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Impact of Nurses’ Shortage on Patient’s Care

The Impact of Nurses’ Shortage on Patient’s Care at Federal Teaching Hospital, Abakaliki (Fetha)

 

ABSTRACT

The nursing shortage in Federal Teaching Hospital Abakaliki has undermined the hospital’s goal of rendering quality and excellent care. The purpose of this study therefore was to assess the impact of nurses’ shortage from the views of its causes, impacts on patient care and nurses work life using all cadres of nurses working in the institution as study sample. A descriptive case study research design was adopted for the study and a sample of two hundred and sixty nurses were selected from the nurse’s population of 746. A validated questionnaire constructed by the researcher was used to collect data for the study. Data derived from the study were subjected to simple descriptive statistics. Major findings of the study revealed that the nurses are aware of the impact of nurses’ shortage in FETHA (69.6%). The findings also showed that heavy workload resulting from nursing and non-nursing work in FETHA are responsible for the nursing shortage, skin breakdown and pressure sore formation were revealed to be the impact of nurses’ shortage on patient’s care outcome, increase in job dissatisfaction and frustration  were also revealed to be the effect of nurses’ shortage on nurses’ work life. It is recommended that the factors in the work environment of FETHA which affects recruitment and retention of nurses be addressed. 

CHAPTER ONE

INTRODUCTION

Background of the Study

The stability of the health care system depends on adequate supply of skilled and trained nurses. Nurses are the front line care givers and backbone of any health care system. They are integral to hospitalized patients’ care and their contribution is recognized as essential for delivering safe, quality and effective care.

However, one of the key challenges facing the nursing profession and the health sector today is the growing and enduring shortage of nurses. The nurses’ shortage is a global concern in terms of adverse impact on health and well being of population. Hence, it calls for increased awareness and intervention from all health care parties (Aiken, 2008).

The global nurses’ shortage is not a recent issue; historically it has been in existence since World War II and is increasing with time. According to Sophen, (1950), it was already present in the United States as far back as in late 1932. It is a cyclic phenomenon affecting both developed and developing countries. However, the current critical nurses’ shortage which has drawn much attention from international bodies and organizational leaders originated in 1998, peaked in 2001and is projected to persist through 2015 (Buerhaus, 2007).

According to International Council of Nurses (ICN), (2006) the recent nursing shortage affecting both developed and developing countries is as a result of increase in demand for nurses exceeding a static or more slowly  growing supply.

The overall scale and magnitude of the shortage is staggering as evidenced by statistics in recent times. For instance American Association of Colleges of Nursing noted that USA in 2008 experienced a shortage of 80,000 nurses which is projected to rise to 500,000 registered nurses by year 2015 (AANC, 2008). Similarly, Canadian Nurses Association projected a significant nurses’ shortage in the near future with a shortfall of over 100,000 by year 2020 in Canada, (CNA 2008). Nigeria has been identified by the World Health Organization (WHO) as among the 57 countries in the world facing a shortage in the nursing workforce, that is those with nurse-density-to- population ratio fewer than 2.3 nurses per 1000 population (WHO, 2006). Nigeria with 1.7 nurses per 1000 population against that ratio, reported a shortage of nearly 40,000 nurses in 2006. According to them, Nigeria, despite having a pool of 210,306 nurses compared to other African countries is still faced with a significant shortage of nurses to meet the health needs of over 154.7million population. In the same vein, Integrated Human Resource Information System (IHRIS) qualify data from Nigeria Nursing Council revealed there are fewer nurses and midwives available than expected to provide much needed health services to Nigerian relation (IHRIS, 2012).

Global nursing shortage is a massive problem in the health care field. It has posed a challenge to efficient health care provision and has affected health care in general. It is not just a problem for nurses. It is a health system problem which undermines health system effectiveness (Buchan & Calman, 2008).The cause of the shortage has been attributed to a number of varied and complex factors such as aging and retiring nurses, aging population, poor image of nursing in the society (this discourages younger ones from entering the profession),changing and unhealthy work environment.

Federal Teaching Hospital, Abakaliki among the many other hospitals in Nigeria is facing a shortage in the nursing workforce, which has impacted on every section of the hospital. (Uneke, Ogbonna and Ezeoha, 2007). Nurses play a significant role in the quality and outcome of hospitalized patient care. With the nursing shortage in the institution comes adverse effect on patient outcome and nurses work life. The shortage in the institution has produced a revolving cycle of heavy work load leading to over burdened nurses who are fatigued, frustrated and more prone to committing medical errors. Generally patient’s cares are compromised. It therefore requires innovative and sustainable solutions from the hospitals management and nursing leaders to address the situation in order to improve the health system and quality of patients care.

