Nurses play a very important function when it comes to guaranteeing patients a care that is safe, efficient and effective (Lowrie, 2015). Providing such healthcare which is patient centered largely depends on the available best evidence and the capacity of nurses to apply the evidence using their skills. Evidence-based medicine is the mostly commonly used method nowadays in providing patient care in the United States. It a term that first came to public domain in the early 1990s and since then it has been gaining popularity with time especially in nursing. Evidence-based nursing can therefore be defined as the diligent use of modern most outstanding evidence in patient care decision making (Academy of Medical-Surgical Nurses, 2014). It is a method used in clinical practice that integrates nurse’s clinical proficiency, using most appropriate current evidence to solve a clinical problem as well as patient choices, values and preferences.
Effective implementation and use of evidence-based nursing has at times experienced a number of challenges. One major problem that hinders full implementation evidence-based care is shortage of nurses. The number of qualified registered and practicing nurses is way far below the required number which is needed to sufficiently attend to the high demand of healthcare services especially by the aging population, management of chronic illnesses as well as attending to emergencies. This shortage of nurses affects both the nurses as well as the patients in a number of ways. For nurses, the shortage increases the workload assigned to each nurse, this may lead to the nurses becoming exhausted and strained as they will be forced to work for longer hours or shifts hence affecting the quality of care being given to patients. On the other hand, the shortage of nurses affects patients in that some of their multiple individual requirements and preferences may not be fully met because there are no enough nurses to respond to the sensitive needs of patients. This is because evidence-based practice requires that multiple approaches are used in providing patient care, thus requires an extensive evaluation of research findings to establish the most suitable. The evaluation process is very demanding in terms of personnel needed and time and therefore shortage of healthcare providers i.e. nurses may pose difficulties in full evaluation of research findings hence strength and relevance of such findings from research may not be ascertained in relation to the determining care.
The ethical problems associated with nurse shortages in implementing evidence –based practice include choosing a good practice that does not harm the patient, nurses normally experience a problem when it comes to decision making. Some patients may choose to make a choice that may be harmful to them; the patients always have freedom and right to choose. However, nurses have a duty of preventing patients from making choices that will harm them; they are therefore faced with the ethical dilemma of either preventing them or allowing them to make the choices they want. Another ethical dilemma brought about by the shortage of nurses is distribution of resources. For example who should be attended to first considering that there are no enough nurses to attend to all the patients at once (Fant, 2012).When nurses also are in a position or have knowledge on what to do to help a patient who is suffering but cannot take any action because there is lack of evidence, they become distress and see it as failing to perform their moral duty. This is another problem that is brought about by the use of evidence-based practice (Wood, 2013).
The economic problems that arise in evidence-based nursing due to shortage of nurses are complex. Shortage in nurses normally causes many financial impacts not only to hospitals and healthcare givers but also to the patients, society and the federal government. The major economic problem caused by nursing shortage is that it makes it costly to access healthcare due to the fact that many hospitals will need to raise money that will be used to increase the number of nurses’ staff, this process of hiring new nurses is normally costly to hospitals and other healthcare providers. Studies indicates that there is a close relationship between more nurses and quality healthcare in that when a hospital has more nurses, they provide quality healthcare to patients which results in enhanced outcomes that satisfies patients. It is therefore clear that nurse shortages often increases the coast of healthcare and negatively affects on the quality of services provided (American Nurses Association, 2015). Another economic problem facing nursing is poor payments that are made to nurses, a poorly remunerated staff often feel less motivated to carry out his/her duties and tasks that are assigned to them. This affects healthcare providers in that they will experience increased rates of turnover. This further will contribute to shortages in nursing.
There are also many legal and political problems linked to nursing shortage that ultimately lead to challenges in successful implementation and efficiency of evidence-based nursing. Nursing shortage can greatly influence how policies and regulations are developed, politics also on the other hand politics can affect nursing shortage and also patient safety in a number of ways. For example it may lead to introduction of nursing standards bills, patient & nurse’s protection and safety laws. These regulations are aimed at reducing cases of injuries or harm to both patients and nurses or all the healthcare providers (Department for Professional Employees, 2014). The laws may be successful in providing a safe environment for patients and nurses, however the rules or regulation s proposed maybe too demanding to nurses to an extend that some may be forced to leave their work because they cannot cope with the rules. The above highlighted problems in nursing are common or similar to almost all healthcare providers and community.
References
Academy of Medical-Surgical Nurses. (2014). Evidence-Based Practice | Academy of Medical-Surgical Nurses. Retrieved from https://www.amsn.org/practice-resources/evidence-based-practice
American Nurses Association. (2015). Nursing Shortage. Retrieved from http://www.nursingworld.org/nursingshortage
Cathy Fant. (2012). Major Ethical Dilemmas in Nursing | NurseTogether.com. Retrieved from http://www.nursetogether.com/ethical-dilemmas-in-nursing
Debra Wood. (2013). The Top Ethical Challenges for Nurses - NurseZone. Retrieved from http://www.nursezone.com/Nursing-News-Events/more-news/The-Top-Ethical-Challenges-for-Nurses_41691.aspx
Leanes Lowrie. (2015). Ethics & Legal Issues in Nurse Staffing | Chron.com. Retrieved from http://smallbusiness.chron.com/ethics-legal-issues-nurse-staffing-76772.html
