Staffing Crisis for Nurses and the Supply of Mental Health Care

This report discusses the issue of staffing crisis amongst nurses and its direct interconnection with the supply of mental health care. It identifies the key contributors to the problem, the impact of the issue on patients, nurses, hospitals, and the community, and the recommended solutions to the problem. The report is addressed to the government, for it is the supreme authority with immediate power to intervene in the issue.

Running head: STAFFING CRISIS FOR NURSES 1
The Interconnection between Staffing Crisis for Nurses and the Supply of Mental Health
Care
Name
Institutional Affiliation

STAFFING CRISIS FOR NURSES 2
1. Introduction
Mental health is the level at which an individual is psychologically well off or lack of any
mental disease (Galderisi, Heinz, Kastrup, Beezhold, & Sartorius, 2015). It is a great aspect of
peoples' lives because it is the main contributor towards an individual’s overall health.
Worldwide, there is a great discrepancy between the demand for mental health care and its
supply due to its direct interconnection with nurses staffing crisis. The prevalence of mentally ill
people in many nations and those requiring specialized mental health care is high. On the
contrary, only less than half of these individuals are able to receive the care that they require.
Consequently, the cases of permanent brain damage have increased greatly. Such people are also
usually at higher risks of suffering from other health conditions. As a result, the quality of life of
individuals having mental illnesses is usually reduced greatly. The effect of the lack of sufficient
mental health care is also felt at the societal level. There are various reasons that bring about the
discrepancy between demand and supply of mental health care (Brenman, Luitel, Mall, Mall, &
Jordans, 2014). Lack of sufficient nursing staff in mental health facilities is one such factor. This
report, therefore, seeks to address the issue of staffing crisis amongst nurses, impacts of the issue
to various parties, an approach available for the problem and the changes that could be
implemented to improve the issue. The report is addressed to the government, for it is the
supreme authority with immediate power to intervene in the issue.
2. Description of the issue
Staffing crisis for nurses also commonly referred to as nursing shortage is described as the
situation at which the supply of nursing professionals is exceeded by its demand in healthcare
facilities either at local, national or even global level. The common points of measurement to
determine the shortage include; nurse to population ratio, nurse to patient ratio, or the total

STAFFING CRISIS FOR NURSES 3
number of job openings (Haddad & Toney-Butler, 2018). Nurses’ shortage is a common scenario
around the globe more so in developed and developing countries, which always capture the
attention of the entire world. It is, however, worth noting that the low supply of trained nurses is
not necessarily the cause of nurses' shortage. There have been various instances in many nations
where shortages have occurred simultaneously with a high rate of admission of learners into
nursing training centers, which is highly contradicting. A global estimate of 4.3 million nurses is
the reported shortage emanating from the World Health Organization (World Health
Organization, 2017). WHO attributes this high figures to low investment in; training, working
environment, management, wages and education of health workers by various nations. In
Australia, a shortage of approximately eighty-five thousand nurses by 2025 and the number set
to rise to one hundred and twenty-three by 2030 is forecasted by the Department of Health.
Subsequently, the mentioned shortages affect the supply of mental health care adversely. This is
due to lack of nurses to administer the required care.
3. Key contributors to the issue
a. An Aging Registered Nurses Workforce.
It is a bitter fact that only a few numbers of the younger population are entering into the
nursing profession. Subsequently, the average age of nurses who are in practice is continuously
rising. Recent reports indicate that 45.2 is the average age of nurses currently. It, therefore, goes
without saying that the number of new nurses to replace the aging ones are not enough (Russell,
2016). Additionally, those available cannot match the quality, experience, competence, and skills
level of the aging nurses. With nursing being considered as an occupation mainly for women,
expansion of career opportunities have impacted the number of women entering in the field.
Women have ventured into other careers they consider more paying and interesting than nursing.

