Nursing Shortage Management Approaches Writing Sample

Introduction

Nurse shortage is one of the national-scale problems that need to be solved at all levels. Governmental policy is not enough to address the issue, although political measures and proper budgeting may contribute to creating a healthy working environment. Both leaders and managers of health organizations are to provide an encouraging environment that will foster healthy workers’ enthusiasm and creativity. It is crucial to remember that workers in health organizations need approaches to address the nurse shortage problem.

Nursing Shortage Issue

The demand for nurses has risen significantly by 2018. Armmer (2017) suggests that “more than 581,000 new positions will be available through 2018” (p. 2). Consequently, nurse shortage is a challenge that may affect the ability of medical care centers to provide patients with optimal and timely care. Horizontal violence, generational gap, and inappropriate work environment are the factors that result in nurses’ willing to turnover (Armmer, 2017). Personal comfort, as well as organizational goals, largely depend on the strategies employed by health centers’ leaders and managers.

Leader and Manager Roles

Importantly, the roles of leaders and managers vary significantly as they concern different tasks. Leaders guide and empower healthcare workers while managers focus primarily on organizational tasks (Huber, 2017). Nurses need systems of guidance that will help them overcome psychological difficulties and understand the importance of their mission. Leaders encourage health workers to make them feel confident in the number of challenging situations and contribute to the constant learning and self-improvement of workers. Leaders focus on workers and their environment, and managers regulate systems (Huber, 2017). Leaders are strategists, who emphasize the importance of inclusion, and managers are tacticians concentrated on particular short-term goals.

According to their roles, leaders are to concentrate on the work environment, trying to make it healthy and non-hostile. Workers’ efficiency depends partly on their performance at work and partly on an encouraging environment, which possesses resources for goal accomplishment. Leaders should interchange the “business as usual” trajectory with a new vision, considering the latest changes in healthcare programs.

Therefore, leaders need to create a learning environment, enhance confidence, provide feedback, and keep the balance between efficiency and psychological comfort (Huber, 2017). The role of leaders includes providing workers with a sense of confidence and guiding them in the complex realities of the healthcare system.

As the healthcare system experiences constant change, leaders need to consider new roles of health workers. For instance, nurses are now expected to be good coordinators as well as proficient specialists in care delivery (Huber, 2017). Therefore, leaders need to encourage their followers to develop some of the leadership competencies. Each worker should be a leader to some extent, being reliable, critical, adaptive, and confident. Helping health workers to adapt to the continually changing healthcare system and regulating a healthy environment at work, leaders can decrease the number of workers that choose to quit their job.

Managers focus on a different side of the work process as they are more goal-oriented. They focus on the safety and comfort of both workers and patients. Keeping the balance between nurses’ satisfaction and clients’ comfort is critical for them. Patient safety is of the greatest importance to healthcare specialists, yet it cannot be achieved without the good psychological conditions of employees. In critical cases, when errors threaten lives, an unstable, sophisticated environment can strongly affect workers’ ability to avoid mistakes (Urden, Stacy, & Lough, 2017). Therefore, managers are responsible for a “safe” environment that will minimize mistakes and foster workers’ confidence.

Managers should encourage nurses to report on their mistakes freely and protect workers from being ridiculed. Planning also decreases the number of medical errors since a hectic, complicated environment disrupts nurses’ ability to stay concentrated. (Urden et al., 2017). Interdependence is a key concept for medical workers, who need to rely on their managers, respect discipline, and be helpful. Consequently, planning and a loyal environment should be the primary goals for healthcare managers.

Although there is a lot of essential approaches that aim to encourage nurses and keep them motivated, providing a healthy working environment seems to be the most critical practice. As a new healthcare program enters into force, there are always changes in financing, formal requirements, and infrastructure. (Urden et al., 2017). The healthcare system in the US is dynamic and complicated. As a result, the lives of healthcare workers are full of stress and instability.

Managers and leaders should contribute to the time learning and support of their followers. It seems that knowledge and loyalty are crucial aspects of an interconnected work environment. Nurses have to possess information about their patients’ cultural differences, the latest programs, and their provisions to see how the healthcare system will change in the future.

Personal Approach

The approach that best fits my view of nursing and leadership is that of a nurse manager. I adhere to the perspective that nursing is more of a science and that effective care can be provided through an efficient, goal-oriented, and teamwork-based approach. The delegation, which is a critical aspect of nurse managing, contributes to meeting the high demands of the modern healthcare system and helps to ensure the needs of the patients are met. Management allows using a micromanagement approach, unlike leadership which commonly attempts to visualize a bigger picture. The micromanagement approach is more effective at resolving day-to-day issues and implement any systemic changes to procedures.

