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Nursing’s Impact on Provider ShortagesJoshua TroastFerris State UniversityIntroductionHealthcare faces continued challenges to meet the needs and expectations of those seeking care. Compounding a healthcare system that continues to grow in complexity and the demands for patient care, is a reality that encompasses a shortage in critical positions that provide care. Primary Care Physicians (PCP’s) and nurses continue to be in great demand, but the supply of these professionals will not continue to meet the future demands for access to healthcare services (Marshall, 2011). Contributing to the increased demand for healthcare services are the tenants of the Affordable Care Act (ACA), which has added an estimated 16 million insured people into an already strained system (Link & Perry, 2014). This paper will review the challenges of the PCP and nursing shortage as well as provide strategies for improving both of these healthcare shortfalls.Literature Support and DiscussionAccording to the Association of American Medical Colleges (2014), it is estimated that in the year 2020 there will be a national deficit of 45,000 PCP’s due to an aging physician workforce, additional Medicare population, and the additional insured individuals resulting from the ACA. Additionally, the Bureau of Labor Statistics (2014) estimates 1.05 million open nursing positions by 2022, despite an increase in the overall number of nurses. These nursing shortages can also be attributed to the same reasons accounting for the physician shortage. The combination of healthcare provider shortages puts the health of the American communities at risk due to a lack of access to timely and sufficient patient care.One potential solution to the apparent PCP shortage is the suggestion that practicing Nurse Practitioners (NP) could fill the void and provide PCP care to patients, especially those in underserved, rural areas or in the chronic disease populations. In addition to improving access to care, it is argued that NP’s functioning as PCP’s is a more cost effective approach to the PCP shortage with no apparent sacrifices in quality or safety. Barriers to this approach are widely due to variation in state regulations governing the practice of the NP. Common barriers to this approach include credentialing, payment rights, prescribing privileges, and required physician oversight or chart reviewing (Odell, Kippenbrock, Buron, Narcisse, 2013).In the context of both the PCP and nursing shortage, the profession of nursing has great opportunity to positively impact healthcare reform through its aptitude for leadership and its clinical competency (Scott & Miles, 2013). Tomey (2009) identified that nursing trends over the last 25 years have shown nursing moving from the bedside to coordination of care, into transformational leadership, and into roles of management participation. These progressive trends in the profession of nursing are a credit to continued evolution in nursing and position nursing for positive influence on the healthcare system. Need For ChangeTo improve the outlook of apparent PCP and nursing shortages, nursing’s continued professional progression will promote a prominent perception and must continue to be a priority. Two strategies that will drastically enhance healthcare’s ability to provide adequate future PCP and nursing care are by first, advancing the public perception of nursing practice and leadership, thus improving professional interest in nursing. Secondly, by attaining governmental standards that allow NP’s to practice autonomously in traditional PCP environments. Developing these key strategies will require flexibility, leadership, and adaptation of the healthcare system, but the results will strengthen the American healthcare systems ability to meet the impending demand for services (Scott & Yoder-Wise, 2013).Research has suggested that increased educational competencies within nursing leads to better patient outcomes. Additionally, increasing these educational competencies for nursing also establishes a strong foundation for nurses to demonstrate leadership potential in diffusely collaborative healthcare environments (Scott & Yoder-Wise, 2013). These scenarios aid in advancing the perception of nursing leadership as legitimate and necessary. Traditional healthcare administration and decision making authority is dominated by those with education and experiences in non-clinical fields, such as finance. This knowledge is necessary, but healthcare decisions should be influenced by patient outcomes and patient care as this is the purpose for healthcare’s existence. Healthcare leadership must consider the value of collaborative teams that can effectively influence and make decisions that are fiscally responsible, make good business sense, and encompass quality patient outcomes. With this direction, it is imperative that nursing leadership seek formal positional authority and have meaningful opinions that are collaborative for the betterment of healthcare.Accomplishing objectives of nursing recognition for leadership and formal positions, allowing nursing to demonstrate their leadership, will require continued emphasis on education. Scott and Miles (2013) identified that education should emphasize leadership in the formal educational setting, which will lead to enhanced conceptualization of nursing leadership. Enhancing this model is the suggestion that lifelong leadership development for nurses should also be stressed within the educational settings.As nursing prominently advocates and displays its ability to provide superior leadership for decisions, nursing will continually gain strength in its ability to appropriately lobby for crucial patient care issues. Gaps in care, such as the PCP shortage, can be effectively improved through the utilization of NP’s in these care areas (Odell, Kippenbrock, Buron, & Narcisse, 2013). For this solution to gain momentum, nursing will need to continue emphasizing its leadership ability through improved perception of nursing which, in turn will increase educational offerings and funding for those seeking advanced degrees in nursing. SummaryShortages in both PCP’s and nursing have the potential to greatly impact access to care in America. The profession of nursing is in a position to continue its influence on healthcare reform through nursing education, enhancing professional perceptions, and influencing necessary advancements of nursing scope. These evolutions in healthcare have the ability to drive change, improve recruitment to the nursing field, and better the healthcare system. ReferencesBureau of Labor Statistics (2012). Economic news release [Data file]. Retrieved from: , A. (2014). Medical experts say physician shortage goes beyond primary care. Association of American Medical Colleges. Retrieved from: , D. G. & Perry, D. (2014). Meeting new health care challenges with a proven innovation, nurse-managed health care clinics. Nursing Administration Quarterly, 38 (2), 128-132.Marshall, E. (2011). Transformational leadership in nursing: From expert clinician to influential leader. (1st ed.). New York: Springer Publishing Company, LLC.Odell, E., Kippenbrock, T., Buron, W., & Narcisse, M. R. (2013). Gaps in the primary cre of rural and underserved populations: the impact of nurse practitioners in four Mississippi delta states. Journal of the American Association of Nurse Practioners, 25, 659-666.Scott, E. S. & Miles, J. (2013). Advancing leadership capacity in nursing. Nursing Administration Quarterly, 37 (1), 77-82.Scott, E. S. & Yoder-Wise, P. S. (2013). Increasing the intensity of nursing leadership, graduate preparation for nurse leaders. Journal of Nursing Administration, 43 (1), 1-3.Tomey, A. M. (2008). Nursing leadership and management effects work environments. Journal of Nursing Management, 17, 15-25. ................
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