Answer

Addressing Staff Shortages in Hospitals

1. Witten Proposal
2. Identification of the Problem

The identified problem in nursing practice that needs to be addressed is staff shortages in the US, specifically in the state of Colorado. Hospitals are trying to meet their budgets and save costs whenever they possible. This can mean fewer members of staff working at busy times. These cuts are putting greater pressure on staff because they have less support while working long hours (Haddad, Annamaraju, & Toney-Butler, 2020). As a result, the nurse-to-patient ratios continue to increase because healthcare organizations want to cut on the costs of staffing.  Although the standard nurse-to-patient ratio in the medical surgical unit is 1:5, there are facilities where, due to low staffing levels, the average nurse to patient ratio  is 1:10 (King University Online, 2019). Addressing this issue is vital to ensuring patient safety and better quality of care.

1. Explanation of the Problem

            Staff shortage, in the context of healthcare, means that the number of healthcare workers is inadequate to provide quality health care to patients. Specifically, when the number of nursing staff members is not enough to attain the nurse-patient ratio recommended, then staff shortage occurs (Haddad, Annamaraju, & Toney-Butler, 2020). The problem of staff shortage is applicable to nursing practice because it directly affects patient safety, outcome and wellbeing. There are around 3.9 million nurses in the United States with an additional one million needed. To avoid a further shortage of nurses, there will be a need to have 11 million additional nurses around the world by 2022 (King University Online, 2019). The ageing population as well as an increase in the cases of COVID-19 has led to a heightened demand for healthcare workers, especially nurses. Nursing staff shortage affects the healthcare environment because it is a key determinant of the quality of care and the satisfaction of patients.

2. Investigation of the Problem

The investigation of the problem of staff shortage was done via an exploration of different resources and materials. Some of these include scholarly articles that have been written on the matter. Specifically, peer-reviewed articles were examined to determine the extent of the problem and its effect on patient populations and the entire healthcare sector. Additionally, data from different bodies such as the American Nurses Association (ANA) and government bodies were examined to provide critical information that could tell the nature and extent of the issue of staff shortage. Also, hospitals in Colorado were reviewed to establish whether they had adequate staffing and hence, further determine problem.

1. Evidence to Substantiate the Problem

After an examination of different materials during the investigation of the problem, it was established that the nursing workforce is expected to grow by 15% from 2016-2026. Specifically, the demand for registered nurses (RNs) is expected to grow from 2.9 million in 2016 to 3.4 million in 2026, which is an increase of close to half a million nursing staff members (American Association of Colleges of Nursing (AACN), 2019). As such, there is a need for an additional 203,700 each year to avert any shortages (AACN, 2020). Based on information from the United States Registered Nurse Workforce Report Card and Shortage Forecast, there is a projected shortage of RNs across the US between 2009 and 2030 with the severity of the shortage being felt in the South and West of the country (Haddad, Annamaraju, & Toney-Butler, 2020). Only 56% of RNs are prepared at the baccalaureate or graduate degree level, which denote a shortage and a need for increased labor force.

3. State of the Situation using Current Data

Staff shortage in the US, especially RNs, is a shortfall of around 200,000 nursing professionals in 2020. Nursing shortages have resulted in not only higher morbidity and mortality rates, but also errors (Gubar, 2020). The high patient-to-nurse ratio has also led to burnout among nursing workers as well as high levels of dissatisfaction. Ultimately, the failure-to-rescue rates and higher rates of mortality have been experienced. According to the ANA, the increasingly aging “baby boomer” population is likely to lead to a demand for 3.44 million nurses by the end of 2020, which will translate to a 20.2 percent demand for RNs (AACN, 2020; Marć et al., 2020). Also, there will be a demand for an additional, 1.13 million nurses in the US by 2022 (Gubar, 2020). Currently, the patient-to-nurse ratio is still high, which means that the quality of healthcare and the safety of the patients are being compromised.

