Research Paper on How To Overcome Nursing Shortage by Hospital Management

1.0 Summary Overview

The research paper aims to fully address how hospital management can overcome the shortage of healthcare nurses. Research has found various concerns raised worldwide about the shortage of nursing staff turnover because of the further growing concerns on the aging population. The paper further aims to do the literary analysis of the article “Nursing shortage in the public healthcare system: an explanatory study of Hong Kong. Literature review suggests the various consequences and reasons for the nursing shortage (Leung et al., 913). The research paper consists of making a literary analysis. The first part is the systematic literature search. There is the employment of review to explore the key determinants that cause the underwhelming nursing shortage. The additional part explores a survey study conducted to investigate the correlation between the intention of the nursing staff leaving and the various job dissatisfaction factors in Hong Kong public health care systems (Leung et al., 914). The methodology and data analysis is also presented in the survey study of the literature review. The literary analysis also analyses and presents the results, discussion, and conclusion of the as given by the literary study review. Healthcare services are in high demand in the health sector, which is gradually and continually increasing, which possess a threat to the various hospital management on how they will overcome the challenge of shortage. The hospital management has put on various strategies to ensure the retention and enrolment of more nurses in healthcare.

The main cause of the nursing shortages in the health care systems is the high nursing education turnover rates, voluntary retirement schemes and reformation of nursing education (Leung et al., 920). The worldwide population has gradually increased over the past years, which has resulted in an increasing demand for healthcare professionals. The increased population of aging baby boomers has mainly resulted in the increased need for surplus healthcare services. These changes have stretched the current healthcare workforce, especially in western countries such as the US, Australia, the UK, Italy, and Germany, China. The prevailing nursing shortage in China and the US poses a great threat to the healthcare industry and overall patients’ care. According to Marc et al. (11), there is a high population of individuals turning 65 years, which means an urgent need to meet healthcare needs. Therefore, the challenge of the nursing shortage needs to be thoroughly understood for solutions to be sought. That will be achieved by studying the significance of the challenge and planning to resolve the problem through quality improvement techniques. It will also be appropriate to focus on the roles that nurse leaders have in mitigating the challenge in the public health care of Hong Kong.

2.0 Literary Analysis

The systematic search and review of the personal planning in the public healthcare system were literary searched using the method of evidence-based to explore the major nursing shortage determinants. The searches and data sources where the systematic search was on Science Direct and Emerald where their search terms were ‘personal planning,’ public healthcare system in the personnel planning and ‘public health system’ which was without any relevancy to ensure broader capture of all the studies (Leung et al., 917). The journal articles that fulfilled these conditions were in the inclusion criteria; written in English, published in peer-reviewed journals, published between January 2004 and December 2014, and available as full text. The search of the articles began, and they found 2219 articles. By the end of the screening, the excluded articles were 297, which was based on their duplication within the databases, and the articles that remained 1344 were excluded based on the irrelevance of abstracts and titles (Leung et al., 917). The remaining 578 were analyzed well to remove those that did not relate to the nursing shortage. The review found anonymous articles that were 46 in number while the inappropriate articles for the research objective were 505, and the remaining articles, which were 27 in number, were thoroughly independently analyzed by the co-authors.

The recent studies provide comprehensive and updated data information, which describes the utilization of the current healthcare services by the elderly. The main cause of the public healthcare system nursing shortage, according to the article, is the undersupply of nursing staff which results from the nursing education reformation (Leung et al., 918). Several requirements are determining whether an individual qualifies to serve as a nurse. In research, an individual has to complete the associate’s degree or bachelors in nursing, after which they have to complete a national licensure examination. The nursing board is responsible for monitoring the curriculum to ensure that it meets the standards. According to Abhicharttibutra et al., 25), there is a predicted shortage of 53,000 nurses in 50 states and countries by 2025. The main reasons for the shortfall include voluntary leaving due to work pressure and the high retirement rates of baby boomers. Some of the challenges facing the practice include three minimal investments in nursing schools. The issue of minimal investment in the country’s healthcare institutions has translated into reduced interest among the students in joining the nursing sector. Thus, this has led to a reduction in nurse graduates and practitioners.

