Definition Of The Issue

The aspect of nursing is a crucial one in context of healthcare sector and has been considered as a vital element for safe and flexible provision of healthcare services to the general population (Breimaier, Halfens & Lohrmann, 2015). The consideration of nursing staff as vocational entities reflects on their capabilities for addressing the social, physical, spiritual and psychosocial requirements of an individual patient in a healthcare setting. However, the trends observed in the modern healthcare scenario reflect on the cases of increasing shortage of nursing since the profession is gradually expanding into a progressive technical era wherein use of technology, technical data and clinical judgment can be assumed as notable influences on the retention of nurses. Therefore the contemporary healthcare scenario requires nurses to adapt to the needs of the sector effectively through technical and clinical training (Cronin, 2014).

This requirement of change could be assumed as a major reason for the explicit promotion of shortages in nursing profession in Australia. Therefore the following report aims to illustrate a literature review with explicit references to the definition of the identified issue, overview of the literature and discussion in which the issue would be analyzed in context of literature. The report outcomes also facilitate specific opportunities for framing appropriate change management frameworks through credible inferences from the literature.

The observed statistics for the number of registered nurses in Australia in 2012 was estimated to be well above a quarter of million and enrolled nurses amounted to almost 60000 in Australia. As per Ellis, this fact suggests a large scale investment in the Australian economy which could be observed in the form of the costs required for recruitment and selection of nurses alongside the embedded cost of education (Ellis, 2016). Therefore the requirements for coordinated organization, planning, deployment and administration of the workforce become mandatory in order to facilitate appropriate healthcare outcomes for the community alongside improving the financial gains through leveraging the appropriate utilization of a research. However, Fain said that the issue identified for this literature review report is identified from the predictions presented by the Health Workforce Australia regarding the health workforce scenario expected in 2025 with references to the employment of Nurses, Midwives and Doctors (Fain, 2017).  Shortage Of Nurses In Australia: Literature Review Discussion Paper

The document could be variably accounted as a unique representation of the potential future in the three key professions in the sector of healthcare. The trends predicted that the population health trends and the increasing age of the nursing workforce could lead to profound implications for poor retention rates among nursing professionals thereby causing an acute shortfall in individuals associated with nursing process. The issue is further complemented by the concerns of workforce planning projections that indicate the exceeding of Australia’s demand for nurses above the supply that could involve a potential loss of almost 85,000 nurses by the year 2025 which has been estimated to be lower than that of the predictions made by Health Workforce Australia in HW2025 (Grove, Burns & Gray, 2014).

This factor could be attributed to the probabilities for changes in the behaviour of healthcare organizations and nurses through reflecting on the recent data in order to derive workforce planning projections. Some of the examples of such factors could be identified in the lower demand rates for nurses that are employed in acute care reflects the fact that labour demand is lower than the projected trends in the public sector. Another necessary highlight that can be perceived as an influential factor on the workforce planning projections with respect to nursing is the lower exit rates (Holloway & Galvin, 2016).

Factors Contributing To The Shortage Of Nurses

However, these changes are formidably observed due to the impact of external factors, economic conditions and changes in the public sector health systems and policies. The review of research literature would facilitate a comprehensive impression of the elements that would be required for analysis of the existing scenario and the implications of demand and supply, reasons for the shortage of nurses and appropriate practice opportunities for addressing the issues of shortage of nurses (Houser, 2016).

Research literature associated with Australia as well as other countries and their characteristic implications towards the basic factors such as magnitude of shortage and determinants of the shortage. The overview of the literature could be helpful for obtaining a credible impression of alternative to address the issue identified in context of this report. Nursing staff shortage has been found to have a formal impact on the quality of service delivery in healthcare which has been assumed as a major precedent in research study literature.

As per LoBiondo-Wood, et al, the reasons for shortage were highlighted as multifaceted entities which were associated with variations in the employment patterns of women, nursing work environment, professional obligations, population demographics and the healthcare system. First of all, the ageing population in majority of OECD countries such as Australia is the prime reason for increasing the demand for effective nursing services (LoBiondo-Wood, et al., 2014). The drastic age growth rates predicted in context of populations in Australia would imply the requirement of higher health demands.

