Tuesday, May 26, 2020

Nursing Shortage The Cold Hard Facts and Possible Solutions - Free Essay Example

Sample details Pages: 7 Words: 2134 Downloads: 5 Date added: 2019/08/16 Category Nursing Essay Level High school Topics: Nursing Shortage Essay Did you like this example? The United States is expected to have such as large shortage in nurses that its going to intensify as baby boomers retire and the amount of health care grows. Nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care. According to the American Association of College of Nursing (AACN), In 2014, the U.S. Don’t waste time! Our writers will create an original "Nursing Shortage The Cold Hard Facts and Possible Solutions" essay for you Create order Bureau of Labor Statistics (BLS) projects healthcare employment to grow by 26 percent between 2012 and 2022, with an increase of about 4.1 million jobs. (Healthcare: Millions of jobs now and in the future, 2014) Hospitals, long-term care facilities, and other ambulatory care settings added 36,000 jobs in October 2018. Over the past 12 months, health care employment grew by 328,000. As the largest segment of the healthcare workforce, RNs likely will be recruited to fill many of these new positions. (Employment Situation Summary, 2018) As a nurse I know the importance of my role and also know that my contribution now in the healthcare is as much appreciated and needed part of several peoples lives. Without Medication Techs, Certified Nursing Assistants, Certified Medical Assistants and the variety of nurses the quality care would be a lot different than how many facilities care for them. The efforts in reducing the nursing shortage is currently apparent and will become more apparent as the nursing shortage grows. I feel the nursing shortage is not fully being addressed in the efforts to improve the number of nurses to fill the huge current and upcoming gap of jobs in healthcare. I will start by addressing some important numbers and problems that attribute to the nursing shortage. I spoke with Danielle Conrad in 2012 during her term as senator about a bill that she had addressed as an interim study to examine the nursing shortage in Nebraska. As a potential nursing student at that time I knew the importance of my role as a future nurse. After reading through the public hearing, it has been estimated that by the year 2030 there will be vacant positions of nearly 3,838 RNs, nurse practitioners, midwives, and faculty teachers. Juliann Sebastian, dean of the University Of Nebraska Medical Center College Of Nursing spoke about how Nebraska is not alone in the nursing shortage. Nurses provide a great amount of care to healthcare sectors, which are vital to the public. With qualified nursing applicants turned away in 2011, other avenue need to be explored to reduce the nursing shortage. Nebraska is not alone in facing a serious nursing workforce shortage that threatens public health and undermines economic opportunity. The U.S. Bureau of Labor Statistics predicts that, in addition to hundreds of thousands of positions that will be vacant by 2020 due to replacement primarily for retiring nurses, a total of 581,500 new nursing positions will have been created by 2018. Nearly one-third about 262,000 jobs are expected to be for registered nurses. (Healthcare: Millions of jobs now and in the future, 2014) Nursing care is vital to the health of the public and nurses provide care in every sector of healthcare, including hospitals, Long-term care, and primary care. There are two key issues in Nebraska related to the nursing shortage. First, we have a shortage of the number and type of nurses needed to care for Nebraskans now and into the future. Second, we have a shortage of faculty to expand nursing programs throughout the state. Seventy-three of Nebraskas ninety-three cou nties have fewer nurses than the national standard. Rural areas are particularly hard hit by the nursing shortage. The Nebraska Center for Nursing estimates that Nebraska will have a shortage of 3,838 nurses, registered nurses, by the year 2020. In 2010 schools of nursing around the United States turned away over 7,000 qualified applicants to baccalaureate and graduate degree nursing programs. In Nebraska, 402 qualified applicants were turned away from baccalaureate and graduate nursing programs in 2010. If another 402 applicants were enrolled each year in Nebraska schools of nursing, the shortage projected by the Nebraska Center for Nursing for 2020 would be significantly reduced. (LR 285 Hearing Transcript) Although interest in nursing careers remains strong, many individuals seeking to enter the profession cannot be accommodated in nursing programs due to faculty and resource constraints. AACN data showed that 39,423 qualified applications were turned away in 2009, which is comparable to that in past years. Another problem in accepting all qualified applicants is not only space, but funding, clinical sites, and faculty. As the shortage increase and the number of nursing students is limited, much of the problem is factors such as space and funding, but a huge part is the faculty. According to AACNs report on 2016-2017 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 64,067 qualified applicants from baccalaureate and graduate nursing programs in 2016 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. Most nursing schools responding to the survey pointed to faculty shortages as a reason for not accepting all qualified applicants into baccalaureate programs. (Nursing Faculty Shortage Fact Sheet, 2017) Looking at these numbers asks the valid question, How does this impact patient care? Hospitals in 2016 experienced an estimated 16.5% of turnover rate of registered nurses. Its estimated that it takes approximately 54-109 days to recruit an experienced RN. The lack of adequate numbers in nursing staff can affect patient well-being in a number of ways. One of these ways is higher mortality rates. An increase in 1 full time RN per 1000 inpatient days decreased patient mortality rate by 4.3%. Hospitals with fewer nurses witnessed a 2–7 percent increase in mortality. With a shortage of nurses leads to an increase in the workload of the existing workforce, which results in a increase in medication errors. These can range from infusing medicines at the wrong rate (most common) to giving the wrong medicine or mixing up medicines between patients, which easily can result in fatal consequences. Lastly, we are seeing overcrowded emergency departments with longer wait times to see provid ers. (The Nursing Shortage and How It Will Impact Patient Care, 2017). So, what do we do about the problems that are leading up to a big gap in the number of nurses? I think that there are a few areas that we specifically need to look at to improve this problem. The first being with current healthcare employees, the