Response to the Discussion: Workforce Shortages in Healthcare Paper

Response to the Discussion: Workforce Shortages in Healthcare Paper

Hello Troutman

I enjoyed reading your post because it captures all aspects and issues surrounding workforce shortages in healthcare and the subsequent consequences. Also, you comprehensively provided scholarly and statistical contentions regarding the extent of workforce shortages in the US healthcare system and appropriate organizational-level strategies to address these shortages. I concur with the contention that nurse leaders face multiple challenges when developing and implementing strategies to support tenets of quadruple aims, including access to care, cost management, quality care, and care delivery. One of the major reasons that constrain the plausibility of achieving these objectives is the current workforce shortages in healthcare systems.

While echoing your perspective on the state of workforce shortages globally and nationally, it is essential to single out the prevailing unfavorable nurse-patient ratios as the primary reason for delayed, fragmented, and uncoordinated care. According to Haddad et al. (2020), the US will require more than 275,000 additional nurses from 2020 to 2030. The underlying causes of workforce shortages in healthcare include high turnover rates, inequitable workforce distribution, the poor transition from students to healthcare professionals, and a lack of collaboration between educators and employers.

Equally, workforce and patients’ demographic aspects contribute to nursing staff shortages. For instance, the aging population in the country has increased the demand for quality and timely healthcare services. Conversely, an aging workforce population and subsequent retirements have created a shortage of workforce, prompting healthcare organizations to opt for more expensive approaches, such as training and hiring more new nurses. Lockhart (2020) contends that it costs between $40,300 and $64,000 to replace one clinical nurse. Therefore, an average hospital can lose $4.4 million to 6.9 million annually. Besides the aging workforce population, increased workloads, nurse burnout, exposure to workplace stressors like violence, intense physical and emotional labor, long working hours, and irregular shifts can facilitate nurse turnover and shortages by facilitating intentions to quit professional responsibilities. Therefore, preventive interventions should focus on addressing the causal and contributing factors for nurse shortages.

The effects of nurse shortages are adverse since they led to increased workload, burnout, job dissatisfaction, stress, and higher mortality and failure-to-rescue rates. Haddad et al. (2020) contend that nurse shortages contribute to medication errors and the desire to leave the nursing profession. It is possible to address and reduce workforce shortages in healthcare by implementing contextual and interdisciplinary interventions. I agree with you that implementing nurse-run clinical and training healthcare professionals are among institution-level approaches for retaining nurses and preventing nurse turnover. However, it is essential to understand the problem of nurse shortages from internal and external perspectives. According to Drennan & Ross (2019), the micro-level interventions for addressing nurse shortages and retaining the workforce include supporting them through training, developing nurse education infrastructure in clinical settings, supporting nurses’ professional development, and implementing preceptorship and mentorship programs for new nurses.

At the macro/meso level, it is possible to address nurse shortages through building strategic partnerships between healthcare organizations and educational institutions, reviewing salary scales and benefits consistent with career progression, and ensuring equitable distribution of the nursing workforce across all regions. From a personal protective, addressing workforce shortages from micro, meso, and macro levels is essential in promoting sustainable interventions for ensuring healthy nurse-patient ratios and fair distribution of the healthcare workforce.

References

Drennan, V. M., & Ross, F. (2019). Global nurse shortages—the facts, the impact, and action for change. British Medical Bulletin, 130(1), 25-37. https://doi.org/10.1093/bmb/ldz014

Lockhart, L. (2020). Strategies to reduce nursing turnover. Nursing Made Incredibly Easy! 18(2), 56. https://doi.org/10.1097/01.nme.0000653196.16629.2e

Haddad, L. M., & Toney-Butler, T. J. (2022, February 22). Nursing shortage. NCBI; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493175/

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Kim Troutman
RE: Discussion – Week 1 Main Post Kim Troutman
COLLAPSE
Main Post

Workforce Shortages in Healthcare

There are shortages in the workforce in all aspects and settings of healthcare delivery, with reasons including retirements, job fatigue, and movement to better-paying industries. Nurse leaders face the challenges of devising new and creative ways to develop care delivery teams to support the concepts of the Quadruple Aim, which include access to care, management of costs, quality care, and improvement of work life for caregivers (Broome & Marshall, 2021). Leaders in healthcare settings address workforce shortages by building an integrated care team, division of tasks, crosstraining, and utilizing nurses in non-traditional care delivery methods, to name a few.

The purpose of this discussion is to address the issue of workforce shortages in healthcare settings in general, how shortages have impacted the university health center that I currently work in, as well as discuss the implemented changes that have been made at the university health center to address this while supporting the Quadruple Aim.

