If so, why is there a shortage of nurses? 3. How can this shortage be overcome? What are the short and long term solutions to the nurse shortage? Background: work in two Nursing Homes in Cheshire, hiring approximately 120 staff between them. In my job role as Administrator and Marketing Manager help with the recruitment of nurses, care assistants, etc. This is usually done through the Governments job portal, which frequently supplies us with enough candidates for interview and eventually, after checks in line with our Employment Procedures, to hire.
Unfortunately, this has not been the case recently and I had been tasked with researching new ways to recruit nurses for the Care Homes. Analysis: Recently, in our care setting we have found a severe shortage of Nurses. This is not just the case within our setting, but has been reported to be a problem across the UK within Private and Social care homes and also the NASH. This problem has got increasingly worse, so much so that in April 2014 the NASH made it mandatory that all hospitals have to “publish staffing levels on a ward-by-ward basis together with the percentage of shifts meeting safe staffing guidelines. NASH (2014). This was done in order to find out the extent of the problem and will be continued for the next few years. Not only the NASH have reported Nurse heritages with the Care Industry News stating that there is a “growing crisis which is forcing nursing homes to close – with many other being pushed to the brink. ” Jackie Brook, 2014). The NASH and also the Care Industry News are both very reliable sources of information and will have a good insight into the current issues relating to both nurses and the care industry.
The Care Industry News is a National publication based on Care Homes specifically “Care Industry News covers news for UK care providers of elderly care, residential & nursing care, assisted living, homes with care, social care, home care, domiciliary care, detriment villages, mental health and mental illness issues, acquired brain injury and all other types of adult care”. (Care Industry News, 2014). Therefore any information obtained from here will be relevant to my research and also reliable.
The NASH is also a reliable research source as it has access to National figures and information regarding Nurse shortages which could not be obtained elsewhere. There are also a number of Newspaper articles written about the Auk’s shortage of Nurses, for example, headlines such as “Stroke victims in danger because of major nurse shortage” (The Telegraph, 2014) and ‘Worrying shortage f senior NASH nurses” (BBC News, 2014).
Although these articles will reflect some of the current issues in the NASH and Care Settings, they are not as consistent as the NASH itself or the Care Industry News as most papers sensationalist stories for better headlines and aren’t always as factual. The reason why there is a shortage of nurses in the UK is difficult to pinpoint. Some articles have stated that the problem lies with increasing need for nurses, with BBC News stating that there are an “increased the number of nursing posts, with 2,500 more jobs compared with 2013. (BBC News, 2014). This is an issue as there does not seem to be enough qualified nurses to fill these new positions. After speaking to my colleagues, the Matron of one of the homes believes that there “are not as many newly qualified nurses as there used to be. More and more are retiring and there aren’t enough younger nurses to replace them”. This would confirm the NASH findings that “Skill shortages at a local or national level are the most reported reason for recruitment difficulties” (NASH, 2014).
These reports of skill shortages show that there are less people becoming qualified nurses. This could be due o the bad press that the nursing profession has had in recent years. Reports of long hours, low pay and poor working conditions in NASH hospitals could be discouraging people from the nursing profession. “We do not have a shortage of nurses. We have a shortage of nurses who are willing to work in a system where staffing levels have been reduced to the point where patient care and professional integrity is compromised. (Gordon, Buchanan and Brother, 2012). This has a knock on effect to Nursing Homes as a lot of nurses start their careers with the NASH and move to Nursing and Residential Homes later. As the heritage has become apparent and it is now had an effect on our Care Homes, we need to ask ourselves how we can overcome this shortage, both in the short term and the long term. In the short term, many settings have been using agency nurses, ourselves included. This is positive as they can be called on short notice.
However, they may not have been to the homes before. The Care Homes work in are large, both with over 40 beds each, they are also not purpose built, which means the rooms are spread out across different floors and areas, which if you are not used to them, can be difficult to navigate. Also, most of the residents eve been there for some time, they therefore know the staff and the staff know them, their special needs and requirements and the best way to care for them.
As agency staff do not know the residents they are relying on the advice of permanent members of staff and also care plan notes, which although adequate, are not as beneficial as having a member of staff who knows the Home and the residents well. “If the agency nurse works at the institution infrequently, the nurse will need to be re-orientated each time he or she works at that institution. ” (lyre, 2001). As well as this, agency staff are very costly to a business ND some agencies can take advantage of the desperate need for nurses and charge very high rates.
