Scarce Resources Article: Strategies for Addressing the Nursing Shortage: Coordinated Decision Making and Workforce Flexibility
LANDI L SCHOCK
NURS/531
September-17, 2012
Holly Stenerson

Scarce Resources Article: Strategies for Addressing the Nursing Shortage: Coordinated Decision Making and Workforce Flexibility
The issue that was chosen to do an editorial response on was “Strategies for Addressing the Nursing Shortage: Coordinated Decision Making and Workforce Flexibility”. The nursing shortage statistics are as follows: in 1990 the United States had an 11% vacancy rate of unfilled, full-time RN positions. This number ebbs and flows over time but since 2001 the United States has had a 13% vacancy rate of unfilled , full-time RN positions and this has not changed as in past times ( Fox & Abrahamson, 2009). According to Fox & Abrahamson, 2009,” A web of dysfunction exists that is far more complicated than any single factor, “(235-244).
There are many influencing factors to blame for this nursing shortage. One such factor is the population imbalance created by the Baby Boomers aging and leaving the workforce and the smaller Generation X’ers that have to try and care for all of these aging people (Fox & Abrahamson, 2009). Another influencing factor are our aging pool RN’s. Our average RN age is 43 and we have many nurses retiring. Half of RN’s are going to be over 50 by age 2010 and the U.S. does not have enough new nurses to replace them (Fox & Abrahamson, 2009). The third influencing factor is that 65% of our nursing graduates come from associate degree programs. This is in itself not a problem, but there are not enough nursing faculty, which must at least have a BSN degree if not an MSN degree to teach nursing. We are turning away perspective nursing students from programs because there are not nursing faculty to teach them (Roman, 2008). I have seen this first hand, as whenever I open up the paper there are faculty openings in nursing schools. Usually I see two or three openings and I live in a pretty rural area.
The fourth influencing factor is that many Generation X ‘ers do not want to become nurses. The hours are long, the work not so glamorous, pay is not that great, and one must work weekends and holidays and nights. Many young people are encouraged to go into nursing and these are the answers that are heard. The fifth influencing factor is that many nurses are leaving the workforce and going into other occupations due to the fact that they are unhappy with their current work environment. Many nurses with the nursing shortages are having to work overtime, more weekends, and having to care for more patients and have decided to leave the nursing profession for something else.( Wright & Bretthauer, 2010). All of these influencing factors are making the nursing shortage even worse. If this issue is not addressed we will not have the nurses to care for all of the patients that are out in the United States aging at this minute. Other consequences are quality problems and medical errors. As a recent DON, I have seen how medical errors increase in times of call-in’s and just being short- dramatic increase in errors. According to Coile, 2001,” The public fears are rising about the impact of nursing shortages on consumer safety in healthcare facilities” ( p. 1). There was even a report in this article by Coile about a consumer magazine telling patients that they should consider bringing with them their own nurse or aide if they have to go into the hospital! Wow! Our whole health care system will collapse if there are no nurses to care for people. The expertise and assessments that are brought about with nurses are irreplaceable.
The article about Coordinated Decision making and workforce flexibility was pretty in depth and above my head. Having been a manager and scheduler I still had issues understanding all of the algorithms that this article proposed to help with the nursing shortage. However, say that, it had some very good points. It talked about how important it was for managers to get together and work on scheduling especially with the float pool manager so that there was adequate staff to cover every floor. It also talked about the cost savings by eliminating overtime and using the float pool instead. These funds would then be available to help retain existing nurses and attract new nurses (wright & Bretthauer, 2010). The article also emphasized how important it is for the float pool to be cross-trained but not the regular staff as this did not pay off. Workforce flexibility included algorithms to use to help staff to get the schedule that worked for them thinking that if nurses had more flexibility or choices in their schedule that they would be happy and stay in nursing. The algorithms were way above my head and I did not understand them at all. I found the article was hard to follow due to all of the algorithms but the information did make sense. I did feel that they assumed that there were enough nurses to hire to make the schedule in the first place which is not always the case.
My solution for solving the nursing problem would be to put nursing schools and hospitals working together on a very intimate level to try and solve both the shortage of nursing and the shortage of nursing faculty problems at the same time. I would like to see us work together because then resources and staffing could be shared, and there would be educational benefits to the nurses working and many more educated nurses to teach and with this would come more nursing students and end to the shortage. There would be more faculty and more advanced degree nurses to care adequately for our patients. The hospital could also serve as the teaching part for the school and there is then extra people to staff the hospital as well. This is my solution for nursing and nursing faculty shortages.
Economic investment needed is going to be large because money is needed and a lot of it because money is needed to get nurses through schools and BSN schools are optimal. Also money is needed for faculty to get their MSN degrees and I believe incentives and a wage increase are an important start if we want nurses to stay and others to come to nursing. The lay public should join in these efforts because it will affect them and there loved ones. Do you to bring your own nurse with you when you go into the hospital? I do not believe so! The quality of care of everyone is affected and every patient that goes into a hospital is affected. We need to work together to solve this problem.

REFERENCES
Coile, Jr., R.C. (2001). Magnet Hospitals Use Culture, Not Wage, to Solve Nursing Shortage. Journal of Healthcare Management, 46(4), p. 224.
Fox, R.L., & Abrahamson, K. (2009). A Critical Examination of the United States Nursing Shortage: Contributing Factors, Public Policy, Implications. Nursing Forum, 44(4), p. 235-244.
Janiszewski-Goodwin, H. (2003). The Nursing Shortage in the United States of America: An integrative review of the literature. Journal of Advance Nursing, 43(4), p. 335-343.
Roman, L. (2008). Nursing Shortage: Looking to the future. RN, 71(3), p. 34-36, 38-41.
Wright, P.D. & Bretthauer, K.M. (2010). Strategies for Addressing the Nursing Shortage: Coordinated Decision Making and Workforce Flexibility. Journal of the Decision Science Institute, 41(2), p. 373-401.