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Nursing Shortgage to Worsen: How this Affects Nursing Homes
Posted on Mon, July 20, 2009 at 10:49 am
As you watch the news and read your morning newspaper, you are no doubt becoming increasingly aware of the fact that there is a nationwide and global nursing shortage. According to a 2002 Canadian Nurses Association survey, if utilization patterns remain the same, we can expect a shortage of 78,000 registered nurses in 2011, and 113,000 in 2016.
As you consider the impending nursing shortage and its implications, most people are inclined to think only of longer wait times in hospitals. However, this is only of one many consequences that result from an insufficient number of nurses. In a survey of Canadian nurses, 28% reported that quality of care decreased because of a nursing shortage. Furthermore, a 2005 Statistics Canada survey found that 19% of Canadian nurses made medication errors occasionally or frequently, and there was no relationship between the nurses who made errors and their education or level of experience. Errors were attributed to an increase in overtime, inadequate resources, lack of support from coworkers, and low job security. – all of which are typical during a staffing shortage.
The impending nursing shortage will be felt across all healthcare settings from hospitals, to clinics, and to nursing homes. Nursing homes may be at more serious risk, however, because of a greater nurse to resident ratio. In a hospital, a RN typically cares for 4 – 8 patients, however it is not uncommon for RNs on a night shift in a nursing home to be responsible for 100 residents. If a hospital is short an RN, the others on duty may each only have to increase the number of patients they are responsible for by a handful, whereas a nursing home who is short an RN will have to increase the load of a RN by upwards of 50 residents. According to a Statistics Canada survey, 54% of nurses working in long-term care report that there is insufficient staff to complete work loads and absenteeism rates are higher in long-term care settings when compared to other health care settings.
Most work places frown on absenteeism because of the bottom line- it is extremely costly. As an administrator I was concerned about absenteeism because I had so few nurses to call on when another nurse was sick. I used staffing agencies as a last resort because I preferred to staff the home with nurses who knew the residents and our practices and policies. This left me in the difficult position of asking nurses to work overtime, the concern being that I did not want to overwork and exhaust our front line caregivers. The last thing I wanted was a tired nurse administering medications or giving treatments. It was not uncommon for a nurse on the management team to work a shift on one of the floors because we were that desperate to properly staff the home.
Summer was a particularly sensitive time for staffing because nurses requested vacations during this time. If I declined their vacation, I risked losing a nurse because they knew that they could easily get a job elsewhere. Thankfully, the nurses were very understanding of our vacation policy that limited the amount of vacation they could take during the summer because of the shortage.
If you have a loved one in a nursing home, I believe that it is important to be very involved in their care. Ask questions, attend the care conference with the staff and doctors, and visit regularly to ensure that your loved one is receiving the care that is prescribed. Besides, their days will be brightened by your presence and companionship.
Christine Taylor
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