STAFFING CRISIS FOR NURSES 4
Aging RNs are also more susceptible to feet, neck and back injuries. Subsequently, they are
constantly on sick leaves and thus contributing to a huge demand-supply gap in the provision of
mental health care.
b. Aging of Baby Boomers
The aging and subsequent retirement of people born after the end of World War II is
another reason attributed to the shortage of nurses. In the years that followed after the 1940s,
more than seventy million children (baby boomers) were born worldwide (BRADLEY
UNIVERSITY, 2016). There is a direct proportional relationship between age and demand for
mental health care. With the baby boomers advancing in age, a significant number of them
develop mental health problems that calls for medical attention. The main factors that make the
demand of mental health care among the elderly rise are work related stress, depressions, as well
as various life encounters that could have led to deterioration of mental health. Nurses’ shortage
comes into existence when the number of baby boomers requiring mental health care increases
but there is no proportional increase in the number of nurses in mental health facilities (LeRouge,
et al., 2014).
c. Nurses recruitment and retention challenges.
Often used as an indicator of retention or recruitment problem is the rate of job turnover.
The inadequacy of recruitment and retention policies of mental health care workers demonstrates
the shortage symptom (Stilwell, Dolea, & Zurn, 2005). The severity of shortages varies in
various nations across the globe with the African region being the worst hit. The magnitude of
shortages can be assessed using a variety of factors that are directly related to recruitment and
retention challenge. These indicators include; turnover rates, vacancy rates, absenteeism as well

STAFFING CRISIS FOR NURSES 5
as retention rates. There are various reasons that contribute to these challenges. Poor working
conditions, low remuneration, harsh rules, and cruel management are some of the key
contributors to the aforementioned (Bower, et al., 2014). Subsequently, when the retention rate is
low and turnover of nurses high, it simply means that there will be no sufficient labor force to
handle the high demand for mental health care.
4. Impact of the issue on;
a. Patients
In mental health care settings, patients are the most affected by shortages of nurses. This
is due to the fact that they are the direct consumers of such care. First, nurses' shortage results in
a higher patient mortality rate (Munn, 2017). There are mental patients whose conditions calls
for close attention from nurses as well as constant checks. With a shortage of nurses, then such
personalized care lacks. Subsequently, patients are placed at higher risks of death. Secondly, the
chances of medication errors are more likely to occur when a shortage of nurses exists. Mental
patients are always under medications with drugs that are highly sensitive. A medication error
could, therefore, have lethal effects on the affected individual. Nurses having to work for long
hours and attending to many patients due to the shortage is the leading cause of these errors.
b. Nurses
The problem of nurses’ shortage also adversely affects the nurses in practice. First,
mental health nurses are faced with a huge workload than what they are supposed to handle.
With a large amount of mental health care seekers and a small workforce, the nurses in operation
have to assume the work that could have been tackled by the nurses in deficiency. Nurses are
also forced to work for long hours than they should. It is a common scenario for nurses to work

STAFFING CRISIS FOR NURSES 6
for more than 26 hours without rest in areas with a shortage of nurses. It is general biology that
lack of sleep and exhaustion affects the output of an individual. As such, the quality of work
decreases with increased cases of medication errors and near misses. Lastly, a shortage of nurse
leads to demotivation and demoralizing of current nurses (Yau, 2013). When such nurses are
overworked, of course without any extra pay, their morale for work goes down. This
subsequently leads to absenteeism and, worst of all, labor turnover at a high rate.
c. Hospitals
Shortage of nurses has a large impact on the delivery of care as well as the capacity of
hospitals in mental health care settings. First, there are various processes that are run in hospitals
and whose nurses’ presence is vital. Subsequently, when nurses required to run the processes are
unavailable due to shortages, the processes end up stalled. During the construction of mental
health facilities, there is always the maximum capacity set for each facility. When under the
operation of the required number of nurses, doctors, and other staff, such facilities can
comfortably offer care to their maximum capacity. When a shortage of nurses exists, however,
hospitals can only admit patients to a limited capacity and thus cutting their expected income.
Subsequently, the supply of mental health care in demand cannot be met (Everhart, Al-Amin,
Nogle, & Weech-Maldonado, 2015). Hospitals also have reputations to keep. It is usually a sign
of dissatisfaction when patients or people close to them get back to their homes complaining of
how poorly they were attended to at a certain hospital. They could also complain of being not
attended to when the ratio of nurse to patient is extremely high.
d. The community

