Nursing shortage, a different challenge in Iran: A systematic review

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Abstract

Background: Nursing shortage is an important and multifaceted challenge in the health systems and has reached a warning threshold. The factors associated with nursing shortage vary from country to country. Therefore, this study compared the causes of nursing shortage and suggested strategies to help resolve this concern both in Iran and in the world.

Methods: To conduct this systematic review, search was done in English and Persian databases from 2000 to 2016. In the preliminary review, 537 articles were included in the study. After reviewing the titles, abstracts, objectives, and results of articles, 32 studies were finalized.

Results: The important causes of nursing shortage in the world included aging of the nursing workforce, inadequate admission and training of nurses, aging population, and job abandonment. However, the leading causes in Iran were unwillingness and lack of desire to enter and remain in the nursing field, job abandonment, inadequate salaries, low social status, and negative perception of nursing. Proposed strategies in the world are increasing the salaries, redesigning the work environment, improving the public’s perspective, retaining the existing nursing workforce, and flexible work schedules. In Iran, these strategies include increasing salaries and recruitment, enhancing the public’s perception of nursing, and supporting nursing organizations.

Conclusion: Nursing shortage is a multifaceted concept with varying magnitudes in different countries. Therefore, the strategies to resolve nursing shortage should be based on the unique conditions of each country. The most important strategies to overcome nursing shortage in Iran are focused on the improving the retention of existing nursing workforce.

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Most cited references 52

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Solving nursing shortages: a common priority.

Linda Aiken, James Buchan (2008)

This paper provides a context for this special edition. It highlights the scale of the challenge of nursing shortages, but also makes the point that there is a policy agenda that provides workable solutions. An overview of nurse:population ratios in different countries and regions of the world, highlighting considerable variations, with Africa and South East Asia having the lowest average ratios. The paper argues that the 'shortage' of nurses is not necessarily a shortage of individuals with nursing qualifications, it is a shortage of nurses willing to work in the present conditions. The causes of shortages are multi-faceted, and there is no single global measure of their extent and nature, there is growing evidence of the impact of relatively low staffing levels on health care delivery and outcomes. The main causes of nursing shortages are highlighted: inadequate workforce planning and allocation mechanisms, resource constrained undersupply of new staff, poor recruitment, retention and 'return' policies, and ineffective use of available nursing resources through inappropriate skill mix and utilisation, poor incentive structures and inadequate career support. What now faces policy makers in Japan, Europe and other developed countries is a policy agenda with a core of common themes. First, themes related to addressing supply side issues: getting, keeping and keeping in touch with relatively scarce nurses. Second, themes related to dealing with demand side challenges. The paper concludes that the main challenge for policy makers is to develop a co-ordinated package of policies that provide a long term and sustainable solution. This paper highlights the impact that nursing shortages has on clinical practice and in health service delivery. It outlines scope for addressing shortage problems and therefore for providing a more positive staffing environment in which clinical practice can be delivered.

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The global nursing shortage: an overview of issues and actions.

J Oulton (2006)

Today's global nursing shortage is having an adverse impact on health systems around the world. A major initiative by the International Council of Nurses (ICN) yielded important information regarding the shortage and solutions to it. These are organized into five priority areas: policy intervention; macroeconomics and health sector funding; workforce planning and policy, including regulation; positive practice environments; and retention and recruitment (includes migration); and nursing leadership. Internationally momentum is building, providing the opportunity to bring attention to these issues and to take action. This article presents an overview of the global nursing shortage (which, since 2002, has been termed a global crisis), provides the perspectives of the ICN, and discusses the ICN's initiatives regarding that crisis. Founded in 1899, the ICN is the world's first and largest organization for health professionals. As a federation of national nurses' associations in 129 countries, ICN represents the more than 13 million nurses working worldwide. It works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected, competent professional workforce.

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Nursing profession in Iran: an overview of opportunities and challenges.

Reza Negarandeh, Soheila Broomand, Nahid Dehghan Nayeri … (2010)

Iran's health-care system has witnessed profound changes in the last decades. Despite its progress, the system has currently faced many challenges in one of the important subsystems, nursing. The present review article aimed to present an overview of the opportunities and challenges of the Iranian nursing system, based on recent literature. A broad search of the English and Persian-language literature was carried out, incorporating both electronic and manual components from 1999 to 2009. The results of the investigations among the searched literature are summarized. The major challenges are nursing shortages, job dissatisfaction, poor social position of nurses, the gap between theory and practice, lack of community-based nursing care, lack of an appropriate student recruiting system, and shortages in the nursing educational curriculums. The authors believe that media, political and public support play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses, and promoting the sociocultural climate and the welfare of nurses, which will result in higher levels of quality of care as well as greater patient satisfaction.

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Author and article information

Journal

Journal ID (nlm-ta): Med J Islam Repub Iran

Journal ID (iso-abbrev): Med J Islam Repub Iran

Journal ID (publisher-id): Med J Islam Repub Iran

Journal ID (publisher-id): MJIRI

Journal ID (publisher-id): Med J Islam Repub Iran

Title: Medical Journal of the Islamic Republic of Iran

Publisher: Iran University of Medical Sciences

ISSN (Print): 1016-1430

ISSN (Electronic): 2251-6840

Publication date Collection: 2020

Publication date (Electronic): 19 February 2020

Volume: 34

Page: 8

Affiliations

¹Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

²Department of Critical Care Nursing, Iran University of Medical Sciences, Tehran, Iran

Author notes

[* ] Corresponding author: Aziz Shamsi, shamsi.a@ 123456tak.iums.ac.ir

Author information

Aziz Shamsi https://orcid.org/0000-0003-1949-7988

Article

DOI: 10.34171/mjiri.34.8

PMC ID: 7139261

PubMed ID: 32284932

SO-VID: ed041349-3316-45e9-856d-3075eeb81f9e

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0), which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

History

Date received : 09 February 2019

Page count

Figures: 1, Tables: 3, References: 67, Pages: 9

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Nursing shortage, a different challenge in Iran: A systematic review

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Journal of Health Sciences

Most cited references 52

Solving nursing shortages: a common priority.

The global nursing shortage: an overview of issues and actions.

Nursing profession in Iran: an overview of opportunities and challenges.

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Cited by 25

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