Nurse Staffing Ratios

The purpose of this article is to discuss appropriate nurse staffing and staffing ratios and its impact on patient care. Although the issue is just not about numbers as we discuss staffing we begin to see how complex the issue has become over the years. Many factors can affect appropriate nurse staffing ratios. As we investigate nurse staffing ratios we can see the importance of finding the right mix and number of nurses to provide quality care for patients.

Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press.

Answer: A 30 beds unit with four RNs and three LVNs makes a nurse-to-patient ratio of 1/4.2. Considering that LVNs scope of practice requires RNs supervision and the assignments that have to be done particularly by RNs, these increase the RNs workload (Texas Board of Nursing, 2013). If one of the four RNs is going to be absence for six weeks, it is not a safe choice to fill the temporary vacancy using the overtime for the current staff, or either working with the available staff during the six weeks. “Workload, work hours, work structure, and many other factors can indirectly or directly cause fatigue in multiple industries and affect safety” (Weinstein, 2015, p.1 ). Nurses are going to feel overwhelm, overworked and at risk of causing medical errors.

Nursing theory influences the practice of nursing in a multitude of ways that can have a profound impact. Theory provides a framework to support and define nursing practice, support quality of patient care, and can be implemented in practice situations to provide solutions to nursing practice problems. Applying theory to resolve nursing challenges can be utilized in educational and research settings, direct patient care situations, as well as in administration and management of nursing care services. The benefits of applying theory to address a practice dilemma can be demonstrated by applying Jean Watson’s theory of human caring, and Ken Wilbur’s integral theory and examining how these theories impact the problems surrounding nurse staffing situations in an acute care hospital setting.

Since the times when Florence Nightingale took care of patients, there has been a question about what factors affect patient care. One of these factors, nurse-to-patient ratios, has gotten significant publicity over the last several years due to a change in legislation in California. This increase in publicity has sparked many researchers' interest to further evaluate these ratios in connection with patient outcomes and other variables. Through lots of research and analysis there is evidence that a lower nurse-to-patient ratio does reduce the negative patient outcomes in patient care. Some of these

Striving for excellent patient care is the cornerstone of nursing. However, delivery of innovative care requires nurses to take initiative in finding issues and concerns in current clinical practices to promote change that leads to optimal patient outcomes. One current issue in clinical practice is the varying patient-to-nurse ratios (PNRs) amongst different hospitals (Aiken et al., 2012). Having high PNRs may lead to nurse burnout, medical errors, and ineffective nursing care (Aiken et al., 2012; Karavasiliadou & Athanasakis, 2014). The solution would be to regulate PNRs, especially in areas such as the emergency room. To initiate this change, a task force would have to be established to use current data and research as evidence to propose the change, implement the change and evaluate its effectiveness.

Safe nursing ratios provide better outcomes for patients and provide better working conditions for nursing staff. Unsafe nursing to patient ratios have detrimental and negative outcomes in the nursing care that patients can receive in the hospital. For example, medications that are administered to patients late can alter their drug administration schedule. The late administration of cardiac drugs can be detrimental to patients’ well-being because this can cause a failure in maintaining the drugs therapeutic serum levels and consequently increasing the likelihood of arrhythmias. High patient to nurse ratios can also cause nurse burnout. Nurse burnout is precipitated by the increased physical and emotional exhaustion from being assigned too many patients depending on the type of floor that one is working. This causes nursing staff to leaves the nursing field due to the undue stress and look for positions that aren’t as stressful. This will only contribute to the nursing shortage. Patient hospital stays can also be effected due to the number of days that a patient stays in the hospital. This leads to an extended number of days in the hospital which can cause a loss of money that insurances would not agree to pay. The safety of the patients need to be a nurse’s priority and this can be a great cause of concern with an unsafe number of patients being cared for by the nurse. As nurse timing becomes a priority, it becomes important to be able to take care of each patient that is

