J Korean Acad Nurs Adm.  2014 Jan;20(1):106-116.

Issues and Challenges of Nurse Workforce Policy: A Critical Review and Implication

Affiliations
  • 1College of Nursing, Nursing Policy Research Institute, Yonsei University, Korea.
  • 2Division of Nursing, Hallym University, Korea.
  • 3Department of Nursing, Wonkwang University, Korea.
  • 4College of Nursing, Seoul National University, Korea.
  • 5Department of Nursing, Dong-A University, Korea. eykim@dau.ac.kr

Abstract

PURPOSE
In this paper issues and challenges of the workforce policy for nursing were explored and appropriate policy responses identified.
RESULTS
Many countries, including South Korea, are facing a shortage of nurses. In South Korea, the number of practicing registered nurses is about half the average for Organization for Economic Cooperation and Development (OECD) member countries. The shortage of nurses is not necessarily a shortage of individuals with nursing qualifications but also includes complex issues, such as lack of well-educated nurses, shortage of nurses willing to work, and geographical imbalances of nurses. The present nurse workforce policies are to increase number of nursing schools, to reduce the length of training, and to replace nurses with nursing assistants. However, the findings of many studies have shown that these attempts resulted in a worsening of patient outcomes and increasingly low quality of care.
CONCLUSION
The findings in this study indicate that nurse workforce policy should have a multi-faceted approach in order to address the many factors affecting nurse shortages.

