The Nursing Crisis: Improving Job Satisfaction and Quality of Care

1
The Nursing Crisis Improving Job Satisfaction
and Quality of Care

• Linda Searle Leach, Ph.D., R.N., C.N.A.A.
• Assistant Professor
• California State University, Fullerton

2
Current Conditions
Turnover Unstable Workforce Few Incentives for
Experienced RNs Increased Cost of RN
staff Declining Morale Quality Concerns Unionizing
/Labor Activity
Higher Census Aging Patient Population Shorter
Lengths of Stay Increased Patient Load Lack of
Collaboration Increase Overtime Stressful Work
Environment
Aggressive Recruitment Image Campaigns Registry/Tr
aveler Staffing Hiring Bonuses Higher Wage
Rates Salary Compression
 
3
Increase the Supply of RNs

• Expand educational capacity and opportunity
• Increase state and federal support for nursing
  education
• Do not cut budgets that currently fund nursing
  education
• Provide incentives for and access to
  degree-granting education programs
• Fund workforce data collection and planning
• Systematically compile workforce data
• Forecasting models of supply and demand
• Promote partnerships between service and
  education
• More effective recruitment
• Recruit future generations
• Enhance diversity
• American Organization of Nurse Executives(AONE)
  Legislative Priorities 2003
• Health Care's Human Crisis The American Nursing
  Shortage. The Robert Wood Johnson Foundation.
  2002.

4
Increase Retention

• View RNs as strategic assets
• Satisfying work relationships
• Improve compensation
• Make positive changes in work environments
• Support integration and development of new nurses
• Labor saving technology
• Ergonomic technology
• Adopt characteristics of Magnet hospitals
• Health Care's Human Crisis The American Nursing
  Shortage. The Robert Wood Johnson Foundation.
  2002.

5
Increase Retention

• Expand career options
• Paid opportunities
• Strengthen nursing leadership
• Support education for managers and administrators
• Nurse executives must be key decision-makers
• Nurse involvement in decisions
• Increase visibility of RNs contributions to
  quality of health care
• Decrease individual workloads
• Health Care's Human Crisis The American Nursing
  Shortage. The Robert Wood Johnson Foundation.
  2002.

6
State Strategies to Address Workforce Issues

• Increase Supply
• Registered Nurses
• Masters Prepared Nurses
• Faculty
• Protect Workforce, Ensure Safety
• Obtain Data for Workforce Planning

7
Californias Nurse Staffing Legislation

• Assembly Bill 394 (2002)
• Directs the California Department of Health
  Services (CDHS) to establish minimum, specific,
  and numerical licensed nurse-to-patient ratios by
  licensed nurse classification and by hospital
  unit.
• Little data to drive decision-making process,
  even less agreement
• Increased costs
• Expected implementation date July 03
• Enforcement challenges

8
CDHS Nurse Staffing Ratios

• Nurse means
• Licensed Nurse
• RN
• LVN
• LPT