An investigation by The Telegraph found that ‘The bill for temporary workers has risen by more than 20 per cent in just one year, with private agencies receiving more than seven times the rate paid to nurses on the pay roll. ” (The Telegraph, 2013). This is supported by the statement “An agency nurse may cost twice that of an employee staff nurse” (lyre, 2001). After researching agency Nurses and speaking to a number of agencies regarding the hourly cost of hiring Reigns, I collated the data which can be seen in the table below. Table to show the hourly cost of Agency Nurses from a number of agencies working in the North West.
The table above shows the high cost of using agency staff. Most of the rates above are more than double the usual hourly rate of a permanent RAG. The use of agency nurses also raises ethical questions, such as, the agency staff leave at the end of the shift and have no loyalty or ongoing responsibility to the residents, therefore, will they provide the best possible care to our residents? The cost and question over the quality of care given to residents shows that although agency staff can be a short term solution if urgently needed, they re not a viable long term solution, particularly for small businesses.
After further research I had seen a number of articles mentioning that a growing number of Care settings, and also the NASH, were recruiting nurses from abroad. “Overseas recruitment of nurses has more than quadrupled in a year, underlying the extent of the difficulty hospitals are encountering in their efforts to boost nurse numbers. ” (The Guardian 2014). I started my research by looking at different recruitment agencies in the area. Most of this research was done online, looking at agencies that specialized in Nursing recruitment n the Cheshire and surrounding areas.
I also found recruitment agencies that recruited for numerous different jobs and did not just specialist in Nursing, but after investigation, I felt that the Specialist Nursing recruiters would be more appropriate, as they knew the field and therefore the expectations and procedures. After compiling a list of agencies, which recruited from both the UK and abroad, that I thought were suitable, I rang each of them to find out more about their services and fees. The services provided varied significantly and also the agency fees. After speaking to a few agencies I recorded and compiled the ATA below.
Name of Recruitment Agency Initial Quote (% of 1st years salary) Negotiated to of 1st years salary) Recur ting from (UK or abroad) Any other fees? Remedial None TFH Healthcare 15% 12% (but only if we provide accommodation for any overseas nurses) UK and Overseas Only if we have to provide accommodation (rent, purchasing a house, etc) PC Recruitment No negotiation Overseas – mainly Romania Yes – Accommodation for the nurses (for up to 6 months), paying for the flights to fly the nurses over to the UK, an advance on their wages to help them get settled in the UK and pay nay initial costs.
New Approach Recruitment Ltd Table to show the costs incurred to a company if using a recruitment agent to find nurses from the UK or abroad After analysis, recruiting nurses from the I-J, although a large one of sum, (ranging from E,000 plus in most cases), these nurses would be with the company for hopefully a number of years and would alleviate the shortage of nurses on a long term basis. However, after instructing an agency to look for nurses on our behalf, I found that the agencies also struggled to find nurses.
When they did find a suitable candidate, the nurse was in high demand from not only other Care Homes but also from the NASH. Due to this the nurse was able to be very selective regarding working hours, pay, etc and more often than not had already had several interviews arranged before I was sent their C.V.. Due to this, to this date, as a company, we have not managed to recruit any nurses using a recruitment agency. Recruiting from abroad also provided problems. Mainly the fact of time constraints and large costs involved.
As you can see from the table above, TFH Healthcare can provided nurses from overseas, however when questioned further they were much happier only recruiting from the UK as it was ere difficult for them to find accommodation for the workers and a very long process. The whole process can take up to 6 months and as a Care Home the recruitment needs to be quicker than this. (An Erg’s standard notice period is a month, which could leave up to 5 months without a full time RAG).
The other company that recruited from abroad, PC Recruitment, has a competitive initial percentage fee, however the costs on top of this are very high and as a small business it may not be viable. The cost of flights, nurses’ accommodation for up to six months and advances on their wages would amount to several thousands f pounds and if you are hoping to recruit more than one nurse is unlikely to be feasible. Recruiting from overseas also raises some ethical questions. Firstly, where are the overseas nurses come from? Have they been treated fairly? Is the agency a reputable agency?
Will the overseas nurses be happy here and not feel isolated if they are the only worker of their Nationality? This is something that, as a company we would have to consider before employing any new member of staff. It is up to the Care Home to ensure that all staff “have the relevant skills and experience and apply these in their work”. Care Quality Commission, 2010). Foreign workers can also only be employed “after confirming their legal status and entitlement to work in this country and after making equivalent checks on their criminal records and fitness to work with vulnerable people” (Crooner, 2012).
We would also have to ensure that we comply with our own employment procedures. The final long term solution is word of mouth and the support of current employees. In the past a number of our employees and nurses have come from our staff asking friends who are nurses if they are looking for a job or would consider coming to work for us. This has worked very well previously and is an ongoing recruitment process that our staff do for us. I believe this is because we are a small, family business and have a very good relationship with our employees.