“You need me on that wall” In an excellent movie from 1992 entitled “A Few Good Men” U.S. Navy Colonel Nathan Jessup (played by Jack Nicholson) tells U.S. Navy Lt. Lawyer Daniel Kaffee (played by Tom Cruise) 3 lines in the dramatic conclusion of a court trial involving a murder of a U.S. Marine. These 3 phrases could be used by nurse managers across the country when they are caught between representing their front line nursing staff and trying to appease upper management personnel during hospital budget discussions. The 3 lines are: “You need me on that wall, you can’t handle the truth, and YES I ordered the CODE RED”. If you have seen the movie you might agree with the analogy. If you have not seen the movie, but are a nurse, more …show more content…
In an article published by Applied Nursing Research the authors point out that nurse staffing is related to patient outcomes, “lower levels of RN staffing are associated with higher rates of OPSN (Outcomes Potentially Sensitive to Nursing) in both medical and surgical patients treated in hospitals, U.S. Medicare, and other publically available administrative data” (Duffield et al., 2011, p. 245). The writer of this paper researched 5 relevant articles regarding the relationship between nurse to patient ratio, morbidity, and mortality, every article related similar information. “A systematic review of 102 studies concluded that increased RN staffing levels are associated with lower rates of morbidity and mortality” (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2013, p. 2).
As one might predict from the articles reviewed not one eluded that the bedside nurse disagreed with an improved RN to patient ratio. At this point you may be reading this saying; so hospitals need more nurses, why don’t they hire them. The answer is hospitals do, but because of the growing number of patients in the hospitals, nurse burnout, and nurses moving from one department to another or quitting all together, there is a nursing shortage. The problem becomes how hospitals can retain nurses when there are so many opportunities elsewhere. The upper nursing management, often known as the VP of nursing, collaborate with the accountants and CEO’s of the hospitals and have pressure to save money
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.
Stanton, M. R. (2004, March). Hospital Nurse Staffing and Quality of Care. Research in Action. Rockville, MD, USA: Agency for Healthcare Research and Quality.
The literature review studies discuss the recurrent issue of higher and lower staffing ratios and how they affect patient outcomes. The studies show how several factors affect the nursing workload and the adverse results of the patients. The information is investigated under several methods that range from level one to a level five on the pyramid. The extensive research studies provide the support and the evidence on the issue needing change.
with a 4% decrease in the risk of patient death”. Study concluded that staffing nurses from
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,
This nurse is interested in the affects administrative decisions surrounding nurse staffing in regards to patient outcomes and nurses work satisfaction. This nurse began her research with a question in mind; “How do RN to patient ratios affect patient outcomes?” The search returned greater than 2000 articles related to Nurse Staffing and patient outcomes. Although, many of the abstracts supported the relevance of the topic the amount of material was excessive and the subject too broad. In an effort to create a list that would be more manageable, this nurse concluded her topic needed to be refined and constructed a much more concise and limited search until finally she constructed a PICOT question which yielded less results within a limited topic.
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).
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.
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
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.
Purpose of a literature matrix grid help organize the data extracted from research studies for examination. Rationale for choosing the five articles noted within the literature matrix grid (see Table 3) was for their relevancy to the PICO. All five research articles were published within the last 10 years and spoke specifically to staffing, missed cares, and critical access hospitals. Search quality included only the data based mentioned in Table 1. The most attractive research article I found is the one entered into the literature matrix grid in Table 3.
Martin’s journals stated that adequate staffing levels have been shown to reduce mortality rate by more than fifty percent. Staffing levels in nursing care are attributed to poor quality of care, more adverse reactions and leads to higher rates of job dissatisfaction and burn out rates. Inadequate staffing make it harder for the nurse to ethically abide by their requirements of providing patients with nonmaleficence and beneficence. There is an umbrella of people that are affected in different ways due to the understaffing. Patients and their loved ones are affected due to less quality of care as there is less amount of time allotted for everyone, with research showing that an increase in different medical emergencies such as Shock, Cardiac arrest, and Urinary tract infection are
I love working in critical care and they can only push the ICU nurses so far, but the medical floors are at their max and they continue to push. Floor nursing has gone from 6 to 1, to 7 sometimes 8 to 1 nurse/patient ratio. The nurse tech ratio has also increased which means less help for everyone. I hope and pray things change for this once wonderful hospital. With profit hospitals, I feel it’s all about the money. I read an interesting article on the problems we face with nurse staffing issues and hospital operations. For us to do our job properly and take care our patients the nurse to patient ratio and the lack of staff needs to change for many hospitals. If you adequately staff a floor and purchase proper equipment and show you care, I guarantee that certain hospitals would not lose staff every day to poor working environments. The ones that suffer the most due to these cut corners are our
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