IO002 Professionalism

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Western Governors University

D030 Leadership & Management in Complex Healthcare Systems

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Date

Organizational Policies Report

Since the onset of the Covid-19 pandemic, the shortage of nurses in healthcare settings has become a critical challenge worldwide. This shortage, particularly of experienced nurses, has intensified the complexities within healthcare organizations. As a result, many facilities face shortages not only in nursing staff but also in available beds, which compromises the quality of care provided, especially for patients with unfamiliar or complex medical conditions (Jacobs, 2021). This report explores the competing demands that contribute to the nursing shortage, evaluates policies affecting this issue, and offers recommendations to mitigate the problem.

What Are the Competing Needs Contributing to the Nursing Shortage?

The nursing shortage stems from several interrelated factors tied to workforce dynamics and personal challenges nurses face.

Aging Workforce and Retirement: The nursing workforce is aging rapidly, leading to a projected loss of over 2 million years of nursing experience annually between 2020 and 2030 (Buerhaus, 2021). This trend significantly reduces the number of seasoned nurses available.
Career Advancement and Role Changes: Many nurses are pursuing advanced degrees or shifting into managerial and non-traditional roles, reducing frontline nursing staff (Buerhaus, 2021).
Workload and Job Satisfaction: Nurses often face unsafe work environments, heavy workloads, burnout, and limited autonomy, all of which contribute to high turnover and dissatisfaction (Saikia, 2018).
Work-Life Balance: Nurses, especially those of childbearing age, struggle to balance family responsibilities, such as maternity leave and caregiving duties, with demanding work schedules (Marć et al., 2018).
Increasing Patient Complexity: The aging population with chronic medical conditions intensifies the demands on nursing staff, creating further strain.

How Do These Needs Intersect?

Competing Need	Impact on Nursing Shortage	Explanation
Aging Workforce	Loss of experienced nurses	Experienced nurses retire faster than new ones enter, causing a skill and knowledge gap.
Career Changes	Decreased clinical staff	Nurses move to advanced degrees or administrative roles, reducing bedside caregivers.
Workload and Burnout	Increased turnover	Excessive workload and stress lead to burnout and early exits from the profession.
Work-Life Balance	Reduced availability	Family care responsibilities cause nurses to reduce hours or leave work temporarily/permanently.
Patient Complexity	Increased care demands	More complex patient needs require more time and expertise, stretching nursing resources thin.

What Policies or Practices Impact the Nursing Shortage?

Healthcare institutions have begun implementing policies aimed at managing staffing levels. For example, Prairie Ridge Health enforces specific nurse-to-patient ratios, such as maintaining one nurse in the obstetrics unit and two nurses in the medical-surgical unit at all times, regardless of patient volume (Jacobs, 2021). While experienced nurses often adjust to these staffing policies, newer nurses sometimes report feeling unsupported and unsafe, highlighting the tension between policy enforcement and staff perceptions.

What Ethical Considerations Arise from These Policies?

Nurses dedicate themselves to delivering patient-centered care; however, healthcare organizational policies often emphasize fiscal responsibility and efficiency, potentially leading to ethical conflicts. New nurses, in particular, may find these policies challenging as they navigate the tension between cost containment and providing safe, high-quality care (Kelly & Porr, 2018). Cultivating ethical awareness is crucial to empower nurses to advocate effectively for safe staffing practices and uphold patient safety (Milliken, 2018).

What Are the Recommended Policies to Address the Nursing Shortage?

To mitigate nursing shortages and support competing needs, the following recommendations are proposed:

Empower Nurses: Encourage nurse participation in decision-making, offer career advancement opportunities, and create safe work environments.
Implement Minimum Staffing Ratios: Establish a baseline of at least two nurses per unit to ensure patient safety and reduce nurse burnout.
Promote Work-Life Balance: Develop supportive policies such as flexible scheduling, paid family leave, and resources for caregiving responsibilities.
Invest in Retention Programs: Develop mentorship and residency programs targeting new graduates to reduce turnover and foster professional growth.

Research supports that adequate staffing is linked to shorter hospital stays and improved patient outcomes, which also benefits organizational costs (Phillips et al., 2021).

Conclusion

The ongoing nursing shortage requires urgent and strategic policy interventions that balance the needs of nurses, organizations, and patients. Ensuring safe work environments, reasonable workloads, and supportive staffing policies is essential to reduce turnover, particularly among new nurses, and maintain high standards of patient care (Pickens & Palokas, 2023).

References

Buerhaus, P. I. (2021). Current nursing shortages could have long-lasting consequences: Time to change our present course. Nursing Economics, 39(5), 247–250.

Jacobs, A. (2021). ‘Nursing is in crisis’: Staff shortages put patients at risk. New York Times.

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: The Online Journal of Issues in Nursing, 23(1), Manuscript 6.

Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2018). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9–16.