Description of the Impact of Workforce Shortages in Healthcare

The shortage of healthcare workers garners national attention because it threatens access to care and quality of care in communities around the nation. COVID has increased workforce shortages due to caregivers suffering from stress, emotional trauma, and burnout (American Hospital Association [AHA], 2021). Becker’s Hospital Review (2022) lists the following statistics:

The U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses nationwide by 2030.
The United States could see a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025.
Within the next five years, the U.S. faces a projected shortage of more than 3.2 million lower-wage healthcare workers, such as medical assistants, home health aides, and nursing assistants (Gooch, 2022).
These statistics highlight the challenges that nurse leaders and administrators face in all aspects of healthcare organizations to ensure that the delivery of care is low cost, high quality, accessible, and allows for caregiver satisfaction. This shortage and its challenges are felt in all areas of healthcare, including outpatient, inpatient, community, and other vital areas. Increasing workloads for healthcare delivery teams only adds to the burden of stress and burnout. Adding the statistic of a decreased number of primary care physicians (PCP) in healthcare amplifies the issue. Studies show that the projected shortage of PCPs will be between twenty to fifty-five thousand by 2033 (Alley et al., 2021).

How these Workforce Shortages in Healthcare Affect My Personal Work Setting

I am the Nursing Coordinator of the Urgent Care Center at the James Madison University (JMU) Student Health Center in Virginia. The shortages include physicians and nurses who retired after COVID, some earlier than expected, most likely due to stress and burnout. We have seen medical assistant staff move out of healthcare into the workforce for better salaries and less stressful work. The health center is divided into General Medicine, Urgent Care, and Gynecology Clinic. Each area is staffed by nurses and medical assistants, other than Urgent Care, which is staffed by RNs and student volunteers who are part of the health sciences curriculum at JMU.

The shortages cause the workload to be increased by physicians/advanced practitioners, nurses, and medical assistants and, if not addressed, can lead to burnout and dissatisfaction with the job.

Strategies Implemented to Address Shortages in My Personal Work Setting

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Each healthcare organization or entity must decide on strategies to address workforce shortages to avoid burnout and job dissatisfaction that could lead to more staff leaving. Understanding the issue and strategies to address the problem is vital to healthcare leaders and politicians who can help write legislation to mitigate the crisis (Pittman & Scully-Russ, 2016). JMU is a public research university, and medical leaders and administrators are actively looking for solutions to the workforce shortage in the health center and making legislators aware of the issue.

The health center recognized that advanced practitioners such as nurse practitioners and physician assistants would be an asset to the health center, especially in the wake of physician retirements. This has helped immensely, and many of our nurse practitioners are at the doctorate level. This alone is not enough to solve the issue, and another solution was to utilize our registered nurses to the highest extent of their license level. We started a nurse-run clinic to help shift tasks from the providers and allow students to be scheduled with a nurse for things such as suture removal, immunization/vaccine administration, sexually-transmitted infection (STI) testing for non-symptomatic students, and pregnancy tests, to name a few (James Madison University [JMU], n.d.). We also implemented a service where the student can call in and talk to a nurse. They can be triaged to an appointment for medical reasons, behavioral health, or to get information on services. Implementing the nurse clinic and the talk to a nurse service have greatly decreased the workload on the physician and advanced practice providers. The nurses are supplemented with trained prn nurses oriented to phone triage and nurse clinic, which helps to allow full-time staff to have time off when needed to improve job satisfaction and reduce burnout. These strategies allow for a positive work environment for all.

Conclusion

In conclusion, workforce shortages in healthcare are very real and increasing rapidly, causing healthcare leaders, administrators, and legislators to work towards solutions that will thwart the threat of access to care and quality of care. This affects healthcare in all areas, including inpatient, outpatient, and community settings. This has affected my area of work, a university health center, and our leadership implemented several initiatives to alleviate the stress and share tasks. Utilizing more advanced practice providers, starting a nurse-run clinic, and implementing a nurse phone triage process helped my work setting adjust and successfully maneuver through workforce shortages.

References

Alley, R., Carreira, E., Wilson, C., & Pickard, K. (July/August 2021). Using nurse-sensitive indicators to assess the impact of primary care RNs on quality ambulatory patient care. Nursing Economics: The Journal for Health Care Leaders, 39(4), 200–207.

American Hospital Association. (2021, May 26). Fact sheet: Strengthening the health care workforce. https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company, L.L.C. https://doi.org/10.1891/9780826135056

Gooch, K. (2022, May 23). Healthcare workforce shortages by the numbers. Becker\’s Hospital Review. https://www.beckershospitalreview.com/workforce/healthcare-workforce-shortages-by-the-numbers.html

James Madison University. (n.d.). Health center: Make an appointment. https://www.jmu.edu/healthcenter/medicalservices/my-jmu-health.shtml

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14(56). https://doi.org/DOI 10.1186/s12960-016-0154-3