The Issue of Global Nursing Shortage

Nurses today provide a critical role in maintaining a functioning healthcare environment. Many nurses have the same complaint—too much work, not enough nurses to go around. There are three main components that make up the this shortage: Not enough nurses to staff the hospitals at a safe level, not enough professors to teach the large amount of interested students, and an increasing complexity of patient care. This problem is not limited to the United States. In fact, there is a growing shortage of nurses worldwide. The World Health Organization estimates that globally, there is a need for over 4 million healthcare providers. This growing problem does not have a simple solution. 

Contributing factors to global nurse shortage 

Although the shortage of nurses is evident globally, some countries are affected to a greater extent. The American Hospital Association reported a 13% vacancy rate for nurses across the United States. Some countries in southern Africa report over 30% vacancy rates (Peterson, 2004). One reason for the greater shortage is that of nursing migration. The most common nursing migration that occurs is from low-income countries to more wealthy countries. The appeals of moving to a wealthier country for a nurse include: enhanced compensation, better nurse to patient ratio, more educational opportunities and potential for career advancement. This forms a vicious cycle of shortage in less developed countries. Even though wealthier nations are on the benefiting side of nurse migration, there still lies a shortage. One major issue that contributes to this shortage is the global lack of nurse educators. Faculty shortages at nursing schools across the country are limiting student capacity at a time when the need for professional registered nurses continues to grow. Budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this crisis. 

Ethical Nurse Recruitment

The migration of nurses is often facilitated by foreign nurse recruitment. An estimation of nearly 20% of the United States nursing force is made up of nurses who received their basic nursing education outside the United States (Squires, 2009). Some of these nurses are provided with low cost or even free training in their home country. An issue can arise when a nurses education is supported by a country then the nurse does not stay. Not only does the country lose the money supplied, they also lose the individual that could help to provide healthcare desperately needed in the home country. Another challenge faced is that there are private recruiters that can take advantage of international nurses by garnishing wages or locking them into strict contracts (Squires, 2009). Nurse employers should do their best to assure they are practicing ethical international recruitment. But not all is bad, international recruitment can be valuable: in addition to being mutually beneficial for both hiring institutions and international nurses, it creates a more culturally diverse workforce, attracts professional immigrants to communities, and fosters a positive image of hiring institutions globally. 

Ethical Response to Staffing Issues 

It is the baseline responsibility of a healthcare organization to provide the best possible care to the patient. Managing care of patients when not adequately staffed can present several issues. Hospitals with low staffing tend to have poorer patient outcomes. Often, there is simply not enough time to fully assess and monitor each individual patient if the nurse has a large patient load, which then leads to higher readmission rates. With large patient-to-nurse ratios a nurse can find it difficult to practice to their best ethical ability. Nurse burnout is another issue that can stem from inadequate staffing. Higher than average nurse-to-patient ratios have been proven to increase nurse burnout (Martin, 2015). This can create a vicious cycle of the inability to maintain adequate staffing. Finally, experienced nurses retiring at a rapid clip, but there aren't enough new graduates to replenish the workforce. Hospitals and other medical facilities are getting so desperate to recruit and retain nurses they're offering pricey perks and incentives, including five figure signing bonuses. 

How to Alleviate Global Nursing Shortage

Global nursing shortage cannot be addressed without improvement to the shortage of nursing faculty. There cannot be an increase in available nurses without more nursing educators. In fact, Nardi (2013) writes that it is estimated over 75,000 qualified applicants are turned away from beginning nursing education because of a lack of nurse faculty. Nardi (2013) also suggests that nursing education needs a complete paradigm change. With ever increasing and improving technology and medical research, all facets of education must adapt to stay efficient. 

Conclusion 

There is not a simple answer to the problem of global nursing shortage. I believe there has to be three different aspects addressed to take effect to notice any change. First, the issue of education must be addressed. This would involve a global increase in the training and employment of nursing educators. Second, hospitals in more the most developed countries must be properly funded to assure the ability to hire adequate staffing. Third, is that poorer nations that have nurses migrate out must be assisted in replenishing their resource. Affluent countries have a responsibly to participate in assisting the poorer countries in subsidizing nursing education and offering compensation to the nations that lose their workforce to nursing migration.

References 

• Anderson, B., & Carr, C. K., (2011). The global nursing shortage- an issue of social justice. In Cowen & Moorhead (Eds.), Current Issues in Nursing (8th ed., pp.768-775). 
• Barney, S. M. (2002). The Nursing Shortage; Why Is It Happening?. Journal of healthcare management, 47(3), 153. 
• Gross, J.M., Rogers, M. F., Teplinskiy, I., Oywer, E., Wambua, D., Kamenju, A., & … Waudo, A. (2011). The impact of out-migration on the nursing workforce in kenya. Health Services Research, 46(4), 1300-1318. doi:10.1111/j.1475-6773.2011.01251.
• Martin, C. J. (2015). The effects of nurse staffing on quality of care. MEDSURG Nursing, 24(2), 4-6 
• Nardi, D. A., & Gyurko, C.C. (2013). The global nursing faculty shortage: status and solutions for change. Journal of Nursing Scholarship, 45(3), 317-326. Doi:10.1111/jnu.12030 
• Peterson, C. (2004). The global impact of nursing shortage. Retrieved from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_Feb04_Peterson.pdf 
• Squires, A. (2008). Ethical international recruitment; many faces, one goal – part 1. Nursing Management, 39(9), 16-21. http://doi.org/10.1097/01.NUMA.0000335253.23789.98