There is serious concern in the health care field that the system is experiencing a shortage of nurses (Prescott, 1987, 1989). Several factors have been postulated as causing the problem. According to Raffel and Raffel (1994), these factors include: (1) wage compression and high levels of job stress leading to withdrawal from the workplace; (2) an increased ratio of nurses to patients due to increased technology and sicker patients; and (3) a decline in nursing school enrollments during the 1980s.
Many health care settings have attempted to reduce the problem of nurse shortage by hiring unlicensed personnel to handle supportive services (Evans, 1991). An example of this response to the nurse shortage problem was provided in the developed action plan. Specifically, the plan was constructed in relation to an ambulatory care setting make the decision that RNs and LVNs providing support services to Advanced Practice Nurses should be replaced by unlicensed personnel.
In essence, the developed plan proposed that following replacement of LVNs and RNs with unlicensed personnel, a pilot study be conducted and evaluated to determine its effectiveness as a response to the shortage problem. The research proposal presented here consists of a study designed to evaluate the pilot project.
Raffel and Raffel (1994) have stated that the nurse shortage places in jeopardy both the quantity and quality of patient care.
It is the jeopardy of patient care that makes research related to dealing with the shortage a significant area of study. Since this proposed study relates to methods of dealing with the shortage (namely the use of unlicensed personnel as supportive personnel), this fact also gives significance to the proposed research.
The proposed research will examine whether using unlicensed personnel to replace RNs and LVNs now providing supportive services to Advanced Placement Nurses working in am ambulatory care setting res...