Abstract
Israel has a low density of professional nurses. New evidence suggests less than optimal hospital work environments may undermine efficient and effective delivery of nursing care and contribute to job dissatisfaction and nurse turnover among nurses who are in short supply. Potential approaches to address these challenges are discussed.
Introduction
Nursing shortages in developed countries have two related causes: 1) inadequate national/regional supply of nurses; and 2) in health care services, too few budgeted nurse positions and poor work environments that waste nursing resources. International evidence suggests that both of these causes of nursing shortages are remediable.
In this issue of the Israel Journal of Health Policy Research, DeKeyser-Ganz and Toren report on new research in Israel, a country with too few nurses, showing that hospitals have not done all they can to create optimal work environments to maximize the contributions of the nurses they have [1]. The convenience sample of hospitals they studied probably trended toward the better hospitals in Israel, and thus their findings that hospital work environments were not outstanding does not portend well for the rest of the hospitals in the country and the patients cared for in them. In addition to lackluster ratings on work environment features that are easy to improve and necessary for good patient outcomes such as nurse participation in hospital affairs, nurses gave their hospitals only average ratings on staffing adequacy — a measure that is highly correlated with actual patient to nurse staffing ratios and a variety of patient outcomes including preventable deaths [2]. The authors conclude that less than optimal hospital work environments are associated with less job satisfaction among nurses and greater tendency of nurses to consider leaving their positions thus potentially exacerbating a national nurse shortage.