[N181] LEC 14 - Global Nursing Workforce Challenges: Shortage, Migration, and Education

Burnout

Nursing Shortage in the Philippines: A pressing issue exacerbated by high levels of __________ among healthcare professionals

127,000; 200,000 to 250,000

Nursing Shortage in the Philippines: Currently, the country faces a deficit of approximately ___________ nurses, with estimates suggesting that __________ to __________ nurses have left the profession entirely (Alibudbud, 2023)

1. Low salaries

2. Delayed benefits

3. Understaffing

4. Overwork

5. Job Insecurity

What are the factors contributing to nursing shortage?

• 22,000

• 8,000

• 50,800

Low Salaries: Fill in the blanks

• Entry-level salaries can be as low as _________ PHP/month

• Private hospitals may offer even lower wages of _________

• PHP/month. High cost of living in urban areas, expenses can reach _________ PHP/month

Delayed Benefits

Factor Contributing to Nursing Shortage:

• Lack of timely compensation contributes to feelings of exploitation and dissatisfaction, further driving nurses away

• Many Filipino nurses experience delays in receiving essential benefits such as hazard pay and special risk allowances

TRUE

TRUE or FALSE? Timely provision of benefits is crucial for job satisfaction and retention

TRUE

TRUE or FALSE? Understaffing positively impacts the workload and mental well-being of nurses

1:12

1:50

Understaffing: Typical nurse-to-patient ratio often exceeds the recommended standard of ______, with ratios soaring to as high as ______

burnout; leaving their positions

Understaffing: Leads to long shifts— sometimes lasting 12 to 16 hours—without overtime pay, resulting in __________ and a higher likelihood of nurses________________

Factor Contributing to Nursing Shortage:

• Combination of understaffing and high patient loads leads to excessive work hours and stress among nurses

• Affects their mental health and also compromises patient care quality.

• Can lead to decreased job satisfaction and increased turnover rates

FALSE

TRUE or FALSE? Many nurses in the Philippines are employed on long-term contracts

Factor Contributing to Nursing Shortage: Limits their access to benefits and career advancement opportunities, making the profession less appealing;

Attrition rates

Job Insecurity: Uncertainty surrounding their positions contributes to higher ______________ as nurses seek more stable employment elsewhere

7,000 to 10,000

Skills Mix & Nursing Shortage: The Philippines produces approximately ______ to _________ nursing graduates annually.

FALSE; Oversupply, not undersupply

TRUE or FALSE? The post-pandemic environment has led to an undersupply of nurses without corresponding job opportunities in local healthcare facilities

TRUE

TRUE or FALSE? Actual clinical exposure during training was significantly impacted by the shift to online learning during the pandemic

Professional nurses (69%)

Associate professional nurses (22%)

Unclassified personnel (9%)

Global nursing workforce (identify the percentages): professional nurses (___%), associate professional nurses (__%), and unclassified personnel (__%)

1. Create an environment that supports work-life balance

2. Demonstrate active professional and personal support for existing nursing staff

3. Adjust compensation based on industry trends

4. Adapt care models to relieve nurses from burdensome tasks

5. Make your brand personable and relatable

6. Advertise on leading job boards and nursing publications

7. Utilize social media

8. Create nurse ambassadors

9. Implement policies to improve working conditions

10. Engage in partnerships for recruitment

What are the Recruitment Strategies to Address Nursing Shortage? Give at least 5

Create an environment that supports work-life balance

Recruitment Strategy to Address Nursing Shortage: Implementing flexible scheduling and shift options can reduce burnout and improve job satisfaction among nurses

Demonstrate active professional and personal support for existing nursing staff

Recruitment Strategy to Address Nursing Shortage: When current staff feel valued and supported, they are more likely to recommend their workplace to new hires, thereby improving recruitment efforts

Adjust compensation based on industry trends

Recruitment Strategy to Address Nursing Shortage: Competitive salaries, tuition support, and signing bonuses can significantly attract new nurses.

Recruitment Strategy to Address Nursing Shortage: Utilizing technology to streamline administrative duties allows nurses to focus more on patient care. Implementing team-based care models can also distribute workloads more evenly, reducing stress and improving job satisfaction among nursing staff

Make your brand personable and relatable

Recruitment Strategy to Address Nursing Shortage: Developing a strong organizational culture and using personalized communication in recruitment efforts can help attract candidates who resonate with the values of the healthcare facility

Advertise on leading job boards and nursing publications

Recruitment Strategy to Address Nursing Shortage: Targeted advertising in relevant channels ensures that job openings reach a wider audience of potential candidates

Utilize social media

Recruitment Strategy to Address Nursing Shortage: Active engagement on social media platforms can attract both active and passive candidates.

