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Effects of Nursing Staff Shortages on the Health Care System

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Nursing Staff Shortages in the Health Care System

Introduction

The shortage of nurses is a global health issue that negatively affects healthcare delivery, and the problem is expected to worsen with the increasing demand for healthcare providers caused by the aging population (Stokes & Iskander, 2021). It is approximated that by 2029, there will likely be 73% more Americans over the age of 65, which will increase the demand for healthcare practitioners to provide medical services. This paper provides a comprehensive discussion of the issue of nurse shortage in the cultural and ethical context. Two Level 1 research questions, one from the ethical perspective of inquiry and the other from a cultural perspective, have been selected to guide the paper. Also, a Level 2 research question has been formulated for each perspective of inquiry to further explore the issue of nursing shortages from the cultural and ethical context. The chosen Level 1 question from the ethical perspective of inquiry is “What laws pertain to the issue?” while the formulated level 2 question from this perspective is “What are the ethical implications of nursing staff shortages?”. On the other hand, the chosen level 1 question from the cultural perspective of inquiry is “Which cultural values influence the issue?” and the corresponding level 2 question is “How does cultural diversity affect nurse shortage?”. All these questions are addressed below.

Research Questions from the Ethical Perspective of Inquiry

The Level 1 research question from the ethical perspective of inquiry aims to uncover the laws that pertain to the issue of nurse shortages. Since different countries have different laws that pertain to this healthcare issue, the focus of this paper will be on the US laws that pertain to the issue of nursing staff shortages. One of these laws is the Nurse Reinvestment Act, P.L. 107-205. The 107th Congress passed the Nurse Reinvestment Act on July 22, 2002. Congress had been significantly engaged since the 1960s with the goal of providing the US with sufficient nurse manpower. The Act was later signed into law by President George W. Bush on August 1, 2002. The Nurse Reinvestment Act pertains to the issue of nursing staff shortages because Title I and Title II pertain to nurses’ recruitment and retention, respectively. Title 1 of the Act provides two ways of boosting nurses’ recruitment. The first initiative is the development and broadcasting of grant-based funding of local and state public service announcements to promote and advertise the nursing profession. During broadcasting, the rewards ad advantages of the nursing profession should be highlighted, and people are persuaded to enter into this profession. The second initiative entails the revision of provisions of the National Nurse Service Corps (NNSC) related to items such as scholarships, loan repayment, funding, and reporting and eligibility requirements. Boosting nurses’ recruitment helps in addressing the main health care issue selected, which is nurse shortages. Title II of the Nurse Reinvestment Act presents policies intended to improve the retention of nurses. The provisions of Title II relate to areas such as creating career ladders and retaining high-quality nurses through retention grants and nurse education, developing and funding comprehensive geriatric education, and creating and running a nurse faculty loan program to improve the number of qualified nursing faculty. Title II of the Act helps address the issue of nurse shortages by ensuring nurses do not quit their profession. Another law that pertains to the issue of nursing staff shortage in the US is the Nurse Training and Retention Act of 2007, S.2064. The 110th Congress passed this Act on September 18, 2007. This Act aims to ensure comprehensive programs are funded to facilitate a sufficient supply of nurses. Increasing the supply of nurses helps deal with the selected healthcare issue, nursing staff shortage.

Level 2 research question from the ethical inquiry perspective aims to uncover the ethical implications of nursing staff shortage. Persistent nurse shortages across the world challenge the values and beliefs of this profession and result in various ethical implications. One of these ethical implications is poor patient care. One of the ethical obligations that nurses must fulfill during their line of duty is ensuring that patients are protected from harm (Haahr et al., 2020). However, nurse shortages make it challenging for the nurses to fulfill this obligation as the hospitals assign them to cater for many patients. Since chronically ill patients require holistic care, inadequate staffing denies nurses an opportunity to provide such care to these patients, resulting in poor patient care. Another ethical implication of nursing staff shortages is nurses’ reduced job satisfaction. Usually, ethics assist nurses in making the right decisions guided by their morals. However, nurse shortages leave nurses dissatisfied with their jobs because they do not have sufficient time to communicate with their patients and provide holistic care. Moral distress is another ethical implication of nursing staff shortages. Nurses who serve in healthcare facilities with shortage of nursing staff experience moral distress since they feel that they are compromising their ethical obligation of ensuring patients are protected from harm by providing inadequate patient care (Bayat et al., 2019). Also, nurses who work in health care facilities facing the issue of nurse shortage may suffer moral distress because they feel that they would have rendered better patient care if they were not assigned many patients. Lastly, burnout is another ethical implication of nurse shortages. According to Mullen et al. (2017), increased ethical conflict at work may result in emotional stress and mental burnout.