second with nursing programs, and thirdly with potential nursing students. Current demand for RNs is high with a limited supply, considering this fact it is noted that one half of RNs are not satisfied with their salaries. By paying more or offering bonuses to those individual who sign on can go a long way in helping to rectify this problem. Providing more training and educational opportunities already in the existing field allows for better growth and personal/professional development, which can create a sense of loyalty. Lastly considering the use of temporary nurses during surges in hospital admissions and common illness seasons. In the article The Shocking Truth about the Nursing Shortage in the United States, in speaking about the nursing shortage it mentions that, fewer nurses means the ones who are employed experience a higher workload, and often have to cover shifts or work overtime to keep patients covered. The combination of high pressure situations and more hours worked can lead to staff burnout, both emotionally and physically. Compassion fatigue can affect caregivers who arent able to take time for themselves or who are too stressed in their work environment. Minimal sleep from picking up extra shifts, combined with the emotional energy required to care for additional patients, can contribute to burnout and inadvertently cause the quality of patient care to decline. This can be frustrating if your schedules dont allow for adequate breaks and basic human needs like enough sleep. So, rather than asking nurses to do what feels impossible under these circumstances, employers need to accommodate their nu rses basic needs and listen to their feedback. (The Shocking Truth about the Nursing Shortage in the United States, 2018) Hospitals in Buffalo, New York are partnering with international corporation and local headquarters to help pay for people to attend nursing school if they promise to work for the hospital after graduation. More and more hospitals around the United States are more desperate for nurses and are using sign-on bonuses of $1,500-$2000 and even as high as $8,000-$10,000 to help obtain nurses. But these sign on bonus are not enough to make a long term change. Furthermore, Its not about the bonus check; its about respect, better working conditions, and job satisfaction. Hospitals have typically responded to past nursing shortages by offering bonuses to nurses who sign up to work there. Why arent the sign-on bonuses effective at recruiting and retaining nurses in U.S. hospitals like previous years? According to the National Council of State Boards of Nursing, the current shortage is different from past shortages. This one is worse, and the traditional solutions arent likely to work. Liz Jacob s, RN, spokeswoman for the California Nurses Association said, Nurses need the profession to return to a place where we can do the things that give us job satisfaction, like patient education and basically feeling like youre not jeopardizing patient care and your license every day. With the nursing shortage some places are taking more acting such as the Tallahassee Memorial Hospital. I think nurses want to be paid adequately and recognized for their performance, said Ann Evans, RN, senior vice president for nursing for Tallahassee Memorial Hospital. I think they want to work in a place with good outcomes. People want to work where theyre respected. Tallahassee Memorial Hospital is also using a market-based pay strategy to remain competitive and regularly re-evaluate its wages. They are adjusting its pay strategies to better suit its employees needs and has instituted a tuition reimbursement program as an incentive for its nurses to continue their education. The California Nurses As sociations Jacobs suggests that mandatory nurse-to-patient ratios, which California recently announced, may also improve the work environment for nurses enough to draw more nurses back into hospitals. Jacob says, Nurses want to feel the importance of their work, nurses want to feel valued for their work, and nurses must feel they have a voice in decision-making that impacts their practice and work life. Nurses are the glue, the backbone of the healthcare system. (Larson, Creating Solutions to the Nursing Shortage, 2016) Nursing programs are a very important step in adding more RNs to the workforce and will require more in-depth approach then sign on bonus. Assistance in replacing nursing school faculty is of key importance so that nursing classes can continue to be staffed adequately. When it comes to nursing programs one-third of facilities that educate nurses described their salaries as uncompetitive. Higher salaries and additional incentives, monetary as well as non-monetary, can help retain existing talent and attract better teachers into the profession. Another way to make nursing financially attractive would be to facilitate faster and easier payment of nursing student loans. One in every four RNs owes a student loan, which can be a contributing factor to the industrys high turnover. (The Nursing Shortage and How It Will Impact Patient Care, 2017) The third area that we need to take into consideration is the potential pool of nursing candidates. Grants, loans, and scholarships in order to attend nursing school would allow students who might not be able to afford nursing school attend. This can increase the number of nursing students and future number of nursing staff. (Solutions for the Current Nursing Shortage) The problem also lies in hopeful applicants. Many are turned away or waitlisted. Much like those who cannot afford to pay for initial schooling, the nurses who further their education the costs add up. We invest years of time and money into certification, clinical hours, and so forth. Loan forgiveness and ways to help pay for the increased education would help nurse continue to further their education and improve their knowledge for patient care. There are many theories as to the best strategies to address the shortage, but the strategies that focus on improving workplace have a greater potential. Many places are already struggling to provided enough nurses. Jan Rabbens, spokeswoman for the Minnesota Nurses Association says, Nursing needs money, social commitment, and efforts to improve working conditions, or patients will suffer the consequences. And nurses do not want to feel that they are compromising patient safety. Not just one solution will be enough to fix the problem; a solution will most likely require changes across the board. In order to keep a quality number of healthcare providers to meet the demand the US needs to come up with more nursing colleges or find ways to improve space and increase faculty numbers. If things to improve the shortage are not addressed, you might be the one on the short end of the stick when it comes to quality care received.

