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STAFFING effects on nursing care
STAFFING effects on nursing care
STAFFING effects on nursing care
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Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. 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. However, that value doesn’t always coincide with the employer. Instead it is about the e... ... middle of paper ... ...ort to Congress. (2001). Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes. http://www.allhealth.org/briefingmaterials/Abt-NurseStaffingRatios. Gregory, L., A. An Analysis of Nursing Home Quality Measures and Staffing. (2010, Dec. 21). Web. Retrieved from http://www.ncbi.nlm.gov/pmc/articles/PMC3006165/. Nelson, A., Powell-Cope, G., Palacios, P., Luther, L. S., Black, T., Hillman, T., Christiansen, B., . . . . Nathenson, P., (2007). Web. Rehabilitation Nursing. Nurse Staffing and Patient Outcomes in Inpatient and Rehabilitation Settings. Rehabilitation Nursing, Vol. 32, 179-200. Vahey, C. D., Aiken, H. L., Sloane, M. D., Clarke, P. S., and Vargas, D. (2010 Jan. 15). Web. US National Library Of Medicine National Institutes of Health. Nurse Burnout and Patient Satisfaction. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904602/
Harvey, P. D., Moriarty, P. J., Friedman, J. I., White, L., Parrella, M., Mohs, R. C., & Davis, K.
Rizzo, A. S., Difede, J., Rothbaum, B. O., Reger, G., Spitalnick, J., Cukor, J., & McLay, R.
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
...ck, T., Anen, T., & Soto, E. M. (2013). Nurse staffing: The illinois experience. Retrieved from http://www.medscape.com/viewarticle/815065_3
Reid, M., Bennett, D., Chen, W., Eldadah, B., Farrar, J., Ferrell, B., & ... Zacharoff, K. (2011).
McConaughy, S. H., Volpe, R. J., Antshel, K. M., Gordon, M., & Eiraldi, R. B. (2011).
Khenzi, N., Hutton, D. N., Garber, A. M., Hupert, N., & Owens, D. K. (2009).
There are three main types of staffing models that are used; budged based, nurse-patient ratio, and patient acuity. According to research there is no perfect staffing model,
The nursing profession is becoming very challenging to nurses nationwide, when the health care system is constantly changing. The nursing staffing issue is becoming an increasing global issue in hospitals and long term care facilities. Patient acuity in the hospital is growing rapidly, the patient acuity determines the level of care a patient needs, the higher the acuity, the more care is needed or required. The higher acuity results in high demand for nursing care which then resulted in increased workload, burnout and job dissatisfaction. There is an alarming concern of nurse shortage and retention in our hospitals nationwide which could seriously affect overall patient outcome.
It is imperative to discuss with nurses how they perceive staffing and how it relates to patient safety, quality of care, and if there are certain cares left undone due to staffing concerns. This article was chosen because nurse staffing is a massive issue in any nursing practice. The patient’s and other staff feel the devastation when the patient to nurse ratios are not precise. Working overtime produces exhausted nurses that cannot perform at their ideal productivity level. This results in poor patient outcomes, frustrated colleagues, and subpar work.
Kobau, R., Zack, M. M., Manderscheid, R., Palpant, R. G., Morales, D. S., Luncheon, C., et al.
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). From the results of these longitudinal studies, it has been found that there is still some shortcomings with staffing systems based solely on nurse-patient ratios. Therefore, even though the ratios staffing system accounts for appropriate patient care, it does not take into consideration different patient complexities and needs for nursing care (10). Staffing by acuity is the third and final staffing system that is considered when looking at nurse burnout and job
It is important to have a strong nurse-to-patient relationship to ensure adequate care is provided. However, when nurses are short staffed this does not occur the way it should because the nurses are now having to take care of more patients. This means that the one-on-one time with each individual patient is cut short and nurses are now becoming overworked which affects their overall performance as well. Ensuring proper staffing levels have been shown to; reduce errors, decrease complications when providing patient care, lower death rates, improve patient satisfaction, reduce nurse fatigue, improve nurse retention and job satisfaction. (2015, American Nurses Association) Optimal staffing is essential in order to provide optimal patient care. Innovative and collaborative strategies that focus on developing long-term solutions will improve
The California Department of Health set a criterion that was unit specific, and provided mandated ratios for each unit. Some examples include that an ICU nurse should have a nurse-patient ratio of 2:1, Psychiatry 6:1, Telemetry 5:1 and Medical-surgical units 5:1. According to the research study “Implications of the California Nurse Staffing Mandate for Other States” by Aiken, L, “29 percent of nurses in California experienced high burnout, compared with 34 percent of nurses in New Jersey and 36 percent of nurses in Pennsylvania, states without minimum staffing ratios during the period of research. The study also found that 20 percent of nurses in California reported dissatisfaction with their jobs, compared with 26 percent and 29 percent in New Jersey and Pennsylvania” (2010) Aiken found that about 74% of California staff nurses thought the quality of care of their patients have improved significantly as a result of the mandated staffing
Nurses are one of the most valuable resources in any healthcare organization (Longest, Rakich, & Darr, 2006). Nurses play an important role as members of the multidisciplinary healthcare teams. Nurses help organizations to achieve its mission and vision and meet its goals and objectives. Nursing care is vital to the provision of the healthcare delivery system in promoting health and wellness, preventing illness, restoring health, caring for disabled, and helping dying patients and their families (Catalano, 2006). The promotion of quality of nursing care and the safety of nursing practice takes place through nursing education and ensuring clinical practices meet evidence-based practice, accreditation, and certification requirements (Ironside,