A man named Jay Vandemark at the age of forty-seven who had a stroke last year roamed the halls of Beechtree Center for Rehabilitation & Nursing with not a single nurse in sight that could help him with putting on his shirt (Rau, 2018). Vandemark described the nursing home as being almost like a ghost town (Rau, 2018). Stan Hugo, who’s wife Donna is a resident at the facility, visits his wife daily at this center. And while he is there he monitors the amount of staff he sees tending to the residents. His wife has Alzheimer’s, is no longer capable of speaking, and is wheelchair bound. So when he is there he sits next to her while at the same time he keeps an eye on the amount of nurses there are on the floor providing care for the rest of the residents in the facility. As stated Hugo goes there to keep track of how many nursing assistants he saw helping the other residents, so during lunch time as he fed his wife he observed the environment in the facility. He even went to the extent of deciding to take pictures of the amount of staff he saw and everything else he observed while he was there. As he sat there and fed his wife he claimed that he only counted two nursing assistants for the forty residents that were there in the facility. And although family members see this as striking and blame the nurse’s for not being there to address the needs of the residents promptly, nurses and nursing assistants have to go through the constant struggle to serve meals and aid in feeding the residents who are not capable of eating on their, answer call lights to address residents needs such as for pain medication or other needs, or even to help aide a resident to the bathroom (Rau, 2018).
And they sometimes struggle to do this in a timely manner, not because they are lazy and don’t want to provide care, but because they are short on staff. That is not the fault of the nurses but of the facility as a whole for not hiring and scheduling more nurses to work. Residents in nursing homes need to get bathed, dressed, and fed every day but the worldwide problem of there not being enough nurses leaves the aides scrambling to try to address everyone’s needs and concerns. And because of this residents who need more attention from the nurses are overlooked and complications occur that lead to hospitalizations that could have been avoided in the first place if there was a sufficient amount of nurses or aides for the residents. An incident of another resident, Effie Hamilton, who also is also a resident at Beechtree Center for Rehabilitation & Nursing fell victim to getting hurt because of the shortage. Hamilton is blind and fell out of bed and had to be hospitalized due to dehydration and septic shock. Her falling out of bed led to the discovery of other conditions she was in. Since incidents like this constantly kept occuring there was an investigation because of all the complaints, only to find that there was low staffing on the days where incidents like this took place.
Does a nursing shortage in nursing homes affect patient care?
There are a lot of impediments that come with pursuing a nursing career. For many years nurses have faced a variety of different obstacles that impede them from being able to provide the services they want and are expected to provide to the community. Individuals who seek a career in the medical field can almost all relatively agree that they want to provide the best care to their patients/residents while working in a good environment. But that is not always the case because there are a variety of different barriers that stop a nurse from doing so. The current issues that nurses have been facing for years is there being a nursing shortage and facilities they work in. Facilities such as nursing homes are being sued because of this issue that has been at hand for years. There not being a sufficient amount of nurses in nursing homes ends with residents not being attended to promptly and incidents such as a resident getting harmed like the example stated above or even to the drastic measures of death can occur. And majority of the time nurses are burned out because of the load of work that is put upon them so they end up leaving the job. But by doing so they leave the stress of work on the other nurses and making the epidemic of a nursing shortage even bigger. The nursing shortage links back to old times during World War II, so it has been around for many years and still continues to be a current barrier stopping nurses from being successful in their career.
What factors are the cause of the nursing shortage?
The nursing shortage has been seen all throughout history, the same factors that date back years ago are the same factors that are still seen in current day. In an article I found, A Historical Perspective on the Nursing Shortage, written by Edith West addresses the prominent elements that have caused this shortage and discusses and compares the struggle nurses have had in the past to now in current day. Evidence that proves this to be true is when West states Recruitment and retention problems, public image distortion, and negative work environment have been the major contributors to nursing’s continual shortages throughout the years (West, 2007). Other healthcare providers that work alongside nurses can also agree that this shortage has a negative impact on the working environment of medical professionals. This only makes it difficult for departments such as hospitals to recruit more nurses. This shortage is not an issue that is just solely focused in one particular area, it is a worldwide issue that is only continuing to get worse. The article goes into depth about the causes of the nursing shortages that has stayed active over the years. West also states Consistently stressful work environments with little monetary or prestige incentives for nurses have been a mainstay in nursing history (West, 2007). This shows how the same problems regarding wages have stayed evident in the nursing workforce throughout history without any solutions.
