Nursing turnover issue is multifaceted

Running head: HEALTH CARE
Health care
Name of the student:
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Author’s note

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Introduction
Nurses are the most trusted health care professionals who play a role in the continuity of
care and providing timely care to patient. The field of contemporary nursing today is however
dominated by several critical issues such as staffing issues, long shift timing, occupational
hazards, bullying and harassment. Being aware of the ways these critical issues affect nursing
practice and the way the issue is being reported in three different forms of media is important.
This report will mainly examine the issues in nursing practice by reviewing written opinions
expressed through 3 types of media.
Critical issues in nursing
Shortage of nursing staffs and poor working environment for nurses are some of the
critical issues facing the nursing profession currently. This has been reported in various forms of
print idea and the discussion on the topic will initiate following the review of written opinions in
research followed by review of website based information and newspaper articles. A systematic
review by Halter et al. (2017) highlighted the issue of high nursing turnover and the supply-
demand gap in nursing practice. High rate of nurses leaving the job implies lower retention of
qualified nurse in health care system and this issue is having adverse impact on the quality of
patient care. Nursing turnover issue is multifaceted and by the review of research papers, the
study revealed that stress, burnout, job satisfaction levels and job related factors are some major
determinants of nursing turnover. The systemic review indicate five major job related factors
such as nature of job, workload, task variations, shift patterns, role ambiguity and poor
promotion opportunities as some of the reasons for intention to leave the job. However, the
turnover intention was found to be higher in newly placed nurses compared to experienced

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nurses. The quality of the opinions expressed in this paper is limited by the fact that very less
papers with strong research methodology was taken. Despite this, the paper gives implication to
modify the staff recruitment and staffing ratios in hospital as nursing turnover can disturb
hospital services, the revenue of the hospital and negatively influence patient care quality. The
HR department should take note of the issue to better interpret nurse’s expectation and optimize
the selection process (Dewanto & Wardhani, 2018).
The academic papers have also highlighted several other critical issues in nursing practice
such as the issues of discrimination, bullying and occupational safety hazards for nurses.
Through the descriptive analytical study, Zarrini et al. (2018) affirms that nursing is a high risk
occupation and working in intensive care units (ICU) increases the likelihood of occupational
risk for nurses. By collection data from nurses in tertiary hospitals, the paper highlighted that
nurses were exposed to various forms of hazards such as ergonomic, biological, psychosocial,
organization and physical hazards. However, these hazards were restricted to ICU setting only.
But Sarani et al. (2016) revealed about an issue of much higher concern which was the
prevalence of hospital acquired injury and the burden of this on nurses. It is a type of infection
that is mainly acquired by patient after 48 hours of hospital admission and nurses have been
recognized to play a vital role in transmitting this infection by coming in contact with patients
during medication administration process or other activities like dressing. Such issue has
increased hospitalization rate, nursing care burden and health care cost. Sauer and McCoy (2017)
reported about the nursing well-being issues because of experiences of bullying. Bullying is a
common occurrence for newly placed nurses and this affects the quality of nursing care too.
These issues highlight the role of policy makers and leaders on acting against the perpetrator and
implementing strict measures to develop bullying free environment.

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Research related to critical issues in nursing has attracted attention because of its negative
implications on health care performance and quality standards However, various websites and
newspapers have also reported about the issue so that common public become aware of the
problem too. For example, a report published in CBC news by Roussy (2018) revealed about the
issue of nursing burnout and stress. The article discussed about the experiences of 400, 000
nurses in health care facilities across Canada as they are finding it difficult to cope with violence
and stress on the job. The opinion of the writer was that nurses in Canada need to regularly work
in long 12-hour shifts or rotational shifts. This takes a toll on their mental health. One major
consequence raised by the author was that due to longer working hours, nurse does not engage in
enough physical activity and this expose them to greater risk of cardiovascular disease, obesity
and hypertension. The paper looked at the issue of nursing violence too and reported that nurses
are at great occupation risk because of acts of violence and aggression. The main irony is that
such events are underreported. The main intention or conclusion to the article was not given.
However, the article is clearly reflective of the fact that how nursing professional has changed
since the time of Florence Nightingale.
The websites of health care agencies have also published articles on the issue of nursing
shortage and the adverse impact that it will have one nursing population of Canada. The key
estimate of the Canadian Nurses Association was there will be an extreme shortage of 60, 000
nurses in Canada by the year 2020. The justification for such statistics was provided based on
lack of nursing professionals in the country and the impact of the nursing shortage on the quality
of Canadian healthcare services. The significance of this article is that instead of just reporting
about the nursing shortage issue, the author gave solution to address the issue. This solution
included addressing the nursing shortage issue through immigration. The author suggested that

