Term Paper on "Current and Projected Nursing Shortage"

Term Paper 3 pages (1333 words) Sources: 6 Style: MLA

[EXCERPT] . . . .

Nursing Shortage

New Nurses

Nursing shortages are increasing at an alarming rate. By the year 2020 the deficit of nurses is expected to reach one million and will affect 44 states plus the District of Columbia (AACN web site). Hospitals will be hardest hit because of the shortage of bedside nurses. This is not the first time a nursing shortage has occurred. During the 1980s there was a nursing shortage but for different reasons than the present one. At that time, not enough people were going into nursing, but as enrollments for nursing increased, the shortage decreased. Now, however, the nursing shortage is primarily due to nurses leaving their jobs because of disillusionment (Block, Claffey, Korow, & McCaffrey, 2005).

Between 1992 and 2000, the number of registered nurses who changed to non-nursing jobs increased by 28% (Block, Claffey, Korow, & McCaffrey, 2005). According to Butler & Hardin-Pierce (2005), during their first year of work 53% of new nurses will change jobs. In public teaching hospitals the turnover rate is as high as 55%. The result is a critical shortage of bedside nurses. The impact on patient care can hardly be overstated. In 24% of hospital deaths, understaffed nursing was found to be a contributing factor (AACN web site).

New nursing graduates may start out excited and joyful, but soon they are hit with the reality of the workplace. Expectations for caregiving have changed significantly. Length of stays, for example, are dramatically shorter, and only very sick people are in the hospital (Ellerton, 2003). Many new nurses feel under-prepared. They experience great anxiety about making mistakes and possibly harming their patients. Many feel they lack knowledge to communicate effectively with doctors and with family members and feel inadequate for the job. The reality of the workplace is a shock. In school they were imbued with high ideals, but the workplace requires them to carry a larger caseload of patients with serious medical problems. The process of learning can take from six months to a year, but they are under pressure to function effectively in the real world immediately (Cosentino, 2003).

New graduates report they don't feel confident or competent; they make errors because of heavy workloads and responsibilities; are constantly confronted by new situations, procedures, and surroundings where they don't know what to do; their preceptors are not consistent; they don't know anybody on staff; run-ins with disgruntled nurses and other staff members are disturbing; not enough staff is on hand to do the job right; and other nurses are not willing to help them. They also report feeling anxious, overwhelmed, intimidated, disappointed, disgusted, sad, angry and guilty (Butler & Hardin-Pierce, 2005). No wonder they quit!

Part of the problem, unfortunately, is the disturbing, sometimes abusive treatment new nurses receive from their colleagues. During the first three months of employment, when the nurse is still a novice, he or she may experience "horizontal violence" in the workplace. The term refers to conflicts with other nurses who treat the new nurse with hostility and psychological harassment. Verbal abuse and threats, intimidation, humiliation, excessive criticism, innuendo, exclusion, denial of access to opportunities, and intentional information-withholding may occur (Butler & Hardin-Pierce, 2005). The effect on the new nurse is intimidation, absenteeism, and the decision to give up nursing as a career.

Butler and Pierce-Hardin report a survey of new nurses done in 2003. On the Impact of Event Scale to measure psychological stress, 58% of new nurses reported symptoms of post-traumatic stress disorder. 34% reported incidents in which they were verbally abused, treated rudely, humiliated, and unjustly criticized. Other unpleasant experiences included sexual harassment, racial slurs, and verbal threats. Dean-Barr (2003) points out that experienced nurses may see their workplace environment as full of problems that never get solved, and they may view the inexperienced nurse as part of the problem.

Although nursing schools try to prepare students for "real life," theory needs practice to become meaningful. Simulated scenarios are helpful, but not the real thing (Consentino, 2003). Capstone courses… READ MORE

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