1
Nursing Shortage
Deidra Viers
Liberty University
Busi 646
10/10/21
2
Abstract
Registered nurses have played an essential role in healthcare since Florence Nightingale. As the
years have gone by, the demand for healthcare has grown unprecedented—registered nurses
make up the largest segment of the healthcare workforce. Nurses are the first to greet us upon
birth, and they comfort us at death. They are there when there is a foot of snow on the ground
during hurricanes, and as we have seen in our time, they even work during Pandemics. There
need to be double the number of nurses to address the nursing shortage.
3
Nursing Shortage
Nurses are essential healthcare providers, especially during the coronavirus pandemic.
This pandemic has been a blessing and a curse at the same time. It has exposed the nursing
shortage in public and private health facilities as a blessing in disguise. Many patients continue
to stream in dire need of healthcare. Hospitals are overwhelmed in both human resources and
infrastructure. One of the essential human resource hospitals require are nurses. The World
Health Organization recommends a nurse-to-patient ratio of 83:10,000 (National Nurses United,
2021). Different sources cite different ratios. However, the goal is to establish an adequate
balance that will ensure quality service delivery. The shortage of nurses should, therefore, be
addressed as it negatively impacts patient care. This paper analyzes nursing shortage through
various lenses. Readers will understand the Biblical foundation of the topic as related to the
healthcare industry, fathom integrated concepts, issues related to the topic, appropriate
employment legislation, and analysis of the matter as applied to healthcare organizations.
Biblical Foundation of Nursing Shortage
Understanding nursing practice as a Biblical calling requires one to evaluate the Biblical
foundation of nursing. Early in the cradles of civilization, communities utilized nursing to care
for the sick. However, this religious duty transformed into charity over centuries and comprised
specialized skills for shaping societal wellness. Phoebe was the index nurse mentioned in the
Bible. She is said to have exemplified ancient Christian ideals of selflessness and charity. Phoebe
cared for strangers, orphans, travelers, and the sick under her roof. Protestant reformation also
demonstrates how the nursing practice evolved as a spiritual entity (Sacred Heart University,
2020). As the European society transformed disillusioned by Christianity, power shifted from
religious figures to monarchies. As such, nuns stopped offering nursing services. Women in the
4
lower socio-economic status who were unsuitable for work replaced nuns and monks in
healthcare centers. Consequently, there were several setbacks in patient care, perhaps showing
the early consequences of the nursing shortage.
The distinctiveness of Christian-directed nursing lies in its emphasis on holistic care as it
embodies and respecting patients as God's image. Therefore, nursing is both an art and science,
but primarily a response to God's grace and reflection of his demeanor. Fouch 92016) suggests
that nursing is rooted uniquely in the gospel of Jesus Christ. Therefore, the shortage of nursing
significantly affects service delivery even in the church. Jesus said that all humans are made in
God's image. Factors such as gender, sexuality, age, race, and social class should not deter nurses
from providing quality care. Besides, God has granted everyone dignity and the value of treating
others with love. The Bible also describes love as the greatest commandment.
Fouch (2016) also demonstrates the relationship between nursing and Christianity and
how it works in practice. First, nurses provide care as a form of worship. Caring for patients
includes caring for Jesus since the nursing practice grows in direct response to human's
relationship with God. Therefore, shortage of nursing means that God's people receive poor care,
thus undermining His want. Secondly, nurses care as a service. Nurses serve vulnerable
populations just like Jesus did. Disabling this provision through shortage of nurses means that
God's creations are denied essential services, therefore undermining Christianity. Christians also
believe that humans were made in God's image. Therefore, nurses offer patient-centered care
without discrimination. A shortage would result in poor quality of service delivery characterized
by loss of dignity. Holistic care is also a function of Christianity that demands an understanding
of spiritual needs. Finally, nursing care embraces community service, which Jesus did. Shortage
of nurses means less community work and less caring for God's creation.
