Index IntroductionEthics of the Shortage and Effects on Patient CareFuture of the Staffing Problem and Possible SolutionConclusionReferencesIntroductionNursing is a respected profession that offers numerous benefits such as job security, personal fulfillment, a livable wage, etc. With all these benefits, there is one major drawback to nursing that affects hospitals and other healthcare facilities throughout the United States: nursing staffing. The topic of inadequate nursing staffing is a popular topic found not only in hospitals, but also in nursing schools and healthcare facilities, such as nursing homes. The shortage leads to longer hours and higher patient loads for available nurses, the pressure of working additional shifts, as well as increased stress and a greater risk of personal injury. With this growing problem, ethical dilemmas and poor patient outcomes become increasingly common. In this article I will discuss the ethical implications of nursing shortages, including the effects on patient care and stress on nurses. Additionally, I will discuss expectations for this trend, as well as possible solutions. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay Ethics of Shortage and Effects on Patient Care From an ethical standpoint, why do nurses continue to work longer hours and additional shifts if they begin to notice negative patient outcomes, personal stress, or feelings of burnout? One reason is that many nurses honor their duty to patients, to the point of feeling obligated to stay longer, take on more, or show up on their day off when asked. This mindset follows provision 2.1 of the ANA Code of Ethics for Nurses, which considers the patient to be the nurse's primary concern. It seems logical that when a unit is short on nurses, any extra help would be better than no help. This means that nurses may come to help despite having inadequate sleep and time for themselves; therefore, a lack of adequate staffing on a unit can significantly compromise the level of care received by each patient. Herein lies the ethical dilemma. Is it really better to have these tired, overworked nurses come in and work shifts when their judgment could be compromised? If they are unable to make informed decisions or carry out their job responsibilities to the best of their ability, do patients receive compassionate, evidence-based care? By accepting additional patients, are all patients receiving the care they need? Although it may follow Provision 2.1, working in this way may breach Provision 3.4 which highlights the nurse's involvement in promoting patient health and safety. In terms of the bioethical principles involved in this national problem, beneficence, which essentially means doing well, comes to mind. When coming in for a shift or staying for extra hours, the nurse may feel that she is practicing charity. By working harder, there is an extra nurse on site, which would reduce each nurse's patient load, thus allowing each nurse more time to use evidence-based practice and spend more time with their patients. While this sounds positive, this may not always be the case. In theory, this extra help should allow every nurse to practice with charity at the forefront of their mind, but in practice it will likely cause stress and burnout. The nurse whoworks harder and is more likely to have less professionalism and show greater irritability towards patients, potentially leading to non-therapeutic nursing care. The same can be said for nurses who have to take on additional patients to make up for the lack of nurses. For these nurses, charity is violated. Non-maleficence, or the nurse's obligation not to cause harm, is another ethical principle that is called into question in the event of staff shortages. When staffing is inadequate to accommodate patient requests for care, patient outcomes can be poor and even lead to increased mortality rates, as highlighted by a cross-sectional study conducted by Jane E. Ball and colleagues. This study examined post-operative patient data from 300 acute care general hospitals in 9 countries. They found that staffing shortages, which led to missed nursing care, resulted in a significantly higher mortality rate within 30 days of hospital admission. Each additional patient added to a nurse's workload increased the chance of patient mortality by 7%. Based on this study, it appears that low nurse staffing ratios inadvertently violate the principle of nonmaleficence as nurses are more likely to miss necessary patient care actions related to lack of time with each patient. These actions include care such as patient education, sterile procedures, and medication administration. In addition to nonmaleficence, the principle of fidelity may also be at risk. Fidelity means a nurse follows through with what she says she will do. When a nurse has more patients than the state or facility allows, the time available for each patient is limited. While in a patient's room, the nurse can tell the patient that she will be back at a certain time or that she will bring him something he needs. The nurse may have every intention of doing whatever she promised to do, but may not be able to do so due to time constraints. Future of the Staffing Problem and Possible Solution According to the American Association of Colleges of Nursing, the nursing shortage is expected to get worse as nearly one million nurses are expected to retire by 2030. Unfortunately, the upcoming classes of new graduate nurses they will not be able to completely replace the large group of retirees. By 2026, even though the profession is expected to grow by 15%, more than 200,000 additional nurses would be needed to replace the large number of retiring nurses. One area that will be hit especially hard is nursing homes, home care and skilled nursing communities. The acuity of patients in these facilities will continue to increase at a much higher rate than nursing staff can safely handle. Is there a solution to this nursing shortage? If there is no solution, what can be done to relieve pressure on nurses and improve patient outcomes? One way to increase the number of nurses in the workforce, as well as improve patient outcomes, is to create an environment of safety (Wolf et al, 2017, p. 156). For example, when administering any type of scheduled controlled substance, the nurse administering the medication should have a witness to verify that the correct medication and dose is being administered. This action would reduce medication errors attributed to fatigue, multitasking, or other factors and improve patient outcomes. If hospitals and healthcare facilities are known to give priority.2016.09.003