For a long time now, nurses have been fighting against inadequate staffing and the outcomes that such issues have on them and the patients under their care. Additionally, the ever ballooning needs of the health care system have resulted in the number of patients requiring care going above the available healthcare personnel (Aiken, et al., 2014). As such, the available nurses presently working in the country, both at the state and the federal level are overwhelmed by the responsibilities bestowed on them. From the foregoing, therefore, it is evident that finding the optimal level of the nurse-to-patient ratio has been a problem and has transformed into an issue of national concern. As such, from the foregoing, there is the need for having strategies in place to address this problem once and for all.
It is crucial to take into consideration the fact that a poor nurse to patient ratio has got undesirable outcomes both on the patient and the care provider. By nurses being involved in longer working hours, the risks of them developing musculoskeletal disorders, cardiovascular diseases, depression and hypertension increase significantly. The resulting effect is that nurses end up missing important work days thereby worsening the conditions at the hospitals they work for. Secondly, by nurses working longer hours than recommended, they increase the risk of burnout (Aiken, et al., 2014). Incidences of fatigue, headaches, easy irritability, back pains, depression and weight gain are possible outcomes of nurses working longer hours. The result from this condition is that many of them end up leaving the bedside; a situation that results in undesirable patient outcomes like rising mortality rates and readmission cases. Thirdly, by nurses overworking, the chances of emotional exhaustion are also high. A result of such an outcome is that the possibilities of nurses making mistakes in their care provision process are high (Cimiotti, et al., 2012). Such mistakes have got profound effects on the health of the patients that they are currently taking care of. Generally, with increasing levels of workload to nurse, the profession becomes unattractive to the current care provider a situation that results in lowered levels of job satisfaction. Consequently, the levels of nurse turnover significantly increase over time, thereby creating more shortages to the already deteriorated condition. On the contrary, with the correct staffing ratios being adhered to, there have been positive outcomes associated with it. With ratios like 1:6 for medical surgical units, 1:4 for intermediate care units and non-critical emergency rooms, 1:2 for trauma patients and 1:1 for patients who are currently anesthesia, there have been reported positive outcomes for this condition (Cimiotti, et al., 2012). The levels of medication and medical errors have considerably dropped, patient complications have also slumped by a great margin, mortality rates from have also been adequately addressed. Moreover, reduced cases of nurse burnout, nurse fatigue, improved satisfaction levels both to the patient and the nurse have also been reported.
The purpose of this paper is to identify the current inadequacies as far as the nurse to patient ratio is concerned and the proposals that have been put in place to address the problem.
Knudson, L. (2013). Nurse staffing levels linked to patient outcomes, nurse retention. AORN Journal, 97(1), C1.
The key concepts being studied in this article are mainly concerned with the levels of nurse staffing and the effects that it has both nurses and patient satisfaction. Increasing the number of patients for every nurse amplifies the possibilities of the patient dying by 7%. Additionally, the levels of nurse burnout have also increased by having nurses work for longer hours. Such realizations usually lead to increasing turnover rates (Knudson, 2013). By hospitals increasing legislations such as mandatory overtime for nursing professionals, it has been established the levels of medical errors have been on the increase. From the foregoing, many states have been on the forefront in enacting laws that address the problem of the nurse to patient ratios. The recommendations from this study suggest that the ratios are supposed to be 1:1 for operating rooms, 1:2 for emergency rooms or critical care conditions, 1:3 for pediatric and antepartum care, 1:4 fro surgical and acute care units and 1:5 for rehabilitation units. It is, however, important to note that increasing staffing levels in the hospital do not have any relationships with their profitability (Knudson, 2013). Therefore, to satisfactorily address these issues, there is the need for developing nursing committees whose mandate will be to come up with staffing policies that are patient-centered, include qualitative factors in the care delivery process, train nurses on for them to suit particular job descriptions and also empower nurses to prevent cases of high turnover rates.
White, K. M. (2006). Policy spotlight: staffing plans and ratios: What’s the latest US perspective?. Nursing management, 37(4), 18-22.
There are genuine concerns relating to the staff ratios and the mechanisms that hospitals will put in place to ensure that these ratios have been adhered to. Several bills have been passed in the senate with the intentions of ensuring that hospitals are operating with a specific number of nurses who guarantee safe patient care, provide protection on nurses who act as whistleblowers and specify penalties on for hospitals that do not adhere to evaluation policies. There is the need for hospitals to post their nurse-to-patient ratios in order to increase the awareness of the public about the levels of care in theses hospitals (White, 2006). Additionally, to ensure that patient safety is adhered to, hospitals will be required to enforce the required minimum nurse-to-patient ratios in different states, a situation that will act as a basis for licensure. The services that ancillary care providers give in patient care are important and as such, there is the need to uphold such care providers like LPNs in hospitals. To ensure that hospitals comply with the required staffing levels, there is the need for hospitals to produce core staffing plans that specify the number of nurses and ancillary staff with the intentions of reducing nurse workload. Moreover, hospitals are prohibited from having mandatory overtime for nurses to reduce burnout incidences. There is no evidence that mandating nurses to work overtime results in better patient outcomes (White, 2006). Same case, having more nurses on the bedside does not necessarily translate to better patient outcomes. In this direction, therefore, there is the need for providing nurses with the appropriate resources like up to date technologies to support their daily activities.
These two studies have employed a descriptive approach, therefore, the methodology and the sample sizes have not been given much attention. Additionally, the studies are reliable since they reflect the clear picture of what is happening in healthcare settings. The studies are also valid in the sense that the sources of data used in carrying out the studies are from trusted secondary materials like legislative bills and nursing journals. The limitation of these two studies, however, is based on the fact that the sample size and the sampling techniques have not been identified thereby affecting the credibility of the studies.
The purpose of the study has been addressed by these articles since the current inadequacies concerning nursing staff ratios in relation to improved patient outcomes and job satisfaction have been tackled. The proposals that have been given by these studies are; creating nursing policies that are patient-centered, providing nurses with required technologies and skills to provide care to patients.
Conclusively, it has been established that nurse-to-patient ratios have got profound effects on the way holistic and quality care is provided to patients. In the event that nurse is required to work for longer hours than they are required, the possibilities of them making mistakes because of burnout are very high. Therefore, having optimal nursing staffing levels is an important effort towards curbing nay instances of nurse burnout. Such moves are directed towards having better patient outcomes and improved job satisfaction on the side of nurses. Additionally, there is the need to provide more resources and training to nurses for them to adequately provide care to patients under them.
References
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., & McHugh, M. D. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383(9931), 1824-1830.
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care–associated infection. American journal of infection control, 40(6), 486-490.
Knudson, L. (2013). Nurse staffing levels linked to patient outcomes, nurse retention. AORN Journal, 97(1), C1.
White, K. M. (2006). Policy spotlight: staffing plans and ratios: What’s the latest US perspective?. Nursing management, 37(4), 18-22.