Keyword

Nurse education; Nurse staffing; Skill-mix; Nursing policy

MeSH Terms

Humans
Nursing
Republic of Korea
Schools, Nursing

Reference

1. Aiken LH, Clarke SP, Sloane DM, Lake ET, Cheney T. Effects of hospital care environment on patient mortality and nurse outcomes. J Nurs Adm. 2008; 38:223–229.
2. Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Sermeus W, Consortium RC. Nurses' reports of working conditions and hospital quality of care in 12 countries in Europe. Int J Nurs Stud. 2013; 50:143–153.
3. Ellenbecker CH. Preparing nursing workforce of the future. Policy Polit Nurs Pract. 2010; 11:115–125.
4. Board of Registered Nursing. Licensees. 2013. Retrieved September 10, 2013. from http://www.rn.ca.gov/licensees/index.shtml.
5. Buchan J. What difference does('good') HRM make? Hum Resour Health. 2004; 2:6.
6. Buchan J. Evidence of nursing shortages or a shortage of evidence? J Adv Nurs. 2006; 56:457–458.
7. Buchan J, Aiken L. Solving nursing shortages: A common priority. J Clin Nurs. 2008; 17:3262–3268. http://dx.doi.org/10.1111/j.1365-2702.2008.02636.x.
8. Buchan J, Calman L. The global shortage of registered nurses: An overview of issues and actions. 2006. Retrieved September 21, 2013. from http://www.icn.ch/global/shortage.pdf.
9. Buchan J, O'May F, Dussault G. Nursing workforce policy and the economic crisis: A global overview. J Nurs Scholarsh. 2013; 45:298–307.
10. Buchan J, Black S. The impact of pay increases on nurses' labour market: A review of evidence from four OECD countries. 2011. Retrieved November 11, 2013. from http://dx.doi.org/10.1787/5kg6jwn16tjd-en.
11. Canadian Nurses Association. Post basic RN Baccalaureate. 2013. Retrieved September 11, 2013. from http://www.cnaaiic.ca/en/professional-development/post-basic-rn-baccalaureate/.
12. Canadian Nurses Association. Position Statement - Canadian regulatory framework for Registered Nurses. 2013. Retrieved November 12, 2013. from http://www.cna-aiic.ca/en/search-results?q=licensure%20renewal.
13. Cho SH, Lee JY, Mark BA, Lee HY. Geographical imbalances: Migration patterns of new graduate nurses and factors related to working in non-metropolitan hospitals. J Korean Acad Nurs. 2012; 42:1019–1026.
14. Duffield C, Diers D, O'Brien-Pallas L, Aisbett C, Roche M, King M, et al. Nursing staffing, nursing workload, the work environment and patient outcomes. Appl Nurs Res. 2011; 24:244–255.
15. Esparza SJ, Zoller JS, White AW, Highfield ME. Nurse staffing and skill mix patterns: Are there differences in outcomes? J Healthc Risk Manag. 2012; 31(3):14–23.
16. Health Resources and Services Administration. The U. S. nursing workforce: Trends in supply and education. 2013. Retrieved November 11, 2013. from http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf.
17. Ikeda M, Inoue K, Kamibeppu K. Goals and potential career advancement of licensed practical nurses in Japan. J Nurs Manag. 2008; 16:821–828.
18. International Council of Nurses. About ICN. 2013. Retrieved November 11, 2013. from http://www.icn.ch/about-icn/about-icn.
19. Institute of Medicine. The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press;2011.
20. Japanese Nurses Association. Nursing education in Japan. 2013. Retrieved September 12, 2013. from http://www.nurse.or.jp/jna/english/nursing/education.html#basic.
21. Joumard I, André C, Nicq C. Health care systems: Efficiency and institutions. Retrieved November 11, 2013. from http://dx.doi.org/10.1787/5kmfp51f5f9t-en.
22. Kane RL, Shamliyan T, Mueller C, Duval S, Wilt TJ. The association of registered nurse staffing levels and patient outcomes. Med Care. 2007; 45:1195–1204.
23. Kim CB, Kim PS. Current status and new policy direction of healthcare personnel in Korea. J Korean Med Assoc. 2012; 55:940–949.
24. Kim SM, No YJ, Kim JL, Park JS. A study on expand jobs and improve working condition in health care in health and medical industry. Seoul: Economic and Social Development Commission;2010.
25. Kim JH. The demand and supply of registered nurse in Korea. In : Invited lecture presented at the 2013 Annual Spring Meeting of Korean Academy of Nursing Administration; Seoul, Korea. 2013.
26. Korea Ministry of Government Legislation. Qualification test of nursing assistants. 2013. Retrieved September 25, 2013. from http://www.law.go.kr.
27. Lee JY, Cho SH. Trends in salaries for registered nurses compared with elementary school teachers and salary differences by workplace size and geographic location. J Korean Acad Nurs Adm. 2013; 19:108–117.
28. Lee SY. Ensure autonomy and professionalism in healthcare. Doctor's News. 2011. 04. 11. E1.
29. Lee TW, Kang KW, Ko YK, Kim KK, Moon IO, Park HO, et al. Introduction to nursing. Seoul: HN science;2012.
30. Hall LM. Staff mix models: Complementary or substitution roles for nurses. Nurs Adm Q. 1997; 21(2):31–39.
31. Ministry of Health & Welfare. Statistical yearbook of Ministry of Health & Welfare. Seoul: Authors;2013.
32. Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and quality of care inhospitals. N Engl J Med. 2002; 346:1715–1722.
33. Organization for Economic Cooperation and Development. OECD Health data 2013. 2013. Retrieved November 11, 2013. from http://www.oecd.org/els/health-systems/oecdhealthdata.htm.
34. Oh YH. The future requirements and supply of registered nurses in Korea. Korean J Health Econ Policy. 2010; 6(3):139–161.
35. Oulton JA. The global nursing shortage: An overview of issues and actions. Policy Polit Nurs Pract. 2006; 7:3 Suppl. 34S–39S. http://dx.doi.org/10.1177/1527154406293968.
36. Park B, Seo S, Lee T. Structure of nurse labor market and determinants of hospital nurse staffing levels. J Korean Acad Nurs. 2013; 43:39–49. http://dx.doi.org/10.4040/jkan.2013.43.1.39.
37. Robinson S, Griffiths P. Nursing education and regulation: International profiles and perspectives. London: National Nursing Research Unit;2007.
38. Statistics Korea. Population Census. 2010. Retrieved November 11, 2013. from http://kosis.kr.
39. Statistics Korea. National Health Insurance Service Benefits. 2011. Retrieved November 11, 2013. from http://kosis.kr.
40. Taiwan Nurses Association. Continuing education. 2013. Retrieved September 25, 2013. from http://www.twna.org.tw/web_data/eng_web/nursing_in_taiwan/index_2.htm.
41. Tourangeau AE, Doran DM, McGillis Hall L, O'Brien Pallas L, Pringle D, Tu JV, et al. Impact of hospital nursing care on 30-day mortality for acute medical patients. J Adv Nurs. 2007; 57(1):32–44.
42. Trinkoff AM, Johantgen M, Storr CL, Gurses AP, Liang Y, Han K. Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nurs Res. 2011; 60(1):1–8.
43. Twigg D, Duffield C, Bremner A, Rapley P, Finn J. Impact of skill mix variations on patient outcomes following implementation of nursing hours per patient day staffing: Aretrospective study. J Adv Nurs. 2012; 68:2710–2718.
44. Welfare State Society. A study on the secure the hospital manpower to improve quality of medical service. 2011. Retrieved December 5, 2011. from http://www.rapportian.com/n_news/news/view.html?no=2766.
45. Whelan JC. Where did all the nurse go?: Mid-twentieth century nurses shortages, causes, solutions, and continuing problems. 2013. Retrieved September 7, 2013. from http://www.nursing.upenn.edu/nhhc/Pages/WhereDoAlltheNurseGoMid-TwentiethCenturyNurseShortagesCausesSolutionsandContinuingProblems.aspx.
46. World Health Organization. A toolkit for planning, training and management. Geneva: Author;2001.
Full Text Links
  • JKANA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr