Shortage Of Nurses In Australia: A Change Proposal

The change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Background
Problem statement
Purpose of the change proposal
PICOT
Literature search strategy employed
Evaluation of the literature
Applicable change or nursing theory utilized
Proposed implementation plan with outcome measures
Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

According to the statistics published in the year 2015 by the Australia Institute of Health and Welfare, there were only 307,000 nurses together with the midwives in Australia. This is however in contrary to the population of the country (Cheng, Bartram, Karimi, & Leggat, 2016).According to the same report. There was a total population of 24 million as by February 2016 and this had the potential of subjecting the country’s healthcare system under a lot of stress (Aggar, Gordon, Thomas, Wadsworth, & Bloomfield, 2018). The Government had earlier on in 2014 predicted that the Australia future health workforce was in need of more than 123,000 nurses come the year 2030.

The Australian government always checks different industries to identify any shortages of the skills in particular industries. According to a report published by the Australia’s future health workforce, it was established that the nursing industry would have a shortage of 85,000 nurses by the year 2025 (Timilsina Bhandari, Xiao, & Belan, 2014).This number was however expected to grow to 123,000 as of 2030.The government then recommended that the nursing profession be listed at the skilled occupation list which should subsequently be filled up by the immigrants who apply through the temporary work visa subclass 457.

The study established that shortage in skills usually occur whenever there is a mismatch between needs of the population and the available nursing staff. This has subsequent effects on the economy and the general quality of life of the Australians (Whitehead & Myers, 2016). The key reason as to the shortage of nurses in Australia is the higher ageing population that are living with very chronic and complex health conditions. By the time the nursing report on workforce sustainability was being undertaken, it was confirmed that the population health trends as well as the ageing nursing workforce would eventually lead to a shortage of nurses in Australia (Ng Chok, Mannix, Dickson, & Wilkes, 2018). The key areas that would be affected with the shortage of nurses include the aged care as well as mental health .It was also predicted that the focus on future healthcare would be health promotion ,monitoring of chronic diseases and finally the care of patients suffering from very complex health conditions.

There are different reasons as to why there is generally a low number of nurses and midwives in Australia. According to the SBS, one of the core reasons is the fact that there are very few professionals who enter the country and this is due to complications surrounding obtaining of visas. There are only 457 visas preserved for the employers to only sponsor temporary skilled overseas employees (Reid, Jones, Hurst, & Anderson, 2018). According to the same research by the SBS, there were only 1879 nurses who were registered on 457 visas as of September 2017.This was the least number as from the year 2009 (Tuckett, Winters-Chang, Bogossian, & Wood, 2014).The low number of the professionals is due to the fact that the Australian Government want to upskill the local talent so that they can rely on them in future.

Problem statement

To curb the nursing shortages, the Australian government should come up with strategies so as to avoid stress on the healthcare or the nursing industry. One of the initiatives is to allow more overseas professionals to come in and boost our local based team of nurses. Setting up of more nursing schools is another strategy to improve on the number of nurses.The commonwealth government should also provide better remuneration to the nurses so that more nurses can be enrolled at the nursing schools (Allen, Holland, & Reynolds, 2014). Within this paper, there will be an analysis to the possible causes of low number of nurses in Australia, the effects, how to solve the mystery and the potential barriers to implementation of the strategies.

According to studies, the number of nurses remain relatively low in Australia. This has general negative impact on the Australia’s healthcare system. As compared to the 24 million population of Australia, 307,000 nurses are very few to meet the World Health Organization recommendation of the patient nurse ratio. This imbalance leads to stress among the nurses as they strive to meet all the patients’ needs and this eventually leads to poor services. There should be efforts from the commonwealth government to make sure that the nurse patient ratio recommended by the World Health Organization is achieved.

This change proposal has different objectives. One of the objective is to find out why there is a shortage of nurses in Australia. Once the reasons have been established, there should be efforts to come up with strategies that can improve on the number of nurses in Australia. The proposal change will examine barriers in implementing the strategies and finally how the barriers could be overcome.

PICOT stands for Population, intervention, comparison, Outcome and finally Time .In this change proposal, the population refers to the nurses and the Intervention include training opportunities, providing scholarships and finally juggling between education and work. The outcome in this proposal is having an increased number of nurses in Australia. The expected time to reach the recommended time of the number of nurses is 2030.This means that it should be around 12 years. In this change proposal, there is no comparison. This is because this is not a nursing intervention program

During the search strategy, the key terms for the proposal include, Patient Nurse Ratio, Australia. Literature was to be outsourced from well-known databases such as PubMed. Most of the literature found was however found through the use of combined key terms. An illustration of the PubMed database is shown below.

