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Nursing Shortage

Jason Conk

Objectives
What is the nursing shortage?
Is there really a shortage?
How big of a problem is it?
Why should I care?
How do we fix it?
Important Theories
Root Cause Analysis

Introduction

The impending nursing shortage is real


and is poised to become a national
healthcare crisis!

Introduction

But Is It Real?
https://www.youtube.com/watch?v=tU1emGCPTc8

Theory of Human Caring

Jean Watson- 1988


What is a human being?

A valued person in and of him or herself


to be cared for, respected, nurtured,
understood and assisted; in general a
philosophical view of a person as a fully
functional integrated self. Human is
viewed as greater than and different from
the sum of his or her parts.

Theory of Human Caring

Watsons Nursing Model


Promoting Health

Preventing Illness
Caring for the Sick
Restoring Health

Theory of Human Caring


Watson's model makes seven assumptions
1.Caring can be effectively demonstrated and practiced only
interpersonally.
2.Caring consists of carative factors that result in the
satisfaction of certain human needs.
3.Effective caring promotes health and individual or family
growth.
4.Caring responses accept the patient as he or she is now, as
well as what he or she may become.
5.A caring environment is one that offers the development of
potential while allowing the patient to choose the best action for
him or herself at a given point in time.
6.A science of caring is complementary to the science of curing.
7.The practice of caring is central to nursing.
https://www.youtube.com/watch?v=Yu1v_HCh7xA

General Systems Theory


Ludwig von Bertalanffy- 1936
Biologist-

theory to guide several disciplines

Laws & Principles-

wholeness, differentiation, order,

progression etc.

Common Framework Systems & Order-

for researchers to build upon

Too much information- focus based

General Systems Theory


System- A set of objects or elements in interaction to
achieve a specific goal.

Elements of a System
Input
Output
Throughput Process
Feedback
Control
Environment
Goal

Assessment of the Healthcare


Environment
Baby Boomers
Retirees
Increase in Cancer and Chronic Diseases
Not enough teachers, schools, clinical
sites
BSN degrees are becoming standard
Obama Care

Assessment of the Healthcare


Environment

Inferences and Implications

Increased stress
Decrease job satisfaction
Leaving the field
Longer wait times
Decreased patient satisfaction
Increase in Morbidity and Mortality

https://www.youtube.com/watch?v=22YS6Q_j
FoQ

Role-play

Lyndon B. Johnson-1965
Nurses today are essential members of our Nations
health team. The health needs of a growing population
cannot be met without their help. Blessed with the gifts
of healing and with a wise and understanding heart,
nurses perform a vital role in maintaining and
strengthening Americas health services and our national
well-being. Yet we are critically short of the nurses that
we need.
Title VIII of the Public Health Service Act

Recommendations
QSEN
Teamwork and Collaboration- Function effectively
within nursing and inter-professional teams, fostering open
communication, mutual respect, and shared decisionmaking to achieve quality patient care

o KSA
K- Describe examples of the impact of team functioning
on safety and quality of care
S- Demonstrate commitment to team goals
A- Acknowledge own potential to contribute to effective
team functioning

o ANA- Standard 13
Collaboration- The RN collaborates with healthcare
consumer, family, and others in the conduct of nursing
practice.
Title VIII of the Public Health Service Act

Recommendations
QSEN
Safety- Minimize risk of harm to patients and
providers through both system effectiveness and
individual performance.

KSA
K- Describe processes used in understanding causes of
error and allocation of responsibility and accountability
S- Engage in root cause analysis rather than blaming
when errors or near misses occur
A- Appreciate the cognitive and physical limits of
human performance

ANA- Standard 10
Quality of Practice- The RN contributes to quality
nursing practice.

Regulate Staffing and Overtime Requirements

Recommendations
QSEN

Evidence-Based Practice- Integrate best current evidence with


clinical expertise and patient/ family preferences and values for
delivery of optimal health care.

o KSA

K- Describe EBP to include the components of research evidence,


clinical expertise and patient/family values.

S- Question rationale for routine approaches to care that result in


less-than-desired outcomes or adverse events

A- Value the concept of EBP as integral to determining best clinical


practice

o ANA- Standard 9

EBP and Research- The registered nursei ntegrates evidence and


research findings into practice.

Fishbone Diagram
Baby Boomers

Not Enough
New RNs

10,000 retirees
everyday

Lack of Educators
Long Wait
Expensive

Fewer
Births

Effect
Specialize

Cause

Burnout

Turnover

No experienced
RNs

Retirees

References
American Nurses Association (2001). Code of ethics for nurses with interpretive
statements. Silver Spring, MD: American Nurses Association.
American Nurses Association. (2010). Nursing: Scope and standards of
practice (2nd ed.). Silver Spring, MD: American Nurses Association.
Code of Ethics. (2014). Retrieved from:
http://www.nursingworld.org/MainMenuCategories/Ethi
csStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf
Erik Erikson (2014). Retrieved from: http://www.simplypsychology.org/ErikErikson.html
Kalisch, B. (2006). Missed nursing care: A qualitative study. Journal of nursing
care quality. 21 (4). 306-313.
McHugh, M., Berez, J., Small, D. (2013). Hospitals with higher nurse staffing
had lower odds of readmissions penalties than hospitals with lower staffing.
Health Affairs. 32 (10). 1740-1747. doi: 10.1377/hlthaff.2013.0613
Needleman, J. Buerhaus, P., Stewart, M., Zelevinsky, K., Mattke, S.
(2006). Nursing in hospitals: Is there a business case for quality? Health
Affairs. 25 (1). 204-211 doi: 10.1377/hlthaff.25.1.204
Pre-Licensure KSA. (2014). Retrieved from: http://qsen.org/competencies/prelicensure-ksas/
Zappe, J. (2014). Nursing jobs still hard to fill and forecast is it wont improve.
Retrieved from: http://www.ere.net/2014/05/06/nursing-jobs-still-hard-tofill-and-forecast-is-it-wont-improve/