5
Integration of Concepts
Nurses comprise almost half of the world's health workforce. Shortage of nurses would
therefore mean a significant reduction in the global health workforce. This shortage will also
transform into poor service delivery. Drennan and Ross (2019) examine this issue through
research. The investigators determined that the scope of nursing practice, legislations, levels, and
type of education vary between countries, making it challenging for governments to adopt
universal measures to curb the nursing shortage. Besides, policies proposed by international
bodies rely on data from the medical workforce and apply it to nurses despite the different
demographic profiles, career options, work, and remuneration. Policies to curb nursing shortage
are therefore crucial when understanding concepts of nursing practice.
Additional concepts to understand are the effects of nursing shortage on patient care, the
impact of COVID-19 pandemic on nursing care, the role of nurses as leaders, and nursing in the
future. Nursing shortage significantly affects patient care. Adverse health outcomes include poor
medication, medication errors, reduced patient-centered care, and ignorance of holistic care
(Nettina. 2019). Potter et al. (2018) also state other consequences of nursing shortage. Many
deaths are witnessed in healthcare institutions with a smaller number of nurses. This
consequence is due to increased medical demand for nurses by numerous patients. The overall
effect is compromised care. The nurse-to-patient ratio also reduces when there is a nursing
shortage. As such, patients fail to obtain adequate nursing care, resulting in poor quality of care.
COVID-19 has also negatively impacted nursing care. Healthcare providers are among
those who suffer coronavirus due to the type of work and patients they manage. In a
heartbreaking tribute, Keogh et al. (2021) remember nursing staff who have lost their lives due to
coronavirus. The authors show how vulnerable nurses are when in the line of duty caring for
6
other patients. Catsella (2021) also indicates the number of healthcare workers who have lost
their lives due to the pandemic. This concept is worth exploring since it is new amongst us. It
simply demonstrates the effect of covid-19 on the number of nurses. Healthcare institutions and
governments should therefore work to ensure healthcare workers are safe from the pandemic.
Another concept worth discussing is the role of nurses as leaders and managers. These concepts
are taught during undergraduate and post-graduate studies. Nurses can add up as healthcare
institution leaders and managers, therefore regulating the shortages. Embracing transformational
leadership will ensure that nurse leaders understand adequate staffing (Collins et al., 2019).
Related Issues
Nursing shortage prevents the provision of standardized and safe care to patients. Nurses
have a responsibility to enhance practices that promote safe and quality care to patients.
Therefore, nurse shortage affects the delivery of quality patient care, thereby increasing mortality
and morbidity rates. As a result of the shortage, there is a low patient-to-nurse ratio. Nursing
shortage can also be attributed to the small number of nursing students being trained. This lack is
related to fewer nursing schools and facilities like classroom space, inadequate funds, and
insufficient clinical areas.
Consequently, the remaining nurses experience work-related stress due to burnout from
an increased workload, increasing nurse turnover. Besides, an increasingly aging workforce is
another factor related to shortage. Most nurses in the field are older and would reach the
retirement period in the next ten years, creating a gap for more new nurses to be recruited
(Tamata et al., 2021). The increased aging population also is a factor in a shortage of nurses.
The aging population requires constant medical checkups for chronic diseases like
diabetes, hypertension, and geriatrics care. This step is necessary as most older adults have more
7
than one disease they are battling, thus increasing the need for more nurses and creating a gap as
these strain the workforce. Most nurses are females and therefore face numerous challenges. For
instance, female nurses have to take leaves, and some find it difficult to work after their
maternity leave. Workstations also play a role in the nursing shortage. Increased shortages are
experienced in certain specialties of nursing like the intensive care unit, labor wards. However,
other specialties have enough nurses (Tamata et al., 2021).
Additionally, violence in the health care setting poses a threat as emotional and physical
abuse causes a stressful working environment. Nurses who work in psychiatric and emergency
departments are prone to these kinds of abuses and experience poor job satisfaction. These issues
are therefore a threat to the healthcare workforce.
