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The aging of a population poses significant challenges to healthcare, housing, social security and elderly care services. Active aging is promoted by the Hong Kong government but is compromised by a shortage of nurses, doctors and professional aides. This study aims to review the history of nursing education in Hong Kong, evaluate Hong Kong's nursing manpower policy with a macro–micro analysis based on sociological imagination and provide sound recommendations.

This article analyzes the nursing shortage in Hong Kong. A comprehensive literature review was conducted, concerning the Hong Kong healthcare workforce and covering relevant government reports, consultation papers and articles from academic journals from 1943 to the present.

The nursing shortage in Hong Kong can be understood from both absolute and relative terms. The total number of practicing nurses and fresh graduates registering through the four aforementioned pathways increased from 17,034 in 1996 to 61,295 in 2020 (growth rate of 74.4%), but it is predicted that there will be a shortage of 455, 1,383 and 1,669 nurses in 2020, 2025 and 2030, respectively. Moreover, Hong Kong had 8.2 nurses per 1,000 people in 2020. Although this rate exceeds those of China, South Korea and Singapore, it lags behind those of the USA and Australia as well as the international recommendation of nine nurses per 1,000 people. The nurse shortage has been further aggravated by an interaction between macro factors, including aging population, a lack of coherent and long-term nursing manpower policy (an analysis is based on a health policy triangle), numerous obstacles imposed on nurses from abroad and micro factors emanating from an interplay of push–pull factors among nurses.

The proportion of the Hong Kong population aged 65 years or older was 18% in 2019. The availability of healthcare workers is essential for attaining optimal health outcomes for older adults. The high turnover rate of nurses in public hospitals negatively affects the provision of timely high-quality medical services in the dual-track medical system. Therefore, workforce projections should be made every three years. Such policy should rely primarily on local nurses trained both by University Grant Committee-funded institutions and by self-financed tertiary institutions. Foreign nurses should be a supplementary resource. The budget allocated to the public healthcare sector should be increased to improve remuneration, provide abundant training opportunities and improve working environment to retain nurses in public hospitals.

Given that deep-seated problems surrounding the quantity and quality of nurses, the avenues for pursuing nursing degree education and the turnover rate of nurses in public hospitals remain unsolved, it is imperative to investigate how to alleviate the healthcare workforce shortage in Hong Kong.

In this second part of a paper examining the problem of nursing shortages in the health profession in Canada, the author draws on nursing reports from three provinces, Ontario, British Columbia, and Alberta, to identify how professional associations are dealing with the nursing shortage. Although education is seen as a major key to the nursing dilemma, the author notes that Canadian nurses are already exceedingly well educated. Neither more education nor public relation campaigns have been able to overcome the systemic problems facing the nursing profession today. If there is a solution, it lies in a more integrative approach, where structural issues, value issues, and even legal issues related to statute can be addressed. The author believes that the issue of nursing shortages cannot be resolved without a substantial degree of empowerment and autonomy for the profession.

The purpose of this study is to apply a rhetorical lens to the exploration of symbolic interactions used to negotiate contested identity. Specifically, we provide and analyze an Internet discussion among nurses concerning job duties and responsibilities. In this case study, one nurse questions her superior's remarks about her “abandoning” her responsibilities if she does not undertake “non-nursing” tasks. Ironically, the majority of posts that follow from other nurses perpetuate the notion that nurses must perform “non-nursing” tasks to fulfill their primary moral obligation and sustain an identity of nurses as flexible and caring. A rhetorical lens is applied and suggests that multiple framing techniques and rhetorical tactics (i.e., mutual negation, minimization, red herrings, sunny-side of domination, and perhaps most important the moral imperative) are used to persuade the nurse toward a collective identity – flexible professional. Although the main contribution of this study is found in the use of the rhetorical lens, an additional contribution is discussed – unexpected evidence, which suggests that the primary assumption of a “nursing shortage” may be a discursive reality, as well.

Although the nursing profession is a large occupational group and a major part of the National Health Service, surprisingly little is known about the demand for and supply of nurses. Current demographic trends, however, have ensured that a traditional “easy in/easy out” model of recruitment and retention, with high wastage rates during and after training, is being replaced by the idea that nurse education is a valuable and expensive investment and trained nurses must be encouraged to view nursing as a life‐time career. In 1988 there was considerable media interest in shortages of skilled nurses. A number of factors are examined, relevant to assessing whether there are such shortages. In particular, the demand for nurses, manpower and financial aspects of supply, recruitment and retention, and skill mix are considered. Two groups of nurses in which there are said to be shortages are briefly discussed: paediatric intensive care and community mental handicap and mental illness nurses.