For the past decade, nurse-patient ratios have been a widely controversial debate as to whether it should be mandated by law across the United States. Studies have shown nurse-staffing levels are a critical component of determining patient outcomes (Hertel, 2012). Advocates supporting minimum staffing levels argue that it can ensure better quality care, better working conditions, positive patient outcomes and improved rates of nursing retention. Those opposing minimum staffing levels argue that it would be expensive and reduces management flexibility. This topic was chosen because of how essential it is for this issue to be resolved in nursing. Within the past decade, only one state, California, has adapted to this unique law

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

As a new graduate registered nurse, I know that when I begin my first job the reality shock will occur. I will be overwhelmed at times by anxiety, fear, failure, and disappointment. Burnout is higher for new nurses, and it is my responsibility to help combat it for my fellow graduates and for myself. For years nurses have felt the increased impact of compassion fatigue, with patient safety and satisfaction rates plummeting. Nurses are faced with sicker patients with shorter hospital stays everyday. The pressure to treat the patients, but get them out of the hospital as soon as possible; without making any mistakes is a huge burden most nurses will feel at some point in their career. There have been countless studies, thousands of hours, and billions of dollars for research spent on finding a solution to the problem. In order to find a solution one must first understand the problem. These are three separate issues with one common problem, high nurse-patient ratios.

Nursing shortages in the United States have left practicing registered nurses (RNs) with strenuous workloads. Such heavy workloads can lead to poor patient outcomes, decreased satisfaction among both patients and nurses, and questionable quality of care, among other things (Cimiotti, Akien, Sloane, & Wu, 2012; Department for Professional Employees, 2014; Duffield et al., 2011). Realizing the potential for error that accompanies such circumstances, efforts are being made to decrease the workload of nurses in hopes of improving quality of care. One such effort, and the focus of this paper, is the implementation of mandated nursing staff ratios. Mandated nursing staff ratios would restrict the number of patients a nurse is allowed to care for at one time (Tevington, 2011). While this idea seems to be a fitting solution, there has been much debate about the effectiveness of mandated nursing staff ratios. This paper will discuss arguments for mandated nursing staff ratios, arguments against mandated nursing staff ratios, and the impact of mandated nursing staff ratios on the profession of nursing as a whole.

The contrast between an adequately staffed ward and one with a low nursing staffing level is tangible. Staff nurses and patients have expressed how inadequate staffing levels affect them and there is a substantial amount of evidence-based research showing the negative effects of low nursing staffing levels on patient and nursing outcomes. Nursing resource allocation and reallocation of staff nurses is a time consuming and challenging task for nurse leaders, who must ensure safe staffing levels are upheld (Ball et al. 2014). With an increasing constraint on health expenditure, nursing staffing levels in hospitals has become a main target for financial limits and spending reductions. To the extent of which the nursing profession has been called a ‘soft target’, for it is easier to reduce nursing staffing level, as opposed to other means of cutting costs, such as improving efficiency (Aiken et al. 2014b).

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 nurse manager in today’s health care has a solid role in providing a healthy working environment. Healthy working environment is the basis for safe and better patient outcomes. Healthy working environment in a unit depends on the inspiration, motivation and support from the nurse manager and the management in all the ways. So as a nurse manager in a unit, the change I wish to initiate is the safe staffing patterns. Safe staffing patterns are always important for safe working environments to deliver excellent patient care. Staffing and scheduling means providing an adequate staff mix to meet the needs of the patients (Grohar-Murray & Langan, 2011). Nurse manager should know how to schedule and skill mix to provide adequate

One of the greatest challenges in healthcare, as well as the biggest threat to patient safety, is staffing and the nurse to patient ratio on hospital floors. Studies have shown that low staffing levels lead to increased mortality rates in patients, as well as multiple other adverse effects including falls and pressure ulcers. These adverse effects are all preventable, but policies on staffing must be in place to ensure safety for staff and patients.