Global Nursing Shortage and Impact on Health Care Environment

In recent years international health care organizations are more and more recognizing the impact of nursing shortages in every aspect of health care delivery. Many health care delivery systems are increasingly recognizing the threat recurrent shortages of registered nurses impose on the health care system (Krall & Prus, 1995). This trend has become increasingly apparent from about the mid 1980s through the present, with concerns over nursing shortages leading many health care specialists to explore â€Å"the dynamics of the nursing labor market using neoclassical labor market analysis† (Krall & Prus, 67). Using this approach many suggest that chronic nursing shortages in the global market result from depressed wages and excess demand, and that hospitals tend to command â€Å"monopsonistic power† when it comes to nursing management (Krall & Prus, 1995). Under this line of thinking hospitals have traditionally resulted to substituting less skilled nursing personnel in place of RN's when the need arises to cope with nursing shortages, potentially decreasing the quality of care afforded patients and customers of the hospitals. One thing is certain; the future of the modern global health care organization is uncertain in light of chronic labor shortages among qualified nursing staff (Epstein, 1999). Many health care organizations are seeking alternative methods to provide patients with the quality care they need despite nursing shortages. Many are resorting to more emphasis on preventive care while others are branching out into the community in an attempt to identify community resources that may promote more support for patients in the health care environment (Epstein, 1999). Heirich (1998) notes that it is vital that health care organizations rethink the health care delivery system in order to provide the innovation necessary to accommodate the rapidly changing world economy and global health care environment. Old formulas for funding health care no longer work; health care costs continue to rise. Many organizations are focusing on cost control, which may include budget shortfalls when it comes to compensating nursing staff. More and more however health care organizations are also realizing the need to focus on adequate compensation and attention to nurses and nursing shortages. New business and health coalitions are forming in major metropolitan areas to help control costs and also attract more qualified personnel, stimulating physicians and nurses as well as other providers to work together to improve service delivery in light of new health care challenges (Heirich, 1998). Future of Workforce Design and Organization As health care organizations are changing in response to chronic nursing shortages so too are organizations re-evaluating workforce designs and organizational development within the health care setting. More and more the emphasis within the health care community and organization has been creating more flat organizational structures and global enterprises that encourage cross collaboration or multi-disciplinary approaches to health care delivery (Heirich, 1998). Chronic labor shortages of nurses in the global workplace have encouraged healthcare organizations to adopt new strategies for attracting qualified personnel. In Britain for example, long standing labor shortages among nurses has resulted in dire efforts to recruit migrant nurses from other countries (McGann & Mortimer, 2004). Other organization's including the Illinois State Association are considering recognizing various grades of nurses, including nurses with twelve months vs. urses with twenty seven or more months of training, in an effort to provide more and lower cost nursing care for patients (McGann & Mortimer, 2004). Nursing workforce design is increasingly taking on an interdisciplinary and collaborative approach, with more nurses and health care staff trained in a diverse array of services (Clark & Drinka, 2000). More health care systems are developing teams that consist of a nurse, doctor, nurse practitioner, social worker and other community members that provide a mix of services to patients (Clark & Drinka, 2000). Such efforts may help relieve some of the burden associated with nursing shortages while still ensuring that patients are cared for and offered the highest quality services possible in the health care setting. Health care organizations are also working to involve nursing staff more in decision making processes in an attempt to increase job satisfaction and promote reduced turn over and greater loyalty among qualified staff, as many nursing shortages have been attributed to overworked nurses and lack of job satisfaction (Clark & Drinka, 2000). More and more workforces are designing systems that allow nurse practitioners to provide feedback and work in an environment that is more supportive even in light of chronic over scheduling or nursing shortages. Impact Nursing Shortage on Education and Training Educational facilities are increasingly realizing the need to cross train staff to work in a variety of settings to cope with nursing shortages. Additionally more and more educational institutions are promoting team building skills training to promote greater collaboration among nurses and among other health care professionals. The chronic global nursing shortage has affected the future of nursing education, encouraging more training program development with emphasis on training nurses in other skill areas including stress management to cope with increasing burdens associated with under staffing and increasing job demands (McGann & Mortimer, 2004). Mosley (1998) suggests that the health care delivery and training model is shifting to move from more individual patient care to care in an integrated environment or system that affords a continuum of services . In this environment accountability for the health and well being of patients moves from a single nurse or care provider to multiple members of the health care team. This wellness model is increasingly promoted in educational facilities where potential health care providers and nurse trainees are taught to include community organizations, family, physicians and individuals as part of the health care team working to promote the health and well being of patients. The new model for educating nurses includes more diversity training so nurses are capable of working with diverse patients from diverse backgrounds (Clark & Drinka, 2000). It also includes an interdisciplinary approach to training that cross-trains nurses and other health care staff members to work in various settings and under dynamic conditions. Despite these efforts chronic shortages still exist with regard to attracting and retaining competent staff. Many educational facilities are realizing decreased enrollment in nursing programs, in part because many perceive the field of nursing to be one that is over taxing (Clark & Drinka, 2000). Educators will have to work diligently at highlighting programs that provide potential nursing students with the skills necessary to face the new challenges associated with working in a global nursing environment.