This factor leads to higher work pressure on registered and enrolled nurses thereby implying the lower retention rates of the nursing staff. Research also reflects on the multiple factors responsible for the lower workforce in the nursing sector which could be apprehended from the distinct secondary information research conducted by authors in this context. The two major categories for reasons for which the acute shortage in the nursing workforce is observed include references to individual and organizational factors. Organizational factors which are responsible for the higher exit rate of nurses could be identified in the form of work environment, work demands, organizational culture, commitment of employees and social support accessible within the organization (LoBiondo-Wood & Haber, 2017).

The aspects of individual factors which are considered essential in context of the issue of shortage of nurses in the existing healthcare scenario include references to the demographic factors, burnout and job satisfaction. According to Parahoo, Demand side factors which affect the need for the nurses to execute their operations can be identified in the form of rising activity through population ageing, downsizing of hospitals, technological aids to ensure diagnosis and treatment and the dynamics of customer expectations from healthcare service frameworks. The supply side factors that could be observed in this case refer profoundly to ageing of nurses and the working hours for the nursing staff (Parahoo, 2014).

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The social environment facilitated to nurses in a specific healthcare setting would have to be associated with formidable references to the empowerment of an organization through changes in structure. The particular implications related to reforms in organizational structure could involve the induction of flexibility in access to support, information, opportunities and resources that could be used for empowering nursing staff. Shortage Of Nurses In Australia: Literature Review Discussion Paper  As per Samuels, et al.,, the research studies also depict a positive relationship between the reforms in organizational structure and job satisfaction (Samuels, et al., 2015). Therefore the support provided to nursing employees at the organizational level can be identified as a profound impact on the retention rate of nurses. Furthermore, the set of beliefs, values and behaviour patterns could be considered as a vital organizational resource intended to improve the behaviour of employees considerably. Furthermore, the commitment of nurses to an organization is largely subject to the influence of organizational culture since their perception of the organization’s contribution to the fulfilment of personal goals. Nursing staff should be able to align themselves with the values and beliefs of the organization as well as state and federal health authorities thereby leading to higher commitment to the profession (Sandelowski, 2014). This would enable nurses to establish a connection with the profession effectively and thereby implying the favourable outcomes of improved quality of care.

Potential Solutions To The Shortage Of Nurses

The individual factors were also identified as another broad category of influences which affect the decisions of nurses to stay or leave the profession. The specific reasons which are included in this category refer to demographic factors and job satisfaction. Job satisfaction can be considered as the extent to which employees perceive their job as favourable. Different studies have been able to depict that lower job satisfaction is responsible for increasing the rate of staff turnover among nurses (Staggers & Blaz, 2013). Lower job satisfaction could arise from external factors outside the scope of the profession, personal reasons, higher work pressure and higher patient loads. Research studies have profoundly indicated that while almost 45% of nurses depicted that they were unhappy with their professions while approximately more than 60% of the respondents depicted their inclinations towards resigning from nursing jobs (Tappen, 2015).

Other formidable factors which were obtained from literature review pertaining to shortage of nurses could be identified in the form of the distinct symptoms and behavioural patterns developed by nurses in their profession. This factor could be attributed to burnout and is characterized by profound references to the issues of chronic fatigue, anxiety and abrupt mood disturbances (Thomson, Smith & Annesley, 2014). The absence of staff on the basis of reasons such as stress, anxiety and depression as identified by the reviews conducted by Department of Health reflect on the possible reasons leading to acute nursing workforce shortage in Australia. Furthermore, these aspects lead to the depiction of precursors that influenced the decision of nurses to exit their jobs. The professional implications for part time nurses could also be accounted as a source of information ascertained from literature review since they are subject to profound implications of the financial considerations, management of multiple life roles and the impact of shift work on them.

The prominence of anxiety, stress and depression among the existing nursing workforce of Australia could be assumed as a viable indicator of the factors leading to the acute shortage of nurses. The predictions from research study literature indicate a drastic fall in nursing workforce which can be addressed only through a coherent reform in the behavioural patterns of nurses and organizational factors such as empowerment and social support. The research literature depicts formidable references to the dominance of total withdrawal and part-time employment in the profession of nursing and the necessity for emphasizing the central role of nurses in the healthcare industry. Majority of nurses complied with the majority of issues that improved the quality of care of nurses as groups or individuals. The traditional image of a caring and supportive nurse has been transitioned into a caring and stressed nurse thereby leading to lack of productivity of nurses in delivery of quality care outcomes.

