The shortage of nurses across healthcare sector in the United States raises numerous issues of concern about the quality of healthcare services that are being provided in different facilities across the United States. The low nurse to patient’s ratio in most of the clinical settings across the country coupled with the high turnover rates witnessed in the nursing profession is wanting (Daniel Wright, Bretthauer, & Côté, 2006). The spiral decrease in the number of nurses has not been addressed over the years, compounding the problem on a yearly basis. If the current condition is not solved then, there are higher chances that in the long run the quality of treatment in most clinical settings will significantly reduce and the effect will be felt more with the ever growing sick populace (Nardi & Gyurko, 2013). Numerous other factors have contributed to this condition. They include poor satisfaction rates due to poor salaries and work overloads as well as an ever increasing population of old nurses nearing the retirement age with a population of younger people who seem uninterested in careers like nursing due to the nature of the job and the way it is portrayed in the society (Nardi & Gyurko, 2013; Siela, Twibell, & Keller, 2008). Also, nurses have opted for different career paths with some investing most of their time in activities such as business that seem to be associated with more profits in the long run as compared to their nursing careers.
Some proposals have been passed back and forth over the years with the sole aim of retaining nurses in their career path as well as increasing the number of new nurses who join the profession. Such states as California imposed the mandatory nursing ratio which seeks to reduce work overload in the nursing profession by ensuring that there is an increase in the nurse to patient’s ratio which can deal with the ever increasing number of patients across the healthcare setting (Tevington, 2011). Having a mandatory staffing ratio will ensure that the issues related to satisfaction levels among the nurses are addressed adequately. In other words, it means that all issues, especially the key issue that relates to high turnover rates, will have been directly dealt with. High turnover rates across the healthcare setting were witnessed due to the issues related to satisfaction, with the overworking of medical staff being the key one. The mandatory staffing requirement has not been embraced by most states which have complained of the high costs of hiring nurses to reduce the gap. However, it is one of the few methods that could be used in reducing shortages in the healthcare settings. Other methods that could be applied include improving the working condition of nurses across the health care setting by providing promotions and opportunities for educational growth as well as engaging the current generation on the importance of becoming nurses (Daniel Wright et al., 2006; Toh, Ang, & Kamala Devi, 2012). Also, improving the payment structure of nurses as well as increasing the number of nurses who join the workforce on a yearly basis seems to be one of the best solutions that could be used in dealing with the current shortage.
Background of Issue
Shortage of medical practitioners and nurses in particular is an issue of concern because it started in the previous centuries. In the earlier medieval periods, the number of nurses was still low as compared to the populace that was supposed to be treated for different conditions. For example, the number of nurses required to treat wounded soldiers was quite low from the beginning. This problem has evolved through the years despite nursing being recognized as one of the best professions. The population continued to grow, and there has been an increase in the number of people who need adequate treatment while the number of nurses across the globe remains quite small to meet the demands of all of the sick individuals. The number of students taking nursing courses across the world is still too low to meet the needs of the population. Also, the number of old nurses in the system is too big and without a gradual replacement it will become more difficult to deal with the high turnover rates witnessed across different healthcare settings. Nurses like other professional have a critical role to play in the healthcare profession. It goes without aphorism that nurses need to be remunerated in the correct manner due to the heavy nature of their job. In the past different parties attempted to remunerate nurses in the right manner but they failed because of either high demands of the nurses or because different parties were not able to reach a long-lasting solution (Daniel Wright et al., 2006; Tevington, 2011; Toh et al., 2012). This is not to say that other state agencies and even countries have not attempted to solve the nurse shortages across different healthcare settings. It seems that the right solution has not been implemented in resolving the issue. In most cases, governments of the day have looked at the nurse shortage issues as a singular problem. The truth remains that there are many reasons as to why nurses leave their preferred profession. Therefore the government and all the other agencies should look at this problem as a multifaceted issue that requires attention before it spirals out. If this issue is approached as a multifaceted problem, then there are higher chances that it will bring better results and improvements in the nursing field as compared to earlier periods.
Political Setting, Structures and Evaluating Stakeholders
The political setting plays a key role in the formulation of policy that could help alleviate the current shortage of nurses. They formulate laws that are applied across different states. Some of these laws have been essential in reducing the nursing shortage. A good example of law formulated in the political setting has been the mandatory staffing ratio in various states such as California and now in Florida (Tevington, 2011). The political setting does not just engage in the formulation of laws which become policies but also in setting up systems and structures that provide oversight over the laws. For example, they assign relevant bodies to ensure that all healthcare agencies have the required staffing ratios and their salaries are taken care off.
There are different stakeholders who play an important role in the above process. They include the political class, members of the healthcare profession, private and public hospitals and the patients or populace at large (Siela et al., 2008). However, there are players who have a greater effect in the management of these conditions. Examples of such players include the political class who have a greater influence on policy formulation.
Value Assessment and Recognising Resources
A value assessment of the current number of nurses present in any of the healthcare institutions would help in solving the above crisis. First, it will identify the number of nurses that are working in the system and those that are required to meet the end goals in the future. This way the new nurses can be hired to deal with the shortage that the profession is currently. In essence value assessment helps to plan for the future of the profession.
Value assessment will also recognize the different resources that are required in implementing any of the associated changes that come with the formulation of any new policy that seeks to redress issues related to nursing shortages. In essence, it might determine the number of nurses who need to be paid and the type of resources that are supposed to be invested in any of the venture (Toh et al., 2012). In the end, it will also identify the available resources that are currently being utilized and could be diverted towards the achievement of the objective.
Intended Goals and Power Bases
The intended goal is the formulation of a policy that addresses the nursing shortage issues as a multifaceted problem. This means that a variety of issues will be considered in analyzing the problem. If the policy is adopted, there are higher chances that this problem will be solved and the issues such as nursing shortages will be in the past. For this to happen, the government and other agencies should invest more in provision of healthcare services and more so in the future plans that will stabilise the number of nurses working in the healthcare setting (Nardi & Gyurko, 2013; Roche, Duffield, Homer, Buchan, & Dimitrelis, 2015; Siela et al., 2008).
The power base in negotiating all of the above factors will remain in the hands of the unions that represent the nurses as well as the government which has a key role in ensuring that its populace receives the best form of treatment (Kendall-Raynor, 2013). Other important power bases that have an influence include the political class that represents the will of people and other stakeholders mentioned above.