 Statement of Problem

The nursing shortage in FETHA has become a major challenge to the achievement of the hospital’s goals of rendering excellent services and quality care. It bothers on every section of the hospital setting where nursing care are needed, from the ward and clinics to acute settings such as accident and emergency department, intensive care units and theatre department.

Nurse’s roles have been recognized as vital to the stability and effective operation of any health care facility. They are the core health care professionals and are in the best position to affect the care patients’ receive during a hospital stay. This is because they have the greatest contact and involvement in patients’ care.

However, the ongoing nurses’ shortage experienced in FETHA has greatly undermined the nurses ability to render quality care deserved of them as front line care givers. Following the shortage, the few available nurses are faced with increased work load which leaves them dissatisfied, frustrated and stressed out leading to burnout and eventual turnover. These further aggravate the situation. In addition, patients’ quality of care is compromised.

Given the seriousness of the situation, the study is designed to analyze the phenomenon of nurses’ shortage in FETHA in order to identify the factors responsible for it and possible solutions to address it.

 Purpose of the Study

The purpose of the study is to conceptualize, describe and analyze the impact of nurses’ shortage in FETHA II from the views of its causes and effects on patients and nurses.

Objective of the Study

The specific objectives of this study are as follows:

  • To determine the knowledge of the existence of nurses’ shortage among nurses in FETHA.
  • To identify the inherent factors responsible for the shortage of nurses in FETHA.
  • To determine the impact of nurses’ shortage on patients care outcomes in FETHA.
  • To determine the effects of nurses’ shortage on nurses work life in FETHA.
  • To proffer possible solutions to address the nurses’ shortage in FETHA.

Significance of the Study

The study is significant for the following reasons:

  • It will promote an understanding of the inherent factors in hospital that contribute to the nurses’ shortage.
  • It will promote the knowledge of the institution’s leaders and nursing leaders on the impact of the nursing shortage on patient’s care and nurses work life. This will help them to find ways to address it.
  • It will create an understanding of the importance of recruitment and retention on solving the nursing shortage.
  • It will promote the nurses knowledge on the nursing shortage and the type existing in Federal Teaching Hospital, Abakaliki.
  • It will contribute to the growing body of new knowledge on nursing shortage in Nigeria and globally.
  • It will serve as a future reference for other researchers on the subject of nurses’ shortage.

Research Questions

The following research questions have been raised with the view to help the researcher assess the impact of nurses’ shortage on patient’s care.

  • To what extent do the nurses in FETHA know about the existence of nurses’ shortage?
  • What are the inherent factors responsible for the shortage of nurses in FETHA?
  • What is the impact of nurses’ shortage on patient’s care outcome in FETHA?
  • How does the nurses’ shortage affect the nurses work life in FETHA?
  • How can the nurses’ shortage be addressed in FETHA?”

Scope of the Study

The study was conducted in Federal Teaching Hospital, Abakaliki and the study population was all the nurses working in the institution.

The study focused on and analyzing the impact of nurses’ shortage on patient’s care in Federal Teaching Hospital, Abakaliki, factors responsible for it and impact on patient’s outcome and nurses’ work life.

 Operational Definition of Terms

  • Nurses’ Shortage: This is the inadequate number of qualified nurses to meet the professional demand for nursing care within a Health Care Setting.
  • Impact of Nurses’ Shortage: This is the effect of nurses’ shortage on patient’s care such as failure to maintain and improve the health of patient.
  • Patient care: This refers to the intense attention given to the needs of a patient accomplished by a registered nurse based on the severity of the patient’s condition.
  • Factors responsible for nurses’ shortage: Are those things that causes nurses’ shortage such as the working environment, aging and retiring of nursing work force etc
  • Effect on Patient Care: The result of nurses’ shortage/inadequacy on patient’s care
  • Effect on Nurses’ Work Life: The physical and emotional results of inadequate nursing work force the lives of nurses.
  • Solution to Nurses’ Shortage: Interventions to combat nurses’ shortage such as making work force policy, providing positive practice environment etc

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