(2002) Coping with occupational stress in healthcare: a comparison of social workers and nurses. Admin Social Work. ; 26(3):37–52. Halm, M. (2005) Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction. Clin Nurse Spec.
However, there is a nursing shortage globally that is expected to increase as nurses from the baby boom era are set to retire. This is where human resource management and organizational culture come into play. There have been prior studies that have linked organizational culture to the decrease in nurse turnover rate and the increase of nurse retention. It is important that there is an adequate nursing workforce supply in order to achieve quality patient care. Nurse managers play a pivotal role in the organizational culture with in their unit of division.
“...the vast majority of employers (88%) are looking for a “cultural fit” over skills in their next hire as more and more companies focus on attrition rates” (Forbes, 10/04/2012) While important, this certainly does not supercede the ability to have excellent practical nursing skills. With that in mind, these essential nursing skills should be present in any student that has attended a state board approved program and has passed the NCLEX. Having students leaving a nursing program with other valued team and critical thinking skills will ultimately make for better nurses in the healthcare field. For nursing education to produce qualified nurses equipped and ready to enter a real healthcare working environment there needs to be a focus on preparing nurses to maintain high levels of satisfaction in their jobs. “Job satisfaction among nurses has long been recognized as a critical indicator of their performance and quality of patient care (as cited in Zurmehly, 2008, para.
Researchers anticipate that by 2010, the United States will need almost one million more registered nurses than will be available (Cherry & Jacob, 2005, p. 30). The term “nursing shortage” is not new to America. In fact, the United States has past experiences with such shortages. It is important to recognize past nursing shortages because the events will assist researchers in examining the sources and strategies used to overcome the nursing deficit and facilitate a solution to the current crisis. During World War I and World War II, America called upon thousands of women to become nurses for their country to help in hospitals and overseas units.
Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction? In nursing school, nurses are taught to apply the nursing process to administer care safely and effectively.
The number of patients assigned per nurse has been directly linked to nurse job satisfaction and patient outcomes; with a ratio of four patients to one nurse being the ideal ratio (7). Research has shown that the addition of just one patient per nurse has been associated with a higher risk of death for patients and an increase in nurse job dissatisfaction and burnout (2). This is significant because nurses wish to provide the best quality of care for patients and with increased patient to nurse ratios, nurses are unable to maintain their ideal quality of care; which leads to job dissatisfaction and nurse burnout. Originally, after the passage of the California nurse staffing act, which set mandated nurse-patient rations, overall job satisfaction appeared to increase (1). However, several longitudinal studies have suggested that direct care nurses are still dissatisfied despite increased nurse to patient ratios (1).
Studies indicate that the higher the nurse-patient ratio, the worse the outcome will be. Nurse Manager’s need to be aware of the adverse reactions that can occur from nurses working overtime and limits should be established (Ford, 2013). Working Understaffed Nurses have a responsibility and duty to provide safe and effective care to every patient. In order for the nurse to cover themselves while working understaffed, they must report their concerns to the supervisor. In addition, the nurse should document and complete the appropriate form regarding safety concerns.
The primary focus in health care is to improve patients’ health status and quality of life. Many times nurses assist in treating or managing all the apparent medical conditions of the patients, but they fail to tackle the underlying causes of the disease due to inadequate patient-nurse communication. Continuing with this idea, Patak et al. (2009) proposed a call to action for nursing administrators to position patient-provider communication as a patient safety-care quality priority within the healthcare organization and incorporate bedside practices that achieve effective patient communication, especially with those most vulnerable to impair communication. Effective patient-provider communication is an essential component of patient care, and for communication to be effective the information must be completed, accurate, timely, unambiguous, and understood by the patient (Patak et al., 2009).
Introduction: Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover than any other specialty with a rate of 16.8%.
An English Nurse who laid the foundation for professional nursing, Florence Nightingale stated, “It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm.” Acute care facilities try to maintain low costs and employ quality nurses, making the nurse-to-patient ratio become more of an issue with patient care. Nearly every person’s health care experience involves the contribution of a registered nurse, and the effects of not having an appropriate nurse to patient minimum ratio affects not only the patient and nurse physically, medically, but also the hospital financially. Determining nurse-to-patient ratios is a difficult task with no single or definite solution and many variables exist to develop guidelines to cover every possible situation in an acute care facility. There are two boards of the state of Ohio that help with patient safety and keeping a safe workplace for the healthcare professional such a nurse. The first board is the Ohio board of Nursing, and the following is their description of what they are responsible for: The Board exists solely to enforce the law and rules regulating practice.