Friday, May 15, 2020

The Great Gatsby By F. Scott Fitzgerald - 1006 Words

The Great Gatsby is a book that you will read and instantly fall in love with. If you enjoy English and reading you ve probably thought about reading it. From the lavish and extravagant party scenes and the epic love between the two main characters this book is something you just can’t put down. It’s one of those books that you’ll end up reading in one day because you just can’t put it down. F. Scott Fitzgerald is an amazing author with interesting plots ideas and a great use of detail. The setting for this book is New York in the 1920s. There are many people and the hustle and bustle of New York is very prominent in this book. Most of the people in the book have a lot of money and the parties are very grand. The women wear flapper†¦show more content†¦West Egg is where the newly rich live. The people who have recently come into money are throwing huge parties to show off their new wealth. â€Å"I began to like New York, the racy, adventurous fee l of it at night, and the satisfaction that the constant flicker of men and women and machines gives to the restless eye.† The biggest parties happen at Jay Gatsby’s house every saturday night. Everyone from every walk of life in New York travels to go to his legendary parties. Nick gets invited to one of Gatsby’s parties and plans to attend the following Saturday. When he gets there he learns that he was the only person there to receive an invitation. Nick finds his friend that he knows through his cousin, Daisy. They both meet the mysterious Jay Gatsby to find that he is just as extraordinary as his parties. Gatsby tells Nick about his love for Daisy and how he would like for Nick to get them all together. Nick, knowing that Daisy is married, is hesitant but he eventually agrees because he knows that Daisy’s husband is cheating on her with another woman. When the three of them have tea Daisy and Gatsby fall back in love. They start an affair and Gatsby admits to throwing all of his extravagant parties just hoping that Daisy would show up one night. â€Å"They had never been closer in their month of love, nor communicated more profoundly one with another.† After that afternoon Jay and Daisy were more in love than ever, constantly

