Problem
When nurses are forced to work with larger numbers of patients than they can adequately manage, the likelihood of patients dying, getting injured, getting injections, and being sent home earlier without appropriate education increases. This results in patients returning to the hospitals, often with more health issues than previously. However, when nurses have fewer patients, they are capable of taking more time to dedicate to every patient and engage them in self-care and disease management (Griffiths et al., 2018). Therefore, the problem of nurse understaffing is essential to regularly monitor and manage to maintain the quality of care at the highest level achievable.
Context of the Problem
Research has found associations between the levels of nurse staffing and patients’ adverse outcomes, such as in-hospital mortality, comorbidities, and poor quality of education for patient self-care (Aiken et al., 2018). In a hospital setting, understaffing is a significant challenge because of the risks of missed care, medication errors, and delays in treatment (Griffiths et al., 2018). Such settings are associated with a large number of tasks that nurses have to perform regularly. Beyond administrative assignments such as filling patient forms and managing EHRs, nurses have to take time to communicate with their patients, discover their needs and challenges, and recommend appropriate solutions (Dash et al., 2019).
Description
Nurses may experience high workloads because of several reasons, such as the increased demand for a skilled nurse workforce, an inadequate supply of professionals at facilities, the reduction of staffing and increase over time, as well a reduction in patients’ length of stay. Understaffing occurs when there are too many patients for every nurse to handle, and there is not enough time to dedicate to adequate health management and treatment (Molina-Mula & Gallo-Estrada, 2020). Besides, mandatory overtime policies that many hospitals implement further increase the workload on nurses, leading to further issues such as burnout or turnover.
Effect of the Problem
There are several notable effects of nurse understaffing, such as the increased risks of injuries, infections, and mortality. When there are too many patients, nurses have to choose the patients whose conditions are the most severe and urgent in order to tend to them first. This means that less urgent patients have to wait more before receiving care, with the likelihood of adverse events increasing (Morley et al., 2018). As a result, care quality decreases, which is positively correlated to patient outcomes.
Significance and Implications for Nursing Practice
In the current healthcare climate, nurse understaffing should not be overlooked. As suggested by Lasater et al. (2020), chronic hospital nurse understaffing has shown to present a critical problem during the COVID-19 pandemic. During a large influx of urgent patients, nurses have been burdened by the need to address emergencies, and tend to recover patients while also having to deal with self-care and avoiding contamination themselves. It is imperative to solve the health challenges of understaffing because it harms both patient and nurse outcomes.
Proposed Solution
For hospitals, the proposed solution to nursing understaffing is multi-dimensional and should involve several components. First, nurses should be offered higher compensation for their work while also being rewarded financially for relocating from other facilities that are less burdened by understaffing (He, Chaussalet, & Qu, 2019). Second, access to nursing education should be easier to encourage young people to consider nursing as a profession. Third, it is necessary to provide and promote opportunities for professional growth so that nurses can advance their careers and not get stuck in one place for many years.
References
Aiken, L., Ceron, C., Simonetti, M., Lake, E., Galiano, A., Garbarini, A., … Smith, H. (2018). Hospital nurse staffing and patient outcomes. Revista MĂ©dica ClĂnica Las Condes, 29(3), 322-327. Web.
Dash, S., Shakyawar, S., Sharma, M., & Kaushik, S. (2019). Big data in healthcare: Management, analysis and future prospects. Journal of Big Data, 6(54). Web.
Griffiths, P., Recio-Saucedo, A., Dall’Ora, C., Briggs, J., Mariotti, A., Meredith, P., Smith, G. B., Ball, J., & Missed Care Study Group (2018). The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74(7), 1474-1487. Web.
He, F., Chaussalet, T., & Qu, R. (2019). Controlling understaffing with conditional Value-at-Risk constraint for an integrated nurse scheduling problem under patient demand uncertainty. Operations Research Perspectives, 6, 100119. Web.
Lasater, K., Aiken, L., Sloane, D., French, R., Martin, B., Reneau, K., … McHugh, M. (2020). Chronic hospital nurse understaffing meets COVID-19: An observational study. BMJ Quality & Safety, 2020, 1-9. Web.
Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17, 1-24. Web.
Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PloS One, 13(8), e0203316. Web.