1. Areas that might be Contributing to the Problem

The problem of nursing shortage arises from a plethora of areas including the nursing schools and the human resource departments of the hospitals. Notably, a report from the AACN on the 2018-2019 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing indicates that around 75, 000 qualified nurses for the baccalaureate and graduate nursing programs were turned away because of factor such as lack of clinical sites, classroom space, clinical preceptors, and budget constraints (Gubar, 2020). Additionally, some organizations have failed to hire enough staff because of budget constraints and lack of resources necessary to ensure they have enough nurses in their different departments. Also, the increase in the number of the ageing population has led to nursing staff shortages because there has been a high demand for nurses in such areas leaving healthcare facilities in shortage of such critical healthcare workers. Principally, nursing shortage has emanated from inadequate skills and competencies required for nursing leadership.

4. Solution or Innovation for The Problem

The evidence-based solution to the problem of staff shortage of nursing professionals in healthcare facilities is investing in long-term training and professional development of the nurses. Notably, it has been established that 75,000 applicants for graduate programs in the US were turned away because the facilities did not have enough space and resources to accommodate the applicants (Gubar, 2020). As such, medical facilities that wish to keep their nurses should invest in continuous training and development of nursing professionals. When nurses get promoted into innovative and leadership positions, they require new knowledge and skills that they may not have obtained. As such, training done through distance learning, on-site classes, and self-tutorials can be vital in ensuring that there are no shortages for nurses in different positions (Marć et al., 2020). Additionally, the government should also contribute to the training and development by incentivizing some nursing courses to make sure that some of the nursing fields do not have shortage of critical workers.

1. Justification of the Proposed Solution or Innovation

            The proposed solution can be justified on its ability to equip nursing staff members will skills and competencies that can make them provide their services in a variety of areas. For instance, with long-term training and professional development, nurses will be equipped with skills that will make them perform well in innovative and managerial positions (Price & Reichert, 2017). Notably, a recent report by the Robert Wood Johnson Foundation indicates that the institutions and hospitals should be committed in the lifelong learning of their nurses so that they do not experience shortages in some of the key positions that require RNs to acquire baccalaureate and graduate trainings (Gubar, 2020). As such, the proposed solution of investment in lifelong learning and professional development will ensure effectuate resolution of the issue of staff shortages in hospitals.

5. Resources to Implement Proposed Solution/Innovation

The implementation of the proposed solutions will require financial resources. Specifically, the lifelong learning and professional development of the nurses will be required hospitals to invest financial resources into the trainers. The financial resources will be to pay for the training as well as in hiring experts who will provide the nurses with skills required to improve their competencies. The overall cost of implementing the solution will be high because the organization will have to get into its pockets to makes sure that it invests in its workforce. However, the benefits of investing in training and professional development outweigh the costs. Whereas the hospital commits its financial resources in the training and professional development of its staff, they will benefit from improved quality of care from their RNs and ultimately, improved patient satisfaction and profitability (Price & Reichert, 2017). As such, the benefits of the proposed solutions outweigh the costs incurred in its implementation.

6. Timeline for Implementation

Table 1 below provide a timeline for the implementation of the proposed solution.

Table 1: Timeline for implementation of nursing training and professional development

7. Stakeholders Important for Implementation

The key stakeholders and partners who will be important in the implementation of the solution are the nurses, hospital administration, and the shareholders. The nurses will be important shareholders because they will be the ones receiving the training and professional development. As such, their efforts in the training will be vital in ensuring the success of the proposed solution. The hospital administration ,on the other hand, will be key in making sure that it provides the resources required for the training and development. For instance, it will not only allocate financial resources towards the training, but also hire experts who will impart vital skills on the nursing staff members. Finally, the shareholders of the hospital will be important in approving the allocation of the resources and the implementation of the proposed solution.

