Running Out of Nurses: Nursing Shortages in the Middle East
Nursing is a demanding and ever-changing profession. Throughout the previous decades, the nursing profession has faced struggles and challenges. Although nursing began in an unorganized and poorly defined manner, our sisters and brothers did not give up until nursing became a respected and recognized profession. The most difficult problem in the twenty-first century is nursing shortage, which is considered a public concern due to its massive impact on the quality of care as well as patient health and safety. The first nurse Nightingale’s concept was ’cause no harm to patients’. This was the foundation for nurses’ scope of practice. Any obstacles that may jeopardize patient safety should not be overlooked. (Cherry & Jacob, 2002).
A nursing shortage occurs when the number of nurses required exceeds the supply. Because of the severity of the nursing shortage, it has been declared a crisis. At the time of writing, there are 200000 vacant nursing positions worldwide, with a million or more expected by 2020. 85% of hospitals are concerned about a nursing shortage, and half are having difficulty retaining and recruiting nurses. Furthermore, the rate of turnover among nurses is constantly increasing. It has recently reached 40% in some hospitals across the country (Albro, 2008).
This assignment was completed as part of a contemporary nursing course requirement; it will discuss the history, causes, and impact of nursing shortage. Investigate the issue of recruiting foreign nurses as well as the Middle East nursing shortage.
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There was a time when nursing was a popular pastime. The difficulty in finding an adequate number of trained nurses to hand round during the Civil War led to the establishment of the first nursing school in the United States. Following World War II, the medical services provided significantly changed, resulting in a significant increase in the number of hospitals and the creation of special care units, which created a need for more nurses to serve. Nursing educational centers began to appear at that time in order to educate and train nurses in order to address the nursing shortage. The evidence now shows that nursing shortages affect all countries worldwide, and this is a global issue that must be addressed as soon as possible (Andrews & Dziegielewski, 2005).
Factors That Contribute
It was simple to identify the causes of nursing shortages in the 1980s: increased hospitalization, length of hospital stay, and an aging population. Although these are valid reasons, they are not the entire picture. It’s more complicated than that.
Age Nursing has experienced highest registering rate in 1960s-1970s. Because of new job opportunities that emerged in the 1980s and 1990s, fewer women registered. As a result, the average age of a registered nurse is now 45 or higher. The majority of middle-aged nurses will reach retirement age between 2005 and 2010. (Abualrub, 2005).
Nurses have expressed concerns about their public image over the years. Nursing has been variously described as saints or sinners, admirable or despised, powerless or powerful. Can we say that nursing shortage caused nursing image or that nursing image caused nursing shortage? These two are inextricably linked. Above that, the education preparation for nurses differs by two years for an associate degree, three years for a diploma, and four years for a baccalaureate. People no longer value nursing as a profession because of these levels of education. A bachelor’s degree isn’t required when you can be qualified to work in 3 or 2 years. This discourages people from entering nursing and undervalues it (Daly, Speedy& Jackson, 2003).
The reasons why nurses want to leave nursing and why the turnover rate is increasing are primarily due to job dissatisfaction. Overload, schedule changes, a lack of appreciation, and less family time are all common reasons across the country. The nursing profession does not allow dissatisfied nurses to express themselves, which feeds the dissatisfaction. Nursing is not an appealing profession for young people due to a lack of satisfaction. More than half of working nurses would not advise their children or sisters to pursue a career in nursing (Diana, 2005).
There is a faculty shortage.
Linda, Clarke, and Silber (2003) conducted research that found a strong link between nursing education and patient mortality rate. Education is important in providing high-quality care. The mortality rate in hospitals with 60% of nurses having a bachelor’s degree is 19%, while it is higher in hospitals with only 20% of nurses having a bachelor’s degree.
Lack of nursing faculty who provide proper education for the demand of bachelor graduating nurses has a direct impact on the nursing shortage, which has a direct impact on patient safety. Nursing institutions are seeing an increase in registration; the American Association of Colleges of Nursing reports a 13% increase in enrolment between 2004 and 2005. This growth necessitates more nursing schools and clinical settings to educate these students. The situation will deteriorate if there are insufficient nursing faculty. According to the AACN, nursing schools rejected 41683 qualified applicants in 2005. The main reason was having not enough nursing faculty, clinical areas and preceptors to educate this number of students (Allen, 2008).