Funding Organizations

Undoubtedly, managers and leaders cannot ensure qualitative learning without financial support. There are plenty of international, governmental, state, and local organizations funding workforce training. Such programs as CDC and HRSA aim to make healthcare training a priority of both private and public healthcare organizations. Collaboration between primary care and public health organizations is essential as healthcare actors are to form interprofessional teams to address healthcare issues (Bigley, 2016).

The Public Health Training Center program is an example of a goal-oriented, well-collaborated program that is responsive to changes in healthcare provisions. For instance, this program created a national webinar, which provided up-to-date information about Ebola. Timely delivered information and training are vital for healthcare workers. Therefore, leaders and managers from medical organizations should consider applying for organizations like HRSA.

Conclusion

To conclude, both leaders and managers deal with staff training and empower nurses, creating a healthy working environment. However, the tasks of leaders and managers are utterly different. Managers deal with healthcare safety issues and they monitor the quality of work being done. Leaders concentrate on strategic goals and create a mission for their workers. Leaders should encourage employees to undergo training and embrace self-development.

Managers are to regulate the process of training and contribute to a healthy working environment, taking specific steps towards more qualitative care services. The US health care system is complicated and dynamic, which leads to unprecedented problems and great opportunities. Workforce training should be a priority for both healthcare leaders and managers to decrease the number of nurses that are not satisfied with their jobs.

References

Armmer, F. (2017). An inductive discussion of the interrelationships between nursing shortage, horizontal violence, generational diversity, and healthy work environments. Administrative Sciences, 7(4), 34.

Bigley, M. B. (2016). HRSA’s transformation of public health training. Public Health Reports, 131(1), 4-6.

Huber, D. (2018). Leadership and nursing care management. St. Louis, MO: Elsevier.

Urden, L., Stacy, K. M., & Lough, M. E. (2017). Critical care nursing – E-book: Diagnosis and management (8th ed.). Maryland Heights, MO: Elsevier.

Nursing Turnover Management Approaches

Introduction

Nursing shortage and turnover is a significant problem that has to be addressed and eliminated. There are several reasons associated with the issue that include the lack of caregivers’ education and dedication, as well as the increase in their age. To approach the problem, it is necessary to implement leadership and management techniques. This paper discusses the statistical data related to the issue and methods that can be used to decrease the number of shortages and the turnover rate. It concludes that communication between nurses, their patients, and leaders or hospitals’ authorities is crucial to eliminate the problem.

Significance of the Problem

The problem of a nursing shortage and turnover has become more acute over the past decades. Cox, Willis, and Coustasse (2014) note that one of the reasons for this is the inability of medical organizations to establish caregivers’ dedication to their work. Some of the other preventable causes of the turnover and shortages include the lack of professional skills, the increase in nurses’ age, and demographic changes in patients (Cox et al., 2014).

The data provided by Blegen, Spector, Lynn, Barnsteiner, and Ulrich (2017) reveals that the problem is acute not only among older caregivers that enter retirement. The study performed in 34 states showed that 15% of newly licensed registered nurses leave their job within the first year of work (Blegen et al. 2017). This data suggests that it is necessary to address the problem and discuss the methods of its management.

Leadership and Management Techniques

Since leaders are responsible for ensuring the high quality of care, it is necessary for them to work on the elimination of high turnover and shortage rates. It is essential to distinguish between the roles of nursing leaders and managers in the maintenance of the problem. Leaders’ role is to motivate nurses to achieve their professional goals (Huber, 2017). Leadership encompasses administrative, financial, and operational capacities to address the problem; it is associated with innovation, change, and risks.

A leader should be able to examine an issue, adapt the situation to workers’ needs, and communicate with caregivers to reach an understanding of the problem. At the same time, the purpose of management is to control the issue and utilize the already existing strategies for improvement. Managers assign tasks and direct individuals while leaders convey their ideas but do not create a plan for their implementation.

To approach the issue, it is necessary to study the reasons for its occurrence within each particular medical institution. For example, if a problem is associated with a lack of education or professional skills, it is necessary to provide training for nurses or improve existing educational programs. Leaders and managers should communicate with caregivers to learn about their concerns related to work. It is necessary to reassure nurses that the measures of improvement will be taken.

However, it is also crucial to encourage them to reflect on their tasks and skills to identify challenging aspects. The American Association of Post-Acute Care Nursing (2014) presents several strategies of leadership and management that can eliminate the problem. For example, the servant leadership style considers individuals’ needs and the development of their skills. A democratic approach encourages open communication and involves the personnel in the decision-making process. Halter et al. (2017) suggest another management technique, such as creating support programs that assist nurses during the process of transition, development, as well as early clinical experience. A combination of these approaches can be an effective strategy for improvement.

