Nursing Staffing Hours Influence On Nursing

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.

Neither staff member identified the downward trending of the patients available vital signs and did not evaluate consciousness of the patient. Failure to assess appropriately and recognize deterioration of the patient resulted in a prolonged period of time in which the patient was not adequately oxygenated. Research has shown that short staffing, with decreased nurse to patient ratio, has been found to be associated with increased mortality (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; Joint Commission on Accreditation of Healthcare Organizations, 2005; Needleman, Buerhaus, PKankratz, Leibson, Stevens, & Harris, 2011). This reinforces the need to match staffing with patient census, acuity, and need for nursing care.

Durning, (2010) tells how nurses are limited in giving quality care due to the number of patients they have on their shift. It also explains the huge difference in the task of caring for a post-partum mother and a patient recovering from a major trauma surgery. When nurses are too busy because they have too many patients to care for, they are more likely to overlook an important change in their patient. This will cause the patient to deteriorate unnecessarily and could potentially result in death (Durning 2010). “Nurses are the main surveillance system in hospitals” (Queensland Nurse, 2010, p.14). If they have too many patients to look after, something is more likely to be missed. There was a study done last year by Nursing Times, that showed the more nurses a hospital had per bed, resulted in fewer patient deaths, and actually lowered the patient’s length of stay (Queensland Nurse, 2010). The state of Victoria in Australia, like California actually has government mandated nurse-to-patient ratios. Since its implementation of the ratios 10 years ago, Victoria’s health system has been made considerably better. There is a safer environment for the patients, the workplace morale is better, and there are less complaints from the public about the quality of care they receive while hospitalized (Holmes, 2010).

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.

As a result, overtime can compromise patients ' health or safety. Medical residents cited fatigue as a cause for their serious mistakes in four out of 10 cases (Boodman 2001), and two studies linked infection outbreaks at hospitals to overtime work (Arnow et al. 1982; and Russell et al. 1983). Indeed, the California Nurses Association reports that more nurses are refusing to work in hospitals with unsafe conditions, in which they include being forced to work unplanned overtime. The American Nurses Association (ANA), in a national survey of 7,300 of its members, found, disturbingly, that 56% of nurses believe that the time they have available for care for each patient has decreased, and 75% feel that the quality of patient care at their own facility has decreased in the last two years. The cited inadequate staffing as the chief reason.

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.

Nurse-Patient staffing ratios have created debate among health care professionals for years. Who determines where, when and how many patients a nurse can handle on any given shift? Who determines the acuity of the patients handled by the nurse? Does the floor nurse have a say in what she or he can feasibly handle during their shift? At what point does patient care begin to suffer? These questions and many others have led to federal and state legislation coming to light to better serve the care of a patient. “The varied agendas and the inability of nurses, hospital administrators, and financial experts to communicate toward a single purpose, as well as the complexity of meeting staffing needs, have moved the issue into the political arena (Hertel, 2012, p. 1)”. Several states have already instituted mandatory nurse-patient ratios. While you can debate for or against political involvement, I will look at many factors regarding care and safety of patients.

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

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

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.

As a result of nursing shortage hospital staff nurses are working longer hours with few breaks (Chen et al., 2011). In one quantitative study by Scott, Rogers, Hwang, & Zhang (2006) they randomly selected 1148 critical care nurses and sent them a demographical questionnaire to fill and return related to medical errors and the hours they worked. The objective of this article was to describe the work patterns of critical care nurses, determine if there was a relationship between the occurrence of errors and the hours worked by the nurses, and explore whether these work hours had adverse effects on nurses’ vigilance. The 502 respondents consistently worked longer than scheduled and for extended periods. Longer work duration increased the risk errors and near risk errors and decreased nurses’ vigilance. The findings supported the Institute of Medicine recommendations to minimize the use of 12 hour shifts and to limit nurses’ work hours to no more than 12 consecutive hours during a 24 hour period

Research has shown a nursing environment lacking adequate resources, such as strong nurse leadership, and a solid nursing foundation for quality of care also appears to negatively affect both nurses and patients (Cho,2015). Moreover, a nurses close observation which involves ongoing vigilance, assessment, recognition and interpretation of patient data, is a critical component of nursing care that improves patient outcomes (Cho, 2015). A direct relationship existed between not having adequate nursing staff with decreased patient outcomes/mortality because of the inability of nurses to provide the detailed vigilance each patient needs therefore placing the patient at risk, and decreasing deserved safety.

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.

There are many different variations of healthcare professionals that assist people in regaining and maintaining a healthy lifestyle. The career field of licensed nursing is often considered to be one of the most vital professions within the medical community. Registered nurses work to prevent and heal various different types of injuries, diseases, and illnesses. They are also responsible for administering a variety of patient services, consisting of individual patient care, analyzing and monitoring patient medical reports, and also possessing the ability to operate technical medical equipment. As well as, be able provide comfort and emotional support for both physically, and mentally ill patients. All Registered Nurses are responsible for providing patients with quality health care, in compliance with professional standards set forth by the American Nurses Association. As the field continues to rapidly evolve, an increase in responsibility is placed upon registered nurses to maintain a professional standard of care. With the increase in responsibility, the role of registered nurses consistently changes to accommodate individual patient needs. As a result, the rise in responsibility placed on registered nurses correlates to a higher probability of malpractice and negligence occurring within the community. The consequences of malpractice and negligence can