Unsafe Staffing
Introduction
Unsafe staffing has detrimental effects on everyone it touches; patients, nurses, and hospitals. What is unsafe staffing? According to the Massachusetts Nurses Association (2017), “An unsafe assignment is anything that you, the assigned RN, judge to be unsafe. It is your license”. It is important to know the issues that face us in regards to this so that we can work to create a better healthcare environment for all of us. There are many changes that can be made; and plans for action that can work for any institution.
Definition of Frameworks
According to Kearney-Nunnery (2016), “A conceptual model is defined as a set of relatively abstract and general concepts that addresses the phenomena of central interest
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To provide nursing care that encompasses the “Whole Person”, we need to attend to all the patient’s needs; physiological, psychological, sociocultural, developmental, and spiritual.
Effects on Patients and Nurses
As nurses, our main goal is to provide the best possible care we can to our patients. According to Nightingale (1859), “No man, not even a doctor, ever gives any other definition of what a nurse should be than this -- 'devoted and obedient. '” In order to be devoted to our patients in the manner Florence has stated, we need to have the adequate time in which to do so. Higher patient ratios overall equal less personalized nursing care for the patients. When nurses have less time to spend with their patients, things can get missed that otherwise would not. According to Silber, et. al (2016), “There is a 20% lower risk that a patient will die within 30 days of having general surgery at a hospital with above average nurse staffing levels, defined in this study as facilities that had a mean ratio of about 1.5 nurses per bed vs. those with a mean of less than one nurse per bed.” Overall, this goes to show that appropriate nurse to patient ratios ultimately leads to more positive outcomes for our patients.
Nurses are also adversely affected by unsafe staffing in many ways. Nurses go to school for many
Julia, a registered nurse, has been run down all week making medication errors and recently one of her patient’s fell out of bed. Julia has eight patients assigned to her due to staffing shortage since the hospital decided to stop using LPNs. Julia is very overwhelmed and is unable to safely take care of her patients. Julia was required to report to her manager’s office the next morning due to her patient neglect and fall. The manager informed Julia the high nurse to patient ratio is not a problem as other floors and nurses are doing fine with it. Recently, I have seen this occur with in my own facility I work for. As of right now it is staffed with fifty percent locums or travel nurses, which leads to increased
Primarily, it is crucial for health care organizations to focus on ensuring safe and quality patient care, as well as improved job satisfaction by enforcing an optimal and adequate nurse-to-patient ratio and creating innovative and long-term strategies through a collaborative effort. In order to ensure the safety of patients and nurses, state-mandated safe-staffing ratios are necessary. Adequate nurse staffing is key to patient care and nurse retention, while inadequate staffing puts patients at risk and drives nurses from their profession. As baby boomers age and the demand for health care services grows, staffing problems will only intensify. Consequently, safe-staffing ratios have become such an ever-pressing concern. In 2004, California became the first state to implement minimum nurse-to-patient staffing ratios, designed to improve patient care and nurse retention. Subsequent studies show that California’s program measurably improved patient care and nurse retention.
Human caring is what sets nursing apart from other professions. As Watson (1998) stated, “care and love are the most universal, the most tremendous and the most mysterious of cosmic forces: they comprise the primal universal psychic energy. Caring is the essence of nursing and the most central and unifying focus for nursing practice” (p. 32-33). It is important to establish a good nurse-patient relationship in order to create a healing environment that would meet patient’s needs on all levels including physical, mental/emotional and spiritual, promote recovery, maintain health, and create positive outcomes. Jean Watson emphasized the importance of human
In any practice of care, nurses must be able to provide care that is holistic and centred to the individual client. According to the World Health Organisation (WHO), to care for a patient ‘holistically’ is to look beyond their illness or disability and care for them as individuals considering not just physical but also their mental, emotional and spiritual well-being (ref). Whilst, person-centred care is to deliver care moulded to the patients’ personal preferences, treating them with value and respect, ensuring that the care provided is appropriate for their needs (Goodrich and Cornwall, 2008).