Personal Philosophy

The approach that best fits my personal and professional philosophy of nursing is creating a safe and positive environment for both patients and caregivers. Many hospitals tend to ignore the needs of their personnel which results in individuals working long hours, experiencing burnout, and being unable to rest. Nurses may not be seen as people that need care too, which often is associated with high turnover rates.

To improve the situation, a leader should consider the factors that create a negative working environment for the staff and discuss them both with nurses and administrative personnel. I believe that good working conditions may contribute to caregivers’ job satisfaction and commitment. It is necessary to mention that the elimination of the problem may improve the quality of care as well because nurses will be more motivated to show dedication to their work.

My philosophy of nursing also considers the importance of communication between all individuals involved in care. It is necessary for medical professionals, their patients, and hospitals’ authorities to express their perspectives on health and treatment, and consider each other’s goals and needs. To implement this vision into a strategy of the problem elimination, it is crucial to establish a dialog between these parties.

For example, sometimes the expectations novice nurses have about their practice do not correspond with the reality, where they encounter challenges and difficult situations while providing care. Consequently, they may decide to leave their job to avoid stressful situations. In this case, leaders should approach caregivers to discuss their concerns and offer possible solutions. Hospitals’ authorities should also consider the problem and implement discussion sessions or training during which they can address the challenging issues associated with nurses’ practice. Such an approach may change caregivers’ perspectives on their tasks and responsibilities, improve their work dedication, and decrease the turnover rate.

Funding Sources

In the US, many initiatives consider the problem of nursing shortages and serve as funding sources. For example, the Health Resources & Services Administration (HRSA) (2018) provides funding for advanced nursing education programs and traineeships for registered nurses. Moreover, the organization supports individuals of disadvantaged backgrounds providing them with opportunities to improve their professional skills.

The grants provided through HRSA may decrease the number of shortages and the turnover rate associated with a low level of training and education. It is crucial to mention that many state initiatives consider the problem as well. The American Association of Colleges of Nursing (2017) reports that the University of Wisconsin, the University of Minnesota, and other educational institutions provide fellowships, loans, and grants to improve nurses’ professional skills. They also offer training programs and aim to maximize caregivers’ clinical capacities.

Conclusion

The problem of high turnover rates and nursing shortages has become acute in recent years. To approach the problem correctly, it is necessary to implement management and leadership strategies including communication and training sessions. The concepts of the servant and democratic leadership styles can also be utilized to eliminate the issue. In the US, this problem is addressed by several governmental and local initiatives, including the ones created by HRSA and educational institutions.

References

American Association of Post-Acute Care Nursing (2014). Nursing leadership. Management & leadership styles. Web.

American Association of Colleges of Nursing (2017). Nursing shortage. Web.

Blegen, M. A., Spector, N., Lynn, M. R., Barnsteiner, J., & Ulrich, B. T. (2017). Newly licensed RN retention: Hospital and nurse characteristics. Journal of Nursing Administration, 47(10), 508-514.

Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Web.

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J.,… & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123.

Health Resources & Services Administration (2018). Nursing. Web.

Huber, D. (2017). Leadership and nursing care management (6th ed.). Philadelphia, PA: Saunders.

“Depression And Ways Of Coping With Stress” By Orzechowska Et Al.

Research Problem

The research conducted by Orzechowska, Zajaczkowska, Talarowska, and Galecki (2013) explored the problem of the adverse impact of stress on depression. The scholars indicated that the issue has started gaining increased attention in psychology and psychiatric research, as well as became important for healthcare providers to address. The study aimed the solve an important issue pertinent to nursing since depression can influence any patient (Zamanzadeh et al., 2014).

The main objective of the research was to determine the most commonly used strategies of stress coping among people with depression as compared to healthy individuals. Studying mental health is crucial in the context of nursing because the treatment of a physical issue usually includes addressing psychological considerations.

Review of the Literature

In the literature review, the researchers have explored several topics pertinent to their study problem. The identification of stressors that trigger the development of depression and coping mechanisms for dealing with stressful situations have been explored in the context of the cognitive transactional model. If to look at the publication dates of references used in the study, the researchers have used an array of current and old articles. The main reason for this was the need to incorporate a diverse look on stress and depression, and the 1990s represented the beginning of advanced studies on this topic.

Theoretical Framework

The cognitive-transactional model was the main theoretical framework on which the researchers based their study. It explained that in order to cope with stress, patients had to implement consistent behavioral and cognitive efforts of dealing with internal and external demands, which are often “excessive or overwhelming” (Orzechowska et al., 2013, p. 1050). The theory has been drawn both from nursing and psychology to develop an overview of the most common methods of dealing with stress among depressive and non-depressive patients. The cognitive-transactional model was chosen as the main theoretical framework for the study because the process of coping with stress is responsive and dynamic, which means that strategies and coping methods can be substituted by others. Overall, the researchers focused on the individual activity of patients rather than the impact of their environments.

