The Emergency Room Is A Fast Paced And Hardcore Working Facility

With over 2 million jobs, registered nurses represent the largest health care occupation (Windle, 2008, p. 209). Although nurses are the biggest health care occupation, there continues to be a shortage in the United States. The shortage has worsened because of rising healthcare costs and a focus on cost containment, which has negatively impacted nurse work environments (Keeler and Cramer, 2007, p. 350). With demand for healthcare expecting to continue to increase and financial pressures becoming more burdensome, these shortages will likely become even more critical in coming years if not adequately addressed (Love et al., 2006, p. 558). The U.S. Bureau of Labor Statistics estimates 1.2 million nurses will be required to fill new and vacated nursing positions by the end of 2014 (Windle, 2008, p. 209).

According to Peter Buerhaus of Vanderbilt School of Nursing who has studied the problem on staff shortage. “Nursing care in America's hospitals has reached a critical shortage -- the worst in 50 years.”(1)

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

The nursing shortage has been influenced by the aging workforce, shortage of nursing faculty, professional alternatives, poor working conditions and poor nursing image. By 2020, there will be an increase in demand for registered nurses (RNs) due to the increase need for healthcare services to meet the needs of the baby boom generation (Keenan & Kennedy, 2003). It is estimated that the nursing shortage will range from 400,000 to 808,000 full-time equivalents (FTE) RNs. The nursing shortage has impacted the intensive care units (ICU), medical surgical units and operating rooms (Keenan & Kennedy).

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

In 1960, Virginia Avenel Henderson a nurse and a theorist in the same time, defined nursing, “the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible”. It is a noble function and to be fulfilled at the highest levels, it takes time, patience and the devotion. When the number of people given this care is much lower than that of people who must receive the care, then a crisis occurs. The phenomenon is acute not only in America but all around the world. Even if the nursing is considered a meaningful work, the country is facing a nursing shortage that grows more with each passing year. Nursing shortages in America affect all parts of the health care delivery system.

There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster

When people think about nurses, many ideas come to mind. They think of the hideous old starched, white uniforms, a doctor’s handmaiden, the sexy or naughty nurse, or a torturer. The media and society have manipulated the identity and role of nurses. None of these ideas truly portray nurses and what they do. Nurses are with the patients more than the doctors. People do not realize how little they will encounter the doctor in the hospital until they are actually in the hospital. People quickly realize how important nurses are. Because nurses interact with their patients constantly, nurses are the ones who know the patients best.

The healthcare profession is an ever evolving world that has changed greatly over the course of history in response to the needs of the communities and world at large. Gone are the days of doctors traveling to homes and communities near and far to provide a service. So much of the care provided now is driven by policies, legal agenda and financial impact. As a result of the changing dynamics within the healthcare industry, the roles of medical personnel have transformed into something once unfathomable. Nursing is a key area where significant changes have been observed over the last half century. Due to the ever increasing number of patients within the healthcare system and a physician pool that is not growing at the same rate, there has

Nursing education has progressed throughout history from one of uneducated lay persons to the current standards we know today. As the career has progressed it has become apparent that there is a need for a skilled labor forced trained to deal with the sick and dying, “the provision of nursing care by American women…demonstrated the effectiveness of skilled nursing on improving outcomes for sick and injured soldiers” (Creasia & Friberg, 2011, p. 4). However, as the career progresses so does the need for more specialized training amongst nurses to help them deal with the changing atmosphere of patient care. The future

Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care

It is likely that most people have heard about the nursing shortage for years now, and perhaps they believe it’s been fixed. However, the nursing profession is experiencing a reoccurring deficiency. According to Brian Hansen, (2002), there was a nation wide shortage in 2001 of 126,000 full-time registered nurses, but the shortage will surge to 808,000 by 2020 if something isn't done. This pattern is a persisting cycle of high vacancies followed by layoffs and a high over supply of registered nurses. Various factors contribute to the lack of nurses within the health care facilities, but today’s shortages are a little different. Many feel that this scarcity is severe and long-drawn-out. The four major issues contributing to

Emergency and critical care can be the most challenging parts of nursing and some of the most rewarding as it is carrying out intensive care for patients which may not always end well or may have the best result.

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.

Nurses are known as the heart of health care. Being a nurse is a demanding job that requires commitment, but does not lack rewards. A fact stated by the American Association of Colleges of Nurses claims that “Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation 's long-term care” (“Nursing Fact Sheet”). With many roles throughout the healthcare system as a whole, nurses are a large, very important role that interacts with every other part of the health care system. They have great qualities that not everyone has. They are highly compassionate, caring, professional, diligent and understanding individuals. A nurse experiences people at their worst and still care for patients in a way that no one else would. All these honest points prove that nurses are the most important members of the health care system because, nurses spend the most time with patients, nurses are the managers of patient care; they are teachers and are great with conflict resolution.