1. Engagement with Key Stakeholders/Partners

            An engagement attempt was made will all key stakeholders and partners in the implementation of the proposed solution. The nurses were some of the key stakeholders who were engaged. Their input was that they needed additional training and development to fill some of the positions that contributed to shortage. For instance, in the intensive care unit (ICU), they admitted that there was shortage because they did not have the skills and competencies to fill such a position. Their feedback was that the proposed solution was important in equipping them with skills and competencies that they lacked. An engagement with the administration of the hospital also had a positive feedback about the proposed solution and committed to supporting the implementation by allocating the resources required for implementation. The shareholders were very keen on having the solution implemented to ensure that they do away with staff shortages and ensure that all key positions in the hospital were occupied.

1. Intention to Work with the Key Stakeholders

            To achieve success, the key stakeholders will form part of the implementation of the proposed solutions. For instance, I will work with the nursing staff members in the identification of the areas that they need additional training and development. Additionally, I will work hand in hand with the hospital administration to provide the key resources that ae required for the implementation of the solution. For instance, I will have to get back to them to give financial resources to hire the best experts who can train their nurses on skills that they need to occupy positions in areas where there are shortages. For the shareholders, I will work with them by providing them with reports about the progress of the implementation and seeking their support and blessings to implement the proposed innovative solution.

8. Implementation and Evaluation

The proposed solution of nurse training and professional development could be implemented by enrolling the nursing staff members into different courses based on the areas where they are found to lack specific skills. Additionally, experts could be hired to provide in-house training to the nurses so that they can get skills to fill positions in areas where there are shortages. The evaluation for success of the proposed solution can be done using several metrics. One of those is the number of nursing staff members in the hospital, the qualification of the staff members, quality of care, and patient satisfaction.

1. Fulfillment of Different Roles

RNs fulfil different roles in their practice and in research. Some of the roles that they assume in their practice include scientists, detectives, and managers of the healing environment.

1. Scientist

I fulfilled the role of a scientist by immersing in extensive research about the issue of staff shortages, their causes, and ways to address the issue. Notably, nurses as scientists have the role of identifying research questions and issues, conducting scientific studies, collecting and analyzing data, and reporting on their findings (Broome, 2011). I fulfilled this role by researching different materials such as scholarly articles and reports and coming up with an innovative solution to the resolution of the problem of nursing shortage. Also, I reported on the findings of the investigation that I conducted and hence, ensured the fulfillment of my role as a scientist. The duty of scientists is to uncover facts and provide evidence-based solutions to different issues. As such, through research, I identified the nature and extent of the problem of staff shortage and provided an evidence-based solution to the issue.

2. Detective

            As a detective, I used my clinical imagination and nursing science knowledge to establish how training and professional development could affect nursing shortage and ultimately, the quality of care and satisfaction of the patients. Notably, nurses as detectives should use their innovative skills and clinical imagination to judge and even make a determination of the ways that their proposed solutions should change patterns of different health issues and prevent illnesses (Buffum, 2020). My role; in this endeavor, was to ensure that I investigated the issue of staff shortages in healthcare as well as its causes and effects. I then came up with a plan for the implementation of an evidence-based solution to address the matter. In this context, I fulfilled my role as a detective. Detectives normally solve issues by gathering facts and coming into conclusions. I assumed such a role by engaging in extensive research to understand nursing shortage and come up with conclusion as to what needs to be done to address this issue.

3. Manager of the Healing Environment

            In this proposal, I acted as a manager of the healing environment by ensuring that I understood how different environments impact on the patients. My proposed solution aimed at ensuring that patients had a conducive environment for their healing. Notably, nurses as managers of the healing environment have the role of understanding how different environmental designs can reduce the anxiety ad stress of the patients and the staff (Woolley et al., 2012). In proposing additional training and professional development, I have made sure that nurses can have decreased stress because they will not be subjected to burnout due to shortages. Additionally, the patients anxiety and stress will be reduced because they will get high quality care from the healthcare workers. Additionally, training and professional development supports both staff and patients in hospitals and hence, ensures that the environment is not only caring but also a healing one.