Nursing advancement programs: self managed and nursing focused

Abstract

The nursing body is an integral component of any health care system all over the world, yet it is heading toward crisis. (1-3) The diversity of health problems demands in return a quality/safe caregiving, which is only privileged to well educated, experienced, and satisfied nurses. (4-6) The predicted shortfall of 0.5-1 million registered nurses in the next two decades exerts an inevitable imbalance to the cyclic supply and demand of nurses. (7,8) In other words, we are heading toward a "perfect storm" where few or less-experienced nurses care for an ongoing sicker patient population. (2)

Literature has mainly investigated the numerical gap between the projected need for nurses and the estimated bedside nurses in the upcoming years. (9) The depletion of expert bedside nurses is aggravated by two driving forces: demographics and work-related factors. (10,11) Demographic factors resemble the individual's personal characteristics such as age, sex, marital status, work experience, and tenure. (12-14) Work-related factors tend to be more controllable or modifiable, including salaries/incentives, promotions, workload, empowerment, and autonomy. (15-18) Apparently, when there are not enough enzymes to turn reactants into products, nursing turnover is expected. (19)

Nursing research has found a significant relationship between quality/safe patient outcomes and professional characteristics of nurses. (4) Expert nurses are capable of grasping clinical situations, utilizing an extensive pattern of skills and making fine distinctions of problems before they even occur. (2) As per Benner--novice to expert model theorem--most nurses take at least 5 years to reach the expert stage. (20) Nurses' resignations before reaching this level lead to a dilution of experienced staff, which exerts stressors on junior nurses who see in them their clinical mentors. (5)...