The buffer of bank nurses is very good option in some specialties e.g. theatre nursing and intensive care where staff transferred from other care environments would not have the relevant skills to operate effectively.  The use of bank nurses is one of those strategies that are regarded to affect the quality of care provided as is overtime working [8]. Therefore use of bank nurse as a cover option is more effective where there is local control over the nurse bank. This is more likely to lead to employment of bank nurses who are acquainted with the work and care environment. Large general banks are less accessible-to by individual organizations, and organizations have little control over choice of nurse, quality of the nurse and cost of hiring them.

§        Marketing and Continuos Recruitment

The health care industry should adapt the latest methods to compete and survive, such as use of more marketing tools to attract nurses who may be practicing in other industries and promote diversity [6]. The health care industry and public health in general has lagged behind other industries in securing high performance marketing personnel to help them in the marketing strategy for attracting personnel. The result is that newly qualified young nurses end-up being employed in the non-traditional organizations that now employ nurses e.g. pharmaceutical industries, marketing health products and others. However, with the development of health maintenance organizations, this trend may be changing.

Public health organizations must have a continuous influx of nurse-candidates for potential employment.  New employee positions are required as a marketing strategy and as service areas expand or new-services are initiated. Recruitment should occur even when there is a limited growth or even decline in service capacity, because individuals with specialized skills or training who leave the organization must be replaced and services or technologies that have been revised or modified must be staffed [6].  The strategy of continuous recruitment of nursing personnel may play an important role in helping the organization to adapt and remain competitive. Employees who have recently finished professional nursing training are an important source of information on new methods and techniques in service delivery that allow the organization to remain competitive in its traditional services.

§        Training and Development

Investment in the existing nursing human capital of a health service organization through a well managed training and development activity pays long term dividends for public health organizations. Improvement of the skill and abilities of LPNs to RNs and Nursing Aides to LPNs can contribute to sustained reduction in the shortage of well trained nursing work force. The changing environment of health services industry and public health in general, ensures that the training and development of current nursing staff members contribute to organizational performance in one part, and attracting other young people to the nursing profession on the other hand. Public health institution should develop innovative ways of responding to the nursing shortage to ensure constant flow of the nursing resources.


§        Contracting out Labor Intensive Nursing services

As a way of immediate response to the problem of Nursing shortage the strategy of contracting out labor intensive Nursing services to specialized organizations can be employed. Such services may include care of bedsores, nutrition care for patients and others. Though this has a potential of fragmenting patients care may help a lot in providing quality care in times of crisis. This strategy does not solve the problem of Nursing shortage as such but helps those setting hit by the shortage to survive while providing quality care in the short run.  In USA, Canada and Australia there are increasing example of staff support services such as payroll, planning, marketing and human resources being contracted out [5]. The net result has been a decrease in staff costs, and access to more specialized expertise via subcontracting with outside firms. In public health this has the potential of increasing the time available for the few nurse to provide quality care to the patients, and may provide the patients access to specialized nursing care for some conditions from out side firms.

Salary and Remuneration

One of the most important determinants of job or career choice is the salary or remuneration that it provides. Nursing is consistently known to provide remuneration inconsistent with education or work experience. The actual average annual earnings of RNs employed full-time in 2000 were $46,782 [20]. However, when changes in the purchasing power of the dollar were taken into account utilizing the consumer price index, the “real” salaries of RNs employed full time in 2000 was $23,369 (National Survey of RN nurse 2000). Real salaries for nurses are actually very low compared to the amount and type of work they do. This has left the nursing professional in limbo in terms of attracting new students. Many nurses have left to seek for employment in better paying work settings other than nursing or have gone back to school to change professions. A reasonable revision of the remuneration for nurses based on qualification has the potential of alleviating the situation. Remuneration is one the most powerful motivating factor to any worker, and it increases job satisfaction, and important in attracting new people to the profession.



1. Elizabeth Temkin 2002, “Rooming-In: Redesigning Hospitals and Motherhood In cold war America” Bulletin Of History in Medicine, 76: 271-298

2. James Buchan 2002, “Nursing Shortage and evidence-based interventions: a Case study from Scotland” International Council of Nurses, International Nursing Review, 49, 209-218.

3. Yi M. and Jezewski M. A 2000, “Korean nurses adjustment to Hospitals in The USA” Journal of Advanced Nursing, 32 (3), 721-729

4. Mia Defever 1995, “Health care reforms: the unfinished Agenda” Health Policy 34 (1995) 1-7.

5. Graham Martin 1994, “Characteristics of successful health organizations- the human resource Dimension” Health Manpower Management 20(1) 35-40.

6. Junaid Siddiqui and Brian H. Kleiner 1998. “Human resource management in health care industry” Health Manpower Management 24 (4) 143-147

7. Tor Helge Holmas 2002, “Keeping Nurses at Work: A duration Analysis” Health Economics 11: 493-503

8. James Buchan and Ian Seccombe 1995. “Managing Nurse absence” Health Manpower Management 21 (2) 3-12.

9. Linda O’Brien-Pallas and Andrea Baumann 2000, “Toward evidence-based policy decisions: A case study of nursing health human resources in Ontario Canada”. Nursing Inquiry 2000; 7: 248-257

10. James Buchan 2001, “Nurse Migration and International Recruitment”. Nursing Inquiry-Blackwell Science LTD 8 (4), 203-204

11. Karin Newman etal 2001, “The nurse retention, quality of care and patient satisfaction chain” International Journal of Health Care Quality Assurance 14 (2001) 57-68.

12. Mereille Kingma 2001, “Nursing migration: Global treasure hunt or disaster-in-the-making?”  Blackwell Science LTD, Nursing Inquiry 8 (4) 205-212.

13. James Buchan 1999, “The Graying of the United Kingdom Nursing Workforce: Implications for employment policy and practice” Journal of Advanced Nursing. 30 (4), 818-826.

14. Richard C. Pennell 2002, “Lets give nurses a fair shake” Editorial opinion, The American Journal Of Surgery 184 (2002) 87-88.

16. Peter Buerhaus 2002, “USA nursing shortage continues to affect patients” New England Journal of Medicine 2002.

17. Kovner C. and Gergen J. 1998, “Nurse Staffing Levels and Adverse events following Surgery In USA Hospitals. Image: Journal of Nursing Scholarship 30, 315-321.

18. Lisa Rapaport 2001, “Need for Nurses Gets more acute: Some worry about Lapses in care at area hospital” Published in Bees Newspaper September 2, 2001.

19. Nursing shortage- A Demand for action Nurse-to-patient Ratios are needed now.


20. National sample survey of registered Nurses 2000. U.S Department of health and human services bureau of health professions, Division of Nursing.