The case presents valuable insight into problems regarding nurse staffing problems, and the issues demonstrate how relevant theories and concepts are critical in addressing such challenges in an effective manner. The prime difficulty in the case is the fact that nurses are constantly working overtime shifts, which is causing nursing staff fatigue, exhaustion, and low-quality patient care. In addition, the care provision error likelihood is increased, which makes nurses worried about their performance and patient safety. Therefore, the relevant concepts include appropriate nurse staffing and five fundamental principles of staffing.
Firstly, in order to properly assess the case and relate its context to the weekly material, it is important to consult American Nursing Association’s or ANA’s Principles for Nurse Staffing. The core element of staffing principles revolves around the notion of the Triple Aim, which is focused on the reduction of per capita health care cost, population health improvement, and patient experience of care improvement (ANA, 2020). The recent addition of the fourth goal is centered on staff work satisfaction.
Secondly, the critical relevance of staffing concepts has a direct relationship with safety. It is stated that “nursing care has a direct impact on the overall quality of services received, and that when nurse staffing is appropriate, adverse events decline and overall outcomes improve” (ANA, 2020, p. 4). In other words, one can see how nursing care’s dependence on proper management is well-evidenced since understaffing can lead to a loss in performance.
Thirdly, the concept of appropriate nurse staffing is highly relevant to the case due to its direct emphasis on the maintenance of optimal nurse and patient ratio. The core components of the concept established by ANA (2020) include collaboration, staffing guidelines with measurable nurse-sensitive outcomes, involvement of nurses in staffing decisions, analysis of consumer healthcare status, high-quality work environment, cost-effectiveness, and reimbursement. The case clearly demonstrates a disregard for the nurses’ involvement in staffing decisions since they are assigned to extra shifts without their input.
Fourthly, the case also illustrates a violation of fundamental nurse staffing principles. The first principle does not adhere to because patient safety is affected by nurse fatigue (ANA, 2020). The second principle on the interprofessional team has little relevance to the case, but the third one on workplace culture is not followed. The main reason is that nurse satisfaction, burnout, and care coordination are not accounted for as indicators (ANA, 2020). The major violation of the fourth principle on practice environment can be observed in the case, where it is stated that “staffing includes structures and processes that affect the safety of patients as well as nurses” (ANA, 2020, p. 13). In other words, there is a great deal of concern among nurses about patient safety due to staffing decisions. The fifth principle on evaluation is not covered by the case, but one might predict that nursing care outcomes are likely to decrease due to burnout. It is stated that organizations should factor in indicators when making staffing plans, such as “staffing includes structures and processes that affect the safety of patients as well as nurses” (ANA, 2020, p. 15). Therefore, the staffing principles of ANA are disregarded by the organization presented in the case.
In conclusion, proper management of nurse staffing is dependent on the concept of appropriate nurse staffing and the five fundamental principles of staffing established by ANA. The case demonstrates how failure to adhere to these frameworks results in work dissatisfaction, burnout, fatigue, and low patient safety.
ANA. (2020). ANA’s principles for nurse staffing (3rd ed.). American Nurses Association.