According to Park & Yu. (298), physicians and hospital management teams offer little support to RN’s clinical practice, which increases turnover rates. It also compels them to seek employment opportunities elsewhere while others change their occupation. RNs leaving the occupation also cite negative feelings like defeat, anxiety and lack of support as major contributors to the health providers’ turnover. Additionally, Marc et al. (11) identify negative work relationships and inexperience as contributors to the nursing shortage. The techniques that could be applied to reduce the nursing shortage comprise motivations like better wages and a conducive working environment. Adopting effective staffing models also contributes to feelings of appreciation and value among RNs, thus decreasing their chances of voluntarily leaving.

3.0 Consequences of Nursing Shortage

Nurse staffing is directly linked to patient care and the quality of services delivered. Therefore, a shortage of nurses decreases patient satisfaction since the overcrowding in hospitals prevents sufficient attendance to patients. Delayed patient admission, heavy workloads and increased patient mortality rates are also possible consequences for nursing shortage. Additionally, the shortage sometimes compels a country to hire and recruit RNs from other countries. That was experienced in China, Hong Kong after the 2005 nursing shortage that cost $78,700 for every nurse recruit hired from India (Leung et al., 924). The Chinese considered outsourcing for nurses from India to overcome the country’s healthcare system shortage. China opted to outsource from India due to surplus healthcare practitioners in the region compared to other countries.

However, various strategies have been implemented to combat the problem, and significant achievements are yet to be realized. For instance, statistics from the study indicate that nursing is one of the occupations that will experience significant growth by 2029. The workforce is expected to increase by 7 percent from 2019 to 2029, meaning there will be a high demand for nurses to replace the increasing vacancies (Park & Yu, 300). This research indicates that nursing schools have turned away many successful nursing programs since they have insufficient facilities to deliver the programs. This, among other reasons, has contributed to a decline in the nursing workforce all over the country. That issue needs to be evaluated to prevent drawbacks in nursing staffing.

4.0 How to Overcome the Shortage of Healthcare Nurses by the Hospital Management

4.1. Transforming Nurse’s Work Environment

The job dissatisfaction by various nurses, determined by the benefits, pay, and workload stress, should be addressed in the public healthcare system of Hong Kong since this is associated with leave work and is a significant cause of turnover factors (Leung et al., 919). Changing the hospital culture such that the work environment is observed is one of the measures. The culture helps work on positive employee relationships and promotes employee satisfaction. Improving work processes might also contribute to feelings of value among nurses. Most of the time, nurses are assigned redundant roles landing different handing equipment to doctors, which demotivates them. The mismatched demand and supply for nurses in the healthcare industry can be eliminated by transforming hospitals into healing environments that can promote better working cultures and facilitate patient care.

According to Wei et al. (684), it would be appropriate to combine clinical and administrative roles, which help them develop their careers. The physical design in health facilities also plays a role in nurse retention. This is because it protects the patients and caregivers against infection and injuries. A safe design relieves nurses from work relate stress 5 increasing their chances of retaining the job. Finally, investing in research helps health facilities discover the causes of turnover. It might also facilitate them with ideas on improving work environments and meeting the priorities of nurses.

4.2 Increasing Employee Engagement

To ensure there is employee satisfaction, the hospital healthcare management should increase employee engagement. Maintaining solid leadership and hiring qualified managers, and building good strategies to engage the workforce employee engagement will be achieved. Transforming the nursing work environment has been identified as the best solution to the nursing shortage. First, it would be essential to advocate for policy change to address the nurse shortage issue. The consideration here should be the personal planning contingent since it will achieve continued improvements in organizational performance by nurses. The policy should seek to promote a work environment in nursing that is structured to attract new practitioners (Abhicharttibutra et al., 26). In this case, there should be strategies to promote increased salaries, better working conditions, and improved retirements plans. Such changes may attract current and future students to join the field. Such students may be convinced that the field offers promising and attractive career options. At the same time, they may be convinced that the previous aspects that made nursing attractive are not there anymore. Second, transforming the work environment may address burnout, lost interest, and compassion fatigue among nurse practitioners. This approach attempts to ensure changes in staffing to avoid workload, reduction in working hours to prevent fatigue, and reduction in the duties allocated to an individual nurse to prevent compassion fatigue.