Wednesday, May 6, 2020

Free Falling- by Scott Weckerly - 1014 Words

The impact of saying good-bye and actually leaving did not hit me until the day of my departure. Its strength woke me an hour before my alarm clock would, as for the last time Missy, my golden retriever, greeted me with a big, sloppy lick. I hated it when she did that, but that day I welcomed her with open arms. I petted her with long, slow strokes, and her sad eyes gazed into mine. Her coat felt more silky than usual. Of course, I did not notice any of these qualities until that day, which made me all the more sad about leaving her. The entire day was like that: a powerful awakening of whom and what I would truly miss. I became sentimental about saying good-bye to many people I had taken for granted—the regulars who came into the†¦show more content†¦Don t worry about me too much, Mom. I ll miss you. She drew me close and gave me a hug, and I assured her I d be back sooner than she d realize. She then told me that she loved me. I . . . love you, too. The difficulty of saying those words overwhelmed me. I had always seen myself as someone with solid, untouchable emotions. At that moment, though, I was in a fragile, quivering state; and I could not believe I had conjured such a false image of myself. We drew apart, and I slowly climbed into my gray Maxima. She did not cry, but who knows what happened when I turned the corner. I don t think I want to know. At that time, I felt like a rookie sky diver preparing for his first plunge. The cabin door opens to reveal the extreme distance of his fall, which leads to either sheer excitement or eventual death. The naivete that sheltered his fear disappears at the sudden reality of the moment. By then, of course, it is much too late to turn back. The very thought that this was his idea seems absurd to him, and he feels like the only person on the face of the planet. And so he closes his eyes, takes a deep breath, and