The Effects of Scarcity
There is no doubt that a nursing shortage will have a negative impact on the health-care system. Due to a nursing shortage, hospitals are forced to impose mandatory and dangerous overtime on nurses, increase responsibilities and workload, and create floating nurses. All of these factors contribute to job dissatisfaction and lower quality care (Goodin, 2003).
Regarding the patient
Linda, Clarke, and Silber (2003) studied the relationship between nurse work load and mortality rate. In 50% of hospitals worldwide, the patient-to-nurse ratio is 5:1. According to the study, if the ratio is 6:1 or higher, the risk of patient death is 14%. If it is greater than 8, the risk is 31%.
The number of medical errors is increasing at an alarming rate. Nursing shortage is one of the associated factors. A study conducted by health resources and services reveals a strong relationship between the number of employees and medication errors. These errors may have a negative impact on patient health (Goodin, 2003)
Not enough staff intensifies the level of stress of nurses. Overtimes, increase responsibilities and emotional stress promotes increase staff absenteeism, impair decision making ability and increase level of turnover. More than 75% of RNs believe that their job quality delivered to patient is strongly affected by the shortage. Three from four nurses feel is frustrating, discouraging and disappointment when you unable to provide proper nursing care, just because of there is not enough nurses in the floor. (Revira, 2009).
As a remedy for nursing shortage health care societies have started to hire foreign nurses. Phenomena of hiring foreign nurses has been introduced and practiced for almost 50 years (Leavitt, Mason & chaffee, 2007). (Leavitt, Mason & chaffee, 2007). Recruiting foreign nurses is specifically problematic as a technique to resolve this shortage simply for two reasons. First, the shortage is global issue; means the country which sent her nurses abroad intensified the shortage within its health care system. Second, hiring foreign nurses cost much more than hiring home graduate. This related to the coast of recruiting and training them into the organization (Cherry & Jacob, 2002). (Cherry & Jacob, 2002).
. \sRecruitment and retaining RNs
Nursing associations are constantly working in order to recruit nurses as much as they can. Recruitment strategies should focus on attracting young nurses. Efforts should be maximized to spread the awareness among school aged students in order to make them consider nursing as a career or a profession (Yoho, Timpanaro & Fowler, 2006).. (Yoho, Timpanaro & Fowler, 2006)..
Retention of professional nurses have helped the organization to overcome the shortage. To retain experienced nurses organizations should consider staff needs, In response to that, magnet hospitals were created. Hospitals which they focus in developing proper retention strategies, mainly by enhance nurses’ autonomy and support decision making ability. Magnet program aim to increase job satisfaction, decrease turnover and promote encouraging environment. Now magnet considered the most effective programme in US for retaining and recruiting nurses ( Valerie, & Dreachslin, 2007) ( Valerie, & Dreachslin, 2007)
Nursing shortage in the Arab world
The image of nursing as a profession in the Arab world is significantly improving. The status of nursing will be addressed from three dimensions: practice, education and image. Nursing education in the Arab world causes a lot of confusion due to the different educational levels. The minimum accepted educational degrees to enter the profession can be associated degree (2 years) or diploma degree (3 years) while in the US the bachelor is the minimum accepted degree. Moreover, some countries don’t offer bachelor degree where other countries have recently started bachelor program like UAE. Arab world also tend to recruit foreign nurses especially gulf countries to overcome the shortage. Nursing image plays a big role in promoting the shortage in the Arab world. Most of the population doesn’t prefer their sisters or daughters to choose nursing as a profession (Shukri, 2005). (Shukri, 2005).
Nursing shortage is an international problem which needs to be solved urgently. All the reasons and impacts of nursing shortage are now internationally known and it can’t be ignored any more. There are many reasons that could lead to this problem, few of them were addressed: Age, nursing image, job satisfaction and faculty shortage. Leaders of nursing in practice and in academia should work to gather to develops plans enhance the growth of nursing staff. Impacts of nursing shortage can’t be denied because it has a dangerous effect on patients’ health and on nurses. The practice of hiring foreign nurses doesn’t help in solving nursing shortage. Recruiting and retaining strategies should be carefully studied in order to increase the number of working nurses. The shortage in the Arab world is a noticeable problem in which a lot of efforts need to be done in many areas to overcome this shortage.