Change Proposal for Nurse Shortage


In every healthcare institution, some problems are faced by the management and the people in charge. One of the most common problems is the nurse shortage in the emergency room. These problems result in poor healthcare of patient outcomes. Several reports have indicated an increasing number of patient complaints due to poor service delivery. The nurse shortage also occurs in other problems such as instructions and accountability from the nurses. The wrong perception of the hospital facility comes from the lack of accountability and the availability of nurses who cannot handle the problems as required. According to reports that are given by the world health organization, there are more than two million people who are admitted continuously to the hospitals. Out of this, 60% usually die from poor attendance. Several strategies can be identified to significantly prevent the problems that come as a result of the nurse shortage. One of them is employing more nurses through appealing to the bodies that are in charge of healthcare institutions (Aziz, 2014). The other solution is offering training to those who are part of the system. This will eliminate the errors that are expected from the few nurses that are available. Training will also lead to a better patient outcome as the nurses will use limited time to attend to the patients. A recent study has indicated that the performance of the nurses can be improved by up to 30% when constant training and new interventions are put in place. It also shows that the patients are becoming increasingly more vulnerable if they are not attended to because of the nurse shortage.

Problem Statement

Nurse shortage is a significant problem in many healthcare institutions, and it should be handled with care to improve the patient outcome and the quality of services that are delivered (de Oliveira and de Paula, 2014). Some of the problems that have been identified to be associated with nurse shortage include poor quality of service delivery from the nurses who are available. The other problem that has been identified is that the shortage of nurses leads to a bad reputation in society and lack of trust for the nurses as the patients cannot get adequate services. It also puts too much burden to the nurses who are available as they have to work extra time to cover today nurses who are not available. Consequently, this means that all the available nurses are easily burned out due to the much work that they have done that affects my faculty. One of them is that as I deal with infants that require instant service provision. With the nurse shortage, it becomes difficult to attend to these infants at the emergency department.


Purpose of the Project

The main aim of this project is to suggest some of the most effective solutions for the problem of increasing nurse shortage in the hospital. This project shows some of the advanced programs that can be used to educate the nurses to avoid the excessive effects of nurse shortages. By suggesting the best solutions such as training methods and evidence-based practice, the effects of nurse shortage can be reduced to improve better health for patient outcomes. There are several examples of strategies that can be used in my faculty. One of them is improvising on the shortage of nursing by hiring the interns that would fill for the few nurses. The other strategy is educating the nurses on how to take the limited time on the patients so that they can take the minimum time on the patients. This will enable them to t attend to many patients.





The populations that are targeted in this research project are patients who are within the emergency department and those who need immediate care. At the emergency units, the patients need immediate attention. The patients who had affected are the mothers and babies on the post-mortem unit Mercy Hospital Miami. It is essential to use this population because they give the first-hand information on the effects of nurse shortage and how inadequate the services are because of the shortages.


Several interventions have been identified in this project. The first interventions are finding the strategies of improvising on the situation to help with the nurse shortage. This is done by getting enough interns into the institutions who can fill in for the nurses and provide enough cover for the shortages. The interventions that have been identified include offering training to the available nurses and proposing solutions for the nurse shortage.


The impacts of the interventions can be compared to the situation before the intervention. The use of standardized exercise allows for active group control where the subjects who are their mothers and their children in St. Mary’s hospital. The services are usually compared to the ones in places where there are nurses who can sufficiently attend to the patients.



The outcomes of these interventions can be traced in numerous ways. One of them is through getting the opinions of the patients and their relatives or the caregivers who can give the true reflection of these reflections. The outcome changes will be observed to different levels and opinions of the customers and patience to show their satisfaction.


The timeline for implementing this project is on a weekly basis. The outcomes will be collected after every weekend to show whether the implemented strategies are working or not.

Research Methodologies Employed

Various research strategies have been employed in this work. For example, the use of literature review and informational research that focuses on evidence-based electronic success within the emergency departmentwho has proven to be important. The use of questionnaires to survey and get the opinions of day patients is the other strategy that is employed. The database also has various statistical reports that give different concerns contributing to poor health and how nurse shortage can be solved.  The main sources of data that were used include all the free medical databases such as, PubMed, MEDLINE, and CINAHL. These websites give an extensive analysis of medical research. The search terms include; nurse shortage, nurse solutions, nurse employment, infants, young patients, and others.

