The Global Nursing Shortage: Future Challenges

Letter to Editor The Global Nursing Shortage: Future Challenges Ahmed Lateef Alkhaqani* * M.Sc., Ministry of health, Al-Najaf Direction, Al-Sadder Medical Hospital, Al-Najaf, Iraq Corresponding Author Email ID: [email protected] https://orcid.org/0000-0002-7694-7503 Nurses play an important and critical role in healthcare delivery as caregivers, patient advocates, care managers, and decisionmakers, using critical thinking skills to achieve the best outcomes for patients and help the patients' families through challenging, tough health. Their varied roles as reliable advisers, confidants, companions, and excellent listeners are major reasons nurses are essential to the health system. (Williamson, 2020). In fact, the Gallup Organization polls consistently list nursing as one of the nation’s most honest, ethical, and trusted professions. About 85% of Americans rate nurses as having high levels of honesty and ethics (Reinhart, 2020). However, many nurses have to pay a lot of money to provide the service. Indeed, the study showed that nurses were healthier than the general public on average. They are more likely to become overweight, stressed, and have fewer sleep hours. In addition, as nurses lift the heavy load at work, they are seven times more likely to suffer muscle and skeletal injuries, such as back pain, which is a disease that affects many Americans. (Bavier, 2018). Nowadays, nursing professionals face various obstacles such as the age and increasingly sick segment of the hospitalized patient population, the burden of healthcare expenditures, and the need to stay updated with medical knowledge and technology advancements. These demands are exacerbated by a noticeable growing deficit in nurses and the aging nursing workforce. Additionally, start-up designs for comprehensive health care services are being created to address a wide range of healthcare demands and influence the workforce structure and care delivery (Fawaz et al., 2018). Modern nurses have many tasks, including the management of paperwork and the assistance of patients and other health workers. They also take care of the patients' medications, and they go to medical check-ups regularly. Nurses deal with the most important aspect of human life: health. However, many problems in the health care industry often affect their well-being, which negatively affects their performance. Although most nurses love their careers, there are challenges and problems, causing lower job satisfaction and even causing some people to seek a new career. (Razu et al., 2021). Two main issues for nurses emerged in 2021, according to April N. Kapu, DNP, APRN, president of the “American Association of Nurse Practitioners” (AANP). "The first is the nursing shortage, which was exacerbated by the pandemic," she said. "Burnout, which was intensified by the pandemic, has made the shortage worse, and it has affected healthcare workers across the board physicians, nurses, and advanced practice nurses". The second issue nurses faced was access to care, she noted. During the pandemic, long-standing inequities in care worsened. Before the pandemic, there were already persistent gaps in access to affordable, high-quality health coverage and care, especially among minority communities. "It's all about patients. We care for patients and want quality and equitable care for everyone. And that is our focus," Kapu said. "There are over 80 million Americans that lack access to primary care. And that situation was also worsened with the pandemic " (Cole, 2021). The nursing shortage is widespread worldwide, well-known before the epidemic, and has been exacerbated this year. In late 2020, the global nursing workforce was estimated at 27.9 million but with an estimated global shortfall of 5.9 million nurses, according to the International Council of Nurse's brief on the worldwide nursing shortage and nurse retention [International Council Of Nurses Policy Brief (ICN, 2020)]. The brief stated that about 89% of these nurse shortages were concentrated in lowand lowermiddle countries, with considerable gaps in other countries. Of the national nursing associations surveyed, 20% reported an increase in the nurses' number leaving the profession due to the pandemic (American Association of Colleges of Nurses, 2020) . But aside from the US, other high-income nations are also struggling with shortages (Williamson, 2020). Many European countries were reporting shortages of healthcare workers before the pandemic. The European Commission published an annual report on skill shortages and surpluses in Europe for 2019–2020. It found that nearly all 22 European Nations reported a lack of healthcare professionals, such as doctors, nurses, and healthcare assistants. For example, Germany has reported that all 16 of their federal states experienced a decline in their care workforce (EPSU, 2020) . One of the nursing profession's global challenges is staff shortages. A serious consequence of the international and apparently unabating shortage of nurses is that there is now a recognized worldwide shortage of nurse educators. This contributes to nurses being stretched thin and stressed (Alghamdi et al., 2019). The lack of nurses is a global challenge. There are reports and studies from all over the world indicating a high percentage of patients and nurses. A high percentage indicates that the number of nurses is lower than the number of patients. This results in nurses having to work long hours. It has an impact on production and also increases the likelihood of serious errors. It also leads to dissatisfaction with the jobs and results in higher turnover rates (McAllister, 2012). According to the “American Association of Colleges of Nursing” (AACN), “The number of nurses leaving the workforce each year has been growing steadily from around 40,000 in 2010 to nearly 80,000 by 2020.”. and also, according to the “United States Registered Nurse Workforce Report Card and Shortage Forecast”: A Revisit published “American Journal of Medical Quality” in the June 2018 issue, a shortage of registered nurses is projected to spread across the country between 2016 and 2030. The authors predict that the shortage of registered nurses is the strongest in the south and west in the State-by-State analysis (American Association of Colleges of Nurses, 2020). The shortage of nurses will jeopardise the continuity and patient outcomes of health care and will further reduce the level of satisfaction at work. Employment shortages and high staff turnovers pose problems for nurses and health care, which increases healthcare and health costs. The capacity to care for patients and provide quality care is decreasing (World Health Organization 2021; American Association of Colleges of Nurses, 2020). A 2014 study by Jafaraghaee and his colleagues also reported that the effects of the nursing shortage required some nurses to work 150 hours a month in overtime. Nurses described the amount of work they devoted to this excess as suffering, dissatisfaction, dis-personalization, and disappointment. It also encouraged nurses to change their jobs and leave their professions (Jafaraghaee et al., 2014). The shortage affects the nurse professionally, but it also affects their personal lives. Nurses who work in shortstaffed environments can drive a wedge between personal commitments and relationships. Other than affecting nurses, staff shortages are also unhealthy for patients. A simple error due to fatigue at work or lack of competence in medical care facilities can have serious consequences. A shortage of nurses can affect the quality of nursing work and even patient care. But unfortunately, it also makes nurses more likely to leave the profession. The “World Health Organization” estimates that the 7.3 million nurses working across Europe will struggle to deal with an ageing population. Additionally, 40% of nurses are over the age of 50, which means that as more nurses retire, people of this age group need more attention to health care, creating an imbalance in health care work and demand. Nurses and health workers are not easy to do, and there are many days that it can be overwhelming. In addition, many nurses have become tired of the lack of a balanced life and work. However, any environment may present challenges for nursing, whether permanent staff or agency employees. In short, many of the problems nurses face today are related to the dysfunction of the health system itself and key stakeholders to address workplace issues. A short-term and long-term solution is now needed to prevent the escalation of the shortage of nursing staff. Can't allow this to continue to build up because, in the end, healthcare is going to implode upon itself. So, we need to address this issue and put the appropriate resources in place. Recognizing nursing challenges is the first step, and the second is to overcome challenges. Also needs more attention to be given to other recurring challenges that face nurses in the workplace. These challenges contributed significantly to the depressed and exhausted nurses, forcing many to leave their profession entirely. The search for workable solutions for nurses' health can significantly improve morale, recruitment, and retention. Acknowledgment: None Funding: No specific received from the government, commercial or non-profit funds. 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