Definition and description of the problem
The nonprofit healthcare system is one of the state’s largest employers, but it is losing big money trying to attract new nurses or to keep workers in these positions. In addition to higher salaries and bonuses, hospitals now offer nurses a variety of benefits, such as student loan repayment for those who sign a two-year contract with the hospital, free housing, and other perks. Over several years, the staffing crisis has caused hospitals to spend about a billion dollars to hire and retain employees.
Nursing professionals play a critical role in health care reform, ensuring the availability and quality of therapeutic and preventive care for the population. According to the Japanese Nurses Association, of all healthcare facilities in the country, 15 percent of these workers have faced nursing care because of the spread of the coronavirus. And health care facilities that receive patients with coronavirus have a turnover rate of more than 20 percent. (Poon et al., 2022). The health worker shortage crisis was relevant even before the pandemic, but after 2020, the problem has taken on new, critical proportions.
Why this is a leadership issue
One of the key factors in the problem of staffing shortages is the issue of competent management between medical staff. The nursing workforce lacks an unspoken leader in the team, who will build communication between supervisors and staff. For example, nurses could create a specific work schedule, agreed with their bosses, to avoid overwork and possible emotional burnout.
The background and history of the issue
The problem of staff shortages was acute even before the pandemic since becoming a medical professional involves losing a great deal of time and financial resources. Also, the medical field involves a lot of physical and mental work (Yaqoob, 2018). Night duty in the intensive care unit or the ambulance team alone has many consequences, such as disrupted human biorhythm, the stress of transporting patients, monitoring the patient’s condition, and administering the necessary medications promptly.
The history of the shortage of health workers dates back to 2013, when the WHO published a report “The Universal Truth – No Health Without Workforce” (ICONP, 2020). According to this organization, the main causes of the problem are the aging of specialists with further retirement, as well as the departure of medical workers to higher-paying jobs. Also in 2008, a study was conducted in Poland regarding the danger level of working in the medical field (Haddad et al., 2022). Overall, health care workers are at high risk for violence in all parts of the world, with 8% to 38% experiencing some form of violence in their careers.
Review of the literature
The book Nurse Retention by Dr. Sylette says that the nursing shortage problem is so severe that it is more profitable for a hospital to overpay its nursing staff to retain staff as long as possible (DeBois, 2021). The book Nurses on the Move by Mireille Kingma discusses that in all industrialized countries of the world, patients are increasingly finding that the nurses caring for them are coming from a variety of countries (Kingma, 2018). This work agitates for society to pay attention to the speed with which the drain of personnel from the Third World is developing, which is a threat to the populations of these nations.
The Journal of Continuing Education in Nursing examines the problem of attrition. Nursing administrators face the challenge of recruiting and retaining staff nurses in the face of growing vacancies and turnover rates averaging 21% (S Kleinman, 2017). In Improving the Work Environment, a step-by-step discussion of the various factors that can affect employee retention, one of which is Magnet recognition (Morris, 2019). The Magnet program focuses on innovation and quality results, with limited attention to creating a healthy work environment (Kennedy, 2019). Such actions are necessary for the correct relationship between supervisors and employees.
Newly qualified nurses leave the profession at a higher rate than any other year of experience. Nurse Education Today examines the problem of turnover among newly hired nurses. According to the article, young nurses are more likely to quit within the first six months than nurses who have worked for more than one year (Collard et al., 2020). The article reviews the literature on nursing and social work with young nurses to clarify which factor is critical in the decision to leave medicine.
Summarize what is known about the issue
We already know that the root cause of medical staff leakage is the physical and financial cost to workers. Also the moral repression of workers by patients, superiors, moral dilemmas when patients die, and communication with a relative of the deceased play an important role. There is a large number of scientific works, books and articles devoted to this problem. often the cause of leakage of specialists is insufficient salary, conflicts with superiors and patients, emotional burnout.