Literature Evaluation

The literature that has been used in this research has indicated the massive effects of nurse shortage in the hospital. The materials in search indicated that the nurse shortage is one of the reasons why the nurses burn out as they cannot find the best ways to serve the patients. Most of the affected patients do not consider the issues that are raised by the nurses. Most of the literature does not consider the standards of healthand how it is affected by the shortage of nurses. Most of the literature is about nursing practice and how to improve it.  The studies also show that poor service realized has led to frequent cases of patient complaint and satisfaction. Some of the reasons and the effects of nurse shortage include poor delivery and nurse burnout resulting in resignations (Ford et al., 2014). This even gives the basics of how to avoid the impacts.For example, when someone is involved in a fatal accident and has been admitted in the children’s section, they are expected to be attended to faster so that they can destroy further infections. The peer-reviewed literature below shows how nurse shortage has been a concern and the proposals that can be used;

“..Nurses are the main professional component of the ‘front line’ staff in most health systems, and their contribution is recognized as essential to meeting development goals and delivering safe and effective care. One difficulty in making an accurate global estimate of numbers of nurses is the definition of ‘nurse’…”(Buchan, and Aiken, 2008).

The study shows the measurement of patient outcomes after showing the effects of nurse shortage on the quality of healthcare delivery;

“…isolation at only one type of staff: population ratio may be misleading. WHO has also estimated the population ratios for other staff groups, including physicians and midwives. At the regional level, there are significant variations in the mix between different staff groups (e.g., Latin American countries tend to have two or three times as many physicians as nurses, whilst countries on other regions tend to have more nurses than physician…”(Buchan, and Aiken, 2008).

Nursing Theory

From the information that has been gathered here, nursing education should be taken seriously together with nurse shortage. Various programs have to be put in place so that the nurses can gain the necessary knowledge on how to cater to the shortage of nurses and to perform faster to attend too many patients. By bringing in more nurses especially those who are on internship, the shortages can be covered for, and it can allow the nurses to perform the monetary roll especially when the new nurses can fill in for those who are not there (Clark, Kent, and Riesner, 2018). This is one of the emergency solutions that can help with this problem. Nursing education will also help the nurses realize some of the most effective methods and solutions (Xiang, Yin, and Lim, 2015).The nursing theory that is used in this study is the burn out theory.  Theoretically, burnout comes from the accumulation of the mental stress that is work-related. The shortage is one of the ideas behind this theory as few nurses have to do extra hours to cover for the nurses who are unavailable. The responses from the patient caregivers will be the measure of this success.

Proposed Implementation Plan

Considering the target population as well as the duration of the plan that will be needed to educates the nurses about the methods that they can use to improve on service delivery, the plan is likely to take more than six months. A plan that is efficient and effective should consider the objectives of the research and methods that can be used to improve the situation. There are several ways of providing education and training for the ER staff. One of them is giving presentations on the best methods that can be used to attend to many patients. The presentations have to be put in a way that they do not clash with the service provision.  The implementation process of the proposals will take time. The patient outcomes will be measured by analyzing the change in opinions and feedback from the patient caretakers. The outcome is better health provision in the emergency department and children.

Barriers and their Solutions

Despite the strategies to enhance the treatment and to offer this solution to the nurse shortage, there are several barriers to these solutions. One of the obstacles is that implementing this strategy will require excessive resources that may not be readily available to the healthcare institution. As a result, it will be difficult to implement these strategies as required. The solution to this barrier is to find resources from other nongovernmental organizations as well as an assistant from the government so that these strategies can be implemented as required. The second barrier to these proposals is that they are resistant from people who do not want to implement them as they do not see the need for solving the problem of nurse shortage. These people also discourage education for the nurses as they feel that the nurses have enough to take them through these procedures. The possible solution to this is to convince them also to become part of the strategy.


In conclusion, this proposal has addressed some of the issues that are affecting patient outcomes. The shortage of nurses is one of the most common problems in many healthcare institutions including emergency departments. Some of the solutions that have been proposed here include the application of the improvising strategies and providing nurse training to the available nurses. The other long term proposals include the plans to employ more nurses to solve this problem.  The patient outcome can only be known from the opinions of the caregivers. Through setting the timeline, it will be easier to evaluate whether these procedures are effective or not.





Aziz, A. (2014). Hand hygiene compliance for patient safety. British Journal of Healthcare Management, 20(9), 428-434.

Clark, C. A., Kent, K. A., & Riesner, S. A. (2018). A new approach for solving an old problem in nurse practitioner clinical education. The Journal for Nurse Practitioners14(4), e69-e75.

De Oliveira, A. C., & de Paula, A. O. (2014). Factors related to poor adherence to hand hygiene in healthcare delivery: a reflection. Ciencia, Cuidado E Saude, 13(1), 185-189. doi:10.4025/cienccuidsaude.v13i1.13410

Ford, Eric W., Brian T. Boyer, Nir Menachemi, and Timothy R. Huerta. 2014. “Increasing Hand Washing Compliance with a Simple Visual Cue.” American Journal of Public Health 104, no. 10: 1851-1856. CINAHL Complete, EBSCOhost (accessed June 27, 2017).

Xiang, W., Yin, J., & Lim, G. (2015). An ant colony optimization approach for solving an operating room surgery scheduling problem. Computers & Industrial Engineering85, 335-345.

Buchan, J., & Aiken, L. (2008). Solving nursing shortages: a common priority. Journal of clinical nursing17(24), 3262-3268.


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