In this case, hospital management is an essential aspect in enhancing the transformation of the work environment in the field of nursing. The hospital management has to carry out a project whose goal is retaining the nursing workforce in health facilities which helps reduce the shortage (Wei et al., 685). This effort may require having a better work environment that is supportive of the individuals in participation. A structured implementation plan is essential in planning personnel, actualization, and a conducive work environment, hence curbing turnover. The plan consists of the resources, actions, shareholders, and budget. The evidence-based practice model will be an essential tool and option in guiding the implementation phase of this project.

4.3 Health System Improvement through New Regulations and Policies

Healthcare management should participate in events that provide opportunities to raise and voice concerns about the nursing shortage in the public healthcare system. The specific health institution to conduct the project is the hospital management workplace. The first step in implementing the progress entails informing the executive management in the institution and requesting their approval for new policies and regulations (Marc et al., 11). This step requires making the administration or executive management aware of the nursing shortage issue in an organization. At the same time, the administrators should know about the establishing need to have the issue of shortage addressed and remedied to prevent it from going worse in affecting patient outcomes. It will also be appropriate to present the goal that the project aims to achieve. These goals improve the nurse work environment by adjusting the hospital culture and changing some parts of the hospital (Abhicharttibutra et al., 28). The list of key stakeholders in the project and the time frame are presented to the executive management for approval. The only challenge with the plan is that personal reasons contributing to the nurse shortage are not addressed. The major focus is achieving a better work environment for nursing staff.

4.4 Investing in Nursing Education

Healthcare management should encourage educational opportunities for further growth for the employees. Investing in nursing education will facilitate willingness to stay and guarantee lower attribution (Leung et al., 919). Here, the materials to use in the project are procured. The efficient design promotes space, ventilation and eliminates hazards in the nurses’ work environment. Also, documents containing signed agreements to make changes to the hospital’s functioning are presented. Like adjusting the hospital’s culture and education, some changes include adopting advanced communication models that improve communication between nurses and physicians (Park & Yu, 301). An improved way of handling grievances also contributes to positive work relationships and teamwork, thus improving the work environment. This will reduce the shortage of nurses as most nurses will have a good working conditions.

4.5 Communication Plan and Decision Making

Communication between hospital management requires each one of them to create emails where information is passed daily. A draft of the progress is also made available to remind employees of their daily duties. The design team is also provided with an outline of the desired physical environment. Memos will also be drafted to inform the staff on the adjustment and the expected hospital culture for early preparedness. The hospital management workforce also needs to achieve specific goals as planned, thus requiring newsletters to reflect the same (Abhicharttibutra et al., 27). Roles are also assigned to each team member where some design the working areas and constructing required structures. Other nursing members moderate the training sessions where effective interpersonal skills are facilitated. The most affected departments in the health facility are given special attention, for instance, the emergency department in our case. The departments should be put into consideration in making the changes. These departments should have notable additions in the number of practitioners to enhance efficiency in handling emergent and demanding cases (Marc et al., 14). Allowing nurses to participate in decision-making will have them interested in working and remaining in work due to autonomy.