STAFFING CRISIS FOR NURSES 7
The community at large is also affected by the issue of mental health nurses' shortage in
one way or the other. First, there is a generally reduced quality of life in the community. When
there is a shortage of nurses, it means that not all mental patients are able to receive the required
care. Subsequently, those who do not receive the care that they require lead a life that is of
reduced quality. They are not able to enjoy the normal takes and haves of life due to their
prevailing mental conditions which usually have a significant and lethal effect to their cognition.
Additionally, a shortage of nurses brings about reduced quality of life in the community (Friedel,
2012). When mentally ill patients do not receive the care they need, they are unable to undertake
their daily activities some of which are their sources of income. As a result, they are not able to
raise the income required for personal use. Consequently, dependency comes into play since
such individuals will have to depend on other people for a living.
5. Solution to the issue
There are various strategies that have been developed by different governments to handle the
issue of nurses’ shortage. In the United States of America, the Nurses Reinvestment Act of 2002
is a federal policy legislation that was coined to address the issue. It was part of the amendments
to the Nursing Workforce Development Programs that already existed (Elgie, 2007). The major
provisions of the NRA were, “...nurse recruitment through public service announcements and
expansion of the National Nurse Service Corps, nurse retention through internships, residency
pro-grams and career ladders, improved retention by enhancing collaboration with other
professionals, programs to increase geriatric nurse education, nurse faculty loan programs, and
‘magnet facility’ patient safety grants to support greater provider and care activity coordination”
(Premier, 2005). The NRA consists of several grant programs. The major five were concerned
with increasing the number of the nursing workforce have subsidized the nursing education

STAFFING CRISIS FOR NURSES 8
being offered to students with grants and vouchers. Subsequently, the number of graduate nurses
entering into the job market increased and the American government was able to handle the
issue.
6. Recommendations
To strengthen the above approach of tackling nurses’ shortage, this report recommends
two additional strategies that the government could apply. First, the government can use the
nurses that are already in practice as recruiters with any referrals being compensated (Stilwell,
Dolea, & Zurn, 2005). The idea of converting current nurses as scouts for talents can be adopted
by the government and implemented to effect change in the rate of recruitment. Existing nurses
definitely know some other nurses who they probably schooled together and are unemployed or
have quitted working due to various reasons. Each nurse should then be compensated for each
referral. Secondly, the government, through relevant regulatory authorities, should ensure that
nurses in practice are given room to accommodate professional and personal needs (Russell,
2016). Nurses face difficulties while trying to achieve and maintain a balance between
professional and personal life. Recruitment and retention could be facilitated by nurse leaders
offering schedules that are altered for nurses to accommodate their professional and personal. If
the above recommendations are followed, it is possible to counter the problem and consequently
supply the amount of mental health care that is on demand.
7. Conclusion
Conclusively, it has been established that the shortage of nurses is an issue requiring
urgent intervention to match the demand and supply of mental health care. The government has
been identified as the target audience of this report. The rationale behind this choice is because it

STAFFING CRISIS FOR NURSES 9
the government is the highest authority with the supreme power to effect change. Recruitment
and retention challenges, approach to retirement by baby boomers, and an aging Registered
Nurses workforce are the factors that have been identified as the main contributors to the
problem. Further on, the report has clearly stated how the issue of nurses’ shortage impacts the
provision of mental health care to patients, the nurses themselves and to the community at large.
The most commonly applied solution identified is Investing in long-term professional
development and training and subsequent improvement of working conditions as well as
remunerations for nurses. The report has then recommended to the government to use current
nurses as recruiters. It can also avail opportunities for nurses to balance their personal and
professional life.