The author goes on to also include responses from nursing students who were in training 59 years ago, a majority of the student nurses left in the middle of the training in the 1940s which added to the shortage epidemic. They made these decisions because of the unfair working of routine by retention of nurses on duty after time for relief, without compensation (West, 2007). In addition this shortage continued because in 1948 students described the working environment as being unfair with harsh hours. These shortages did not resolve so another solution they came up with during this time was to create more fast track nursing programs to speed up the program time with the hopes of having more trained nurses quickly so they could jump into the workforce right away. There was some effort put in to try to find a solution, the author goes on to state in the year 1940 the Cadet Corps was instituted to facilitate entry into the profession with accelerated training as demand exceeded supply of nurses during World War II (1941-1945) (West, 2007). This shows how some changes were made in hopes that the shortage would become a less prominent issue, but even after the war the shortage continued. These accelerated nursing programs were implemented but it still did not fix the problem. As stated changes can be made, wages can increase, benefits for nurses can increase and will ultimately attract nurses into the profession; but, if the working environment remains the same then it will do nothing to stop this shortage.
Another book Nursing Student Retention Understanding the process and Making a Difference written by Marianne R. Jeffreys addresses in her book the issues students who want to get an education in this field are steered away from completing their education because of the academic issues and environment issues they face when they are beginning to get into the field. Like every other source they state the similar factors that contribute to the nursing shortage progressing and the outcomes that are resulting because of the shortage. The author talks about the outcomes and states patient safety issues, mandatory overtime, lack of whistleblower legislation, nurse dissatisfaction, low nurse morale, unsafe work environments and plenty more factors such as poor salary that result in a high dropout of new nurses from their career and only lead to the shortage being even bigger (Jeffreys, 2004). This comes to further prove that the same issues in the nursing career that were seen in the past are the same as today, so this issue is basically the same all around. Nurses leave the field because of the same elements that have been seen for years. The author goes on to state how some improvements and strategies in this field can be made to provide students with better opportunities in the working environments. Jeffreys solutions to this epidemic is to guarantee nursing students with jobs right upon completion of their education and raising the salaries of nurses to attract more nurses and have enough to be able to work as a team instead of having one solely suffer on their own trying to take care of a large amount of patients. However there can be a lot of things said about what changes should be made, but if they aren’t any actions made towards it then there are not going to be any improvements to fix this problem.
Does the shortage only affect nursing homes or are other facilities also affected by this shortage?
This shortage is not limited to only a specific area, it is worldwide and is seen in many different states around the world. The book written by Feldman The nursing shortage: strategies for recruitment and retention in clinical practice and education includes some of the different states in which this shortage is seen as well as the different facilities this is a problem in. The shortage is not only seen in nursing homes, it is an issue also seen in hospitals. In the year 2001 The Association of periOperative Registered Nurses (AORN) also had great concerns about the shortage of nurses. This organization has voiced concerns about and provided anecdotal reports of patient injuries, or near misses, related to staffing shortages (Feldman). This illustrates how this shortage is not just happening only in nursing homes, the same circumstances are also occurring in hospitals. Accidents/Incidents that have occurred in hospitals in which a patient suffers an injury ties back to them being short on staff, the problem is so huge that facilities have even needed to reschedule or cancel surgeries because of being short staffed. This book also discusses that the current nursing shortage is happening as a result of a decline in nursing school enrollments, an aging workforce, and competition for getting into departments. In the year 2001 it was expected for the nursing shortage to double because many of the nurses are going to retire and that does not include the predictions for the upcoming years.
