Increase Pay - Pulling Comps From Hospitals And Other Healthcare Organizations

Recruiting new employees is one of the biggest challenges health care organizations face today. The total population of RN's available for staffing is rising at the slowest pace of the last 20 years (Keller, Siela, Twibell, 2009). Healthcare facilities across the nation are struggling to meet the staffing requirements to stay afloat and provide adequate care to patients. The question in front of many organizations is how to stand out in a competitive workforce and recruit top hires.

With a shortage of nurses, the care and safety of patients may become compromised. The nurses themselves may be having feelings of dissatisfaction, overwhelm and distress. Nurses who may become overwhelmed with the high number of patients may become frustrated and burnt out. And inadequate staff of nurses may lead to a negative impact on the patient’s outcome. The quality of care the patients may receive in facilities with low staffing may be poor.

In a different review of literature on staffing and patient outcomes, Heinz (2004) describes the relationships between staffing and mortality, length of stay, and complications of patients. At first the article paints a clear picture of the future of nursing as it starts to feel the shortage which is approaching due to aging of present nurses, lowered nursing school admissions, and other hospital issues including financial hardships. In looking at the impact of ratios on mortality there were five different studies identified that showed that the lower the ratio, the lower the risk of mortality of patients. A patient's length of stay was also influenced negatively with higher nurse-to-patient ratios and positively with specialized units and care from nurses. The impact of staffing on patient complications also showed that there was an inverse relationship between the two. Heinz concludes that the key to solving these problems in nursing and reducing negative patient outcomes is nursing recruitment and retention (Heinz, 2004).

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.

Nurse managers should consider patient needs, level of education, expertise and work satisfaction before dictating the number of nurses-to-patient ration (Murray, 2017). Reported by Martin (2015), the risk of mortality can be decreased by 50%. Starting with the nurses, a large amount of workload can bring fatigue, inadequate sleep, employment and increase in calls-out which leaves nurse managers to make changes to assignments. This takes times out of the resource nurse shift to focus on redistributing patient, in turn, causes a delay in starting their plan of care. As an aide, there have been times at Meritus where a nurse calls out and the resource nurse at least spends an hour with the outgoing nurse communicating with the staffing office to ask for a float pool nurse. On the other hand, outcomes such as “pneumonia, shock, cardiac arrest, and urinary tract infections are directly related to low nurse staffing” (Martin, 2015). On the stroke medical-surgical unit, sometimes there is one aide for 28 patients. Some of these patients need turning every two hours, incontinent or bedrest, but it is difficult to attend to all of them on an hourly rounding base and provide adequate care to each of them. At one point, a new graduate nurse was given seven patients to care for. According to Meritus nurse residency program, new grads can have up to six patients on a medical-surgical floor. One can only imagine how overwhelming that can be for a new nurse. To help prevent these poor outcomes from occurring, strategies to improve nurse staffing can be utilized by

An identified area in which healthcare managers are failing consistent effectiveness is in the retention of their nursing staff. With the need of nurses shaping the way many healthcare managers look at their staff, often it is the veteran nurse persuaded in staying. While in some settings this is truly beneficial, in others the cliché of nurses eating their young instills fear into new graduates; this fear and the lack of support ultimately leads to their exit (Rush, Adamack, Gordon, & Janke, 2014). With the associated costs of nursing attrition meeting rates of nearly $186,000 per registered nurse, it is imperative we institute nursing residency programs immediately and continually retaining staff and protecting healthcare institutions’ sustainability (Cubit, K.A. & Ryan, B., 2011; Lee, Tzeng, Lin, & Yeh, 2009).

Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.

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.

Nurses play a critical role in the healthcare sector. From helping patients with basic hygiene tasks to assisting theatre rooms, nurses are trained and educated to help patients to the best of their ability. The author has noted currently there is an optimal setting for nurse practitioners not only to be responsible for inpatient healthcare team but also be accountable to improve their outcomes which discussed by Kapu, Klienpell and Pilon (2014). Furthermore, the author has noted with such kind of responsibility put it will translate to increase in nurse education and training so that they can adequately perform in the inpatient setting and in a smooth way transition away from their norm predominantly in primary care. Having a policy in place that not only checks the health of the patients but also gauges the performance of the nurses will ensure there is a higher standard set by the healthcare system nurses will have to prove what they worked.

How many patients can a nurse effectively care for at the same time? The complexity of that question has caused it to be quite difficult to answer. In the hospital setting today, managers are found being forced to create guidelines for staffing based on numbers instead of needs. These new staffing models are established based on nurse to patient ratios. Therefore, patient census is the primary determining element for justification of available health care providers per shift (Artz, 2005). Acuity of patients and experience of providers are no longer factors that are being considered, and these nurse to patient ratios do not always provide a safe environment. Research has shown that these ineffective nurse to patient ratios are contributing to inadequate patient care (Sochalski, 2004). A new approach for nursing staffing needs to be put enacted for the furtherance of quality of care, patient safety, nurse satisfaction and the overall healthcare environment.

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

Healthcare institutions need to make their place of work attractive to nurses. There will continue to be a shortage of nurses and the success of the healthcare facility depend upon the ability to have the right amount of nurses working at the facility. In order to make the business attractive the facility must offer benefits such as healthcare, insurance, and tuition reimbursement.

Constantly being understaffed in a medical environment, where patients lives are at risk, adds stress on the nurses and it is wrong. “Nurses often need to work long hours under stressful conditions, which can result in fatigue, injury, and job dissatisfaction. Nurses suffering in these environments are more prone to making mistakes and medical errors.” ("Nursing Faculty Shortage.”) If the supply increases than the environment of working in hospitals will be sure to improve. Less mistakes, and medical errors will diminish as well. “Dozens of studies have found that the more patients’ assigned to a nurse, the higher the patients risk of death, infections, complications, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. “ (Robbins, Alexandra.) The health care system must change their ways, and hire more nurses to improve patients’ safety. If the supply increases than the environment of working in hospitals will be sure to improve. Increasing the supply of nurses will make the patient to nurse ratio reduce the potential risk of malpractice. Additionally, it would yield less over-worked nurses, which would provide nurses with increased energy, which would make it much easier to tend to patient care.

The nursing shortage can have an enormous impact in the healthcare system. If we continue to see a decline in nurses, the healthcare system could potentially crumble. Nurses are the majority of the hospital and clinical settings and help take care of the ill patients. According to Kovner, Brewer, Fatehi, and Jun (2014), there is a poor working environment seen there are companies with an increased turnover rate. The challenges are the decreased ability to hire enough nursing staff to keep up with the demand of patients. Some of the problems are due to the fact that many of the RN’s today are reaching retirement age, the lack of faculty, and the

The ability of nurses to provide a high level of care to each individual patient will cause a decrease in inpatient complications and a decrease in rates of inpatient mortality (Needleman, Buerhaus, Pankratz, Leibson, Stevens & Harris, 2011).