4.6 Training, Promotion and Motivation

To ensure that every nurse in the healthcare system is ready for their task, education sessions should be established for mastering skills. The physical and virtual tools to be applied in the project should be usable, thus requiring training. For instance, PowerPoint presentations to explain the proposed hospital culture. Conducting various meetings with hospital management managers helps identify any errors in the realization of the goals. It is also possible to correct the errors for the adoption of 8 better techniques. These training sessions should also be extended to staff members in the hospital, especially to meet positive work relationships (Abhicharttibutra et al., 29). The training requires projectors and laptops to demonstrate slides to ensure policy interventions like enhancing and aligning workforce planning capacity. A spacious and equipped room is also needed to conduct some training sessions. This will ensure

4.7 Evaluation and Follow-up

To acquire feedback on the progress, specific hospital management members are expected to remain at the facility observing the changes in the nursing work environment. The individual should use special techniques to detect whether the changing physical environment is satisfying. Follow-up also indicates the efficiency of adopting and applying the change in a hospital organization or facility (Park & Yu., 301). In addition to observation, survey questions can be distributed among nurses to learn about their progress after restructuring the hospital culture and external environment. Oral surveys can be used in case the staff is too busy to respond. After six months of strategy implementation, the progress is assessed to determine whether some of the goals have been achieved. The feedback acquired will be a final determinant of whether other health facilities should adopt the changes to promote a conducive work environment. Finally, the evaluation progress should be informed to the executive staff after achievement in every step.

5.0 Hospital Management Role in Healthcare

Nurse leaders have a role in healthcare management as they are entitled to quality improvement in health facilities. They have to be equipped with project management skills and strategies that require them to know their roles at every stage. They are responsible for budgeting, managing costs and observing the timeframes for efficient achievement of the set objectives in specific projects (Abhicharttibutra et al., 24). The management should be aware of the expectations or outcomes of each stage in the project. They should provide carination to the organizational management and administrators on the expected timelines and outcomes associated with each stage or the overall project. Therefore, the role of nurse managers in healthcare will begin in the initiation to planning, implementation, and monitoring stages. The management plays a crucial role in carrying the vision of the project. Their organization entrusts them to ensure the maximum potential of the resources allocated in a specific project.

In the first phase, which is progress initiation, the management is responsible for assessing the proposed changes in improving and overcoming the shortages. That includes examining the set objectives and goals to determine whether they are valid. The nurse manager also determines whether the progress is realistic by conducting a cost-benefit analysis. They must have an idea of the time, workforce, and a rough budget to realize the goals. If the leader discovers the aspects align with their expectations, they allow the changes to move to the next stage. If the changes entail collecting primary data, the nurse manager must have an idea of the best places to acquire viable data to be applied in a project change. These measures are essential since healthcare projects are often adopted and implemented in healthcare institutions aiming at quality care delivery (Marc et al., 11). In this case, other healthcare stakeholders might emulate the plan to reduce the nursing shortage in their institutions, creating accurate projects.

The second phase entails planning, where the implementation procedure and all the requirements are tabled. According to Wei et al. (682), the leader is expected to observe the existing healthcare trends to form effective plans. Specific and transparent details concerning the project are outlined. For instance, the leader determined the specific material and amount of money spent in every activity. Additionally, individuals in the project changes are assigned specific roles until the goals are achieved. A wise nurse leader should incorporate stakeholders in planning healthcare projects. The individuals and institutions targeted depending on the nature of the project are indicated. The leader concludes the phase by setting timelines for every step in the project implementation.

The third phase, which is implementation, also comes with various roles for management, who, in this case, are our nurse leaders. This phase or stage entails applying or adopting a change or project in an organization or healthcare system. The management is already aware of their roles, ready to execute them. Every member is aware of their contribution in ensuring that the project becomes a success. According to research, the success of a project is determined by the role of every team member. Therefore, the leader ensures that all the stakeholders have the required documents and tracks their schedules. They are also responsible for tracking all the expenses and ensuring that communication flows seamlessly.

Additionally, it is their role to foster positive work relationships among project team members and address any concerns arising during implementing strategies for overcoming nursing shortages. (Leung et al., 928) The nurse leaders should demonstrate their advocacy skills, for instance, in communication, problem solving and teamwork. If some of the plans fail to work as planned, the nurse manager is responsible for achieving the target regardless of the challenges. As the vision holder, the project manager ensures that all the planned activities take place accordingly to realize the goals.

