Nursing Challenge Essay

Tags: nursing shortage patient safety swot analysis patient care

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The shortage of nursing staff remains a major challenge in the U.S. According to the American Association of Colleges of Nursing (AACN) (2014), the shortage is expected to be even greater in the next one decade or so. The shortage has been fuelled by factors such as reduced enrolment into nursing schools, increased retirement of the nursing workforce, as well as higher demand for healthcare due to population ageing and greater incidence of lifestyle diseases (AACN, 2014).



The shortage of nursing staff has severe implications for the nursing workforce. A high number of patients relative to nursing staff often translate to increased workload for nurses. Indeed, nurses continue to grapple with unhealthily lengthy work shifts, often stretching up to 12-13 hours. It is an issue that has sparked a great deal of debate given the connection between excessive workload and nurse outcomes. Literature extensively demonstrates that excessive workload as a result of insufficient staffing is a significant predictor of stress, burnout, and job dissatisfaction amongst nurses (Buchan & Aiken, 2008; Carayon & Gurses, 2008; AACN, 2014). There have even been instances of nurses leaving the profession in search of more fulfilling jobs. The negative effects of inadequate nurse staffing affect not only nurses, but also patients. It may increase instances of medical errors and hospital-acquired infections, as well as worsen nurse-patient and interpersonal relationships, eventually increasing patient dissatisfaction (Carayon & Gurses, 2008). Therefore, nursing staff shortage is an issue that deserves more attention than ever given.

The System/Organisation



The shortage of nursing staff is particularly evident at the author's organisation, a full-service, not-for-profit community hospital established in the 1960s. The hospital has a capacity of approximately 250 beds, and delivers both inpatient and outpatient services in disciplines ranging from primary care and emergency care to cardiology, oncology, reproductive health, gynaecology, behavioural therapy, endocrinology, dermatology, orthopaedics, and surgery. With a relatively flat structure and driven by a patient-centred philosophy, the hospital seeks to enhance community wellbeing by fostering relationships between the organisation, staff, and patients.

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The organisation believes in the creation and maintenance of an atmosphere where exceptional and high quality care is delivered and recognised by patients and their families as well as members of staff, volunteers, partners, and the community at large. The hospital envisions being acknowledged as a leader in patient care in the services it offers.



The shortage of nursing staff creates a gap between the organisation's statements and practice. To exceed the expectations of patients and the community it serves, the organisation requires an optimal nurse-patient ratio. Adequate staffing is important for ensuring optimal nurse workload, patient safety, as well as healthy nurse-patient and nurse-nurse relationships. As described by systems theory, a system comprises several interrelated elements that work together to achieve a specified objective (Bielecki & Stocki, 2010). Nursing staff comprises one of the crucial elements in a hospital system. They provide primary care and support other members of the interdisciplinary team in delivering care to patients. Accordingly, deficiencies in nursing staff can be detrimental to the hospital as a whole. It can affect not only nurses, but also doctors, patients, and the reputation of the organisation.

SWOT Analysis



A major strength of the organisation emanates from its patient-oriented culture. The organisation recognises the patient as the most important stakeholder. Even the design of its facilities reflects its patient-centeredness. The hospital is designed based on the Friesen concept, which entails stationing nursing alcoves outside every patient room. This increases contact between patients and nurses, and ensures closer proximity of medications, supplies, and records to patients. The organisation's patient-centeredness has seen it perform quite impressively in terms of nurse-patient communication and staff responsiveness. Other important….....

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References


American Association of Colleges of Nursing (AACN) (2014). Nursing shortage. Retrieved from: http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage

Bielecki, A., & Stocki, R. (2010). Systems theory approach to the health care organisation on national level. Cybernetics and Systems: An International Journal, 41(7), 489-507.

Buchan, J., & Aiken, L. (2008). Solving nursing shortages: a common priority. Journal of Clinical Nursing, 17(24), 3262-3268.

Carayon, P., & Gurses, A. (2008). Chapter 30: Nursing workload and patient safety -- a human factors engineering perspective. In R. Hughes (ed.), Patient Safety and Quality: an evidence-based handbook for nurses. Rockville: Agency for Healthcare Research and Quality.

Kelly, P. (2012). Nursing leadership and management. 3rd ed. Boston: Cengage Learning.

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