This paper is a critical analysis of a research article titled “Education Policy Initiatives To Address the Nurse Shortage in the United States” authored by Linda H. Aiken, Robyn B. Cheung, and Danielle N. Olds.
Problem Statement
Shortages of the nursing staff are expected to hit an all-time high of about three hundred thousand to over a million nurses by the year 2020 (Aiken, Cheung & Olds, 2009). Despite the expected job creation of over half a million new jobs between 2006 and 2016, the deficit in the nursing workforce will persist due to the massive retirements that are looming (Aiken et al., 2009; Buchan & Aiken, 2008). According to Aiken et al. (2009), even a seemingly small shortage of about three thousand nurses would be about three times greater the worst nurses’ deficit experienced in America over the past five decades.
Despite the expected challenges in the availability of adequate nursing manpower, nursing schools in the US are not tapping into the persistently high numbers of qualified applicants. The reluctance to admit more students to nursing programs is partly due to inadequate faculty members and financial difficulties in colleges and universities. Aiken et al. (2009) argue that changes in the education policies that address faculty shortages, budget constraints in tertiary institutions of education, and limited placement options can increase the possibility of expanded admission in nursing school. The implementation of such policies would enable colleges and universities to exploit the persistently high scores of applicants to nursing programs instead of turning them away. Increasing the number of admissions would reduce the nurses’ deficit when these students qualify to work.
This study is important and justified in the sense that it focuses on education policy reforms that would address the looming shortage in staffs in the nursing sector. However, the researchers do not illustrate the effects of the nursing shortage to the delivery of medical services. The research article has not addressed the implications of staffing shortages on patient outcomes and the quality of medical care. Few nurses in healthcare facilities result in massive workloads. As a result the available staff is overworked, stressed and has burnt outs. Such staff issues affect patient outcomes, accelerate the deterioration of patient safety and affect the quality of nursing care negatively (Hassmiller & Cozine, 2006).
Purpose and Research Questions
The researchers’ aim is to examine various options in the formulation of education policies that would enable higher institution of learning to take advantage of the applications flooding their admission centers or offices. The study examines the various ways in which nursing programs can maximize the high interest in nursing so as to produce and introduce an increased number of qualified and competent nurses into the job market. The investigation’s goal is to explore viable policy options that will tackle the faculty challenges and economic barriers that contribute to qualified students not being enrolled for nursing studies in tertiary institutions. These policies would strengthen America’s nursing workforce for the future.
The investigators raise several research questions that include:
What are the contributing factors to faculty shortages in nursing programs?
What are the policy interventions that can be implemented to realign the composition of faculties effectively over time, with an aim of strengthening programs for future nursing needs (Aiken et al., 2009)?
Is the education composition of the nursing workforce a contributing factor in the faculty deficits and the consistently flat enrollments in Advanced Practice Nursing (APN) programs?
Would federal funding and Medicare Support to nursing education assist in increasing the output of nursing schools by encouraging more nurses to advance their studies?
The above research questions were formulated with an objective of exploring nursing education policy changes that would result in increasing the output of nursing programs by addressing the deficiencies in nursing faculties and the financial challenges that are a burden to nursing institutions as well as the students. These policies would contribute to increasing the number of nurses in the workforce thus address the national shortage of nurses (Hassmiller & Cozine, 2006). They would also address the issues in nursing faculties thus increase the competency of the nursing graduates.
The exploration of the education composition of the nursing sector reveals that the different pathways to advanced nursing education and their differences in growth have the potential to affect future nursing faculties negatively. For instance, greater growth in one pathway can discourage nurses from enrolling into a certain program thus potentially worsening the deficit in educators as well as advanced practitioners in that specialty in the future. By examining the Title VIII appropriation and Medicare funding towards nursing education, the researchers show that are financial strategies that can be used successfully to shape the future of the nursing workforce (Aiken et al., 2009).
Literature Review
The researchers have used both qualitative and quantitative research studies to illustrate the national inadequacy in nurses, the faculty deficits, and the role of the nurse in health reforms. Statistical reports from the Bureau of Labor Statistics and the American Association of Colleges of Nursing (AACN) have been used to show the extent of nursing labor challenges and the inconsistencies in the nursing faculties successfully. Other sources include books on health reforms and analysis reports from government agencies and councils (Council on Physician and Nurse Supply, National Advisory Council on Nurse Education and Practice, and the US DHHS) and various health organizations and associations (American Nurses Association, AACN, National League for Nursing, and the American Association of Nursing Practitioners). The authors have also cited several interviews with high-ranking professionals in the healthcare sector.
The paper has cited current sources (from 2004-2009) except a few publications and reports that were published earlier. The oldest source is the “The Nursing Shortage and the Nurse Training Act” published in the Industrial and Labor Relations Review in 1966. Other early reports include the BHPr report to Congress (1990), IOM report (1997), and the Federal Policy Taskforce report (1998). The oldest research article used was published in 1995. These old sources were necessary to illustrate the recurring staff shortages in the nursing sector and the various changes that have occurred in the workforce over the years. Though past studies acknowledge the contribution that the challenges in nursing faculty make in the worsening shape of the workforce, they do not examine the possible solutions that can result from education policy interventions. The literature review provided adequate information to support the researchers’ arguments on the persistent problem of nurse staffing.
Conceptual /Theoretical Framework
The investigators did not use a particular perspective to develop the study neither did they use a theoretical or conceptual framework in their inquiry.
References
Aiken, L. H., Cheung, R. B., & Olds, D. M. (2009). Education policy initiatives to address the nurse shortage in the United States. Health Affairs, 28(4), w646-w656.
Buchan, J., & Aiken, L. (2008). Solving nursing shortages: a common priority. Journal of clinical nursing, 17(24), 3262-3268.
Hassmiller, S. B., & Cozine, M. (2006). Addressing the nurse shortage to improve the quality of patient care. Health Affairs, 25(1), 268-274.