Research Questions from the Cultural Perspective of Inquiry

Level 1 research question from the cultural perspective of inquiry aims to uncover the cultural values that influence the issue of nursing staff shortages. Cultural competence is one of the cultural values that influence the issue of nurse shortages. Cultural competence is the set of values, practices, behaviors, and attitudes within an organization system or even individuals, which allows them to work effectively across different cultures. Cultural competence influences nurse shortages because when nurses are not culturally competent, they tend to get stressed, which results in nursing burnout. Another cultural value that influences nurse shortages is cultural diversity. Cultural diversity is the existence of many cultures in the same society. Nurses must be well prepared to serve culturally diverse patients. Unless nurses are culturally competent, they cannot be in a position to provide quality care to patients. When nurses cannot provide quality care, they get stressed and end up quitting their jobs. The last cultural value that influences nurse shortage is cultural awareness. Nurses’ cultural awareness is their comprehension of differences between themselves and patients from other cultural backgrounds. Similar to cultural competence, a lack of cultural awareness may result in nurse shortages.

Level 2 research question from the cultural inquiry perspective aims to uncover how cultural diversity affects nurse shortage. Cultural diversity may both increase or minimize nurse shortages. Research reveals that nurses without a firm understanding of cultural differences may experience frustrations and stress when dealing with culturally diverse patients (Balante et al., 2021). Consequently, this may result in nurse burnout. Burnout is one of the leading causes of nurse shortages. Thus, it can be concluded that nurses’ lack of cultural competence indirectly results in nurse shortages. On the contrary, cultural competence allows nurses to provide inclusive healthcare service, improves nurses’ job satisfaction, and facilitates patient satisfaction. When nurses are satisfied with their job, they tend to retain their profession. Consequently, this minimizes nurse shortages.

Conclusion

Overall, nursing shortages are a global health issue of concern and have adverse effects on healthcare delivery. This paper comprised two four questions. The first question was a Level 1 question from the ethical perspective of inquiry and sought to uncover the laws that pertain to the issue of nurse shortages. Two laws were found, including the Nurse Reinvestment Act, P.L. 107-205, and the Nurse Training and Retention Act of 2007, S.2064. The Nurse Reinvestment Act pertains to the issue of nursing staff shortages because Title I and Title II pertain to nurses’ recruitment and retention, respectively. On the other hand, the Nurse Training and Retention Act of 2007 aims to ensure comprehensive programs are funded to facilitate a sufficient supply of nurses. Level 2 question from this perspective sought to examine the ethical implications of nurse shortages. They include the provision of poor-quality care, reduced job satisfaction, burnout, and moral distress. The Level 1 research question from the cultural perspective examined the cultural values that influence nurse shortages. The identified cultural values include cultural competence, diversity, and awareness. The Level 2 question from this perspective is how cultural diversity impacts the nurse shortage. It has been established that cultural diversity can increase or minimize nurse shortages. Questions from both perspectives provide insights on how the issue of nurse shortages can be dealt with.

References

Act, N. R. PL 107-205 (2002). Washington, DC: US Government Printing Office.

Balante, J., van den Broek, D., & White, K. (2021). How does culture influence work experience in a foreign country? An umbrella review of the cultural challenges faced by internationally educated nurses. International Journal of Nursing Studies, 118, 103930. https://doi.org/10.1016/j.ijnurstu.2021.103930Bayat, M., Shahriari, M., & Keshvari, M. (2019). The relationship between moral distress in nurses and ethical climate in selected hospitals of the Iranian social security organization. Journal of Medical Ethics and History of Medicine, 12 (8), 1–16. https://doi.org/10.18502%2Fjmehm.v12i8.1339Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing ethics, 27(1), 258-272. https://doi.org/10.1177/0969733019832941Mullen, P. R., Morris, C., & Lord, M. (2017). The experience of ethical dilemmas, burnout, and stress among practicing counselors. Counseling and Values, 62(1), 37-56. https://doi.org/10.1002/cvj.12048Stokes, F., & Iskander, R. (2021). Human rights and bioethical considerations of global nurse migration. Journal of bioethical inquiry, 18(3), 429-439. https://doi.org/10.1007%2Fs11673-021-10110-6Stokes, F., & Iskander, R. (2021). Human rights and bioethical considerations of global nurse migration. Journal of bioethical inquiry, 18(3), 429-439. https://doi.org/10.1007%2Fs11673-021-10110-6

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