STAFFING CRISIS FOR NURSES 10
8. References
Bower, P., Brueton, V., Gamble, C., Treweek, S., Smith, C. T., Young, B., & Williamson, P.
(2014, October 16). Interventions to improve recruitment and retention in clinical trials: a
survey and workshop to assess current practice and future priorities. TRIALS.
doi:10.1186/1745-6215-15-399
BRADLEY UNIVERSITY. (2016, November 17). Aging baby boomer population: What it
means for the nursing industry. Retrieved from online degrees:
https://onlinedegrees.bradley.edu/resources/articles/aging-baby-boomer-population-what-
it-means-for-the-nursing-industry/
Brenman, N. F., Luitel, N. P., Mall, Mall, S., & Jordans, M. D. (2014, August 2). Demand and
access to mental health services: a qualitative formative study in Nepal. BMC
International Health and Human Rights. doi:10.1186/1472-698X-14-22
Elgie, R. (2007, September). Politics, economics, and nursing shortages: A critical look at United
States Government Policies. Nursing economics, 25(5). Retrieved October 7, 2018, from
https://www.researchgate.net/publication/5767280_Politics_economics_and_nursing_sho
rtages_A_critical_look_at_United_States_Government_Policies
Everhart, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2015, August 15). The Effects
of Nurse Staffing on Hospital Financial Performance: Competitive Versus Less
Competitive Markets. HHS Author Manuscripts, 38(2).
doi:10.1097/HMR.0b013e318257292b
Friedel, J. N. (2012, Dec 4). The American Nursing Shortage: Implications for Community
Colleges. Health Marketing Quarterly, 29(4). Retrieved September 28, 2018, from

STAFFING CRISIS FOR NURSES 11
https://www.tandfonline.com/doi/abs/10.1080/10668920902917385?
src=recsys&journalCode=ucjc20
Galderisi, S., Heinz, A., Kastrup, M., Beezhold, J., & Sartorius, N. (2015, June 4). Toward a new
definition of mental health. World Psychiatry, 14(2). doi:10.1002/wps.20231
Haddad, L. M., & Toney-Butler, T. J. (2018, May 13). Nursing, Shortage. StatPearls. Retrieved
September 28, 2018, from https://www.ncbi.nlm.nih.gov/books/NBK493175/
LeRouge, C. M., Tao, D., Ohs, J., Lach, H. W., Jupka, K., & Wray, R. (2014, September 2).
Challenges and Opportunities with Empowering Baby Boomers for Personal Health
Information Management Using Consumer Health Information Technologies: an
Ecological Perspective. AIMS Public Health, 1(3). doi:10.3934/publichealth.2014.3.160
Munn, F. (2017, August 30). Nurse shortages linked to higher patient mortality. Nursing
Standard. doi:10.7748/ns.32.1.9.s7
Premier. (2005). Safety share: Safety news for healthcare. Retrieved April 3, 2006, from
http://www.premierinc.com/all/safety/publications/08-02_full_txt.htm#President
Russell, J. (2016, February 6). Retirements, aging population cause nursing shortage.
INDIANAPOLIS BUSINESS JOURNAL. Retrieved September 28, 2018, from
https://www.ibj.com/articles/57067-retirements-aging-population-cause-nursing-shortage
Stilwell, B., Dolea, C., & Zurn, P. (2005, January). Nurse retention and recruitment:. Research
Gate, 1(4). Retrieved September 28, 2018, from
https://www.researchgate.net/publication/253159418_Nurse_Retention_and_Recruitment
_Developing_a_Motivated_Workforce

STAFFING CRISIS FOR NURSES 12
World Health Organization. (2017). Health workforce - WHO Global Health Workforce
Statistics. Retrieved from World Health Organization:
http://www.who.int/hrh/statistics/hwfstats/en/
Yau, S. Y. (2013, December 4). How nursing shortage affects the work satisfaction of nurses.
Journal of Nursing & Care. doi:10.4172/2167-1168.S1.003