Nursing Shortage
Health care systems all over the world are struggling to meet the needs of the people who depend on them. One of the most serious challenges they face is the shortage of health care professionals such as nurses. In developed countries such as the United States, they periodically experience a shortage of nurses. This shortage is cause by the growing demand rather than the supply. On the other hand, developing countries experience shortage due to the lack of resources that impedes the training of nurses.
In recent years, both developed and developing countries have experienced significant shortages in the number of registered nurses due to the increase demand in the face of declining supply. Registered nurses represent the major occupational group in any health care system. In the United States there are approximately two million RNs employed. However, the demand for nurses had already exceeded the supply. This shortage is expected to grow to more than 275,000 by 2010 and to over 800,000 by 2020 (2006).
There are several factors that contribute to this phenomenon. Primarily, the ageing population in the US is increasing. The age group of 65+ is expected to grow from 13% to 20 % in between 2010 to 2030. Since this population uses an inconsistent amount of health care services, more nurses will be required to take care of them (2006).
Secondly, the supply of nurses has declined in relative terms. One of the reasons is that women who constitute 94% of the work force have more career opportunities now as compared from the past years. The nursing profession has experienced the influx of women during the 1960s until the 1970s. Thereafter fewer women have entered the profession. Consequently, the average age for RNs have risen and those middle aged nurses born during the ‘baby boom’ will retire from 2005-2010 (2003). This means that the experienced nurses are likely to retire at the time when the demand is escalating. About 25.1 percent of nurses are aged below 30 years in 1980. But in 2001, only 9.1% belongs to this age group ( 2006). Lastly, RNs are becoming more dissatisfied with their work. Stress is also causing them to leave their jobs.
More so, potential nurses are driven away from the profession due to the lack of budget. The College of Nursing in the University of Illinois reported a rise in the applications but the decrease in the school budget kept it from increasing its capacity. Among the courses offered by the school are undergraduate, graduate and doctoral nursing programs ( 2005). Another problem which is faced by most nursing schools is the lack of nursing educators.
Other developed countries are also experiencing the same. In Europe, nearly every country has nursing shortages. The Canadian Nurses Association estimated a deficit of 78,000 nurses by 2011 and is expected to grow to 113,000 by 2016. Australia has been able to fill only 60 percent of nursing positions in 2006. In Saudi Arabia, 54,000 positions are filled out of the 100,000. Saudi nurses constitute 1,000 while the remaining 53,000 is filled by nurses recruited abroad.
The situation is even more serious in developing countries of Asia, Africa, Latin America and the Caribbean. In 2003, about 53% of nursing positions in the Caribbean are vacant. Trinidad and Tobago has not been able to fill almost half of its nursing positions. The Philippines had around 30,000 nursing vacancies in 2004. Malawi had a 28% filled positions. South Africa had over 32,000 nursing shortage in 2003. Collectively, the sub-Saharan African region has a shortage of 600,000 nurses (2006).
The reasons for this shortfall are different in the affluent countries from the less affluent ones. For most developing countries the problem lies on the lack of resources tin training the sufficient number of nurses. They have lesser training programmes and nursing educators. Aside from this, there is also the low pay and the unsatisfactory working conditions which make it difficult to encourage nurses into the profession. The lack of medical supplies, equipments, huge nurse-to-patient rations and epidemics such as HIV/AIDS contribute in making the profession extremely stressful among developing countries.
In addition to this, nursing jobs can be very dangerous. The survey of nurses’ unions among 91 countries reveals that workplace violence is greater concern in developing than the developed countries. Aide form this, the exposure to highly contagious diseases reduces the number of nurses. Some are results of death and illnesses while others voluntarily withdraw from their jobs. These factors cause nurses to migrate to other countries that offer better working conditions and higher pay and benefits.
Even before, health care professionals are already migrating from developing countries to developed countries for better professional opportunities. This phenomenon have accelerated increasingly especially with the global shortage of nurses. The recruitment of nurses has become the main response to the shortage. They are recruited either for temporary and permanent positions. While this movement takes place between developed countries, most cases are from developing to developed countries. The most popular destinations for nurses are English speaking countries. In 2001, the United Kingdom has registered nurses from 95 countries. Around 43% of RNs that are registering in 2002-2003 are from abroad. The sub-Saharan countries of Africa as well as Australia, India and some Caribbean countries provide a large number of nurses to the United Kingdom (2006).
Similarly, the United States had begun recruiting foreign nurses to address the shortage. At present there are over 100,000 foreign nurses in the US mainly from the Philippines (50%) and Canada (20%). The number of foreign nurses in the country has grown to about 200 percent since 1998 (2006). Fewer restrictions in the immigration have paved the way for a new market for recruiters that seek out solution to the shortage. According to the figures of the national council, about 16,490 foreign nurses passed the NCLEX in 2003 which almost doubled the figure in 2001 (2004).
The aggressive recruitment of nurses from other countries undermines the supply of nurses in certain regions. For instance, United States have been steadily recruiting nurses form the Philippines over the past years. While this may help in addressing the shortage in the US, it can also be devastating to the country which was left behind. This indicates the loss of a country from the gain of the other. One way to address this dilemma is to work towards achieving an adequate nursing workforce worldwide. This could only happen if the working conditions are improved and the nursing image is enhanced to attract more people to the profession.
There are a myriad ways in which hospitals and universities are responding to the crisis. The New York’s Columbia University, for instance, has offered a clinical practice doctorate program in nursing. This effort is directed in improving the continuance of health care while providing more possibilities for those in the profession. The Massachusetts General Hospital provided nursing graduates with a six months course in the intensive care unit which is once the domain for experienced nurses (2006). These efforts aim to encourage potential nurses into the profession.
While the recruitment of foreign nurses serves as a viable option, there is still the need to train more American nurses to get out of the shortage. One way to encourage women to engage in training programs is by improving the working conditions in the profession. Nurses are often burn out and stress in their work causing them to leave their profession. Similarly those who want to enter the profession but are considering having their own family are discouraged due to the demanding nature of the job. The declining working condition is a serious problem that needs to be addressed. The nurse-to-patient ratios must be set into a minimum to reduce the exhaustion of nurses. Also financial incentives can be awarded to those working in medically underserved areas. Indeed, there are a lot of alternatives that can be adopted to solve the shortage and countries need not rely on the global labor market alone.
Credit:ivythesis.typepad.com
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