Tuesday, May 5, 2020

Oppression of Women in 19th Century Literature free essay sample

Each story elaborates on the importance of social class in the 19th century, how women were presented in society, and how society trapped and defined them as individuals. Maupassant conveys the importance of marriage during this time frame when he includes in â€Å"The Jewelry† that Mrs. Lantin’s mother visited bourgeois families in hopes of marrying her daughter off (Booth69). The public’s view on matrimony took a toll on the independent lives and decisions of women. A woman’s image at this time was important; it reflected who they were, as well as where they came from. Expectations for women to fulfill their duties as a homemaker left little room to deviate from the social normality. Women usually depended on their husband’s income to support their lifestyle; seldom were they employed. Therefore, many women fancied men who were of a high social class. In â€Å"The Jewelry†, Mrs. Lantin’s mother searched among the families of the middle class to find a husband for her daughter. Maupassant mentions in the story that Mrs. Lantin and her mother were poor. In order to relieve her daughter of the burdens of poverty, Mrs. Lantin’s mother tried to find a husband who was of a higher social status. Due to the substantial increase in the size, power, and prestige of the middle class, the 19th century became known as â€Å"the century of the middle class†(â€Å"Women in the Middle Class† 1). An individual’s wealth contributed to how they were viewed by other members of society. To some, image seemed like the most important characteristic one could have. In the story, Mrs. Lantin wears precious stones and pearls when she attends the theatre (Booth 70). Her husband mentions how they do not have the means to afford such extravagant treasures, but his wife insists on wearing the jewelry in public anyway. Mrs. Lantin may be considered wealthy by the public because she wears precious stones. But in real life, her husband does not make enough to support the lavish image she gives off to others. She continues to wear the jewelry out, portraying an image of wealth and well-being. Maupassant mentions in his story how it is unsightly for women to go out in public unaccompanied by their husband (Booth 70). Again, this establishes the unequal views towards women in the 1800s. If it was uncommon for a woman to travel alone, the idea of a woman supporting herself, or even deciding for herself would have been absurd. In a society where the public frowns upon the idea of female independence, many women were forced to hide any ideas or desires for change they may have had. In this time, if women were to rebel or stand against domesticity, they were often declared insane, and confined to a mental asylum (â€Å"Women and Psychiatry† 1). Here, they were treated even more poorly than when they were in the custody of their husbands. The fear of consequences silenced many women who may have desired something more than the typical lifestyle of a home maker. In â€Å"The Story of an Hour†, Chopin expresses the thoughts that could have been running through the minds of women who were caught in this time of gender inequality. Mrs. Mallard is described in Chopin’s story as a typical married woman of the 19th century. A woman we can imply has stood faithfully by her husband and fulfilled her connubial duties throughout the years of their union. In the story, Mrs. Mallard has obviously suffered a terrible loss in learning of her husband’s death. We can tell by her reactions that she cared deeply for him. In the midst of her grieving, Mrs. Mallard pictures the time that is to come, when she will be able to make all of her own decisions and will be given the freedom to live her life as she pleases. Suddenly, she feels relieved more than she is upset. â€Å"She knew that she would weep again when she saw the kind, tender hands folded in death†¦but she saw beyond that bitter moment a long procession of years to come that would belong to her absolutely (Booth 307). Her desire for freedom overcame the despair of her husband’s death. Chopin includes that Mrs. Mallard tried to fight off these ideas with her will (Booth 307). Her embraced feelings of independence could have been viewed as forbidden. Although she is excited by these thoughts, she tries to resist the pleasure she truly feels when she realizes the freedom that she has gained. The words â€Å"free, free, free! † escaped from her mouth (Booth307). She attempted to hold back the overwhelming desires for her own life. Perhaps she is hesitant to welcome these feelings because of the public view on women’s rights, and the potential consequences for those who opposed such views. Despite the faithfulness and love Mrs. Mallard showed for her husband, the extreme relief she felt in no longer having a marital obligation overpowered her feelings of sadness and loss. At the end of the story, Mrs. Mallard’s husband walked through her front door in the flesh, but Mrs. Mallard’s heart could not handle the excitement. The doctors said she died of â€Å"joy that kills†. Since Mrs. Mallard was so overwhelmed by her newly gained idea of independence, one can assume this joy is that of forbidden pleasure. Many would consider it immoral to accept so easily the death of one’s betrothed just because of the freedom acquired. The story shows how it was wrong for women to desire independence from their husbands, regardless of they were treated. In many cases, men responded to their wives as they would children; by limiting their options and making choices for them. Eventually, ideas emerged that women were truly incapable of anything other than caring for their families. In â€Å"The Yellow Wallpaper†, Gilman clearly expresses how John (the husband) treats his wife similarly to how one might treat a child. On one occasion, he even refers to his wife as â€Å"little girl†. The name itself signifies the lack of maturity women were thought to have, along with their defenselessness. Ideas such as these allowed men to dominate over decisions made in households, and in most cases, over women themselves. The narrator tells in the story how her husband will â€Å"hardly let her stir without special direction† (Booth 323). Throughout the story, the narrator mentions several things to her husband regarding her discomfort in the house and her wishes for early departure, but each time she is disregarded, or redirected. While women were subject to orders, men were free to do as they please. There were very few who decided to speak in favor of equality for women; of those who did, most were sent to an asylum. This allowed little hope for women seeking progress or escape. Gilman illustrates this in his story. â€Å"The outside pattern becomes bars, and the woman behind it as plain as could be† (Booth 323). he is saying that there is woman trapped in the wallpaper, but more importantly he is showing the feelings of entrapment faced by women. Most living conditions were similar among women. The desire for equality was a mutual feeling amongst the women of the 1800s. Gilman writes â€Å"Sometimes I think there are a great and many women behind it† (Booth 325). This signifies how many women in this time shared similar feelings of complication in terms of their marriage and their place in society. Without a voice to lead them out of sexual oppression, most women accepted the conditions given to them. The ideas of 19th century society sculpted lives of many women in ways that were not enjoyable, and rather served as a burden to the women who were indeed victimized in this time frame. The way a woman presented herself in society strongly reflected her character. Matrimony or lack thereof, served as a strong basis to this social image which was very important. Each story mentioned holds a female character who is in some way oppressed by the social dominance of men. Each character it treated unequally, or as if they were of little importance. Women in this era were trapped in their own lives. Works Cited Anderson, Lori. â€Å"Marriage and Women From 19th Century On. † Women and Issues of a Woman. CyberParent, n. d. Web. 9 February 2013. Booth, Allison, and Kely J. Mays. The Norton Introduction to Literature. 10th ed. Ed. Peter Simon. New York: W. W. Norton, 2011. Print. McElligott, Caitlin. â€Å"The 19th Century Debate. † Women’s Higher Education in the United States. N. p. n. d. Web. 24 February 2013. â€Å"Women and Psychiatry. † Brought to Life. Science Museum, n. d. Web. 20 February 2013. â€Å"Women in the Middle Class in the 19th Century. † http://web. clark. edu/afisher/HIST253/lecture_text/WomenMiddleClass_19c_Europe. pdf. N. p. n. d. Web. 2 March 2013.