Create nurse ambassadors

Recruitment Strategy to Address Nursing Shortage: Encouraging satisfied nurses to share their experiences can effectively promote the organization’s culture.

Implement policies to improve working conditions

Recruitment Strategy to Address Nursing Shortage: Improving structural issues not only helps in retaining current staff but also makes the organization more appealing to new recruits

Engage in partnerships for recruitment

Recruitment Strategy to Address Nursing Shortage: Collaborating with nursing schools for early career recruitment or using recruitment process outsourcing (RPO) partners can help healthcare organizations build a sustainable pipeline of talent

Recruitment; retention

______________ and ____________ challenges stem from inadequate wages, limited career development opportunities, and suboptimal working conditions

1. Positive Practice Environment

2. Management Practices and Incentives

3. Support Structures

4. Education and Information

5. Occupational Health and Safety

6. Addressing Burnout

7. Flexible Work Schedules

8. Enhanced Compensation Packages

What are the Retention Strategies to Combat Nursing Shortage? Give at least 4

Positive Practice Environment

Retention Strategy to Combat Nursing Shortage:

• Creating a supportive atmosphere can significantly enhance nurse retention.

• Includes promoting professional recognition and empowerment, which helps nurses feel valued and respected in their roles.

Management Practices and Incentives

Retention Strategy to Combat Nursing Shortage: Implementing effective management practices that include thorough orientation programs and work-life balance initiatives can encourage nurses to stay in their jobs.

Support Structures

Retention Strategy to Combat Nursing Shortage: Involve redesigning workflows to reduce unnecessary burdens on nurses, allowing them to focus on patient care rather than administrative tasks

Education and Information

Retention Strategy to Combat Nursing Shortage: By facilitating access to in-service training and specialty associations, healthcare organizations can help nurses advance their skills and careers, making them feel more competent and engaged in their work.

Occupational Health and Safety

Retention Strategy to Combat Nursing Shortage: Maintaining appropriate nurse-patient ratios and adhering to safety regulations that protect the health of nursing staff

Addressing Burnout

Retention Strategy to Combat Nursing Shortage: Implementing workplace mental health programs can help mitigate burnout among nurses.

Flexible Work Schedules

Retention Strategy to Combat Nursing Shortage: Allowing for flexible work arrangements can help accommodate the personal needs of nurses, such as childcare or educational pursuits

Enhance Compensation Packages

Retention Strategy to Combat Nursing Shortage: Increasing salaries and improving benefits are fundamental strategies to retain nursing staff

• 240,000

• 15,000 to 20,000

• 200,000

Nurse Migration (Fill in the blanks):

• _____________ Filipino nurses have been sent to nations like Austria, Iceland, Canada, France, Germany, and Belgium, and about ________ to ________ nurses leave yearly

• An estimation of _________ to _________ have left the country in 2021 (Jackson, 2021)

1. Unhealthy work environment

2. Overwhelming workload

3. Toxic work cultures

4. Power imbalances

5. Unreceived benefits

6. Inadequate compensation

7. Low salary

8. Lack of career opportunities

9. Lack of specialty training

Drivers of Migration: The poor Philippine healthcare system, growth and opportunity, and financial compensation drive nurses to migrate out of the country. Give at least 5 of the causes of this.

1. Improved working conditions

2. Increased financial compensation

3. Opportunities for knowledge expansion

Drivers of Migration: 106 Filipino healthcare workers who are working overseas or are processing overseas work documents identified similar factors for migrating. What are these 3?

FALSE; Filipino healthcare workers are not forced to migrate or leave the country, but rather choose to because they are drawn to or enticed by another country, as the nations that they migrate to provide them a better working environment.

TRUE or FALSE? Filipino healthcare workers are forced to migrate of leave the country.

Positive

• Remittances

• Knowledge and Skill Enhancement

Negative

• Nursing Shortage

What are the positive and negative effects of migration to home country?

