Nursing Issue Paper
Running head: NURSING SHORTAGE
Nursing Shortage
Submitted by:
S0241236
A project submitted in partial fulfillment of the
course requirements of NSG 279
Lisa Zubach
Lethbridge College
March 4, 2009
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The nursing shortage is becoming a national crisis and is expected to increase 23% by
2020 from the current 6% shortage (Cohen 2006). The current recruitment into the nursing field
is helping relieve the staffing shortage, but healthcare organizations should also focus on the
current staff as to why they are choosing to leave the workforce. There are many interrelated
factors as to why there is a shortage in the nursing profession, but there are a few more
prominent factors that are producing the shortage. This paper will discuss the current nursing
shortage within healthcare organizations, and the factors that contribute to this shortage, such as,
the aging workforce, increased career opportunities and the workplace environment. Also, within
this discussion there will be talk about some possible resolutions to help minimize the nursing
shortage within our society.
A study done by the Canadian Nursing Association (CNA, 2009) in 2002 states, "Canada
will experience a shortage of 78,000 RN's by 2011 and 113,000 RN's by 2016". These numbers
are expected to increase partly because the age of the current nursing workforce who is less than
35 years of age is only 22% (Cohen, 2006). This is partly because of the high turnover rates with
younger nurses entering the workforce who are dissatisfied, as well as those satisfied are still
choosing to leave. The high burn out levels in the workplace is causing other nurses to take on a
greater workload because of the decreasing nursing staff (Khowaja, Merchant & Hirani, 2005).
The staff leaving the nursing profession are choosing other areas of work that supply larger
salaries, limited shift work and better working conditions (Cohen, 2006).
Today, there are a growing amount of career opportunities available for healthcare
workers to enter specialised areas. These career opportunities are available through privatized
businesses who work in partnership with the health care system, such as, Cause & Effect
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Foundation, Early Intervention Services (2009), which focuses on specific aspects of children
with special needs. Businesses like this give opportunities to healthcare workers who do not want
to work in the hospital setting. This creates more choices for other career opportunities for
people currently enrolled in healthcare. Also, there are more options available within the
schooling system that offer more specialized training in certain areas, which in turn are leading
away from the traditional nursing profession (Cohen, 2006).
Factors Contributing to the Nursing Shortage
Increased Career Opportunities
There are a vast number of career choices that have opened up for young people today,
especially women who have made up more than 90% of the nursing workforce over the last few
decades (Kelsey, 1999). Women today have more opportunities to pursue careers; this in turn is
taking away from a large number of possible candidates entering the nursing profession (Kelsey,
1999). People are leaving and not entering the nursing profession because they are looking for
more regular hours, more money and more opportunities for advancement (Cohen 2006).
Research shows that "35% fewer women would choose nursing as a career in the 1990’s than
they would have in the 1970’s” (Kelsey, 1999) this in turn contributes to the increasing job
opportunities available.
Aging Work force
There are many reasons for the nursing shortage and they vary greatly. Since 1964 the
post-baby boomers generation is decreasing (Kelsey, 1999). As a result, there are smaller
amounts of eighteen to twenty-four year olds entering the profession, and the nurses working
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now are getting to the age where retirement is closer to their reach (Kelsey, 1999). According to
Cohen, (2006) the average age of nurses is rising steadily since 2002 and will increase by 3.5
years, bringing the average age of working nurses to 45.4 years by 2010. Many of these nurses
are cutting back on the time they are willing to work, as well as retiring or planning on retiring at
around the age of 50 (Coile Jr, 2001). Soon, more nurses will be retiring than new nurses
entering the work force resulting in a shortage of health care professionals (Cohen, 2006).
Workplace environment
The resulting vast number of career choices available today is taking people away from
the nursing profession because it is seen as a less desirable choice of work (Cohen, 2006). Nurses
deal with stressful working conditions on a day to day basis, they work shift work and have no
guarantee of getting holidays or important events off (Kelsey, 1999). They are exposed to
contagious factors, which in turn could be dangerous or even life threatening to their health, as
well as their families (Cohen, 2006). Also, nurses are pushed by employer policies to do more
with less; having outdated equipment, not having the correct supplies and materials, having a
larger patient workload and not having enough staff to maintain proper services. When resources
are limited, the problem for nurses becomes stressful because they are not able to carry out their
ethical duty to "assist persons to achieve their optimum level of health in situations of normal
health, illness, injury, or in the process of dying” (CNA, 2009). Cohen (2006) explains that the
top reason for nurses leaving the profession, other than retirement, is wanting to explore new job
opportunities. The high amounts of stress and the demanding physical work they experience in
their workplace, due to unrealistic workloads and lack of the concerns from administrators is
causing them to seek new job opportunities (Cohen, 2006).
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Decreased Nursing School Enrolment and Shortage in Nursing Faculty
The National League of Nursing states there has been a decrease in all types of nursing
enrolment (Munoz, 2009). This could be a resulting factor from the shortage of nursing faculty
personnel. The lack of faculty to educate has a factor on the growing demand of nurses that are
graduating from the nursing program. Having a lack of graduates takes a major toll on the
availability of hiring more nurses (Allan, 2008). Many hospitals have a bachelor degree preferred
policy for hiring new nurses and in the province of Ontario starting January 1, 2005, first time
nurses require a minimum of a bachelors degree to be considered for a nursing position (Munoz,
2009).
Possible Resolutions
Our society must acknowledge the critical role nurses play in our healthcare system and
provide them with rewards that correspond with these roles. Some of these rewards are financial,
while others are intangible and/or tangible, but all are equally important.
