International Nurses Day! 12 May - Current Challenges in Nursing

It’s time to celebrate the great job that nurses do around the world!

This International Nurses’ Day, I would like to take time to think about where the future of nursing is headed.

For me, I think about the emerging role of Nurse Practitioners (NPs). HealthTimes (2017) highlight that NPs can work in various specialty areas, such as: primary healthcare, aged care, maternity, acute care, perioperative nursing, mental health, or chronic disease management. The Department of Health (2012) convey that NP access to the Medicare Benefits Schedule and the PBS (Pharmaceuticals Benefits Scheme) may help to improve primary healthcare or more effectively meet the needs of different communities within Australia.

In the lead up to International Nurses’ Day, I also think about the increasing demand for practice nurses as GP-super-clinics are becoming more of a trend (Department of Health, 2014). Some of the key objectives of the GP Super Clinics programme (Department of Health, 2014), were to: deliver high quality care; provide multidisciplinary healthcare; and provide more preventative care.

The World Health Organization (WHO) (2016) even have an entire Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 document (accessible at www.who.int). In this document, WHO (2016) acknowledge that despite nurses making up about 50% of the health workforce in many nations, the issue of short-staffing persists.

Apparently, there are 20.7 million of us nurses and midwives (WHO, 2016)! That’s nearly the population of Australia (ABS, 2017); the ABS (2017) indicate that at the end of September 2016, the Australian population was >24. 2 million!

Some of the achievements in nursing, as outlined by WHO (2016), involve: implementation of competency-based training; having regulation standards for nursing; establishing national strategic plans; movement towards advanced nursing and midwifery practice; and, the primary healthcare model.

Challenges for Nursing May Include:

• An ABC news article by Stewart (2014) states that, ‘about 8,000 Australian students graduate with a nursing qualification but that there are around 3,000 nurses who cannot find work.’
• Stewart (2014) also conveys that Health Workforce Australia predicted that by 2025, Australia will face a nursing shortage of over 100,000.
• Stewart (2014) also made it apparent that in 2013, 3,000 nursing graduates were without work; this was comparative to the ‘3,095 ‘457’ temporary business visas that were granted to nurses to work in Australia’ from 2011-2013.
• The Department of Employment (2016) indicates that in regional New South Wales (NSW), there were still shortages of registered nurses in June 2016 in the following specialties: mental health, general practice, drug treatment, Aboriginal health, and also sexual health.
• It was also noted by the Department of Employment (2016) that Sydney is particularly short on mental health registered nurses.
• Registered nurses are in demand due to factors such as the ageing population, increased chronic diseases rate, and unexpectedly, advances in medical technology (Department of Employment, 2016).
• In NSW, this demand for registered nurses appears to continue despite an increase in nursing students (in Bachelor programs) (Department of Employment, 2016).

Getting Work as a Registered Nurse in Australia:

• ‘Metropolitan Sydney employers had an average of 7.6 applicants per vacancy while employers in regional NSW received an average of 4.6 applicants per vacancy’ (Department of Employment, 2016).
• 75% of Sydney employers’ vacancies were filled compared with 50% for regional NSW employers’ vacancies (Department of Employment, 2016).
• The Department of Employment (2016) expresses that for Sydney employers, there were on average 1.3 suitable applicants per vacancy; whereas, regional NSW employers reported one appropriate contender per vacancy.
• In Queensland (QLD), the Department of Employment (2016b) reported that there has been a decline in experienced registered nurse applicants for jobs due to the increased demand for registered nurses.
• Most regional employers in QLD suggested that it is difficult to get experienced or specialist registered nurses due to location appearing as the issue (Department of Employment, 2016b).
• Similarly to NSW, QLD found that there were more applicants for metropolitan areas than regional – over twice as many actually (Department of Employment, 2016b)! There were about 15 applicants per metropolitan vacancy (15.0) and (6.2) for regional vacancies (Department of Employment, 2016b).
• Unlike NSW, metropolitan Western Australia (WA) employers reported less issues with recruiting registered nurses; however, about 50% of regional employers in WA still expressed troubles to fill job vacancies – with one appropriate applicant per vacancy (Department of Employment, 2016c).
• Interestingly, in the Northern Territory (NT), employers are reporting no troubles filling vacancies despite a high turnover of registered nurses (Department of Employment, 2016d)!

So How Can Nursing be Improved?

To overcome challenges in nursing, the following is imperative: excellent leadership; cultures of accountability; effective governance; and superb strategic planning (WHO, 2016).

What does this really mean?

This means that the nursing and midwifery workforce is competent and driven at all levels of the health system (WHO, 2016). It also means that there is a strong focus on creating successful governance, policy production, management and leadership (WHO, 2016).

WHO (2016) additionally highlights that it is important for nurses and midwives to collaborate and improve their capabilities. Moreover, there is a need for political investment in evidence-based workforce development for the nursing and midwifery industry (WHO, 2016).

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References

• Australian Bureau of Statistics 2017, Australian Demographic Statistics, no. 3101.0, ABS, Canberra, viewed 23 April 2017, www.abs.gov.au
• Department of Employment 2016, ANZSCO 2544 Registered Nurses – NSW, June 2016, Australian Government, viewed 26 April 2017, https://docs.employment.gov.au/documents/anzsco-2544-registered-nurses-nsw
• Department of Employment 2016b, ANZSCO 2544 Registered Nurses – QLD, June 2016, Australian Government, viewed 26 April 2017, https://docs.employment.gov.au/system/files/doc/other/2544regnurseqld_1.pdf
• Department of Employment 2016c, ANZSCO 2544 Registered Nurses – WA, June 2016, viewed 26 April 2017, https://docs.employment.gov.au/system/files/doc/other/2544registerednursewa_3.pdf
• Department of Employment 2016d, ANZSCO 2544 Registered Nurses – NT. June 2016, viewed 26 April 2017, https://docs.employment.gov.au/system/files/doc/other/2544registerednursent_1.pdf
• Department of Health 2014, About the Gp super clinics programme, viewed 22 April 2017, http://www.health.gov.au/internet/main/publishing.nsf/content/pacd-gpsuperclinic-about
• Department of Health 2012, Nurse Practitioners, viewed 22 April 2017, http://www.health.gov.au/internet/main/publishing.nsf/Content/work-nurse-prac
• HealthTimes 2017, How to become a nurse practitioner, viewed 22 April 2017, https://healthtimes.com.au/hub/nursing-careers/6/guidance/nc1/how-to-become-a-nurse-practitioner/508/
• Stewart, J 2014, ‘Thousands of nursing graduates unable to find work in Australian hospitals: union’, ABC News, viewed 25 April 2017, http://www.abc.net.au/news/2014-05-24/thousands-of-nursing-graduates-unable-to-find-work/5475320
• World Health Organisation 2016, Global strategic directions for strengthening nursing and midwifery 2016-2020, WHO, viewed 25 April 2017, www.who.int/hrh/nursing_midwifery/global-strategic-midwifery2016-2020.pdf

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