“The Nursing Shortage”

Final Report Abstract

While the nurses are disappearing from developing nations to help the shortage in the United States, it is putting a strain on health systems in the developing world. American found a simple solution to the problem of our nursing shortage and how we have turned to the global market where nurses have become a hot commodity. Even though it seems to be a natural thing to import nurses, since we import everything else. By importing nurses it saves time and money but it will cause more problems in the end. The Nursing Shortage

In the United States is a situation where the demand for nurses is greater than the supply, as is currently the case in several developed nations. According to a U.S. government study, by the year 2020, there could be a nationwide shortage up to one million nurses, which could result in substandard treatment for hundreds of thousands of patients. Just as alarming, fewer nurses are choosing to teach the next generation of professionals, resulting in tens of thousand of applicants being turned away from the nation’s nursing schools. (1)
Reason for Shortage The responsibilities of nurses have increased and the patients are more ill as a result. In addition the average age of nurse’s increases while the number of applications to baccalaureate programs has decreased.(2) New opportunities became available for the nursing practice, which further drains the number of nurses available for acute settings. Other factors that affect the nursing shortage are aging workforce, problems with retention and difficulty recruiting young people into the field.
Job Satisfaction Studies have shown that the nursing shortage is an issue in developed countries today. Students need now apply to schools to become nurses because admission rates have increased. Several studies have been done to understand how nurses feel about their career. A study was performed by, sociologist Bryan Turner, initially identified nurses’ most important complaints as subordination to the medical profession as well as over regulation, and difficult working conditions. Also, a report from the Commonwealth of Austria identified some of the dissatisfaction as stemming from frequent schedule changes, overloads, shift work, lack of appreciation by superiors and colleagues, as well as lack of childcare. Inadequate pay was not a problem. Later, a study revealed that the dissatisfaction among nurses focused on conflicting expectations from nurses and managers due to regulation of cost, lack of opportunity to provide comprehensive nursing care, loss of confidence in and frustration with, the healthcare system. Limitations to comprehensive care were identified because nurses are overloaded with the number of assigned patients, massive paperwork for billing purposes, short staffing to cost. (3) The major reason why nurses leave the field is because of the working conditions. With the high turnover rate, the nursing field does not have a chance to build up the already frustrated staff. Aside from the deteriorating working conditions, the real problem is nursing’s failure to be attractive to the younger generation. There is a decline in interest among college students to consider nursing as a probable career.
Luring Nurses from Poor Countries The amount of nurses from poor to rich countries has strained health system in developing world, which are already facing severe shortages of their own. By removing the immigration cap, would hit the Philippines the hardest because they send more nurses to the United States than any other country. The health care in the Philippines has deteriorated in recent years as a result of thousands of nurses has moved abroad. According to George Cordero, President of the Philippine Nurse Association, “The Filipino people will suffer because the U.S. will get all our trained nurses.” Nursing Shortage Impact Several factors are involved in the shortage of nurses; increase the nurses’ patient loads, the risk of error, increase the risk of spreading infections to patients and staff’s increase risk for occupational injury and a great increase in burnout and nursing turnover. The same negative impact is also true in developing countries due to recruitment to work abroad in wealthier countries.
Patching up the shortage Health care industries utilized float pool nurses and agency nurses to respond to the census of current patients needing medical attention. Float pool nurses are nursing staff employed by the hospital to work in any unit where necessary within the organization. Agency nurses are employed by outside agencies and the nurses have the opportunity to be in any hospital on a daily, weekly or contractual basis as needed. With both types of agencies, the nurses are only able to work within their licensed area of practice, training and certification. The use of these services, increases the cost of healthcare, decreases specialty, and decreases the interest in long-term solutions to the shortage.
