Nursing Issues: Causes, Effects and Strategies to Overcome

This article discusses the causes, effects and strategies to overcome nursing shortage in Australia. It highlights the impact of low nurse-patient ratio on mortality and medication errors, and the effect of nurse shortage on burnout and stress on nurses.

Running head: NURSING ISSUES
NURSING ISSUES
Name of the student:
Name of the university:
Author note:

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Introduction:
Nursing shortage can be defined as the situation where there are increased demands in the
nursing services but there is lack of nursing professionals in the organizations to provide the
services. This can be measured in a number of forms that are the nurse to patient ratio, nurse to
population ratio as well as the number of job openings for the post of nursing professionals
(Jacob et al., 2015). This situation is not only observed in the developing countries but in many
developed countries as well and Australia has not been different. This assignment will mainly be
based on the issues of nursing shortage in the nation (Whitehall & Myers, 2016). The assignment
will also highlight the various points that results in contribution to the nursing shortage issues in
the nation. It will also discuss about the various negative outcomes of the nursing shortage and
will recommend various strategies that professionals can take in order to overcome such issues
on the organization. The similar issue has been discussed in the policy named Australia’s Future
Health Workforce – Nurses that had been put forward by the commonwealth of Australia.
Discussion:
Present condition in the nation:
Researchers are of the opinion that skill shortage can occur when there is a mismatch
between the available staffs as well as the needs of the industry. This has the capability of
creating problem in the economy in the nation of the Australia and this might affect the quality
of the life for the Australians (Buchan et al., 2015). The aging population that is living longer
with different types of complex problems is mainly driving the nursing shortage in the nation.
The present generation has shown a remarkable achievement in the medical field and this had
helped the healthcare organizations to save huge number of lives from different disorders that

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could not be treated successfully before. Therefore, life expectancy had increased and therefore
the aging population has increased as well. However, although they are living for longer days,
but they are not enjoying quality of lives mainly due to the chronic disorders they are
developing. The aging population is living with co-morbid disorders and hence this population
requires healthcare services to manage the disorders effectively. However, with the growing
demands of the nursing healthcare services, the number of nursing professionals had not
increased. This had resulted in a nursing shortage, as the present numbers of nurses are not
enough to provide quality and safe care to all the patients demanding healthcare services.
Statistics:
In the year 2012, there were over a quarter of a million registered nurses for about
273404 and almost 60000 enrolled nurses in the nation. At that particular time, a report on the
nursing workforce sustainability was undertaken by the health workforce confirmed population
health trends when combined with the ageing nursing workforce would ultimately lead to the
nursing shortage in the nation. The areas of the nursing that are at more risks for facing the
nursing shortage are the mental healthcare departments and the aged care services (Zhu, Rodgers
& Melia, 2015). Statistics have stated that the future healthcare can be predicted of involving
greater health promotion, chronic disorder monitoring as well as management and care for hype
older people who have the complex needs. Therefore, nursing shortage would result in huge
issues which will have terrible impact on the health of the citizens and as well as the economy
and social stability of the nation. Research has shown that every 110 healthcare professionals
who would be retiring in the nation, only 84 qualified people will be seen to be joining the
healthcare industry (Wang, 2016). However, the researchers are not completely negative about
the situation in the nation. They are of the opinion that improvement in the retention rates and

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assumed slower economic growth are predicting the reduction in the nursing shortage in the
nation raising to about 29000 by the year 2025 or 45000 by the year 2030. Australia is seen to
require nurses now more than ever and therefore, proper strategies are to be taken to ensure best
health of the citizens of the nation.
Impact of low nurse-patient ratio: mortality and medication errors
Lack of nursing professionals in the healthcare organizations mean that lower number of
nurses is attending higher number of patients and therefore the nurse patient ratio can be stated to
be quite low than what is expected in the healthcare units. Studies have suggested that low nurse
patient ratio affect the patient care in many different ways (Sutcliff & Dhakal, 2018). It results in
higher mortality rates where the study has found an increase o one full time nurse per 1000
patients have the capability of decreasing the mortality of the patient by 4.3%. The study had
also revealed that when the hospital has below target registered-nursing staffing levels in the
intensive care unit, there would be increase in the mortality rates by 2 to 7%. For the patients
who are not in the ICU, there will be also an increase in the mortality rates of 12% for the below
target nursing staffing levels. Low nurse to patient ratio is also seen to be associated with the
increased number of medication errors while caring for the patients. Different types of
medication errors that had been associated with poor nurse patient ratio are wrong infusion rate
about 33.3%, admission of two doses of medicine in place of one accounting for about 23.8%
(Buchan et al., 2015). medication errors due to poor nurse patient ratio also contributes to
omission of medicine accounting for about 14.2% omission of the medicine, mistaken
medication accounting for about 11.9% and giving medication of patient to another patient
accounting for about 9.5%.

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Effect of nurse shortage: burnout and stress on nurses:
The above-mentioned cause can be indirectly caused by the low nurse patient ratio in
another way. Nurses who have to attend higher patient nurses as well as acuity levels are seen to
suffer from the high stress levels. Researchers have found that this often remain associated with
that of the chances of higher job satisfaction and even from burnouts and fatigue. This is often
called by many processionals as the emotion exhaustion or reduced personal accomplishment.
Many of the professionals also state this situation as depersonalization (Cowan et al., 2015). One
of the evidence-based study has shown that 40% of the hospital staff nurses reported a string
indications of their job related burn outs and more than one in five of the professionals were
planning to lee their jobs within the year. These professionals had considered the lower number
of nurses on the shift as one the greater contributors of increased work stress and work burden on
them. This factor resulted in development of burnout and exhaustion in the professionals.
Therefore, professionals suffering from fatigue, stress and burnouts were seen to be
contributing more medication errors and poor quality care. They could not meet the demands of
the patients and were getting physically and emotionally tired and frustrated. This affected their
relationship development with the patient and ineffective communication with them, as they
mostly remained busty in meeting the needs (Bragg & Bonner, 2015). This affected patient
satisfaction and quality of care. High waiting times, lack of emotional bonding with the nurses,
improper communication with the nurses and similar others were stated by the patients who were
admitted in the wards. Hence, burnouts and stress were another effect of poor nursing staffing
which affected many other aspects (Twigg et al., 2016). The nurses tend to leave the
organizations creating additional pressure on the staffing levels. Therefore, proper nurse patient
ratio is indeed one of the biggest contributors to improper care service in the organizations.

