Over the past twenty years, research has established a clear correlation between insufficient nursing staff and poor patient outcomes. An increased incidence of medication errors, infection, pressure ulcers, sepsis, falls, and death rates have been reported due to inadequate staffing and unmanageable workloads (The Canadian Federation of Nurses Unions, 2012). When patients come to the hospital they rightfully expect that nurses will have the time and ability to manage their care in a holistic and safe manner. Instead, nurses are given unmanageable patient loads and end up rushing through care, negatively impacting the well-being of the patient, the nurse, and even the health care system.
Alberta is no exception to this unfortunate circumstance. Over 1400 Members of the United Nurses of Alberta were surveyed and reported that insufficient staffing and heavy workloads leading to burnout are the most imperative bargaining issues that need to
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A solution to this can be found by exploring the outcomes of California’s recently passed mandatory ratio laws which were calculated based on acuity. This formula has resulted in nurse patient ratios ranging from 1:1 to an absolute maximum of 1:6 for the less acute and psychiatric units (http://www.cga.ct.gov/2004/rpt/2004-R-0212.htm). This method of ratio determination will ensure that the patient is allocated the appropriate amount of care for the severity of their condition. In addition, this law has resulted in a 31.6% decrease in the proportion of occupational illness and injury rates among nurses http://link.springer.com/article/10.1007%2Fs00420-014-0977-y. By maintaining a safe, manageable work setting for the nursing staff, the hospital can better ensure that their patients are being cared for holistically, according to policy, and that no aspects of care are being eliminated due to unbearable
According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).
Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).
According to Canadian Nurses Association(2009), human health resources have stated that by the end of 2011 Canada will experience shortage of 78 000 registered Nurses (RN) and shortage of 113 000 nurses by the end of 2016. Globally there will be shortage of 4.3 million health care workers. It was also shown that approximately 38% of new graduate nurses leave their workforce within the first year of employment (Lavoie-Tremblay, Wright, Desforges, Gelinas, Drevniok & Marchionni, 2008). According to registered Nurses Association of Ontario (2011), full time positions of RN dropped to 57.9 % in 2010 from 58.9% in 2009. With the current trend it is expected that the Canadian Nursing shortage will increase significantly. In
For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.
Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.
When was the last time you were in the hospital or a loved one was in the hospital, and ever wondered where the nurse is, and they haven 't returned for hours. You finally push the assistance button several times, and they open the door and hurriedly say, “I will be right back”, then you don 't see them for a while again. When they come back to check up on you, you explain to them what you need, and then they send in a less qualified staff member to assist you. At this point, you become very annoyed and frustrated not to mention scared to be admitted in the hospital to begin with. Little do you know, your nurse has ten other patients and other non-nursing tasks that they are responsible taking care of. They have been working a double shift and are extremely exhausted, and a large stack of charts that they will have to do before their shift is over. As a patient, you now become frustrated and are not happy about this; as a nurse, they are just as frustrated as you are, not only because the amount of work they have but more importantly they can 't deliver the appropriate care they long to give. For most hospitals they do not hire enough registered nurses for reasons that are good and bad. This is an issue that needs to be addressed not only locally but nationally and on a constant basis. When there are too many patients for one registered nurse to attend to, nurses become exhausted, mistakes are made, and patients are unsatisfied. A minimum nurse to patient ratio needs to be
Mandated nurse-to-patient ratios have some flaws to work out. Mandatory nurse-to-patient ratios could increase costs with healthcare costs already hard for many to afford. Welton (2007) stated, “Mandatory ratios, if imposed nationally, may result in increased overall costs of care with no guarantees for improvement in quality or positive outcomes of hospitalization” (p1). According to Welton the cost to the hospital are not covered when these mandates are put in place, leaving the hospital to pick up the extra costs of hiring additional nurses to comply with mandates. Mandated nurse-to-patient ratios do not allow for
Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.
A manager should make sure that the resources that are provided to the staff are useful, effective, and helpful. The manager should ensure that they have the adequate amount of resources and tools in order to complete there work and job. When it comes to the issue of nurse staffing ratios, the manager has the responsibility of making sure that the unit is staffed to meet the demands of the patients and there level of care, or acuity (GCU, 2011). Utilizing there skills in leadership, quality care, people and communication can all be of benefit. Leadership skills, such as leading by example, are necessary for nurse managers. Quality care skills can be beneficial to gather the necessary data and provide adequate staffing to promote and improve overall performance. People skills are used to interview new employees and hopefully increase staffing
Inconsistent nurse-patient ratios are a concern in hospitals across the nation because they limit nurse’s ability to provide safe patient care. Healthcare professionals such as nurses and physicians agree that current nurse staffing systems are inadequate and unreliable and not only affect patient health outcomes, but also create job dissatisfaction among medical staff (Avalere Health, 2015). A 2002 study led by RN and PhD Linda Aiken suggests that "forty percent of hospitals nurses have burnout levels that exceed the norms for healthcare workers" (Aiken, Clarke, Sloane, Sochalski & Silber, 2002). These data represents the constant struggle of nurses when trying to provide high quality care in a hospital setting.
Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.
The issue of healthcare personnel scarcity continues to be an ongoing challenge across the globe. Invariably, nurses are at the pinnacle in the delivery of quality care in any healthcare setting. The ever-increasing demands for care stem from a patient populace that is emergent, growing older and needing more care due to the escalating shift in their disease process. Hence, nurses are torn between balancing an overloaded schedule, working extra hours and maintaining astuteness and professionalism. This transcends to compromised patient care, nursing burnout makes it difficult for them to experience the rewards of caring for patients in the way they had expected; thereby, adding to the shortage of
In recent years, the healthcare industry has seen a significant decline in the quality of patient care it provides. This has been the result of reduced staffing levels, overworked nurses, and an extremely high nurse to patient ratio. The importance of nurse staffing in hospital settings is an issue of great controversy. Too much staff results in costs that are too great for the facility to bear, but too little staffing results in patient care that is greatly hindered. Moreover, the shaky economy has led to widespread budget cuts; this, combined with the financial pressures associated with Medicare and private insurance companies have forced facilities to make due with fewer
Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.
One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.