Employment Legislation
Addressing the nursing shortage issue requires healthcare institutions, governments, and
stakeholders to undertake various employment legislations. One of the robust measures is to
increase the number of nursing schools. Nursing schools provide opportunities for nurse students
to train as future nurses. Increasing the number of nursing schools means that more qualified
nurses will graduate. Hence, more competent nurses will enter the healthcare field to offer
nursing services. Nursing schools allow nursing students to learn about the clinical management
of patients, leadership, and spiritual care. Therefore, when nursing student graduates, they learn
about all the aspects of nursing (McConnell, 2019. This step makes nursing students competent
in all areas, including management. The management principles nursing students acquire during
their learning later translates into quality employment opportunities. These nurses also learn how
to manage healthcare institutions, thereby resourceful when recruiting other healthcare workers.
The knowledge, skills, and expertise during school translate into transformational leadership that
8
believes in the delegation. Nurses who undergo robust training will ensure that their healthcare
facilities have adequate personnel, reducing the nursing shortage.
Another employment policy for reducing nursing shortage is to improve work conditions
for nurses. Okoth's (2020) study on job satisfaction among healthcare workers in a tertiary
hospital in Kenya reveals that improving work conditions increases employee retention. This
policy can be adequately applied to ensure the retention of nurses in their work environment.
Healthcare leaders and stakeholders should thus embrace this practice as it embodies components
of transformational leadership in healthcare institutions. Improving the work environment
satisfies nursing outcomes and increases job satisfaction, which later reduces nursing turnover.
Healthcare institutions should thus employ this strategy.
Healthcare leaders should also transform work processes to enable nurses to achieve job
satisfaction. Nurses usually spend most of their time searching for doctors and medication and
finalizing redundant paperwork. There should be more efficient methods of service delivery. One
of the proposals is to transform nursing care bedside. For instance, ergonomics will improve
nursing care as this step increases efficiency. Another vital step is to change the hospital's culture
of healthcare provision and inter-disciplinary relationships. Hospitals whose professional
cultures are detrimental to nursing care should be encouraged to be mindful of the consequences
of their practices. Cultural norms like allowing professional improvement among nurses will
reduce turnover and improve retention.
Collaboration in practice and investing in research are other employment policies worth
exploring. Employing competent nurses who believe in the power of collaboration will improve
nursing care and patient satisfaction (McConnell, 2019. Besides, employers should venture and
embrace research as this step utilizes gaps in nursing shortage to determine quality measures.
9
Employers should also be strict on the type of nurses they employ. Resilience is a crucial virtue
to have. Hence, nurses with professional resilience and competency should be given priority.
Additional measures include hiring disciplined nurses, encouraging a multi-disciplinary approach
to recruitment, and engaging other stakeholders in the vetting process. These measures will
ensure that nurses are accorded their due diligence hence reducing turnover.
Analysis of Nursing Shortage as Applied in Healthcare Organizations
The shortage of nurses in healthcare organizations has led to burnout as some nurses
choose to leave the field, thereby leaving few nurses with a lot of workloads. When there is a
shortage of nurses, patients get affected as fatigue on the side of the nurses can lead to errors in
medication (Buerhaus et al., 2017). This further leads to overcrowding in hospitals as patients
fail to get the required care. Besides, long working hours lead to exhaustion, thereby developing
negative attitudes and losing interest at work. Consequently, most of them quit due to
frustrations. Analysis of nursing shortage entails ways that can be used to address the nursing
shortage in healthcare organizations. Some of the methods include developing internal and
external communication programs. Formulating internal communication can improve the
relationship between staff and leaders, thus creating confidence. This step also assists nurses in
having improved relationships with their leaders, thus enhancing trust within healthcare
organizations.
Through communication, nurses can air out the challenges they are facing. Therefore,
organization leaders look for ways to address these challenges, thus building their courage and
motivation to continue working. Promoting a conducive working environment to nurses helps
them become satisfied and healthcare organizations increase the nurse's hospital stay and well-
being. They also decrease the threats and factors that may hinder providing a conducive
10
environment that motivates nurses to continue working, thus addressing the nursing shortage.