The final phase is monitoring, where the hospital management evaluates the healthcare services progress. The evaluation may include the assessment of the overall performance of the services. The phase is essential in determining the successes and deficiencies in ensuring there is overcoming of nursing shortages. In this phase, the leader identifies the possible errors and plans modifications. The leader is responsible for assessing whether the set goals are achieved as planned earlier (Wei et al., 686). In this case, the leader’s role in the monitoring phase will be to analyze whether the contributors to the nursing shortage are mitigated. They will also evaluate whether the adopted measures contribute to a safe and positive work environment to reduce turnover among the nursing staff. The nurse can utilize Lippitt’s Seven-Step change theory to perceive the changes and decide whether the desired outcome is achieved. The theory entails diagnosing a problem, fixing it and evaluating the capabilities of change. If the evaluation changes are complete, the hospital management has a role in closing the project changes and closing means that the measures are sustainable and the prevailing problem has been solved about the shortages of nurses.

7.0 Conclusion

The shortage of nurses can be concluded as to be problematic, but it does not have to be if we implement a few changes. The hospital management needs to be one step ahead of the shortage, subsidize training, recruit foreign nurses, integrate robots into the workforce, find ways to retain the nurses now in the workforce and do the nursing recreation of the roles. We can tackle those solutions over time, but the one we can implement right now is providing daycare for the whole staff and the nurses who feel that they cannot balance their home and

work life. This research paper study was completed to explore the strategies to be used by the healthcare management in overcoming the public and private health care nursing shortage. The strategies that emerged were Promotion and Training, improving the healthcare system through new regulations and policies, a positive work environment, investing in nursing education, increased employee engagement, and developing better communication programs (Leung et al., 920). The research concludes that when nurses are not pleased with communication, work environment and are less engaged, they are likely to leave their job. When nurses are happy with the communication, engaged by leadership, and the work environment is enticing, they are more pleased and more productive. Healthcare management should become more involved with their nurses and consider implementing the strategies discovered in this study if they want to overcome the nursing shortage in the future.

Nurses are the vital forefront in the healthcare forefront. There is a global shortage of nursing globally due to the basis of high population growth, poor working environment and search for better income by different nurses’ staff which causes them to migrate to other countries or to private sectors, which leads to an increase in demand in retaining and recruiting nurses. This has made various governments encourage students by giving them higher income, high standard of education levels, and improving the staff by offering them training and motivation to continue with education (Leung et al., 920). This government’s mission in doing this is to improve and prove their effective roles of the national nurses to overcome shortages of nurses. Additionally, it improves the quality of care being given to patients as their knowledge and expectations are significantly increasing. Every government is entitled to prioritizing, ensuring better outcomes are achieved in private and public healthcare systems.

As the demand for nurses increases rapidly due to the rising population, aging individuals, and inpatient numbers globally, more individuals are covered in the healthcare system reforms. Thus, hospital management must do their best to retain and recruit the best-qualified nurses by creating a positive atmosphere that recognizes the nurse’s staff and offers them the advancement opportunities to strengthen their voices in making the demands in the system (Leung et al., 921). Global healthcare organizations have started keeping nurses amid the emerging threats of nursing shortages in the public healthcare system. Additionally, the hospital management has decided to listen to nurses’ voices and promote their career development as a strategy and recommendation to end the nursing shortage in the public healthcare system. Finally, the hospital management has recommended that the nurses decide on their work schedule by depressing their emotional and demanding shifts, which thus keeps nurses at the schedule to plan and create a more positive working atmosphere in the healthcare system. The findings and discussions in the study article have helped make strategic policies in resolving the nursing workforce shortages. This policy will develop and redefine the policies that the hospital management will use to strengthen and address the nursing shortage in the public healthcare system.

Bibliography

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