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Current trends and issues in nursing management- part 3

  1. The Current Nursing Shortage, Opportunities for Lifelong Learning and Workforce Development

There is significant nursing manpower shortage both in acute and long-term care settings. That results from many factors such as :

–nurses of the “baby boom” generation are beginning to retire.

–women today have numerous career opportunities; and

–perception of nursing as a “trade,” versus a “profession,” contributes to the lack of individuals.

As the age of entering students rises, the number of years of practice decreases also affects supply. While the number of male and minority students has been steadily rising, their ranks are still underrepresented. Workforce Development is a positive recent advances which includes the opportunity to practice in a variety of clinical settings has resulted in dramatic increase in opportunities for ANP`S, new careers in care management and case management. There is an increasing interest in biotechnology, information technology, and pharmaceutical companies in hiring skilled nursing professionals.Occupation attracted more women of superior class.Nursing training in regional languages also started.There different levels of education –graduate, post graduate & doctoral levels.

Continuing & in-service education is introduced for the working nurses.Nursing education must partner with the health care industry to develop innovative short and long-term solutions that address the nursing shortage, including aggressive student recruitment and the initiation of an intense media/marketing campaign. The public image of the nursing role must be revitalized to change outdated perceptions.

 

The image of nursing has always been one of dedication, service to the patient, and selflessness. Now as nursing profession, the issue of collective bargaining has become more important. Collective bargaining is the uniting of the employees for the purpose of increasing their ability to influence their employer and to improve the working conditions. Collective bargaining is based on the principle that there is greater strength in large numbers. The nurses who have joined nursing unions have increased. Nursing practices have often been defined and controlled by other groups also such as physician and hospital administrators. These groups saw the potential power of an organized large group of well educated and dedicated nurses and feared the time when they would become independent. Even though , in area of the country where collective bargaining of health care workers is not the part of the system, many hospital administrators react to any unionization attempts on the part of nurses with hostility and resistance.

 

Concept of supportive supervision is coming up. Supportive supervision is a process that promotes quality at all levels of the health system by strengthening relationships within the system, focusing on the resolution of problems, and helping to optimize the allocation of resources. It focuses on problem solving on the spot with the joint participation of the supervisee and supervisor.

Financial incentives are integral to the employment contract. It has been quoted in a study by Hongoro and Normand that at least half of the variation in turnover can be attributed to financial incentives. Now a day there is rise in performance linked payments. In one country in Africa,Nurses and officials posted in remote health facilities in areas of high HIV prevalence are given a 31% bonus if they stay on for more then 3 years. Also non financial incentives are also been introduced into the work place as it has been seen that financial incentives are not enough to motivate the employees e.g of non financial incentives are as follows:

  • Career and professional development (inservice education programmes, study leave)
  • Workload management
  • Overtime payments
  • Letter of appreciation to the good worker or for their extraordinary performance(best nurse award)
  • Flexible working arrangements
  • Positive working environment
  • Access to benefits and support(Child care leave, housing loan, Earned leave )
  1. Continuing nursing education

It has become essential to keep up with the changing needs of patient care. Nurses have to continuously update themselves with new and innovative approaches in patient care management. For this they should enable themselves with workshops, seminars, short term training programmes, attend conferences, make use of library, subscribe and read periodicals and books. Discussion on bedside and supportive supervision helps to keep abreast with newer techniques and information.

 

  1. Evidence based practice

There has been a significant Advancement in Nursing Science and Research. The growing body of nursing research provides a scientific basis for patient care and should be regularly used by the nurses. Most studies concern health behaviors, symptom management, & improvement of patients’ and families’ experiences with illness, treatment, and disease prevention. There is lack in focus on the scholarship and science of nursing as top priorities. Doctorally prepared nursing professionals are not being produced in large enough numbers to meet the growing need. There is need for enhanced mentorship for new researchers to strengthen skills and capacity to conduct meaningful nursing research.

 

  1. Nursing audits

A careful review of nursing care and its effectiveness is done by the administrators of nursing services. Not only clinical improvements but also emotional aspects of the patient need to be measured to decide the quality of nursing care given.

 

  1. Collective bargaining

 The image of nursing has always been one of dedication, service to the patient, and selflessness. Now as nursing profession, the issue of collective bargaining has become more important. Collective bargaining is the uniting of the employees for the pupose of increasing their ability to influence their employer and to improve the working conditions. Collective bargaining is based on the principle that there is greater strength in large numbers. The nurses who have joined nursing unions have increased. Nursing practices have often been defined and controlled by other groups also such as physician and hospital administrators. These groups saw the potential power of an organized large group of well educated and dedicated nurses and feared the time when they would become independent. Even though , in area of the country where collective bargaining of health care workers is not the part of the system, many hospital administrators react to any unionization attempts on the part of nurses with hostility and resistance.

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