Creating new regulations and policies improves healthcare (Muabbar & Alsharqi, 2021). Leaders
can also participate in activities that create opportunities and air their concerns about the nursing
shortage. This can occur at all levels, including the national levels. Enhanced employee
engagement ensures employees satisfaction. This step creates a chance to employ qualified
organizational leaders who promote and encourage an engaged workforce. Furthermore,
investments in nursing education programs enable the nurses to stick to their workplace
according to the agreement, thus addressing the shortage. Signing a contract to go for further
education in exchange for being retained at the workplace helps the health care organizations not
to face poverty.
Conclusion
Overall, the nursing shortage is a worldwide challenge in health care. When nurses are
exposed to poor working conditions, they quickly quit their jobs, thus enlarging the gap. A
conducive environment for nurses motivates them, urging them to continue working and provide
standardized care to patients. Looking for better jobs, increased population growth, and a
conducive working environment is factors that cause nurses to move between countries, causing
an increased shortage. Therefore, it is crucial to consider the strategies discussed above to help
address the issue of shortage, which significantly affects patient care and the nurses' well-being.
11
References
Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C., & Dittus, R. (2017).
Impact of the nurse shortage on hospital patient care: Comparative
perspectives. Health Affairs, 26(3), 853-862. https://doi.org/10.1377/hlthaff.26.3.853
Catsella, T. (2021, May 27). WHO says 'at least' 115,000 health workers have now died from
COVID-19. Nursing Times. https://www.nursingtimes.net/news/coronavirus/who-says-
at-least-115000-health-workers-have-now-died-from-covid-19-27-05-2021/
Collins, E., Owen, P., Digan, J., & Dunn, F. (2019). Applying transformational leadership in
nursing practice. Nursing Standard, 35(5), 59-
66. https://doi.org/10.7748/ns.2019.e11408
Drennan, V. M., & Ross, F. (2019). Global nurse shortages—the facts, the impact and action for
change. British Medical Bulletin, 130(1), 25-37. https://doi.org/10.1093/bmb/ldz014
Fouch, S. (2016). Nursing as a Christian ministry. Christian Medical Fellowship -
cmf.org.uk. https://www.cmf.org.uk/resources/publications/content/?
context=article&id=26522
Keogh, K., Jones-Berry, S., Kendall-Raynor, P., & Hackett, K. (2021, September 8). COVID-19:
Remembering the nursing staff who have lost their lives. RCNi | Information and
inspiration for nurses. https://rcni.com/nursing-standard/features/covid-19-remembering-
nursing-staff-who-have-lost-their-lives-160011
McConnell, C. R. (2019). Human resource management in health care. Jones & Bartlett
Learning.
12
Muabbar, H., & Alsharqi, O. (2021). The impact of short-term solutions of nursing shortage
on nursing outcome, nurse perceived quality of care, and patient safety. American
Journal of Nursing Research, 9(2), 35-44. https://doi.org/10.12691/ajnr-9-2-1
National Nurses United. (2021, May 12). National campaign for safe RN-to-Patient staffing
ratios. https://www.nationalnursesunited.org/ratios
Nettina, S. M. (2019). Lippincott manual of nursing practice. Lippincott Williams & Wilkins.
Okoth, K. T. (2020). Job satisfaction among clinicians at Homa Bay County Teaching and
Referral Hospital. East African Medical Journal, 95(12).
https://www.ajol.info/index.php/eamj/article/view/194562
Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. (2018). Essentials for nursing practice.
Elsevier.
Sacred Heart University. (2020, July 25). The origins and meaning of
nursing. https://onlineprograms.sacredheart.edu/resources/article/the-origins-and-
meaning-of-nursing/
Tamata, A. T., Mohammadnezhad, M., & Tamani, L. (2021). Registered nurses' perceptions
on the factors affecting nursing shortage in the Republic of Vanuatu hospitals: A
qualitative study. Plos One, 16(5),
e0251890. https://doi.org/10.1371/journal.pone.0251890