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foreign nurses should come to Canada so that more number of nurses are available to care for
patient. The article enlightened knowledge regarding various immigration options for nurses
willing to launch their career in Canada (Canadian Immigration Law Firm, 2018). Similar
solution was proposed by Muslin et al. (2015) which revealed that global worker migration is an
opportunity to address the nursing shortage issue.
Several reputed news websites in Canada and other countries have paid attention to the
issue of racism and staffing issues in nursing practice and played a role in making common
public aware about these issues. The nursing shortage issue is prevalent in Australia too
evidenced by a new report published by Calderwood and Miskelly (2018). The author brought
into light how south-west Sydney is likely to face a catastrophic issue as their current staff will
not be able to meet patient demand. The growth in the shortage of workers has been estimated to
be such that by 2030, 82, 000 registered nurses will be required, but only 74, 000 will be
available. The graveness of the issue was discussed on the ground of aging workforce and the
increase in health issues for the aging demographic. Similar views has been raised by WHO too
as the article mentioned that ageing population is likely to increase prevalence of disease like
arthritis, depression, dementia and osteoporosis and the issue of shortage of workers will further
alleviate existing challenges. To attend to the complex needs of ageing population, more amount
of in-service training and continuing professional development on ageing is required (WHO,
2015). Hence, to make this possible, there is a need to resolve the nursing shortage issue first. It
gives the implication for the development of new recruitment policies to mitigate the crisis.
The Canadian health care system is now plagued by negative work environment. With the
acute shortage of nurses and migration of international students, another problem that has come
up is the experiences of employment discrimination. This has become an ethical and political

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concern that needs immediate attention. Each problem in the profession is interlinked to one
another and modifying the conditions likely to affecting nursing staffs today is an immediate
need so that health and well-being of nurse can be maintained. They must be motivated to
contribute positively to the health care system instead of regarding the profession as a burden
and source of stress (Walani, 2015).
Conclusion
From the review of critical issues in nursing in three forms of print media, it can be
concluded that nursing shortage issue is the most critical problem in the profession followed by
the other problems like inappropriate shift patterns, poor working condition, and prevalence of
occupational risk and nursing bullying and discrimination issues. The overall analysis of the
paper indicate that the newly placed nurses are most likely to experience more risk and they are
vulnerable to psychological problems because of the above issues compared to the experienced
nurse. Hence, apart from strengthening the recruitment policies, the results obtained from three
forms of print media gives the insight that there is a need to provide additional training and
support to nurses so that they are able to handle work conflicts and issues like violence and
aggression in health settings.

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References:
Calderwood, K. & Miskelly, G. (2018). NSW needs nurses as 'catastrophic' shortage predicted
to affect patient care. Retrieved from: https://www.abc.net.au/news/2018-01-12/nsw-set-
for-major-shortage-of-nurses-and-midwives/9321464
Canadian Immigration Law Firm (2018). Canada Needs 60,000 New Nurses! Retrieved from:
https://www.canadim.com/blog/canada-needs-60000-new-nurses/
Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a
preliminary study at private hospitals in Indonesia. BMC nursing, 17(Suppl 2), 52.
doi:10.1186/s12912-018-0317-8
Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., … Drennan, V. (2017). The
determinants and consequences of adult nursing staff turnover: a systematic review of
systematic reviews. BMC health services research, 17(1), 824. doi:10.1186/s12913-017-
2707-0
Muslin, I., Willis, W. K., McInerney, M., & Deslich, S. (2015). Global worker migration: Crisis
and opportunity in the nursing profession. Journal of Health Management, 17(1), 1-10.
Roussy, K. (2018). Think you've got a tough job? Try being a nurse. Retrieved from:
https://www.cbc.ca/news/health/nursing-nurses-violence-physical-activity-ontario-
1.4651467
Sarani, H., Balouchi, A., Masinaeinezhad, N., & Ebrahimitabs, E. (2016). Knowledge, attitude
and practice of nurses about standard precautions for hospital-acquired infection in

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teaching hospitals affiliated to Zabol University of Medical Sciences (2014). Global
journal of health science, 8(3), 193.
Sauer, P. A., & McCoy, T. P. (2017). Nurse bullying: Impact on nurses’ health. Western journal
of nursing research, 39(12), 1533-1546.
Walani, S. R. (2015). Global migration of internationally educated nurses: Experiences of
employment discrimination. International Journal of Africa Nursing Sciences, 3, 65-70.
WHO (2015). Health workforce for ageing populations. Retrieved from:
https://www.who.int/ageing/publications/health-workforce-ageing-populations.pdf
Zarrini, K. A., Sanagoo, A., Jouybari, L., Vakili, M. A., & Kavosi, A. (2018). Evaluation of
occupational hazards for nurses in intensive care units of tertiary care centers. Journal of
Nursing and Midwifery Sciences, 5(4), 153.