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I will outline some of the issues in the medical field which has had a negative effect on patient's satisfaction and the quality of care administered by hospital or other health care facility which is a direct result of the lack of nursing staff

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I will outline some of the issues in the medical field which has had a negative effect on patient's satisfaction and the quality of care administered by hospital or other health care facility which is a direct result of the lack of nursing staff. Although hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes, increasing staffing levels is not easy. This is evident from an average vacancy rate of 13 percent. According to a 2002 report by the workforce commission of the American Hospital Association, the nursing shortage "reflects fundamental changes in population demographics, career expectations, work attitudes and worker dissatisfaction ( Staton 2002). .

A Federal Government study predicts that hospital nursing vacancies will reach 800,000, or 29 percent, by 2020. The number of nurses is expected to grow by only 6 percent by 2020, while demand for nursing care is expected to grow by 40 percent. Recent research shows a jump of 100,000 RNs, or 9 percent, in the hospital RN workforce between 2001 and 2002 because of increased demand, higher pay, and a weakening economy. However, since almost all of the increase came from RNs over age 50 who returned to the workforce and a greater influx of foreign-born RNs ( Staton 2002).

Patient care today is difficult and is further complicated by other changes in hospital care, such as new medical technologies and a declining average length of stay, that have led to increases in the amount of care required by patients while they are in the hospital. New medical technologies allow many less seriously ill patients who previously would have received inpatient surgical care to receive care in outpatient settings. Hospital nurse staffing is a major concern because of the effects it can have on patient safety and quality of care. Some adverse patient outcomes potentially sensitive to nursing care are urinary tract infections (UTIs), pneumonia, shock, upper gastrointestinal bleeding, longer hospital stays, failure to rescue, and 30-day mortality. Most research has focused on adverse rather than positive patient outcomes for the simple reason that adverse outcomes are much more likely to be documented in the medical record ( Staton 2002).
Congress passed the Nurse Reinvestment Act, ub 2002 which has put into effect various measures to improve the recruitment and retention of nurses. The Act establishes a National Nurse Service Corps to give scholarships and loans to nursing students if they are willing to serve in hospitals with critical shortages of nurses for a 2-year period, loan forgiveness program for nurses receiving advanced degrees who will teach at nursing schools,nurses continuing education, geriatric training, and "career ladder" programs for job advancement, as well as internship and mentor programs ( Staton 2002).
Finally the results of the 2004 salary survey shows that bonuses are once again one of the top incentives hospitals are using to reward and retain employees. Because the nursing shortage is still an issue, hospitals are implementing incentives to not only retain current nurses, but also to attract new ones (Burke 2004).

The number of heads of nursing directors who received a bonus increased to 88.5 percent in 2004, a 19.2 percent increase from last year. Of the top patient care executives top nursing executives surveyed, 84 percent received a bonus, which is an increase of 5.2 percent. But, the number of nurses in this category eligible for a bonus decreased from 61.8 percent in 2003 to 54.1 percent this year. In some of the larger hospitals, an increase in salaries was significant. The average salary of top nursing executives at hospitals with 500+ beds is $184,200 for 2004, up from $165,500 in 2003 (Burke 2004).