The impact of reimbursement, legislation, regulation and technological advances in the field of nursing


The nursing shortage causes nurses to have to take on larger caseloads, work longer hours and overtime, creates nurse fatigue and ultimately lends way to burnout, injury and medical errors. The impact of reimbursement, legislation, regulation and technological advances must also be considered. A failure to consider the relationships among all these aspects limits the full appreciation of the complexity of the nursing shortage today (ANA, n.d.).

Some of the ways specifically the nursing shortage is impacting the public are higher mortality rates, increased hospital acquired infections, higher medication errors, patients being diverted to facilities farther away from their families, surgeries being postponed longer than they should be and longer wait times (ANA, n.d.).

To facilitate improvements in nurse staffing, now and in the future, healthcare organizations must focus on recruitment, maintenance, and retention. In an attempt to address nurse burnout and shortage healthcare institutions are offering incentives such as providing sign on bonuses, offering competitive wages, providing tuition reimbursement; implementing nurse patient ratios protocols and providing ongoing training and CE’s for their employees. Nurses in general can help work toward the shortage by providing appropriate and thorough education to their patients, decreasing hospital admissions and office visits (Minority Nurse Staff, 2013).


The nurse shortage almost seems to be used to promote many other issues besides nursing. In my previous places of employment, I have felt that the nursing shortage was more of an issue of a short staffing pattern, not that nurses were not available. And I also think that phasing out the LPN/LVN is a mistake. Many nurses that are LPN/LVN do not want to advance to being and RN and many cannot. I have talked to many LPN’s who do not want the added responsibility and I understand that too. I believe there will always be a need for LPN/LVN and I love working with them. I have often thought that in hospitals there should be teams consisting of three-member teams; a RN, a LVN/LPN and a CNA. I do realize that this is not needed everywhere but our profession is continuously being burdened with added responsibilities. If you supply a RN with these qualified positions, the RN can handle more cases while learning gaining experience in leadership and educating. What are your thoughts with your experiences thus far as a RN?

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