Since the dawn of time, there has always been a need for more workers or employees. Very rarely was there a time with little to no job openings. In recent years the healthcare field has become in desperate need of more employees, especially nurses. With the covid-19 pandemic stress, workplace burnout, and payment issues, hospital units are growing sparse. Units that were not up to staffing before the pandemic are working extremely understaffed now. Some of the shortages are due to high levels of RN retirements with not enough new nurses entering the workforce to take their place (Buerhaus, 2021). There are many other influencing factors “including working conditions, increased number of patients, violence in the healthcare system… difficulty retaining new graduate nurses, lack of seats in nursing programs, and a nursing faculty shortage” (Perkins, 2021, p. 50). There is also work that nursing working under the stress of the shortages will become burnt out and leave the profession (Perkins, 2021).
Some hospitals in my area have been recently working under tight conditions and in some cases diverting patients to other hospitals with more staff and resources. I work in labor and delivery at my organization. At current, we have not had to divert obstetric patients, but that does not mean our ratios have been safe. Our unit is also very understaffed. With the specialty population of obstetrics, there is never a time when we know how many patients we will have on the unit. A woman can go into labor at any moment, which makes our staffing and assignments more difficult. Throughout our organization, agency or travel nurses have been hired to assist with the ongoing needs. On our unit, we have opened up incentive and contract shifts for interested staff members. We are staffing our own unit with our experienced nurses, while providing extra incentive and shift pay. This solution has saved our unit budget from hiring agency nurses, while keeping the unit closed to just our experienced employees. Although this is a good solution, it should be used temporarily to prevent burnout of current employees. It remains in use and many employees have left the unit due to work-life balance, burnout, and increased salary elsewhere. Burnout and compassion fatigue have created a huge issue in the healthcare workplace (Trepanier et al., 2022). I hope our organizations, litigators, and peers fight for workplace safety and allow for our wonderful nursing profession to remain strong and make a huge comeback.
Buerhaus, P. I. (2021). Current nursing shortages could have long-lasting consequences: Time to change our present course. Nursing Economic$, 39(5), 247–250.
Perkins, A. (2021). The nursing shortage: Consequences and solutions. Nursing Made Incredibly Easy!, 19(5), 49–54. https://doi.org/10.1097/01.NME.0000767268.61806.d9
Trepanier, S., Henderson, R., & Waghray, A. (2022). A health care system’s approach to support nursing leaders in mitigating burnout amid a COVID-19 world pandemic. Nursing Administration Quarterly, 46(1), 52–59.
A national healthcare stressor that I have personally experienced is the national nursing shortage. I wanted to elaborate more on this issue as I feel more attention is being given due to the pandemic. According to the US Bureau of Labor Statistics, the RN turnover rate within the first year of work was estimated to range between 35 to 60% (Bakhamis et al., 2019). Unfortunately, nursing shortages can expedite burnout syndrome where nurses experience negative side effects like emotional exhaustion, depression, and risks the nurse leaving healthcare completely (Bakhamis et al., 2019). Burnout can also impact the healthcare organization and patients due to increased risk of medical errors, decreased quality of care, decreased patient satisfaction, and increased organization costs (Jacobs et al., 2018). In my healthcare organization, I have noticed nurses will work longer hours up to 16-hour shifts due to other nurses calling in and finding a replacement very difficult. According to Broome and Marshall (2021), when nurses are under high-stress conditions there is a delay of treatment and decreased patient outcomes.
How My Organization is Responding to Nursing Shortages
In my healthcare organization, there have been several solutions offered in order to address the nursing shortage. From my experience, there have been sign-on bonuses as much as $20,000 for experienced nurses and $5,000 for newly licensed nurses who sign a two-year contract. My organization has also addressed wage increases, where there have been market adjustments to be more competitive with the increasing costs of living. The organization has also increased the amount of tuition reimbursement from $3,000 to $5,000 for nurses seeking to advance their education. Finally, there has been an increased investment in hiring travel nurses as short-term relief.
Other strategies I would like to see being utilized include showing recognition to nurses, shared decision-making, and increased involvement from leadership groups. According to a recent study of an emergency department in Texas, the implementation of an appreciation system has been shown to statistically improve nursing burnout and improve retention (Adams et al., 2019). This appreciation system is an online store where managers can send their employees points to be redeemed for gift cards.
Another strategy to consider would be to address nurse mental health through programs sponsored by the organization. For example, my organization uses Inspire Wellbeing, an online group that provides education and support material for improving physical and mental health. The program is free to employees and offers discounts to employees who complete different tasks and learning modules.
Patient outcomes will benefit the most when nurse to patient ratios are appropriate as the nurses will experience less burnout, improving productivity and reducing patient errors (Bakhamis et al., 2019). Through the utilization of the strategies mentioned, it can improve staffing and decrease turnover in the long term. This will lead to an improved work environment and improve the mental health of nurses overall.
Adams, A., Hollingsworth, A., & Osman, A. (2019). The implementation of a cultural change toolkit to reduce nursing burnout and mitigate nurse turnover in the emergency department. Journal of emergency nursing, 45(4), 452-456.
Bakhamis, L., Paul III, D. P., Smith, H., & Coustasse, A. (2019). Still an epidemic: the burnout syndrome in hospital registered nurses. The health care manager, 38(1), 3-10.
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231-245