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Causes:
Aging population:
Only learning about the effects of the nursing shortage will not be enough until the main
causes of the shortage are identified and accordingly proper recommendations are provided. It is
already started earlier that although the aging populations are living longer, but there are not
living quality of lives. Their lives are impacted by several co-morbid siorder that require
complex care and services from the healthcare professionals (Bloomfiled et al., 2015). Therefore,
the need for more nurses to meet the demands of the old population is one of the major causes of
the increased nursing shortage. The number of increased demands of nursing services by the
increasing number of aged citizens is not running parallel with the number of the presently
allocated nursing professionals in the nation.
poor funding and allocation of the resources:
Another cause of the nursing shortage is the poor funding and allocation of the resources
by the different healthcare organizations. In order to increase the profit margin of the healthcare
centers, it is seen that healthcare organizations tend to appoint lesser number of nurses required.
Such low number of nurses are expected to meet the work demands of the all the patients who
admit to the ward. They tend to make more profits by paying lesser number of nurses who have
to complete the work of a higher number of nurses required to meet the patient demands (Squires
et al., 2017). Therefore, in order to save their money, they pose a risk not only on the health of
the patients but also on the health of the existing nursing professional making them to work
beyond their capabilities to serve. Lack of proper funding by the healthcare organizations to the
human resource department in allocating more nurses to their workforce makes the patient

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vulnerable to poor quality care. Another associated similar issue is the lack of the resources of
the nurses. Many of the nursing professionals have complained that they do not get enough
resources that are required by them for maintaining not only the safety of the patients but also
that of their own selves. Getting the proper support of the authority, leaders as well as other
colleagues, medical resources like use of sanitizers, gloves, equipments as well as financial
resources like incentives, health benefit schemes and many others affect their morale and their
decision towards the profession as well as organization (Lamont, Brunero & Woods, 2015). All
these factors make them highly dissatisfied, stressed, and force them to leave their jobs. Effective
leadership and training when not provided to the professionals, they feel less cared by the
organization and they do not see any future prospects in the profession. All these make them to
leave their jobs and nursing staffing levels are seen to fall.
Strategies to overcome it:
It is extremely important for the concerned authorities to undertake actions that would
help in the mitigation of the nursing shortage in the nation. The first strategy would be for the
health education system of the nation should promote and encourage more number of students to
take up nursing professions. They should be more encouraged to handle the challenges of the
changing healthcare industry and the ways they would be serving the nation with their valuable
skills and knowledge. The better they get encouraged; the better will be their determination and
zeal to serve the citizens in the nation (Duffield et al., 2017). These would help to increase more
number of students in healthcare profession and would help in increasing the nursing staffing
levels and develop the condition of the nursing shortage. The second strategy is that the
concerned authorities as well as nursing managers and leaders to maintain the nurse patient ratio
sternly. They should manage the nursing staffs in a way by which appropriate numbers of

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nursing professionals would be allocated to the patients who are admitted to the ward.
Accordingly, the nursing managers need to report to the HR department if they believe that the
nurse numbers are not enough to meet the demands and needs of the patients (Duffield et al.,
2016). They should take upon the responsibility of advocacy and help the concerned authority
develop ideas about the ill effects of the situation and the ways short staffing can be overcome by
proper allocation of nurses.
The third strategy would be the effective handling of the burnouts and stress experienced
by the nursing professionals during their practices. Proper systems need to be implemented by
the concerned authorities where care should be taken about the burnout issues and fatigue issues
(Wang, whitehead & Bayes, 2017). Accordingly, the shift should be arranged in ways by which
the nurses do not become stressed. Proper work life balance and time shift flexibilities can be
instructed by the healthcare systems where the nurses can work as per their convenience.
Moreover, when they have proper work life balance, they can successfully overcome their stress
(Lane et al., 2017). Moreover, they can also involve different fun activities in the working place
during the time when there is less work burden and this will help the nursing professionals to
overcome the stress. Moreover, the nurse and the leaders also need to undertake individualized
consideration and learn about the issues each face. This would help in making them feel that
their issues are cared for. This would help them to feel that the organization cares for them. This
would help in reducing their stress and fatigue and would indeed help in reduction of the
turnover rates.
Conclusion:

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From the above discussion, it is understood that the nursing shortage is one of the
primary issues that the healthcare organization is facing and concerned authorities need to
understand the cause resulting in such issues. One of the identified causes is the increasing
number of the aged population. The other causes are the lack of proper funding and the resources
in the healthcare organizations that affect the quality and safe care of the patients. Excessive
burnouts and fatigues are also the other reasons. The effects of nursing shortage are poor and
unsafe care to the patients resulting in increased mortality and medication errors. It results in
development of stress and burnouts among the professionals increasing the turnover rates.
Therefore, it is important for the concerned authorities to encourage and influence the young
population o take up nursing profession, recruit more nursing professionals to ensure safe nurse
patient ratio and also develop strategies for proper work life balance in the professionals. This
would help the nation overcome the nursing shortage and hence become more successful in
caring for the citizens of the nation.

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