Remittances (Positive)

Effect of Migration to Home Country:

• The significant amount of money that nurses overseas send home each year is one of the positive outcomes of nurse migration for the home country, as these sent by migrant nurses give the home countries much-needed financial help

• This is helpful to the home country’s economy as these help to meet the needs of its recipients thus contributing to reduction of poverty rates

Knowledge and Skill Enhancement (Positive)

Effect of Migration to Home Country:

• The new knowledge shared can boost nurses' self-confidence in their healthcare practice, and help them provide better patient care

• Nurses working overseas can contribute to the advancement of the healthcare practice in their home country by forming transnational partnerships and contacts from their recipient countries

Nursing Shortage (Negative)

Effect of Migration to Home Country: Aside from how home countries lose essential and quality healthcare service as a result of nurse migration, it also results in its perpetuation, as workforce shortage due to migration leads to a greater workload and unfavorable working circumstances, which further promotes or motivates more nurses to leave

Positive

• Workforce Growth

• Economic Boost

• Care Delivery

Negative

• Care Delivery

What are the effects of migration to recipient country?

Workforce Growth (Positive)

Effect of Migration to Recipient Country: A report by Socha-Dietrich and Dumont in 2021 detailed an increase of nurse migrants to recipient countries. This increase is highlighted as an asset to the recipient country’s healthcare system, as this increase in workers provides a solution to staff shortages, and workload division

Economic Boost (Positive)

Effect of Migration to Recipient Country: Aside from workforce growth, nurse migration also benefits recipient countries economically through helping in boosting GDP, taxation, and social security

Care Delivery (Positive)

Effect of Migration to Recipient Country: Cultural diversity, influences, and competencies are brought by migrant nurses, which can help to improve patient care as their foreign education has special language skills and cultural awareness

Care Delivery (Negative)

Effect of Migration to Recipient Country: A multicultural nursing workforce can result from nursing migration, which may limit the nursing team’s productivity as intercultural nursing cultures and practices can affect team performance, which can affect quality healthcare delivery to patients. This also affects patient-to-nurse relationships as these differences can also affect healthcare delivery

• Sociopolitical; policy change

• LMICs

• Integrating these professionals

• Collaborative

Effects of migration to both home and recipient country (Fill in the blanks):

• A positive impact for both home and recipient countries of nurse migration can be found in its ____________ implications. At the national, regional, and international levels, global nurse migration encourages and drives ___________. Nurse migration helps to prompt bilateral and multilateral agreements on mobility, trade, and practice

• The migration of nurses exacerbates workforce shortages in home countries, particularly in _______.

• Recipient countries benefit from the influx of foreign-trained nurses to address their own workforce gaps but face challenges in ___________________.

• _______________ models, such as global skills partnerships, offer a framework for mutually beneficial migration

1. Simulation-based Teaching and Training

2. Outcomes-Based Education (OBE)

3. Online and Hybrid Learning Models

4. Competency-Based Curricula

5. Specialization in Nursing

What are under the trends in nursing education?

Simulation-based Teaching and Training

Trends in Nursing Education and Training:

• It improves clinical reasoning, decision-making, and confidence among students, ultimately enhancing patient outcomes.

• Despite its benefits, cost and resource limitations remain barriers to widespread adoption

1. Mannequins

2. Virtual Reality

3. Standardized Patients

Trends in Nursing Education and Training: Simulation use advanced tools to create realistic clinical scenarios. What are they?

Outcomes-Based Education (OBE)

Trends in Nursing Education and Training:

• Emphasizes the achievement of measurable learning outcomes, ensuring that nursing graduates possess the skills to meet global health challenges

• Focus Areas: Development of global health competencies, critical thinking, and practical application of theoretical knowledge

• In the Philippines, this is part of the broader move to modernize nursing curricula and improve the country’s standing in global healthcare systems

Online and Hybrid Learning Models

Trends in Nursing Education and Training: The integration of this in nursing education has gained traction, driven by technological advances and the need for flexible education pathways. Virtual platforms enable students to engage with course materials and simulations remotely, addressing challenges such as geographical barriers and the global shortage of nurse educators.

Competency-Based Curricula

Trends in Nursing Education and Training: Global nursing education has increasingly embraced this to ensure that graduates are prepared to meet dynamic healthcare demands. In countries such as the Philippines, this approach focuses on achieving predefined core competencies, such as safe and quality nursing care, ethical responsibilities, and health education, tailored to national and international healthcare standards

Specialization in Nursing

Trends in Nursing Education and Training:

• This provides nurses with leadership roles and autonomy in decision-making

• Nursing education has increasingly focused on creating pathways for advanced practice nursing (APN) roles, such as nurse practitioners and clinical nurse specialists

1. Geriatrics

2. Mental Health

3. Oncology

4. Critical Care

5. Community Health

What are the emerging specialties in nursing?

