The profession of nursing came about after the Post World War II created such a demand of service from health care specialists. Nursing is deeply rotted to the provision of service. As years passed, the profession developed its educational programs and capacity to enhance its value as a practice and research field. However, amidst the development in the professional field, nursing has never acquired that same autonomy and authority as compared with the field of medicine.
As the nursing profession continues to evolve in a continuous shift in paradigm, it faces a new challenge yet to be addressed in its modern structure. The problem of nursing staff shortage has been evident for the past years. Many environmental factors have made this problem construct the nursing profession’s reality. Many nursing scholars and researchers have concluded a prediction that the shortage in nursing staff in various institutions will be felt and observed as a long-term situation if not addressed properly today (Janiszewski, 2003).
Factors influencing the problem Kimball (2004) listed some environmental factors which has contributed to the problem of nursing staff. First, the problem is a result of the aging population wherein the demand for nursing care will increase because of the millions of Baby Boomers aging and the increase in tax of health care services. Second, fewer population of young nurses is observed in the general workforce, and consequently it doe not address the aging workforce which is the third factor of the problem.
The average age of majority off nurses who are working in their mid-50s, will retire in the next 10 to fifteen years, and the problem is further aggravated by the lack of new nurses to compensate for the retiring nurses. Fourth, as Kimball () express, there is the mismatch on diversity of nurses in the United States. The racial and ethnic diversity characterizing the U. S as a country is not reflected in the nursing profession, and opportunities must be created to eliminate this disparity.
Fifth, the nursing profession has been dominated by women over the years, however, as times change and the women in society found ore opportunities for them, others has departed the profession, while there is the lack of efforts to attract men into nursing. Sixth, the generation gap between the old and young workers has created a perception that nursing is unappealing, highly structured, and stressful. Seventh, the work environment has inadequate support systems and greater workloads which have inevitably dissatisfied nurses and some were disillusioned about it.
Eighth, consumer empowerment has increased the public’s knowledge on medical errors and this has made consumers vigilant in their own health care experiences. Lastly, the continuous ballooning of the health care system has created competition, regulation, and increased pressure within the system. Importance of knowing the problem As various environmental factors contribute to the surge in shortage of nurses in the country, the research field of nursing must continuously contribute to generating knowledge about the problem, and how it can be resolved as soon as possible.
Most common perception about nursing shortage is depicted as cyclical in nature. Most health care facilities world wide has experienced surges in both shortage and surplus in the nursing workforce. However, the impeding threat aggravated shortage in the nursing workforce is unlike those experienced in the past. An addition to the problem is the ageing workforce of registered nurses has impeding problems in terms of replacement to fill the vacancies in the future.
The nursing profession has experienced this problem during the past years, but today’s shortage in nursing staff is much more different and complex as it was several years ago. The solutions to previous years’ problems must be improved. Strategies to resolve the problem and its impacts must be conceptualized with innovation, creativity, and must be in a long-term basis. Not only the United States is experiencing this problem with nursing shortage, many countries all over the world are in peril due to nursing shortage.
As this challenged is undertaken by the nursing profession, international efforts from the health sector in general have proven that the problem concerns a major sector in the society. Efforts are not only bounded in the profession alone, but involve different sectors to provide a long-term feasible plan to provide a solution to the problem. The nursing profession is rapidly changing, and ever-evolving. Solutions for the nursing shortage are not gained through quick implementation of plans to suffice the urgent need of today, but must realize the long-term effects and impacts of the problem for the future.
Addressing the problem In a world where complexity of systems of different sectors is interrelated with each other, the nursing profession can address the problem with staff shortage by learning several lessons. Several observations this particular study has observed and gathered through its review of literature suggest broad steps to face the challenges in the profession. The nursing profession must redefine its image in the society. It must be able to create a career path that is sustainable which advance the individual skills and potentials of nurses.
Strategies to address the problem must be able to improve the recruitment process and the career information to attract prospective nurses. The system must be able to integrate a solid workforce, and innovative strategies for retention of nurses. One thing good seen in this challenge of addressing the problem of nursing shortage is that it has created a high level of awareness of the problem. Ultimately, it has made the public understand of worker shortage in health care institutions worldwide, and the problem demands urgent and strong will for action.
The three domains of possible solutions to the problem As Feldman (2003) suggested in his book, the problem of nurse shortage can be evaluated using three main domains. The analysis presented in the book through an innovative approach of the case study method provides a demonstration on how the nursing field can come up with long-term plans to solve the problem. The first domain to be considered is policy. This includes the strategies to be employed at a federal and state level of policy-making processes and decisions.
Such partnerships with policy-governing institutions will address the shortage of nurses through promotion of nursing as a future profession. Steps to be undertaken include creation of campaign for nursing, recruitment efforts at elementary levels, identification of potential nursing students in high school and pairing them with nursing mentors to sustain their interest, partnership with higher education organizations to assist nursing doctorates and nursing educators, improvement of nursing public image, and increase funding for continuing education programs and loans.
