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Nursing Understaffing : PICOT Question
For a long time, the labor market has experienced a severe shortage of medical personnel, especially nurses. Hospital staff suffering from a lack of labor is forced to work longer and with many patients during the day, which affects the effectiveness and quality of services. Moreover, the world pandemic of COVID-19 demonstrated the significant relevance of the problem. Haddad & Toney-Butler (2020) identifies the main reasons for the shortage of nurses:
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the aging population (which reduces the number of nurses and increases the number of people requiring help);
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professional burnout;
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care about family;
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uneven distribution of the workforce by regions;
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violence in the workplace.
Consideration of the reasons suggests that most of them need to be solved at the state level to ensure the professions attractiveness among the young population, provide educational opportunities, and take other measures. In clinical settings, the solution lies in retaining nurses at work, and it defines the aspects for PICOT question:
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P (patient population) hospitalized people;
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I (intervention/issue of interest) nurses retention to solve professional burnout, violence problem;
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C (comparison intervention) no intervention and no retention measures;
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O (outcomes) nurses job satisfaction and, as a result, increased effectiveness inpatient care;
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T (time) long-term perspective.
For hospitalized patients, does the use of measures to retain nurses affect care effectiveness (compared to the situation in the absence of such actions)?
Evidence-based solution
Harsh working conditions for nurses lead to severe fatigue and stress, which will result in professional burnout without proper support. During such a period, the employee is likely to quit and find another professional path. Given the shortage of nurses, such turnover is a critical issue. Friganovi et al. (2017), in their study, identified the most common causes for burnout and, accordingly, ways to prevent them. Measures suggest a nurses inclusion in decision-making, autonomy in action, mental support, and other actions.
Nursing intervention
Measures to retain nurses may require some actions from the employees themselves. They need to engage in an open dialogue with the administration about what aspects of work can be improved both for job satisfaction and providing quality patient care. Since the violence among workers is another cause of understaffing, such manifestations cannot be neglected and should be solved with managers. Thus, nurses need to protect their rights in the workplace.
Patient care
Job satisfaction and burnout prevention, which can be achieved by retaining nurses, may increase the level of service delivery to patients. Lu et al. (2019) confirm the correlation between these phenomena and focus on ensuring an adequate nursing workforce. Balanced patient-nurse ratios are among the main factors of high-quality care for patients. This balance will allow allocating more time for each patient, as well as for advanced training and development, and not to overload nurses with work.
Health care agency
Healthcare institutions understand the issue of the lack of nurses and the costs that they incur because of it. Thus, the consequences of the problem are additional motivation for the implementation of staff retention measures. In each organization, they may differ, and therefore, the administration should develop a plan of changes based on information received from nurses and monitor its execution. Such actions may require additional funding and resources, but they will pay off in the long term.
Nursing practice
In practice, taking care of nurses and measures to keep them at work will positively affect their activities. These actions will help prevent burnout and, accordingly, the desire to quit work. Moreover, job satisfaction is an additional incentive for efficiency and benevolence, which is essential when communicating with patients. Thus, the retention of nurses can contribute to solving the problem of their shortage in medical facilities.
References
Friganovi, A., Kova
evi, I., Ili, B., }ulec, M., Krikai, V., & Bile, C. G. (2017). Healthy settings in hospital How to prevent burnout syndrome in nurses: Literature review. Acta Clin Croat, 56(2), 292-298. Web.
Haddad L. M., & Toney-Butler T. J. (2020). Nursing shortage. National Center for Biotechnology Information. Web.
Lu, H., Zhao, Y., & While, A. (2019). Job satisfaction among hospital nurses: A literature review. International journal of nursing studies, 94, 21-31. Web.
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