It is difficult to solve this issue because the demands for nurses are high but it is also hard to attract and keep nurses working in their profession because of the stressful environment they are in constantly. This book also addresses how the reality of nursing for the 21st century consists of a workforce shortage that is seen as one of the most damaging health care crisis of our time (Feldman, 2003). Another article Modeling the benefits of cross-training to address the nursing shortage, written by Jomon Aliyas Paul and Leo MacDonald also subsequently talks about the nursing shortage and what outcomes are expected to be seen in the next couple of years. The authors state how the United states is expecting to face this issue being worse than it has ever been by the year 2020. The issue has brought about a lot of concerns that are expected to be seen more in the future. A more thorough explanation of the issues that are expected to be seen more is regarding patient safety concerns and affected the hospital staff’s ability to detect complications in patients, potentially leading to increased patient death rates (Aiken et al., 2002, Stanton, 2004). This correlates to the patient’s safety owing to the fact that with the shortage of nurses in these past years may lead to an obstruct path of overwhelmness on the nurses due to the many responsibilities to care for many patients, thus having to neglect some which ultimately resulting in sickness or even death.
How have circumstances for nurses changed from the past to now?
In another article NURSES ON STRIKE from the Encyclopedia of Strikes in American History talks about how the nurses are tired of the issues they are facing and are beginning to strike to try to have changes implemented to improve the working force of nurses. It addresses the issue of not being compensated enough for the work they do and also includes how in the past nurses would only have to take care of four to five patients; but, now they are going as far as taking care of 11 or 12 patients which is taking a toll on nurses. While obviously this career is focused on patients and their health, it also needs to focus on nurses and their health as well. Like stated the history of this goes back to the 1900s. In the year 1913 nurses began to form organizations to address the problems nurses have in their working environment.
In a book The Trade Union Woman, written by Alice Henry talks about the reasons why nurses are leaving their field and what changes have been made since this shortage started being addressed. Henry statesNurses and attendants in several of the state institutions of Illinois have during the last two years formed unions. Since this statement was made they have had hours shortened from the old irregular schedule of twelve, fourteen and even sixteen hours a day to an eight-hour workday for all, as far as practicable. The State Board is also entirely favorable to concede higher wages, one day off in seven, and an annual vacation of two weeks on pay (Henry, 2004). This demonstrates how the medical field has made an effort to try to find a resolution for this constant issue by trying to improve the job and making it more manageable and providing a higher salary. However, although there have been changes in some areas, there is no current evidence showing the shortage from stopping or slowing down.
Does gender play a role in the issue?
Another issue that seen that dates back to the past is how there is not a lot of men who are pursuing a career as a nurse. This occupation has always been seen as primarily a women’s job which has steered men away from wanting to pursue this career. Women were usually the ones to dominate the nursing profession. But there were changes made in order to increase the number of men in this field. Men were not involved in the nursing career because from the year 1901 until after the Korean War, the military excluded the men from being able to serve as a nurse. Men were not allowed to join the organization until the year 1930. So the only nurses that were seen during that time period were only female. However there was an increase from 1% in 1966 to 6% in contemporary times (Zupancic, 2004). But regardless of the small increase the female gender still dominated the male gender in this profession. The lack of males being interested in a nursing career was also a contributing factor to the shortage. But more males are beginning to choose this profession as a career, and more and more male nurses are now being seen in medical facilities.
What happened at the Beechtree Center for Rehabilitation & Nursing is a tragedy but it is even worse that these incidents are continuing to happen in other facilities as well. The obstacles nurses have faced in the past are the same complications they continue to experience in current day. Despite the fact that there have been changes implemented throughout the years in regards to attempt to resolve these conflicts, no solution solving improvements have been successful. And because of this the nursing shortage continues to get worse and is predicted to become an even bigger issue in the near future. The changes that have been made have not worked over the years and they still are not working, it is not attracting more nurses to join the field and not convincing current nurses to stay in their career. But I hope in the years to come there are improvements made to make the working aspects of this profession that will benefit both the nurses and most importantly the patients.