Challenges and Competencies for Nurses in the 21st Century

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

1NURSING
With the increase in aging population, decreasing birth rates and the changing nature of
diseases, the health care system has changed significantly. Nurses are expected to meet diverse
and complex needs of patient and the health care managers expect nurses to demonstrate various
competencies while taking decision for patient every day. This essay looks into some of the
challenges that nurse face today in care delivery and critically evaluates one of the four messages
from the Institute of Medicine’s 2010 Future of Nursing report to find out how it is important to
the nursing profession. This will give an understanding about the skills that students aspiring to
become a nurse must have today. The essay also highlights five core competencies that nurse
must have to overcome challenges and promote skill development in nursing practice.
Graduate nurses entering the profession are overwhelmed by several challenges today
which makes them vulnerable to stress and burnout. Some of the major challenges that nurses
confront after entering the profession includes nursing shortage, long working hours and
presence of many workplace hazards. In majority of hospitals, short staffing is the reason for
poor patient outcomes, repeated hospital admissions and increased care burden. Nurse staffing
level has direct impact on patient outcomes. Some of the major risk identified for nurse due to
nursing shortage includes additional pressure on nurses due to higher patient loads, high
probability of errors due to fatigue and need for more on-the floor training to master and fulfill
the needs of the patient (Cho et al., 2015). Hence, failure to deal with nursing shortage will lead
to failure in upgrading the health care system. One of the possible solutions that can help to
overcome adversities associated with nursing shortage is to engage in smart workforce planning
and identify new skills and roles needed by nurse to meet service need. Alignment with
education supply and flexibility in work patterns can support nurse to maintain healthy balance
between work and personal life and promote job satisfaction too (Kunaviktikul et al., 2015).

2NURSING
Another challenge that often leads to dissatisfaction with the job for the nurses and
dissuades them from entering the nursing profession includes extended work hours. Nurses are
often forced to work for long hours or their vacations are cut off because of high service needs.
Long work hours put nurse at risk of fatigue, sleep disturbance, injuries and chronic disease.
Fatigue and sleep disturbance increases risk and harm for patient (Caruso, 2014). Rhéaume and
Mullen (2018) provides the evidence that long work hours and sleep deprivation lead to
cognitive decline and lapse in attention for people. Hence, such nurses are most likely to
experience irritation, bad mood and poor capability to cope with emotional demands of the work
place. Due to this reason, fatigue related injury and worker errors have increased particularly for
evening and night shifts. Apart from personal loss to patient, fatigue is also associated with loss
for the employer and the community. Shifts greater than 13 hours have been linked to patient
dissatisfaction. The common reason being cited by patient were nurse do not communicate
properly, they do get care on time and they did not got relief. Therefore, the odds of making error
are likely to exceed when shift is for long hours. To resolve the issue, it is high time that
managers and employers take an active role in designing better work schedules for nurses and
promoting frequent breaks during work hours. Periodic assessment of employees can also be a
solution to ass illness, alertness, performance and motivation of nurse (Caruso, 2014).
Workplace hazard is also a serious challenge for nurse as due to the nature of work, they
are frequently exposed to infectious diseases, allergies, radiation, mental stress and chemical
exposure. Therefore, nursing comes at the cost of health for patient. Needle stick injuries and
exposure to blood born pathogen is a menace in hospital setting that has increased risk of
occupational exposure. All these events indicate that introducing a culture of safety is necessary
for the welfare of the nursing profession. In response to the issue, one action that can be taken is