REPLY1 I consider myself a relatively new nurse compared to

REPLY1 I consider myself a relatively new nurse compared to so many experienced nurses with careers spanning years.  During my short career, the nursing shortage has always existed. This year the challenges of staffing shortages exceeds any other times I have experienced. We all recognize the COVID-19 pandemic as impacting the nursing shortage across the country with states continuing to plea for help to fill the vacancies. Prior to COVID-19, burnout was already making headlines with reporting that increased workloads, daily pressure and chaos in addition to our dysfunctional health care systems as contributing factors (Wan, 2019).      The nursing shortage at one facility I am currently working has become so extreme that incentives (bonus pay) to fill shifts has become normal practice. Although the extra income can be enticing, the mental and physical ramifications are often not worth putting in another 12 or more hours. Coordination of staff during these shortages impacts the entire facility and is often handled by administrative personnel located in other cities. Often the supervisory staff are in positions that prevent them from making time-sensitive decisions regarding staffing because administrators are slow to respond. Unfortunately, the shortages and inability for efficient staffing impacts the nurses and increases risks to our patients.                                                                   Reference Wan, W. (2019). Health-care system causing rampant burnout among doctors, nurses. https://www.washingtonpost.com/health/2019/10/23/broken-health-care-system-is-causing-rampant-burnout-among-doctors-nurses/ REPLY2 I am currently working in a sub- acute unit of an extensive care center. The center is divided into two sub-acute and senior nursing faculty. However, sub- acute unit is very different from other unit because patients here require total care, have PEG tubes, have tracheotomies and have high levels of acuteness. The unit has 27 beds and each nurse is responsible for taking care of 8 patients in eight hours shift. Nurses also assist other health professionals like CNAs to recommend ADLs (Snavely, 2016). Nevertheless, we are faced with high nurse turn-over rates. I can say it has been hectic one year working in this unit due to voluntary quits because of heavy workloads hence this has affected patients safety. Inadequate training also leads to high turnover rates and for our organization training takes at most 2 weeks, which is short period for one to grasp everything. Implications include burnout and voluntary job quits (Brunetto, Rodwell, Shacklock, Farr?Wharton & Demir, 2016). According to Snavely (2016), nurses become dissatisfied because of heavy workloads and as a result quit thus leading to high turnover rates. Reference Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-101. Brunetto, Y., Rodwell, J., Shacklock, K., Farr?Wharton, R., & Demir, D. (2016). The impact of Individual and organizational resources on nurse outcomes and intent to quit. Journal of advanced nursing, 72(12), 3093-3103.

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