Solutions to the issue as identified from the literature
In the paper, the main deterrents to nursing staff, the research team analyzed the main causes of employee leakage in the hospital and provided examples of solutions to the problems. For example, the paper reported that lack of advancement/professional development opportunities was cited as a reason by at least 39% of survey respondents (Marquis & Huston, 2021). This means that to retain medical staff, it is necessary to provide continuing education to staff through free webinars related to their specialty to raise workers’ salaries, thereby encouraging continuing education for their employees.
How the issue is being addressed at the organization where you work
I work as a nurse in a psychiatric unit. The problem in our organization is solved by competent management when the bosses include the interests of the nursing staff in the work process. For example, if medical workers have problems with a certain room of patients (for example, when a patient shows aggressive behavior towards employees), the bosses meet the nurses halfway, ready to have a conversation with patients to establish who is right in the situation. In addition, during the height of the coronavirus, healthcare workers began to receive increased wages, free treatment in case of covid infection, and shift work.
Best practice solution integrating information from the review of literature
An organization known as the Living Psychiatric Hospital Institute, our department consists of 6 physicians, 15 nurses, and a department head. In my opinion, the best solutions to the problem of nurses leaving the profession were suggested in the paper “Factors Affecting Nurse Retention in the Hospital.” In this paper, the predominant arguments in addressing the problem were the interaction between supervisors and staff (Marufu et al., 2021). The paper stated that nursing staff needed to provide ongoing feedback on possible problems in the workflow.
Conclusion
The problem of nurse leakage has been around for a long time, and the pandemic has made the problem a critical one in every healthcare institution in the world. The initial desired outcome of labor activity is a monetary reward in the form of a salary. And if it is not achieved, the motivation decreases. The ratio of the remuneration received to one’s efforts compared to the remuneration of one’s colleagues for similar work leads to psychological and even physiological discomfort. Motivation involves not only material but also moral incentives. Attacks on the medical staff are not uncommon; there are not always justified complaints from patients. One way to solve this issue is to introduce a system of professional liability insurance for medical workers, which has long been used in many countries.
References
Collard, S. S., Scammell, J., & Tee, S. (2020). Closing the gap on nurse retention: A scoping review of implications for undergraduate education. Nurse Education Today, 84(84), 104253. Web.
DeBois, S. (2021). Nurse retention. Dr Sylette Enterprise Incorporated.
Haddad, L. M., Toney-Butler, T. J., & Annamaraju, P. (2022). Nursing Shortage. National Library of Medicine; StatPearls Publishing. Web.
ICONP. (2020). INTERNATIONAL COUNCIL OF NURSES POLICY BRIEF the global nursing shortage and nurse retention. Web.
Kennedy, M. S. (2019). Improving the Work Environment, Step by Step. AJN, American Journal of Nursing, 119(4), 7. Web.
Kingma, M. (2018). Nurses on the move : Migration and the global health care economy. Ilr.
Marquis, B. L., & Huston, C. (2021). Leadership roles and management functions in nursing, 10th edition (10th ed.). Wolters Kluwer Medical.
Marufu, T. C., Collins, A., Vargas, L., Gillespie, L., & Almghairbi, D. (2021). British journal of nursing – factors influencing retention among hospital nurses: Systematic review. British Journal of Nursing. Web.
Morris, E. (2019). Increasing Nurse Retention. AJN the American Journal of Nursing, 119(8), 10. Web.
Poon, Y.-S. R., Lin, Y. P., Griffiths, P., Yong, K. K., Seah, B., & Liaw, S. Y. (2022). A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions. Human Resources for Health, 20(1). Web.
S Kleinman, C. (2017). Leadership: A key strategy in staff nurse retention. The Journal of Continuing Education in Nursing, 35(3), 128–132. Web.
Yaqoob, A. (2018). Low Nurse retention: A Global Issue. International Journal of Nursing Care, 6(2), 93. Web.