The concept of nurse retention as it relates to employee satisfaction is a critical issue to manage before any nursing theory can be deployed. The problem of nurse retention and staffing can impact the numbers of medication errors, patient mortality, readmissions, a length of stay, falls, pressure ulcers, central line infections, health care related infections as well as costs (Simpson, 2016, p 139). The nursing satisfaction and appropriate staffing have cause and effect results with the ability for a facility to retain the nursing staff in place. Failure to maintain the nursing staff leads to increase training costs, overtime, fatigue with current staff and safety issues when staff falls below par.
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This further aggravates the nursing issue as the lack of physicians only drains the over taxed nursing staff into a larger unsatisfied state.
The antecedents of the nurse retention and satisfaction problem may include the days of fewer patients, more staffing and the population of less acute patients. The addition of technology lengthened life spans, and consumer savvy health care may make the issue of nurse retention and satisfaction more prevalent in today’s healthcare market. The Ana, as well as other agencies, promote and mandate reporting of staffing, preventable infections, sentinel events and other issues related to poor patient outcomes that make the issue more transparent (Simpson, 2016).
The consequences are increased patient mortality, increased complications, decreased job satisfaction and nurse burnout with the lack of staffing from poor nurse retention (Jones, 2014). The lack of staffing lead to areas of care that must be omitted to compensate for the lack of staff available which leads to decreased nursing and patient satisfaction (Jones, 2014). This dissatisfaction then leads to a departure to a more adequately staffed safer care environment that only perpetuates the cycle of poor retention and satisfaction. One study reported a six percent increase in the risk of death for patients with staffing shortages (Hairr, Salisbury, Johannsson & Vance,
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
As the forthcoming nursing shortage threatens the United States, organizations must be knowledgeable in the recruitment and retention of nurses. The challenge facing health care organizations will be to retain sufficient numbers of nurses to provide safe, efficient, quality care to patients. Organizations will look to recruit and attract quality nurses to fill vacancies. As turnover in nursing is a recurring problem, health care organizations will look for strategies to reduce turnover. The rate of turnover for bedside nurses in 2013 ranged from 4.4 to 44.6% (American Nurses Association, 2013). Nurse retention focuses on keeping nurses in the organization and preventing turnover. The purpose of this paper is to discuss the significance of recruitment and retention of nurses, review the literature, and explore how recruitment and retention apply to nursing.
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
Needleman, J., Buerhaus, P., PKankratz, V. S., Leibson, C. L., Stevens, S. R., & Harris, M. (2011). Nurse Staffing and Inpateint Hospital Mortality. The New England Journal of Medicine , 364, 1037-1045.
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
The nursing shortage is divided into four different categories. The four categories are as follows; "willing nurse" shortage, funding or perceived funding shortage, shortage of understanding that nurses are needed to deliver care, and nurse education and empowerment shortages (What is the nursing shortage and why does it exist?., 18 October, 2007). To be able to repair this major problem, all four segments of shortages need to be addressed. The first nursing shortage, A "willing nurse" shortage, is the simple fact of not enough supply to fill the demand of nursing positions. This shortage occurs either because there are simply not enough nurses to fill the open positions, or because experienced nurses are opting out of nursing and the willingness to provide care due to the current occupational environment. The second nursing shortage is the funding or perceived funding shortage. This shortage is merely due to nurses not feeling as if they are being compensat...
Without participating in a longitudinal study, it is difficult to truly assess the efficacy in mandating nurse staffing ratios. It is difficult to measure the benefits of mandated staffing due to numerous confounding variables. These confounding variables include the resources available at specific hospitals in addition to the populations that they serve. Hospital volume, RN job satisfaction and the relationship between physicians and nurses have also been shown to affect patient outcomes (Duval et al., 2007).
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
middle of paper ... ... qualified nurses diminishes. Based on this study, administrators should recruit nurses who understand that health care is at its best when health care professionals work collaboratively as members of a team, committed to providing the best possible patient care. References Aiken, L.H., Clarke, S.P, Sloane, D.M., Sochalski, J., & Silber, J.H. (2000). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.
One of the most serious issues in nursing, that can affect a nurses career is nursing burn- out. According to the article “Where have all the nurses gone”, current nurses that are practicing, report high rates of job dissatisfaction (which is part of burn out) and 1 of 5 nurses may quit nursing in the next 5 years (Dworkin, 2002). Burnout is associated with nurses not coming in to work, not feeling satisfied when doing their job, high turnover rates and a lack of commitment to the work (Katisfaraki, 2013). If a nurse becomes burned- out, they may not take care of their patients as well and could make mistakes with medication administration. A study performed in the United States by Dr. Jeannie Cimiottti, shows that hospitals with high burn-out rates among nurses have higher levels UTI’s, and surgical infections (World, 2012). Nursing burnout not only affects the nurse, but it also affects the patient, the nurses’ colleagues, and the nurses’ family; nursing burn out often leads to emotional exhaustion and depression, that can effect relations and communication between the nurse effected and the person they are communicating with. This paper will cover what burn-out is, who is susceptible to burn out, and treatment and prevent nursing burn out.
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
The major concern for registered nurses regard’s the nurse’s health and well being. Safe staffing levels are continuing to become more of a problem. The U.S is expected to experience a shortage of nurses as the “Baby Boomers” age and the need for health care grows (Rossester, 2014). This shortage is causing some health organizations to work with minimal amounts of nurses. This is affecting the nurse’s ability to provide safe care due to fatigue and injury. This shortage is also resulting in a dramatic increase in the amount of mandatory overtime, which often means that nurses stray from face-to-face patient care and can produce an increase in the amount of medical errors (American Nurses Association,
Finally, a more obvious and direct cause of nurse turnover is overall dissatisfaction with the current job. This can be for numerous reasons related to pay, benefits, job growth availability, lack of autonomy, or simply feeling unappreciated. According to one source, “a 2014 survey of more than 3,300 nurses found that they were stressed, overworked, underappreciated, and underutilized” (Fischer, 2016). No matter the reason a nurse chooses to leave their job, the negative outcomes remain the same. The most common of these outcomes are that hospitals lose money, it decreases patient quality of care, and it continues the cycle of more turnover in the nursing profession. “It is predicted that there will be a shortage of nearly 1 million nurses in the United States by 2020” (Hunt, 2009). Hospitals are impacted financially by the high nurse turnover rates. “The financial costs of losing a single nurse has been calculated to equal about twice the nurse’s annual salary” (Hunt, 2009). With these numbers in mind, the hospital spending more money to retain nurses could be a smart and beneficial action for them to
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main