistakes? It is clear to see that this problem could be solved if more nurses were staffed and able to take care of patients.
There is not just one simple reason why there is such a shortage in nurses. This is interesting to me because I know that nursing is a popular major in college. Even though there are many people applying into nursing schools, there are not enough seats in these programs to keep up with the demand. According to an American Association of Colleges of Nursing, in 2012 colleges in the United States turned away 79,659 applications due to not having the budget or room in these schools. These schools do not have enough nursing teachers to teach the courses. Nurses are required to go through more years of training to become a nursing professor. According to the American Association of Nurse Practitioners, a nurse practitioner has a salary of about $97,083. An Assistant Professor who has their master’s degree has a salary of about $78,575. It is evident in the paid differences that there is no money incentive for nurses to go back to school to be able to teach classes. On top of this, about one third of the nursing professor faculty is expected to retire by 2025. Older nurses are also retiring and the amount of expected new nurses is not going to be able to keep up with the amount leaving.
Another big reason why there is such a demand of nurses that is not being met is the fact that people are living longer. Hospitals have more patients as technology advances, allowing people to live longer lives. The amount of people living in the United States over the age of 65 is higher than it ever has been and is only expected to increase from here. Because of this, hospitals are expanding, needing more nurses to meet the increase of patients. Nurses work in other places outside of the hospital setting. These workers are expanding their skills to outpatient services, such as urgent care centers, home health care, travel nursing, etc. This is only increasing the opportunities of places to work for nurses, resulting in less nurses working in the hospitals.
There have been some ineffective attempts to solve this big issue. Some statewide attempts have been put in place to help with the nursing shortage. The university of Wisconsin made a program that provided fellowships and loan forgiveness to students who agree to teach after they graduate in 2014. Other nursing schools are making partnerships and asking for support to help expand the amount of students they can have. In June of 2013, the University of Minnesota partnered with Minnesota VA Health Care System, expanding their nursing program. The Minnesota VA Health Care System gave the university money so that they could expand clinical sites, find the additional faculty needed, and other forms of support that the school was needing. If more schools engaged in partnerships like these, the nursing shortage would decrease. The Robert Wood John Foundation has dedicated money and time to support nurses, investing more than $140 million dollars in nursing programs. They have been supporting nurses since 1972 but have been inconsistent and have not made a strategic plan on how to solve the nursing shortage. The objective of this company is to help change over hospitals to better work environments, with the main priority of giving the best care possible to patients. They also have a project called Transforming Care at the Bedside, which is a program for nurses to identify and help make changes to improve care. Changes by TCAB make spending time with patients the priority rather than finding equipment, doing paperwork, searching for medication, etc. Changes like this could help turn around the nursing shortage and attract more people to this job.
I believe that there is a lot that can be done to help eliminate some of these issues. Because many nurses are deciding to retire, if they could stay for a few more years, that could help drastically. Hospitals could work with these nurses and give them what they want, whether it is shorter work hours or sharing a job with another nurse. These nurses with experience can be the people that train the new nurses coming in. New nurses will not become burnt out or discouraged as they will have the support that they need. With this help, new nurses will be less prone to make mistakes and there will be more helping hands available, solving the patient to nurse ratio. Another way I believe that this problem could be eliminated is giving RN’s an incentive to go back to school to become a nursing professor. They should get a pay increase as they have to go through the schooling and change their career. This will make becoming a nursing professor sound like a good option, giving nursing schools more teachers. If these schools hire more professors, they will be able to have more students, resulting in more nurses in the end.
Overall, the nursing shortage can be solved, but it will take time and effort from many people. Like every complex problem, there is not one simple answer. However, by looking at this problem from the view of nursing schools, patients, and nurses, I feel that I was able to form good ideas to decrease this issue. I believe that this question is worth exploring because it would help everyone. If there were more nurses, health care would improve and be more beneficial.