1. Decline in Quality of Nursing Schools

2. Faculty and Curriculum Gaps

3. Barriers to Advanced Practice Nursing (APN)

4. Technological Disparities

5. Global Migration of Nurses

What are the issues in nursing education and training?

Decline in Quality of Nursing Schools

Issue in Nursing Education and Training:

• Regional Disparities: Urban HEIs often outperform rural institutions due to better resources and access to qualified faculty

• Interventions: Government bodies, such as CHED and PRC, have implemented measures like moratoriums on new nursing programs and closures of underperforming schools

TRUE

TRUE or FALSE? The quality of nursing education varies significantly across institutions, often influenced by factors such as student-faculty ratios, infrastructure, and accreditation levels

Challenges in Licensure Exam Results

Issue in Nursing Education and Training:

• Contributing Factors: Poorly equipped schools, lack of clinical exposure, and inadequate preparation.

• Government Action: Stricter regulations and monitoring of HEIs to ensure compliance with quality standards

Performance of graduates in the Nurse Licensure Examination

What is the key indicator of educational quality?

Faculty and Curriculum Gaps

Issue in Nursing Education and Training:

• Faculty Shortage: Many experienced nurses opt for higher-paying clinical roles instead of teaching positions.

• Outdated Curricula: Limited integration of technology and modern pedagogical strategies hinders the development of critical skills among students

• The shortage of qualified nursing educators poses a significant challenge to training programs

Barriers to Advanced Nursing Practice

Issue in Nursing Education and Training:

• These roles remain underdeveloped in the Philippines due to a lack of regulatory frameworks and educational readiness

• Challenges include resistance to expanded roles, limited mentorship opportunities, and unclear career pathways

Technological Disparities

Issue in Nursing Education and Training: Despite the growing reliance on technology in nursing education, disparities in access to advanced simulation tools and online platforms hinder the implementation of innovative teaching methods. Rural and underfunded institutions often struggle to incorporate these technologies, perpetuating inequities in nursing education quality

Global Migration of Nurses

Issue in Nursing Education and Training: The migration of highly trained nurses from developing to developed countries has created a dual challenge: depleting the nursing workforce in source countries while highlighting discrepancies in global educational standards. This trend underscores the need for harmonizing nursing curricula worldwide and promoting policies to retain local talent.

1. Innovative Strategies in Education

2. Policy and Regulation Reforms

3. Strengthening Clinical Exposure and Internships

4. Addressing Faculty Shortages

5. Strengthening Global and Regional Accreditation Standards

6. Enhancing Community Health and Disaster Preparedness Training

What are Key Innovations and Solutions regarding Nursing Education and Training?

1. Integration of Technology

2. Interdisciplinary Collaboration

Innovative Strategies in Education: Identify the following being described

1. Use of e-learning platforms, virtual reality simulations, and mobile apps to enhance accessibility and learning.

2. Partnerships between nursing schools and healthcare providers to provide real-world training opportunities

1. Strengthening Accreditation

2. Support for APN

Policy and Regulation Reforms: Identify the following being described

1. Higher standards for HEI accreditation to ensure consistent quality in nursing education

2. Establishing clear guidelines and policies for advanced nursing roles to meet specialized care demands

1. Collaboration

2. Mentorship Programs

Strengthening Clinical Exposure and Internships: Identify the following being described

1. Increased partnerships between nursing schools and hospitals to provide hands-on training.

2. Structured mentorship to support students during clinical placements.

1. Incentives for Educators

2. International Collaboration

Addressing Faculty Shortages: Identify the following being described

1. Scholarships, salary increases, and career development programs to attract experienced nurses into academia.

2. Faculty exchange programs to foster skills transfer and knowledge sharing.

Strengthening Global and Regional Accreditation Standards

Key Innovations and Solutions regarding Nursing Education and Training:

• Adopting and enforcing standardized accreditation systems ensures that nursing programs meet consistent quality benchmarks. For instance, countries like Australia and the UK have centralized accreditation boards, enabling a streamlined evaluation of educational and clinical competencies. The Philippines could benefit from a similar model to enhance its nursing curriculum's international alignment

Enhancing Community Health and Disaster Preparedness Training

Key Innovations and Solutions regarding Nursing Education and Training:

• In response to global challenges such as pandemics and natural disasters, nursing curricula are incorporating modules on community health and disaster preparedness. These additions aim to equip nurses with skills to address public health emergencies effectively, as seen during the COVID-19 pandemic