One of the acute problems, experienced by most of health care organizations is nursing shortage; nursing demand is growing whereas the supply of qualified nurses became really low. Sometimes the job positions remain unfilled for a long period of time and a tense situation with shortage appears. The prognosis and estimations for the year 2020 prove that due to the fact, that the number of nursing students decreases every year, demand and shortage will continue to grow. This is also necessary to consider such factors as demographic transitions (i.e. changes in the numbers of elderly population) and factors of advance developments of medical technologies along with appearance of new diseases and infections. Health care system is a continuous service, which should meet very high demands due to high responsibility level, which makes the health care industry vitally important and unique sector all over the world. Thus this is logical, that this system needs all sided and constant control and management of the labor sources involved. Granting of quality and urgency of medical services is directly related to nurse’s shortages. ĒėThe requirements of quality assurance have shifted the discussion further, from the focus of quality control designed to reduce errors in existing patterns of care, to continuous quality improvement designed to achieve higher levels of, and increased uniformity in standards of care and performance. These changes in the health care system require even more well qualified nurses and health professionals in generalĒĚ (Graham, 1994). All the above-mentioned facts underline the importance of the soonest improvements and supports for health care system in terms of qualified personnel.
There are number of professions connected with provision of health care services, but in our research we are going to stop in detail at nursing personnel, trends in the nursing workforce, possible reasons of personnel shortages as well as possible strategies to be applied for improvement of the situation. In most countries nurses make the majority of the health care giving personnel. A number of surveys confirm the fact, that at the moment there are not enough sufficiently prepared nurses. The most concerning trends in nursing workforce nowadays are: ďinadequate numbers of trained personnel to meet health system needs, limited opportunities for improved nursing and midwifery in relation to primary health care, lack of legislation to guide nursing resource development, limited influence of nursing on health policy, unacceptable working conditions and poor career opportunitiesĒĚ (Buchan, 2002).
There are several indicators of nursing shortage, which are normally used to identify the current trends.¬† The first one is the increase of turnover rates among nursing personnel. The main reasons for turnover are dissatisfaction with payment and work schedule systems, along with some other personal reasons. The second indicator is the use of temporary staff, the more is the problem of hiring people or of finding qualified workforce, the more temporary services are used. As soon as the number of overtime hours starts to increase, this is the time to consider the number of nurses working as not sufficient. Besides the growth of overtime worked is a rather dangerous process as it might in its turn lead to another wave of reduction of personnel. At last one of the most objective measurements for nursing shortage is the number of new graduates who are registered for nursing practice. This is logical, that decrease of these young workers would result in shortage of personnel in the nearest future.
In order to better control and manage the situation with nursing shortage it is necessary to be aware of the facts, which influence this process. Nowadays, nurses work not only at hospitals, but at other health related places, such as health insurance companies, research companies, pharmaceutical companies and so on (Graham, 1994). All the factors, which contribute to rising demand for nurses along with their shortage can be summarized into following:
–¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† as health systems failed to work out the corresponding strategies for cost containment in care systems, new students lose interest in taking up nursing profession and choose other career directions; those, who already worked as nurses prefer to retire or also change the sphere of employment.
–¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† absence of nurses at their work places due to sickness, trainings days, vacations and so on
–¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† various life events, for example pregnancy.
–¬†¬†¬†¬†¬†¬†¬†¬†¬†¬†¬† shift work schedule turns out to be stressful for some people, who quit this job only because of this reason.
As it was already mentioned in order to seize the situation with nurses’ shortage under control, this is necessary to work out and to apply the corresponding strategies, because the health care system and its proper functioning is vitally important for the whole society. In order to have better results timely interference is absolutely necessary. Further we are going to consider the potential strategies, which could support the health care organizations and contribute to increase of supply of nurses.
Researchers state, that there is a number of registered nurses, who perform non-direct care activities, which certainly has a negative impact on their work interest and thus direct influence upon the problem of shortage of personnel. It seems necessary to automatize the non-valued work tasks in order to enable the process of direct patient care. Application of proper software would without any doubts facilitate the work process of nurses and thus a number of full time nurses is likely to increase. Certainly the process of automation would demand higher initial costs and additional trainings for personnel.
The health care industry should consider the modern marketing principles and should be able to use the marketing tools for promotion and recruitment. Young generations of nurses correspond to the modern world, health care industries should also do. For the marketing aim, health care services may be treated in the same way like any other types of services and should not avoid application of marketing techniques for recruitment of personnel and offer competitive work conditions and work places. It seems also necessary to build a perfectly operating system of recruitment, not only during the times, when there is increased demand for this kind of services, but constantly, in order to have constant number of candidates for potential employment. ďThe strategy of continuous recruitment of nursing personnel may play an important role in helping the organization to adapt and remain competitive.
Employees who have recently finished professional nursing training are an important source of information on new methods and techniques in service delivery that allow the organization to remain competitive in its traditional servicesĒĚ (Buchan, 2002).
The process of personnel management should not be concentrated purely on recruitment; it is necessary to provide trainings and other development activities for nurses, who are already working for the health care organization. The mutual interest of the employer and employee are the key factors for their successful cooperation and mutually positive results. This approach would help to develop the existing staff and is likely to attract young people.
Some other industries use the system of employee referrals. As soon as their managers realize, that classified advertising as well as newspaper advertisements fail to bring the desired results, they develop a system of bonuses to the existing workers for attracting new employees to the company. There is a certain sum of money defined as bonus for each new worker, but split into two parts, the first part is paid immediately as the new employee comes and the second one Ēď for example in six months. The result would be, that existing workers would be interested in attracting qualified specialists, because they wouldn’t like to work with low-qualified people, as they will have to perform their part of work as well. In case of application of employee referral program it is necessary to work out some guidelines in order to foresee the roles of HR managers in this program or the issue of relatives and so on.
Another method, which could be applied for avoiding problem with nursing shortage, is development of scholarship programs. This is clear, that it is more convenient for a health care organization to employ a person with good experience for the position of nurse, but as this is not always so easy and as such employees would be able to work less time before they retire, it is reasonable to use the strategy of loan programs for students, who are going to get a nursing degree. The principles of the program could foresee, that the loan is not to be paid back, if the student works for the organization for a certain period of time after his graduation. Such programs can be rewarding to both young employees, because this is difficult to find work without having experience as well as for the health care organizations as they invest not into advertisement, which may or may not bring the results, but into a real young specialist.
Often, seeking for better work conditions and payments, workers leave for other organizations. As time passes some of them realize, that there are enough pitfalls at other organizations, and would probably like to return to the former workplace, where they were more satisfied with their position. That’s why it is necessary for the management of the health organizations not to lose contact to their former workers, as most of them wouldn’t risk contacting the former employer for work after they burnt their bridges. As soon as they are sure, that there will be no negative consequences for them if they agree to come back, some of them prefer to return. If some work conditions, which were the stimulus for the worker to leave can be improved and reconsidered it would be even easier to convince a person to come back.
Overall, in this paper we listed only some examples of possible techniques, which could be applied for attracting nurses in order to improve the situation with nursing shortage. This is evident, that there can not be any universal method and a lot depends on the structure and sphere the organization operates in, on the work conditions of the region, where it is situated and so on. Important is to remember, that even the most difficult problem can be solved if the correct approach is found.