Purpose of the change proposal

An image showing how the PubMed data base work (Tuckett, Winters-Chang, Bogossian, & Wood, 2014)

The kind of literature used was generally of the required standards. Most of the literature that was used was very relevant to the research problem and majority of the articles used were of recent dates. The statistics were very accurate. Basically, the all process was a success.

In this change proposal, there was no nursing theory that was employed or utilized. What we have is only the applicable changes. The applicable changes in the change proposal include an increase in the number of nurses from 307,000 to 430,000 registered nurses and midwives.

Since a shortage of nurses leads to stress on the Australian Healthcare system. There is the urgent need to come up with strategies to bridge that gap. As a result, there are three proposed implementations. The three include providing training opportunities, providing scholarships and finally juggling between education and work. The commonwealth government has come up with a proposal to provide scholarships to nurse practitioners. Scholarships for the Nurse Practitioners are on course to be introduced and this also includes the Nursing and Allied Health Scholarships and the support scheme with the core objective of aiding nurses to further their education as well as the advanced practice. According to research, the high postgraduate fees is a concern to many nursing students. With the introduction of the scholarships however, it will promote as well as encourage better learning and upskilling and finally professional development within the nursing industries.

Training opportunities is another proposed implementation to reduce the shortage of nurses. According to the 2014 European study, it was found out that a 10% increase in the enrollment at the Bachelor of Nursing degrees leads to 7% lower risk of mortality among the patients. Further training enables nurses to acquire skills that will lead to effectiveness and general improvement in the number of nurses.

Juggling education and work is the final proposal to improve on the number of nurses in Australia. According to a survey conducted among the leading Australian Universities established that majority of the students shy off enrolling for the nurses’ course at the University due to fulltime commitment that would not allow them to pursue higher education to masters and PHD levels. The common wealth government should therefore work on how to allow nurses to study further. This will also improve on the total number of nurses in Australia.

PICOT

In attempts to implement the proposed strategies, there are potential barriers. One such barrier is inadequate funds. The amount of funds needed to support scholarships in Australia are quite many and this will negatively impact the economy of the country. Concerning juggling between education and work, this would lead to stress among the available nurses since the numbers are very low. In case a nurse leaves to attend classes, there will be a high number of patients that will be unattended to. Another important barrier is unwillingness amongst the majority of the students. Most of the students are not willing to enroll for the nursing course due to its commitment.

Concerning the issue of inadequate funds, the commonwealth government should seek assistance from International organizations like the World Bank or the World Health Organization. To effectively allow the transition of juggling between education and work, the common wealth government should consider setting up learning institutions around health facilities so that in case of an emergency the nurses can consider attending to it then proceed with the classes later on. The Commonwealth government should take a leading role in encouraging the students to enroll for the nursing program at both colleges and Universities.

References:

Aggar, C., Gordon, C. J., Thomas, T. H., Wadsworth, L., & Bloomfield, J. (2018). Evaluation of a community transition to professional practice program for graduate registered nurses in Australia. Nurse Education in Practice. doi:10.1016/j.nepr.2018.03.005

Allen, B. C., Holland, P., & Reynolds, R. (2014). The effect of bullying on burnout in nurses: the moderating role of psychological detachment. Journal of Advanced Nursing, 71(2), 381-390. doi:10.1111/jan.12489

Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118

Ng Chok, H., Mannix, J., Dickson, C., & Wilkes, L. (2018). The factors impacting personal and professional experiences of migrant nurses in Australia: An integrative review. Collegian, 25(2), 247-253. doi:10.1016/j.colegn.2017.06.004

Reid, C., Jones, L., Hurst, C., & Anderson, D. (2018). Examining relationships between socio-demographics and self-efficacy among registered nurses in Australia. Collegian, 25(1), 57-63. doi:10.1016/j.colegn.2017.03.007

Timilsina Bhandari, K., Xiao, L., & Belan, I. (2014). Job satisfaction of overseas-qualified nurses working in Australian hospitals. International Nursing Review, 62(1), 64-74. doi:10.1111/inr.12146

Tuckett, A., Winters-Chang, P., Bogossian, F., & Wood, M. (2014). ‘Why nurses are leaving the profession … lack of support from managers’: What nurses from an e-cohort study said. International Journal of Nursing Practice, 21(4), 359-366. doi:10.1111/ijn.12245

Whitehead, L., & Myers, H. (2016). The effect of hospital nurse staffing models on patient and staff-related outcomes. International Journal of Nursing Practice, 22(4), 330-332. doi:10.1111/ijn.12463