One can wonder if there is any correlation between patient-nurse ratio and it’s effect on patient safety. In the research conducted by Jack Needleman and his associates (2002), they examined the relationship between amount of care provided by the nurse and compared it to patient outcome. The result showed that the increase amount of time a nurse is able to spend with the patient better the quality of care is. The data for this research was collected from seven hundred and ninety-nine hospitals across eleven states. This covered both medical and surgical patients that were discharged and the data was evaluated the relationship between the time provide to the patients by the nurses and patients’ outcome. As research showed,
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
Mandatory nurse-patient ratios have been a controversial topic facing nurses for decades. Nurses, patients, physicians, nursing organizations, researchers, hospitals, federal government, and state governments have opposing views in regard to mandatory nurse-patient ratios. Those that support the idea of mandatory nurse-patient ratios believe that there would be an improvement in quality of patient care, decreased nursing shortages, increased job satisfaction, decreased client hospitalization, and increased nurse recruitment (Pamela Tevington, 2012). Groups that oppose mandatory nurse-patient ratios believe that mandatory staffing laws ignore factors such as the level of care a patient requires from a nurse, treatments, length of hospitalization, improvements and differences in technology, the expense of an increased nursing staff, and nurse experience and education (Tevington, 2012).
Purpose: The purpose of this speech is to inform my audience about the importance of safe nurse staffing that can help improve patient satisfaction, decrease patient complications, reduce nurse fatigue, improve nurse retention, decrease patient mortality, and reduce medical and medication error.
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.
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
Mandating safe staffing levels for registered nurses in acute care settings has been an important topic of discussion for many years. As the demand for registered nurses continues to rise, so does the clinical demands on the nurses currently working. If there are no specific policies in place that mandate safe and appropriate nurse-to-patient ratios for all acute care facilities, registered nurses (RNs) may be required to take on even more patients than the already high numbers currently given to many of them. Inadequate RN staffing has the potential to cause increases in adverse patient events (American Nurses Association (ANA), The registered nurse safe staffing act, 2015) as well as an increase in nurse injury (Musick, Trotto, & Morrison,
Every academic discipline in any profession is governed by its rules and policies developed and prone to amendment from time to time after viewing or arises of an issue. Nursing as a profession practice and an academic discipline is however not an exemption to this (Lasater et al., 2015). The nursing practice has different policies governing the procedures, and that promotes health and wellbeing of the patients as well as creating a conducive environment for nurses and the people they interact with in delivery of their services such as medical therapists, technicians, among others (Blegen et al., 2007). These policies ensure that there is a smooth running of the activities for the nurses as well as the patients. There exists a broad array of policies, but in this paper, the registered nurse safe staffing Act system will be looked into particularly in Florida.
Nursing goes beyond caring for a patient during their illness and managing their disease process. Nursing includes adapting to a patient’s and their family’s physical, social, spiritual, environmental and psychological needs. I believe in treating the whole patient and being supportive of the family’s needs as well. Shelly & Miller (2006) asserts “while critical thinking, decision-making, and leadership skills are extremely important, the characteristics nurses need most are compassion, competence, faith, integrity and responsibility” (p. 291).
The study that was done shows that there is a significant inverse relationship between nurse staffing and the number of patients who sustain falls or pressure ulcers while hospitalized. The findings have proven that the more nursing staff on during a shift, the less falls and pressure ulcers occurred (He, Staggs, Bergquist-Beringer, & Dunton, 2016).
According to L.H. Aiken et al., there is strong evidence that supports a connection between better nurse staffing and better patient outcomes. Scientists argue that a higher amount of nurses on staff allows for a lower rate of overall patient mortality. The reasoning behind this point is the fact that higher nurse rates correlate with “better nurse care environments.” Patient to nurse ratio, highly educated nurses, and increased nurses on staff during a single period of time effects the environment that allows for proper patient care. If there are too many patients assigned to a single nurse it will lead to increased patient complications (medical care/ medication errors, mortality rates, etc.) increased nurse fatigue, and decreased nurse retention/job satisfaction. Scientists argue that these issues must be looked at immediately because there are “numbers of lives that would be saved through improved care environments.” Scientists also argue that the way to improve care environment is by having hospitals become “magnet