Wednesday, March 11, 2020

Arthur MillerBIO essays

Arthur MillerBIO essays With The Death of a Salesman during the winter of 1949 on Broadway, Arthur Miller began to live as a playwright who has since been called one of this century's three great American dramatists by the people of America. The dramatist was born in Manhattan in October 17, 1915, to Isadore and Agusta Miller, a conventional, well to do Jewish couple. Young Arthur Miller was an intense athlete and a weak scholar. Throughout his youth he was molded into one of the most creative playwrights America has ever seen, without these priceless childhood experiences there would have never have been the basis and foundation for his great works. During his bright career as playwright he demonstrated extreme talent on two of his greatest pieces The Crucible and the Death of a Salesman. He has also written other powerful, often mind-altering plays: A View from the Bridge, A Memory of Two Mondays, After the Fall, Incident at Vichy, and The Price. Who could forget the film The Misfits and the dramatic special Playing for Time. Death of a Salesman was not Arthur Miller's first success on Broadway. His first plays were Honors at Dawn (1936) and No Villain (1937) which won the University of Michigan Hopwood Awards. His Death of a Salesman won the Pulitzer prize in 1949, which was another proof of his excellent talent. Miller wrote The Crucible in 1953 during the McCarthy period when Americans were accusing each other of Pro-Communist beliefs. Many of Miller's friends were being attacked as Communists and in 1956, Miller himself was brought before the House of Un-American Activities Committee where he was found guilty of beliefs in Communism. The verdict was reversed in 1957 in an appeals court. The Crucible is set against the backdrop of the mad witch-hunts of the Salem witch trials in the late 17th century. It is about a town, after accusations from a few girls, which begins a mad hunt for witches that did not exist. Many townspeople were hanged on...

Sunday, February 23, 2020

Project and Change Management Exam Assignment Example | Topics and Well Written Essays - 1000 words

Project and Change Management Exam - Assignment Example In the Denver airport case, there were no alternative options that were initially considered. It was only after the failure of the automated baggage system when they started looking for other options. In terms of finances, expensive means of finance were used to raise the needed money for additional costs.2 2. In the ERP implementation at Bombardier Aerospace, insufficient planning, insufficient risk assessment, overestimated savings on new methods and switching tools in the middle of the project are some of the project classic mistakes that became evident. 3. The automated baggage system was a huge project, which required good estimations in terms of time and finances. To avoid poor estimation, the project should have been broken down into manageable phases.3 The classic mistake of insufficient risk assessment could have been avoided by engaging a risk officer who advises the company on risk measures and procedures. The risk of contractor failure could have been identified and mitigated. The project leaders should have involved and educated all the stakeholders and prevent conflicts and litigation against the organization. United Airlines, a major stakeholder, should have been involved at the start of the project so as to avoid future risks of litigation when the project is abandoned. 5. The project should have been re-assessed regularly to check if it is still valid. Most projects arise due to excitement and group enthusiasm which fades away as time goes by. Exit champions are the best in doing such re-assessments; they challenge the project based on realistic data. If new members were introduced to the Denver airport project, it would have been challenged and stopped much earlier. It ended up taking too long with no success at last because of involving the same people again and again.4 It is also suggested that control