Nursing Tasks, Methods, and Expectations Term Paper

Pages: 44 (11398 words)  ·  Bibliography Sources: ≈ 47  ·  File: .docx  ·  Level: College Senior  ·  Topic: Health - Nursing


Together, this combination of factors is leading toward a health care crisis which is much larger than the question of whether or not the government finances prescription drug coverage.

The State of the Industry

As inferred above, many factors are contributing to the nursing shortage crisis. This section will discuss the major contributory influences.

1. Poor Working conditions

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Dissatisfaction with pay and increasingly stressful work conditions, aggravated by a shortage of nurses at hospitals across the country, is spurring job actions in the health care field. Many nurses are choosing to leave the profession, and seek better conditions, or higher pay scales. Because of what the University of Wisconsin (UW) Hospital calls "staffing shortages," the hospital frequently calls for nurses to volunteer to work overtime. Unfortunately, the shortage has created the situation requiring mandatory overtime form much of the staff. If a nurse works one shift and no one has volunteered to take that position for the next shift, the UW staff aspects the nurse to stay on the job. Otherwise, the nurse could be viewed as abandoning the patients. While this possibility is present in most care facilities, UW Hospital has far more mandatory overtime shifts per nurse than other hospitals in the area, and the trend is rising. In 2000 another Wisconsin hospital, Meriter hospital had 400 mandatory overtime shifts spread among its 700 nurses, which is just over 1/2 shift for each nurse. In 2001, UW Hospital had 2,600 mandatory overtime shifts for 1,100 nurses, which is close to 2 1/2 shifts for every nurse. (Conroy, 2001)

TOPIC: Term Paper on Nursing Tasks, Methods, and Expectations Assignment

As a result, the thorny subject of diverting of patients from the hospital to other care facilities came at a time when the UW were engaged in a bitter contract negotiation with the nurses union. The union claimed mismanagement was causing a nursing shortage and undermining patient care. The UW hospital said it was trying to address a shortage being felt by hospitals nationwide. But the bottom line of the situation was that "Patients were at risk every day because of this situation," said Bonnie Strauss, chief negotiator for District 1199 of the Service Employees International Union, which represents 1,100 employees, mostly nurses, at University Hospital. "They have beds. They don't have the staff."

2. Declining Nurse Population

Hospital nursing staff are trained to watch over the overall well being of their patients. A setting in which the care of the patient is being compromised, regardless of the reason, is an employment environment which creates additional stress and conflict for the nurses. The result is that the hospital can't keep nurses when the poor work conditions, including mandatory overtime, double shifting and short staffing are a regular part of the work-scape. Andrew Campbell, a veteran nurse in the pediatric intensive care unit, said: "The conditions just continue to get worse." (Mosiman, 2001)

The first report to spot the negative trend predicted in 1997 that Canada would be short at least 69,000 nurses by 2011. Subsequent studies have made corroborating projections. A report released recently by the Canadian Institute for Health Information (CIHI) reveals that there are now 70 per cent more nurses aged 50 and over, than aged 35 and under. The average age of Canadian nurses is 44.2 years. Nurses tend to leave the profession as they reach their mid-50s, when their bodies can no longer handle the physical demands of the job, such as lifting patients. A study reported in the New England Journal of Medicine last year found that "low nurse staffing" increased the rate of "life-threatening infections, shock and bleeding." (Silas, 2003)

According to Business Wire magazine, by 2011, the number of new nurses entering the profession is projected to exactly equal those retiring. In 2000, only 32% of nurses were less than 40-years old and 26% less than 30-years old. A significant increase in nursing supply is necessary to recover past losses.' (Business wire, 2003)

The chart below represents data collected from a 2001 survey of 1092 hospitals nation wide.

Adapted from First Consulting Group. "The health-care workforce shortage and its implications for America's hospitals

The nationwide shortage at hospitals is occurring despite a 39% increase in the number of registered nurses nationwide in the last five years, to 2.74 million. More of these nurses - about two out of five - are choosing not to work in hospitals or nursing homes. They opt for easier, better-paying jobs at health maintenance organizations or pharmaceutical companies. The Department of Health and Human Services (DHHS) predicts a shortage of 400,000 nurses by 2020. (Agovino, 2001)

Other agencies which have been watching this trend foresees no relief to the nursing shortage given increasing demand, an aging workforce, and inadequate supply, according to a report released today by Fitch Ratings. The current and projected personnel shortages, especially among registered nurses (RNs), present one of the greatest operating challenges for health care providers nationwide. 'Any improvement in other areas from operational efficiencies or favorable rate increases from managed care payers will be offset by labor cost inflation. Therefore improvement in the credit quality of many hospitals and long-term care providers would be prolonged. Imbalanced supply and demand, which is expected to worsen as retiring nurses outstrip replacements, should create financial strain for many providers in an industry that is gearing up to meet the aging population's anticipated demand for more services,' said Chad Farrington, director Fitch Ratings. (Business Wire, 2003)

The Art and Science of Nursing

The goal of nursing is to "...assist persons to achieve their optimum level of health in situations of normal health, illness, injury, or in the process of dying" (Canadian Nurses Association, 1998). This goal is achieved in the nursing profession through the two related segments of health care which draw from different skill categories. The science of nursing concerns itself with the application of medical care, while the art of nursing focuses empathetically on the emotional and holistic needs of the patients. Nursing as a science involves the technological and research aspect of patient care. The art of nursing is a more holistic view and takes into account all the patients mental, emotional, physical and spiritual needs.

The science of nursing includes mastery of the knowledge base required to function as a nurse, and the accurate application of that knowledge and knowledge is fundamental in the growth of any discipline, especially one which offers care for a complicated creature as the human being. According to Talbot, (as cited in Potter, Perry, 1997) knowledge is information, and discovery is the creative process of obtaining new knowledge. Research is used to scientifically prove theories as well as to discredit others. Personal experience may bring research and increase the body of knowledge. Since nurses have started to do research, they have begun to build their own body of knowledge, instead of borrowing that knowledge from others (Leddy, 1998).

The growing body of knowledge corporately contained within the maturing nurse population is a valuable asset. This knowledge has been built by experience and in recent years by nurses who have undertaken personal research. Managing this body of knowledge, which has been created post-graduation, is an important and valuable asset to the entire field on nursing. This knowledge should be passed along to up coming nursing staff before the current nurses retire. In an environment which is understaffed, the flexibility needed to pass this knowledge along to the new staff could be forever lost.

Research and experience in the nursing field has allowed positive evolution within the profession. According to Meleis (1997), nurses use knowledge of human responses to health and illness in the healing process. Meleis (1997) states that the nurses uses this knowledge by promoting health, by helping to care for the patient, by helping the patient learn to care for themselves, and by helping empower the client, teaching them to use available resources. Philips (2000) discusses Rogers' idea that "nursing science is the prerequisite to the process of nursing" (Philips, 2000).

On the other side of the coin, the art of nursing is also important in every way to the success of the nursing profession, and the success of the individual pursuing a nursing career. Physical health and holistic health are very closely related, and both constructs consider what is best for all aspects of the patients' well being. According to Potter and Perry (1997) holistic health is becoming so popular because of the belief that comfort affects personal physical and mental functionality. Holistic health concerns are considered to be an important part in an individual's wellness. Holistic health looks at all aspects of a person's wellness, and the nurse is responsible to assess the need of the individual and to make sure that all these needs are met.

In terms of the art of nursing, "Caring (for the patient) is a mutual exchange in which both parties relate on the level of their shared humanness." (Montgomery, 1993) While the patient… [END OF PREVIEW] . . . READ MORE

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