Global Shortage and Recruitment The nursing shortage is in global scale according to the International Council of Nurses: Netherlands needed to fill 7,000 nursing position in year 2002, England needed to fill 22,000 position in year 2000, and Canada will need about 10,000 nursing graduates by year 2011.(3) Recruiting Foreign Nurses In the United States, recruiting foreign nurses has been practiced for 50 years. Philippines supplied most of its nurses to the United States and other countries. Philippine nurses have become such an integral part of the American health system they have started their own national organization, the Philippine Nurses Association of America. When the United States started experiencing nursing shortages, the well-educated and English speaking Philippine nurses provided the perfect replacement workforce. The hospitals were able to fill necessary and unwanted jobs with Philippine immigrants without increasing wages. American nurses have seen the salaries decrease as the Philippine nurses arrive and were willing to work for lower wages.
Impact of Global Recruitment Countries that send their nurses abroad experience a shortage in their own healthcare system. In South Africa, accelerated recruitment by developed countries such as United States, United Kingdom and Australia is putting more strain in the healthcare system due to prevalence of diseases, such as AIDS, and limited resources. Similar to the United States, nurses who leave the organization are at a financial disadvantage due to the need to fund recruiting and retraining of new nurses into the system. Every nurse that leaves the country of South Africa is an annual loss of $184,000.(4) In an American Hospital Association study, the cost to replace one nurse in the United States was estimated at around $30,000 - $64,000.(4) Hiring foreign nurses is more financially taxing compared to hiring domestic-graduate nurses. Aids and Limited Resources Is it acceptable for the U.S. to recruit nurses from countries that are struggling with thousands of adults and children with AIDS. On top of the lack of expensive preventive drugs, these countries also face an inadequate number of health care providers to nurse the ailing population.
Nurses Leaving the States and Working Overseas With a heavy demand for nurses overseas in certain specialties is creating opportunities for American nurses who want to experience life abroad. Many are going for the adventure rather than for financial gain. American nurses that are trained in neonatal, pediatrics, intensive care, surgery and psychiatry are being sought out by Hospitals in Saudi Arabia and the United Kingdom. Most of the advertising is done by recruiting agencies on the World Wide Web and in nursing journals and newspapers. Countries attracting nurses from locales facing their shortages are creating a domino effect of nursing shortages.
Travel Perks In the United Kingdom nursing salaries are lower than those in the United States, but nurses are attracted to the opportunity to travel and live in a different culture with the same language. According to Hugo Lyons, RN “experience nurses can earn about $25,000 to $30,000 annually in the United Kingdom, but incentives such as paid five-week vacations, numerous paid holidays and flexible work shifts – which allow time for travel. Less of Foreign Nurses in the United States President Obama has proposed to increase the nursing education budget to end American’s dependence of foreign nurses. (According to President Obama, “the notion that we would have to import nurses makes absolutely no sense,” at a White House Forum on Health Care. “There are a lot of people who would love to be in that helping profession, and yet we just aren’t providing the resource to get them trained.
The Proposed “Nursing Relief Act of 2009 A bill was introduced in the U.S. Congress to provide for the new category of visas for registered nurses with an annual limit of $50,000. The proposed “Nursing Relief Act of 2009 would make it much faster and easier to bring trained nurses from Asian countries.
Conclusion
The nursing shortage is not going to be a quick fix. The shortage has been going on for some time. The problem is not with the applicants applying for nursing school, it is there are not enough instructors to teach nursing. The reason for this shortage of instructors is they are not being compensated for teaching. With this combination of teaching shortage and the nursing workforce getting older doesn’t make matters any better. Even though President Obama has proposed the nursing education budget to end American’s dependence on foreign nurses, this is not going to happen overnight. In the meantime the situations in the hospitals are still going on with nurses overworked, nurses in the profession just for the money and the extreme shortage of nurses. Until this situation is corrected the United States will continue to recruit nurses from foreign countries.
REFERENCE PAGE

1. Nurses Needed – NOW on PBS http://www.pbs.org
2. Bureau of Health Professions (2004) ftp:.hrsa.gov/bhpr/workforce/behindshortage.pdf
3. Trossman, S. (2002) The global reseavh of the nursing shortage: The ANA questions the ethics of luring foreign-educated nurses to the United States. – Electronic Version – American Journal of Nursing, 102(3), 85-87
4. Brush, B. L., Sochalski, J., & Berger, A.M. (2004). Imported Health Affairs, 23(3), 78-87.

IBNLive: http://ibnlive.in.com
Business Week – htt://www.businessweek.com