Nurse Staffing Issues in American Hospitals

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The issue of nurse staffing has always been challenging for healthcare settings because providers are often put in extreme workload conditions that they cannot manage. The problem becomes even more complex when Nursing Managers use their authority to assign overtime and additional shifts, failing to consult with their subordinates. In the case study “Staffing Issues,” this issue was explored in great detail to show what impact overstaffing has on the satisfaction and the retention of nurses. While it is important that hospitals offer the highest quality of care possible, there should not be any sacrifices on the part of nurses who work long shifts and subsequently burn out.

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Case Study Overview and Analysis

In the case study, nurses are gathered in a break room to review their schedules. It is revealed that the shifts they are assigned are long and frequent, which makes them question their work. One nurse even mentions making a medication error due to burnout and that she is afraid of hurting patients in a severe workload. When discussing the issue, most of the nurses are concerned with overtime and mandatory staffing ratios that their manager violates.

Their morale is low; they are even contemplating contacting union representatives. However, there is one nurse that has an opposite opinion on understaffing. She says that extra shifts are good for her because she earns more money, and she is saving for a car. The employee says that her management just wanted a warm body there, and she provides that.


Research suggests that understaffing is among the causes of decreased health outcomes. According to Rogowski et al. (2013), “there are substantial shortfalls in nurse staffing in US neonatal intensive care units,” which leads to the increased occurrence of infections in blood and cerebrospinal fluid cultures (p. 444). This points to the fact that units have to adhere to the established guidelines, especially when it comes to caring for such vulnerable patients as babies. The case study shows that nurses may have different perspectives on working extra hours; however, patients’ safety should come first.

When reflecting on the case study about nurse understaffing, several points should be mentioned. First, experience shows that when nurses work long hours and are assigned extra shifts, the quality of care, they deliver decreases. Concerns about patients’ safety emerge, and such problems as medication errors can cause harm and lead to unpredicted consequences. Second, nurses that agree to work just to earn money fail to understand that their rest is as important as the rest of their patients. Humans are not machines and need sleep and some ‘downtime’ in order to function properly. A similar situation did occur in my nursing practice; I met a nurse whose manager threatened to fire her if she disagreed to work extra shifts. She agreed to work at night and lost consciousness on her shift due to burnout.


Aligning with the government-regulated rules for staffing ratios is essential. No matter what nurses say and no matter how many hours a day they agree to work, the violations of staffing ratios should be considered unacceptable (Worth, 2013). The case study shows that nurses may not always be aware of the required ratios for staffing, thus agreeing to work even when it violates the regulations. In future practice, the problem of understaffing will be taken very seriously because it has a direct influence on patient outcomes.


Rogowski, J. A., Staiger, D., Patrick, T., Horbar, J., Kenny, M., & Lake, E. T. (2013). Nurse staffing and NICU infection rates. JAMA Pediatrics, 167(5), 444-450.

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Worth, T. (2013). Nurses, hospitals continue national battle over staffing ratios. Healthcare Finance. Web.

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NursingBird. (2021, June 4). Nurse Staffing Issues in American Hospitals. Retrieved from


NursingBird. (2021, June 4). Nurse Staffing Issues in American Hospitals.

Work Cited

"Nurse Staffing Issues in American Hospitals." NursingBird, 4 June 2021,


NursingBird. (2021) 'Nurse Staffing Issues in American Hospitals'. 4 June.


NursingBird. 2021. "Nurse Staffing Issues in American Hospitals." June 4, 2021.

1. NursingBird. "Nurse Staffing Issues in American Hospitals." June 4, 2021.


NursingBird. "Nurse Staffing Issues in American Hospitals." June 4, 2021.