The literature review presented a notable reference to the outcomes of high stress in the nursing profession as the initial platform for the decision of healthcare professionals such as nurses to leave the healthcare profession (Ward, et al., 2013). The aspects of changes in behavioural patterns of nurses complemented with the factors of unreasonable workloads and limited monetary compensation lead to the frequent exclusion of nurses from the healthcare workforce in Australia.

Organizational Reforms To Improve Retention Rates

Furthermore, it has also been observed that the lack of adaptability for external practitioners in the domestic healthcare setting could also be a major reason for limitations on the development and expansion of the number of nursing staff. Another important factor that could be derived from the literature review in context of this issue reflects on the individual factor of job satisfaction which is one of the profound reasons for which the inflow into nursing profession is not observed profoundly. Based on this discussion, few alternatives could be derived in order to address the issue of shortage of nursing staff in Australia that are presented as follows.

Reduction of work pressure on nurses through realistic allocation of objectives and precise estimation of responsibilities would enable the improvement of job satisfaction and reduction of fatigue. The element of strength in facilitating guidance and support should be depicted explicitly by leaders that can be ensured through stringent selection approaches for recruitment of managerial personnel in the nursing profession. The employers should shift their emphasis from the financial constraints as well as objectives towards the establishment of a strong framework based on the values, belief and mission responsible for evolution of the nursing profession (Ward, et al., 2013). The ageing workforce in nursing should be facilitated with appropriate financial and social support at organizational and unit level in order to develop training opportunities for new enrolled nurses and part time nurses to consider inclusion in the profession of nursing.

Conclusion:

The report is concerned with the application of research in solving an issue pertaining to the sector of nursing. The issue that has been identified in this case refers to the shortage of nurses observed in Australia. The report comprehensively reviewed the varying aspects of the research study literature related to the factors that influence the retention rates of nurses. The literature review is followed with a discussion on the issue with respect to the literature thereby drawing credible insights into recommendations that can address the shortfall in nursing workforce in Australia.

References

Breimaier, H. E., Halfens, R. J., & Lohrmann, C. (2015). Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach. BMC nursing, 14(1), 18.

Cronin, C. (2014). Using case study research as a rigorous form of inquiry. Nurse Researcher, 21(5), 19-27.

Ellis, P. (2016). Understanding research for nursing students. Learning Matters.

Fain, J. A. (2017). Reading, understanding, and applying nursing research. FA Davis.

Grove, S. K., Burns, N., & Gray, J. (2014). Understanding nursing research: Building an evidence-based practice. Elsevier Health Sciences.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.

Houser, J. (2016). Nursing research: Reading, using and creating evidence. Jones & Bartlett Learning.

LoBiondo-Wood, G., Haber, J., Cameron, C., & Singh, M. (2014). Nursing Research in Canada-E-Book: Methods, Critical Appraisal, and Utilization. Elsevier Health Sciences.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences.

Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.

Samuels, J. G., McGrath, R. J., Fetzer, S. J., Mittal, P., & Bourgoine, D. (2015). Using the electronic health record in nursing research: Challenges and opportunities. Western journal of nursing research, 37(10), 1284-1294.

Sandelowski, M. (2014). Unmixing Mixed?Methods Research. Research in Nursing & Health, 37(1), 3-8.

Staggers, N., & Blaz, J. W. (2013). Research on nursing handoffs for medical and surgical settings: an integrative review. Journal of Advanced Nursing, 69(2), 247-262.

Tappen, R. M. (2015). Advanced nursing research. Jones & Bartlett Publishers.

Thomson, P., Smith, A., & Annesley, S. (2014). Exploration of the effects of peer teaching of research on students in an undergraduate nursing programme. Journal of Research in Nursing, 19(5), 415-430.

Ward, D. J., Furber, C., Tierney, S., & Swallow, V. (2013). Using framework analysis in nursing research: a worked example. Journal of advanced nursing, 69(11), 2423-2431.  Shortage Of Nurses In Australia: Literature Review Discussion Paper