Flexibility
Some recommended solutions to the shortage could include offering flexible scheduling.
People today are busier than ever, so sometimes nurses are too busy with advancing their
education, parenting and other responsibilities within their personal lives (Cohen, 2006). By
having more flexible hours they will be able to balance work and family commitments and be
able to split their shared roles to accommodate their lifestyle as well as the demands from of their
job (Cohen, 2006).
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Benefits and Compensation
There are a number of benefits that are already being used to preserve and employ nurses
within our hospitals. However, these benefits must accommodate both younger and older nurses,
such as, packages geared towards a specific age group. Older workers are looking more for
insurance and retirement planning, as well as health programs and the possibility of reducing
their hours due to age and limitations; younger nurses want benefits that cover paid seminars and
scholarships that will allow them to continue with their education (Cohen, 2006). By offering
benefits of interests it can help not only recruit experienced nurses from outside varying
organization, but also, can help hold on to capable nurses already working (Cohen, 2006).
Compensating could also help deal with the issue of the nursing shortage. Many
institutions are already taking this into effect because of the increase in salaries over the years for
nurses (Kelsey, 1999). Nurses have a very important job and should be acknowledged by
increasing their wages because nurses have the right to earn an acceptable living for the
important job they do for society.
Reducing Stereotypes
Only a few decades ago, men were not seen as the 'typical nurse' because nursing was
seen as a female’s profession, therefore, the role of a nurse was done solely by women (Kelsey,
1999). Because of this view, a stereotype was created and still exists today (Kelsey, 1999). There
needs to be a decrease and elimination of the barriers and stigmas facing men in the nursing
profession. Even though today’s society is becoming more able to except women and men in
different careers, there is still a small stereotype towards men entering the nursing profession
(Kelsey, 1999). The noticeable lack of interest by men needs to be reduced and ultimately
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removed. If men were to enter nursing at the same pace as women, we could potentially
eliminate future shortages (Kelsey, 1999).
Recruiting and Retaining
Nurses going through training and those thinking about entering the profession are all
looking for a career that is exciting, satisfying and rewarding (Kelsey, 1999). These people want
to work in an environment where they are treated as trained professionals, are acknowledged for
their achievements and expertise and are included in decision making concerning their patients
(Kelsey, 1999). These new, up and coming nurses are looking for opportunities where they will
learn and progress within a career which can offer rewards for their efforts along the way
(Kelsey, 1999).
As for those nurses who are soon approaching the retirement age, we need to try and
retain them by not only offering them more money, but by increasing their work place enjoyment
and giving them a sense they are still useful on the healthcare team (Cohen, 2006). We can do
this by enhancing and improving certain parts of their job satisfaction, therefore, it will hopefully
motivate the aging nurses enough to continue in the workforce. By changing some of the
working conditions it can help alleviate any physical and/or mental stress, which will enable job
satisfaction. By having a lighter workload, stress levels can decrease greatly which is beneficial
for creating strategies to help deal with the health and safety of the staff, as well as patients
within the hospital (Cohen, 2006).
“Hospitals must look likewise for strategies to open up nursing to opportunities in
teaching, research, specialization, and management. A number of healthcare institutions
nationwide, notably academic medical centers, have in fact found success with such programs”
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(Kelsey, 1999). Healthcare organizations need to use long-term strategies that will reflect the
career potential and image of nursing as a line of work (Coile Jr, 2001).
Conclusion
If in fact Canada is going to experience a major shortage of nurses by 2016 we need to
start now by taking preventive measures. The nursing shortage has the possibility of becoming
more of a national crisis unless we analyse the factors that contribute to this shortage and look at
possible resolutions. The critical shortage for nurses who are currently working and enrolling
have needs which must be resolved in order to satisfy them. Our society must implement
incentives for nurses to further pursue the continuation of employment, educational seminars and
programs, and improve the work place environment. They need to be offered rewards to improve
their family life, so by giving flexible scheduling they are able to be happy with a balanced work
and family life.
The nursing shortage is a serious matter within our healthcare. Society needs to take the
factors that contribute to this shortage into consideration, and discuss possible resolutions to help
minimize the nursing shortage within our society and keep nurses motivated to stay in the
nursing profession.
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References
Allan, L. (2008). The nursing shortage continues as faculty shortage grows. Nursing Economics,
26(1), 35-40.
Canadian Nurses Association. (2009). The nursing shortage- the nursing workforce. Retrieved
February 24, 2009 from http://www.cna-aiic.ca/CNA/issues/hhr/default_e.aspx
Canadian Nurses Association. (2009). Code of Ethics for Registered Nurses. Retrieved March 1,
2009 from http://www.cnaaiic.ca/CNA/documents/pdf/publications/CodeofEthics2002_e.pdf
Cause & Effect Foundation, Early Intervention Services. (2009). Cause & Effect. Retrieved
March 1, 2009 from http://www.causeandeffectfoundation.com/contactus.html
Cohen, J. (2006). The aging nursing workforce: how to retain experienced nurses. Journal of
Healthcare Management, 51(4), 233-245.
Coile Jr., R. (2001). Magnet hospitals use culture, not wages, to solve nursing shortage. Journal
of Healthcare Management 46(4), 224-227.
Munoz, F. (2009). The nursing shortage. Retrieved February 25, 2009, from
http://www.op.nysed.gov/nurseshortage.htm
Kelsey, K. (1999). Improving nursing's image will help end the shortage today... Hospital
Topics, 68(1), p33-35.
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Khowaja, K., Merchant, R., & Hirani, D. (2005). Registered nurses perception of work
satisfaction at the tertiary care university hospital. Journal of nursing management, 13(1),
32-39.