Hypotheses

In the study, independent variables were the following: factors influencing the onset and progression of depression and patients’ diagnosis. Dependent variables included the strategies of stress coping among depressive and non-depressive patients. The list of these variables was extensive and included such strategies as planning, seeking social support, active coping, suppression, acceptance, and multiple others. No operational definitions to variables were given; however, Orzechowska et al. (2013) made sure to mention that the variables depended on patients’ abilities to deal with stress.

For the study, three research hypotheses were generated. First, the scholars hypothesized that individuals who were diagnosed with depression used such ineffective strategies as avoidance for addressing stress factors as compared to the healthy control group. Second, it was suggested that there was a connection between the extent of depression as identified by the Hamilton Depression Rating Scale and different methods of stress coping. Third, Orzechowska et al. (2013) hypothesized that “women and men differ significantly in preferred methods of coping with stress” (p. 1051).

Methodology

The researchers took a qualitative approach to the study when aiming to explore the most widespread use of coping strategies for dealing with stress. Deductive reasoning was used in order to reach specific conclusions about the identified problem. In order to study common ways in which patients with depression deal with stress, a sample of 80 participants was involved (32 men and 48 women). All patients were enrolled from the Department of Adult Psychiatry at the Medical University of Lodz. In order to have a control group for comparison, the scholars enrolled 30 (10 men and 20 women) individuals without the diagnosis of depression as well as absent family history of any psychiatric disorders and conditions. Unfortunately, the methods section of the research article did not include the description of the sampling method.

The survey used in the study relied on the Coping Orientations to Problems questionnaire developed by Carver, Scheier, and Weintraub. The survey included sixty statements with answers provided on a four-point rating scale, such as

  1. – almost never,
  2. – rarely,
  3. – often,
  4. – almost always” (Orzechowska et al., 2013, p. 1052).

There could be some issues associated with the reliability of the chosen study method because patients may not give honest answers to the questions because of the fear to be misunderstood or judged. When it comes to validity, there have been concerns because the chosen measurement tool measured what it was intended to measure. It should be mentioned that the way in which ethical considerations were addressed was not mentioned in the article, which is a significant disadvantage. Since depression and stress are complex issues that require sensitivity on the part of researchers, the article should have included at least a short description of how the scholars dealt with the problem.

For data analysis, the STATISTICA 10.0 PL tool was used. The analysis was conducted on the basis of the t-test and Pearson’s r correlation coefficient. To present study results, the authors developed a table called “Results of the coping orientations to problems questionnaire in tested groups” (Orzechowska et al., 2013, p. 1052). The columns included the results for patients with depression and the control group as well as the t- and the p-values.

The results were presented for each of the identified strategies of coping with stress. Another table was created to depict the statistical significance between the extent (severity) of depression and strategies for dealing with stress. In terms of the findings, the study identified that compared to depression-free individuals, patients diagnosed with recurrent depression were more inclined to use such coping strategies as denial and behavioral disengagement. In patients with first episodes of depression, behavioral disengagement was the most common.

Conclusion

The main advantage of the research by Orzechowska et al. (2013) is a detailed look at specific methods of addressing stress in the population of depressed patients. Its key disadvantage was the lack of attention to ethical considerations because they play a large role in studies of mental health.

Generalization to other populations is not possible in this case because the focus was placed on patients diagnosed with depressive disorders, and people with other psychiatric diagnoses may show different strategies of coping with stress. The study is important to nursing as a discipline because the treatment of patients encompasses both physical and psychological aspects. If, for example, a person diagnosed with diabetes also has depression and poor stress coping skills, nurses will be significantly challenged in terms of finding the right treatment (Holt, de Groot, & Golden, 2014). The implications for future research are vast since strategies for dealing with stress are continuously developing.

References

Holt, R. I. G., de Groot, M., & Golden, S. H. (2014). Diabetes and depression. Current Diabetes Reports, 14(6), 491.

Orzechowska, A., Zajączkowska, M., Talarowska, M., & Gałecki, P. (2013). Depression and ways of coping with stress: A preliminary study. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 19, 1050-1056.

Zamanzadeh, V., Rassouli, M., Abbaszadeh, A., Nikanfar, A., Alavi-Majd, H., & Ghahramanian, A. (2014). Factors influencing communication between the patients with cancer and their nurses in oncology wards. Indian Journal of Palliative Care, 20(1), 12-20.

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