This is the first part of a two‐part paper examining the problem of nursing shortages in the health profession in Canada. It draws on the problem from a historical and sociological perspective, with personal interviews, and historical data, to demonstrate the author’s theory that nursing shortages are nothing new. They are systemic in nature resulting from fundamental problems in the profession itself. Traditional solutions such as bringing in cheaper labour have exacerbated the problems, serving to perpetuate the commonly held view of nursing as an extension of women’s work in the home. Poor working conditions, ongoing power struggles with administrators and the medical establishment, and a handmaiden image have all served to create an ongoing cultural environment of powerlessness which the nursing profession has been unable to transcend, and serves as a deterrent to successful professional leadership and ongoing recruitment.

This paper presents the findings of a qualitative study, based on interviews with over 130 nurses and midwives in four London Trust hospitals on: the main factors influencing nurse satisfaction and retention; empirical support for the robustness of a conceptual framework or model “the nurse satisfaction, service quality and nurse retention chain”; and some managerial considerations for recruitment and retention. The three main factors influencing job satisfaction were patients, the inherent characteristics of nursing and the nursing team; the two main sources of job dissatisfaction were staff shortages and poor management and amongst nurse retention strategies improving working conditions was more important than increased pay. For recruitment, as well as retention, improving the image and reputation of nursing along with improvements in work‐life balance were pre‐requisites for meeting the challenging target of an additional 20,000 nurses on the wards by 2004.

The statistics and associated literature reveal a chronic shortage of nurses and midwives and difficulties in recruiting and retaining D and E grades, the main providers of hands‐on patient care. This qualitative exploratory study of nurse satisfaction, dissatisfaction and reasons for staying provides empirical support for a conceptual model “the nurse satisfaction, quality of care and patient satisfaction chain”. The in‐depth interviews reveal a spontaneous and explicit linking of organisational resources to nurses’ ability to provide the level of patient care commensurate with their desire and patients’ needs. Nurse job satisfaction derives from knowing that they have provided good care as well as the attributes of the job such as a career, skill acquisition and the “people I work with”. Job dissatisfaction stems primarily from staff shortages, the behaviour of patients and negative media comment. The interviews demonstrate the critical role of the “ability to give quality care” and the satisfaction derived from patients’ demonstration of their appreciation and the influence of this on nurse retention.

The purpose of this paper is to present a new look at solving the national nursing shortage problem by discussing new approaches to minimize the impact of nursing miss‐utilization and or miss‐allocation.

Among the approaches explored is the well‐known financial engineering derivative interest rate swap as well as new scheduling applications including inventory management and queuing models.

The study found that there is great interest in the field of the nurse scheduling and staffing problem. The problems are, however, studied in isolation from one another, while their respective nature is inter‐related: staffing policies impact nursing problem model constraints. This gap may be one of the contributing factors to a well‐known gap between industry application and academic literature. Industry solutions focus encouraging the growth of nurses in the field, most of which result in a financial paradox due to increasing rate capitation for health service facilities, which began in the mid‐1990s.

Possible limitations include a resistance to application from industry, as it has not been possible to minimize the application gap.

This paper introduces a swap model that satisfies the key problems resulting from the shortage: increasing costs and gap needs. The additional approaches offer a new look from outside industry application that have yielded solutions needed in the nurse scheduling problem.

The health-care services in Iraq currently face many challenges. The most noted is the lack of effective nursing leaders to meet the growing needs of the health-care services. Effective nursing leadership is critical to the health-care system, affecting work performance, quality of care and staff satisfaction. The literature suggests that nursing leaders in Iraq are not adequately trained to provide leadership to improve the nursing profession and have limited involvement in decision-making. The purpose of this study is to explore the views of nurses on what they believe constitutes effective leadership in Iraq.

A qualitative methods approach is used involving 20 semi-structured interviews of senior nurses. The sample of nurses came from two large general hospitals in Iraq. The qualitative data was thematically analyzed and interpreted.

The study results indicated that there were factors that influence the performance of nurse leader, namely, excessive workload, personal relationship with nursing staff, professional recognition of nursing and selection criteria of leaders. Test results show that there were significant differences in views of the nurses toward nurse leaders’ performance. This research concludes that the nurse leader performance in developing countries is affected by excessive workload, personal relationship with nursing staff, professional recognition of nursing and selection criteria of leaders.

The relevance of the study stems from the scarcity of research on the leader performance in developing countries, while studies on the factors influencing the innovative performance of leaders in nurses’ professional are significantly limited. This study is one of the earliest studies that investigate these factors influencing the nurse leader’s performance.