Education is the second domain suggested by Feldman (2003), in which strategies are shaped to not only serve the purpose for recruitment purposes, but also to those who are interested in meeting the demands of the dynamic health care environment. The strategies can adopt efficient communication within the educational system and industry, clearly defining career options available, promotion of the nursing profession in the racially and ethnically diverse societies, increase incentives for education (e. g. oans and scholarships), and emphasize leadership and management competencies in the education system of nursing.
In terms of retention as the third domain, Feldman (2003) suggests that strategies be guided by various variables known to influence nurse retention. These includes the emotional and feeling of value variable (competence, communication, respect, recognition, acceptable intensity of workloads, flexible work schedule, and strong CNO which advocates effectively for staff), and the financial variables (salary, compensations, retirement plans and benefits). The innovation of addressing the problem
As Feldman (2003) and Grene and Puetzer (2002) suggests, every strategy employed to remedy the shortage of nurses around the globe need to consider the role of staff development. Narayanasamy and Narayanasamy (2007), outlined staff development as an integral part of clinical governance, activities which advance knowledge, skills, and attitudes of staff, investment to achieve a quality workforce, practices leadership, and it embraces the values of induction, mentorship, continuous professional development, performance appraisals, promotion, personal and professional development, and other related activities.
The benefits of induction and mentorship programs equip the nursing system at every level of organization. As Hardwick (1998) noted in his study, induction and mentorship have relatively recent initiatives in organizations which, as defined in its evidences, vital for initial professional development and appraisal. Induction and mentorship programs are well reviewed in the literatures of Brew (1995), Doidge et al (1998), Forsyth, (2001) and Boevingloh, (2002). In the literature reviewed, induction and mentorship programs have allied the fears and frustrations of most people experience when introduced to a new job.
Mentorship The research proposal aims to focus on the benefits of the mentorship program in nursing staff and retention. All new members of the nursing staff should be allocated with a mentor within the induction period to guide them through a new endeavor in their lives as nursing professionals. A mentor is a role model of new nurses who is there to help new staff settle into their job and remains with them as a companion through their challenges as a new nurse (Grene, and Puetzer, 2002). The structuring of a mentoring program recognizes the need to develop and maintain relationships between the new and experienced nurses (Grene, and Puetzer, 2002).
Mentors and mentees are defined within specific structural orientation program. Specific roles and responsibilities are then highlighted. Other participants in the process will also act as mechanisms to enhance the diversity of skills and knowledge. The mentorship program entails the value of clinical tracking and monitoring which includes planning calendars, development activities, and feedback mechanisms. Role of the mentor and mentee The mentor is an individual who function as a role model, a socializer, and an educator in training specific tasks and interactions (Grene, and Puetzer, 2002).
The mentor assists the mentee by example, demonstrating and personifying how a competent staff nurse performs the job. The mentor also guides the mentee into the social culture of the unit and facility by making new nurses feel welcome in peer groups, with older staff nurses, and in the organization they belong. As an educator, the mentor assists the mentees in assessing their orientation learning needs, plan their learning experiences, and implement the assignment selection to achieve the selected exposures of the mentee (Grene, and Puetzer, 2002).
The evaluation process of the mentorship program can be achieved through a mutual formal or informal basis. It is expected for a mentee to be open to receiving help among his or her colleagues in the profession. He or she must be willing to learn, care, commit in his or her career, and possess a strong self-identity and initiative to succeed. The mentee needs to familiarize him or her self with the orientation schedules, the evaluation procedures, and other related activities in the mentorship program.
Both the mentor and the mentee forming this kind of relationship must work hard for their relationship to be beneficial. Realization of potentials through this program allows growth and development (Hurst and Koplin-Baucum, 2005). The nursing mentorship process The orientation process is essential in the mentorship program. Relationships are not built over night, and the system must provide an avenue for the mentor and the mentee to lay out their goals and expectations as the relationship can entail problems in the future.
The nurse education and staff system can assist in the program by ensuring an understanding of the orientation process and the monitoring of competency behavior. The mentee must be responsible in documenting the process after a learning objective is accomplished. Planning must also ensure that the mentee progress in patient care learning through skill development and effective assignment of plan through an efficient calendar-planning system. Implementation of such plans occurs in shift-to-shift basis, wherein competency is assessed through assimilation of knowledge, attitude, and skills (Grene, and Puetzer, 2002).
The mentorship program can gain knowledge, attitudes, and skills through various activities. Knowledge can be attained through formal core classes, review of policies and procedures, text and journal readings, self-study modules, and other critical thinking exercises. Tests can be done to facilitate evaluation. Attitudes are shaped through role playing, open concept thinking, case study reviews, and feedback sessions. On the other hand, skills can be demonstrated by the mentor through various media available, direct exposure and observation of the mentee, and practice sessions.