The Implications of Nursing Shortage

As the Baby Boomer generation is beginning to get older, health care workers are facing an increase in patient loads. STAFF FQHC (YEAR) states, “the population of seniors (65 and older) in the US has passed 50 million for the first time in history and is projected to reach over 70 million in the next 25 years.” With an increase in the patient population comes an increase in workload for health care workers, the possibility of an increase in hours worked, and the worsening of patient-nurse ratios.

Also, the increase in the geriatric patient population calls for an increase in geriatricians. It is estimated to need roughly 21,500 certified geriatricians, which is four times the current supply (STAFF FQHC). The main focus of this research paper is the correlation of the increase in patient load to the increase in the workload for health care workers, focusing specifically on nurses, and the possibility of an increase in the hours worked.

Trend or Issue

The increase in patient load from the Baby Boomer generation is likely to affect all disciplines and facilities in health care. This increase could act like a domino effect by increasing the work load (tasks per shift) for nurses and increasing the hours worked (overtime to cover the number of patients). Nurses already have an incredibly large list of tasks per shift and there is only 12 hours in a workday. While that may seem like a long time to complete everything, most times nurses find themselves staying late to get those tasks completed and charted. A common full-time nursing job consists of three 12-hour shifts, so working any overtime means taking on another 12-hour shift. By asking nurses to pick up overtime to take care of patients, nurse managers run the risk of high turnover rates and lower job satisfaction among their staff. Both an increase in hours worked and increase in the workload for nurses have the potential to increase medication errors, nurse burnout, and ultimately, mortality rates among patients.

To gain a working nurse’s perspective, a colleague was interviewed to discuss their concerns about the issue. When asked about his thoughts on the rising issue, Spaulding stated, “he can see pros and cons associated with the increase in patients. A pro would be job security; there will always be ill people. The major con is that once patients turn 65 years of age, they will gain medi-care. This is going to increase the patient population because patients who previously weren’t able to afford insurance will now be insured. Along with patients being more prone to coming into the hospital for minor illnesses, they are more apt to have untreated diseases from the time they were unable to come to the hospital. This could increase the acuity of patients’ nurses take care of” (Personal Communication, Feb. 17, 2020).

Another important perspective is that of the physicians who will be affected by the aging population. The issue was brought up to a cardiovascular surgeon to see what his thoughts were. Neel stated, “The aging population will increase our workload as cardiovascular surgeons, but the patient load is already relatively high for this specialty” (Personal Communication, 2019). “A way to help as the patient load increases, is to offer incentives. This means a higher wage for nurses, incentives to get more nurses to the hospital, but also, incentives to make more people want to become a nurse” (Neel, Personal Communication, Feb. 17, 2020).

Relevant Factors

The growth of the elderly population increases the healthcare cost, chronic disease, the aging of nursing faculty, shortage of healthcare workers, the need for home-based care and geriatric care. Many different studies show that average life expectancy has dramatically become higher in the last few decades. People are living longer but not necessarily living healthier with the help of advancing health services or programs and policies created to meet the older individual needs. According to the research, the average human lifespan was less than 70 years old in 1968 and was steadily increasing and almost reach 79 years old in 2016 (“The Aging,” 2019). As life expectancy increases at a rapid rate, elderly people experience a higher risk of chronic illnesses and a higher demand for highly skilled nursing staff. Aging adults tend to have chronic diseases than younger people, which include diabetes, hypertension, heart disease, arthritis, and cancer. About 62% of the elderly ages 65 and older suffer from at least one or two chronic conditions (Jaul & Barron, 2017). To improve the health of elderly people, it is crucial to train future nurses as “78 million baby boomer nurses” are retiring (Middaugh, 2016).

According to the American Nurses Association, 53% of nurses today are over age 50, while 72% of full-time nursing staffs are age 50 and over (Middaugh, 2016). The loss of older nurses who have life-long experiences, wisdom, complex skills, and knowledge will have negative effects on patient outcomes, quality of care provided, and the cost of healthcare. Moreover, the loss of older nursing faculty can cause inadequate staffing and unsafe nurse-patient ratios. Besides, decreasing the nurse-to-patient ratio leads to burnout, low quality of care, stress, heavy workload, a high nursing turnover rate, and compassion fatigue (Park, 2018). According to the study, the cost of nursing turnover is more than double a nurse’s salary (Park, 2018).

Current and Future Impact

As the aging population continues to grow, the demand for health services and healthcare workers increases. The aging adults suffer at least one chronic disease, and managing these chronic illnesses results in a higher healthcare cost. Many older adults face barriers while obtaining care, and those potential barriers are long waiting times, transportation difficulty, lack of access to treatment, and lack of knowledge about the management of chronic illnesses. The inability to carry out tasks related to treatment recommendations put the elderly at greater risk of unnecessary harm. The need for home-based health care professionals increases as the elderly require home care services that provide extra assistance as needed and improve overall health by giving care in the comfort of home. Moreover, the aging nurses’ retirements result in a shortage of health care workers. New graduate nurses who are trained to replace the aging nurses face difficulties and feel overwhelmed as they still don’t have much experience and are forced to limit the level of care due to the nursing shortage and exposed to the challenging aspects of nurses’ workplace, for example, a poor salary, long work hours and excessive workloads (Park, 2017).

“The U.S. Bureau of Labor Statistics predicts 1.2 million nurses’ vacancies between 2014 and 2022, with nearly 700,000 nurses leave the workforce by 2024” (“The Aging,” 2019). The shortage of nursing staff will be dramatically increased in the future. Retaining aging nurses due to increased patient volumes and the unsafe patient-nurse ratio will become a long-term goal for health care employers (Middaugh, 2016). Furthermore, many studies indicate that the older adult population will increase over the years and will have a huge impact on the health care system. Older adults with chronic conditions will seek care and the total cost of health services will skyrocket as hospital visits and admissions of elderly patients with chronic conditions will be doubled by 2023 (“The Aging,” 2019). Also, “according to the U.S Census Bureau and the Centers for Medicare and Medicaid Services, total health expenses are expected to reach $4 billion by 2020 and $5 billion by 2025” (“The Aging,” 2019). Expanding the aging population equals greater patient census, and will continue to increase the national health expenditures and the demand for health care services.

References

1. Neel, J., Personal Communication, February 17, 2020.
2. Spaulding, Z., Personal Communication, February 17, 2020.
3. Staff, FQHC. “Baby Boomers All Grown Up- The Impact of the Aging Population on Healthcare.” FQHC.org, FQHC.org, 31 Aug. 2017, www.fqhc.org/blog/2017/8/30/baby-boomers-all-grown-up-the-impact-of-the-aging-population-on-healthcare.
4. Middaugh, J. (2016). Nursing Management. Valuing Our Senior Nurses. MEDSURG Nursing, 25(6), 433-434. Retrieved from http://web.b.ebscohost.com/jvlapps.nusok.edu/ehost/detail/
5. Park, C. (2018). Challenging rules, creating values: Park’s sweet spot theory-driven central-‘optimum nurse staffing zone’. Journal of Advanced Nursing, 74(6), 1231-1232. doi:10.1111/jan.13496
6. Jaul, E., & Barron, J. (2017), Age-Related Diseases and Clinical and Public Health Implications for the 85 Years Old and Over Population. Front Public Health. doi:10.3389/fpubh.2017.00335
7. The Aging Population in the US is Causing Problems for Our Healthcare Costs. (2019). Business Insider. Retrieved from https://www.businessinsider.com/aging-population-healhtcare

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