The Problem of Understaffing in Nursing


The problem of understaffing in nursing has been associated with a variety of factors ranging from extended work shifts to poor work conditions. As found by Stimpfel, Sloane, and Aiken (2013) such pressures as extended work shifts can increase nurses’ burnout and contribute to low-quality patient care. With exhaustion come shortages in the nursing personnel, and as a result of shortages, healthcare facilities could experience understaffed shifts. Thus, there is a need in focusing on the issue of understaffing in order to ensure that the quality of provided to patients care maintains the highest level possible while that nursing professionals in a health care setting remain satisfied with their job.


The problem of understaffing of nurse professionals occurs within a context of a health care facility. In such facilities, nurses as subjected to extremely intense workloads that have a direct influence on their performance, patient satisfaction, as well as the satisfaction of nurses with the level overall clinical setting, as found by Michtalik, Yeh, Pronovost, and Brotman (2013). Nurses’ working conditions during shifts usually determine whether the skills of medical professionals would support their performance; therefore, if a health care facility lacks necessary resources and does not take patient safety into account (Rochefort, Buckeridge, & Abrahamowicz, 2015), there is a risk of nurse understaffing due to the inconsistencies between what nurses need in their practice and what resources they actually receive.


Registered nurses are the largest group of professionals working in the sphere of health care (Motacki & Burke, 2016). The shortages in the nursing personnel suggest that fewer individuals enter the field; furthermore, it is becoming much more complicated to predict such shortages. Although, some predictions can still be made: it is expected that by the year 2020, the shortage in the number of available nursing professionals will go hand-in-hand with the increase in the demand for their services because the generation of baby boomers would age.

This means that the issue of understaffing in nursing is not only associated with the workload or the availability of supporting tools that help nurses fulfill their responsibilities but also with the peculiarities of the society that align with specific healthcare needs. Therefore, nursing understaffing is a multi-faceted problem that requires addressing from a range of perspectives such as the overall wellbeing of a society at a particular point in time or the quality of education that prepares future professionals for the role of nurses operating in health care settings.


Researchers investigated the impact of nurse understaffing in a variety of context ranging from patient mortality to nurses’ burnout. For instance, research by Aiken, Clarke, Silber, and Sloane (2003) found anecdotal evidence that was linking inadequate nurse staffing or lack thereof with patient deaths. It was also found that high patient-to-nurse ratio had an impact on the health outcomes of surgical patients as well as the failure-to-rescue rates (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002); furthermore, nurses were much more likely to be dissatisfied with their jobs and experience burnout when there are inconsistencies in staffing.

It is also important to mention that understaffing in nursing can be linked to risk-adjusted mortality in neonatal care; as found by Hamilton, Redshaw, and Tarnow-Mordi (2007), the exposure of premature infants to the inadequate level of nursing staffing can potentially result in risk-adjusted mortality, which presents a tremendous challenge for the sphere of health care.


Resolving the problem of nurse understaffing is significant since it would potentially enhance the level of provided care and ensure that nurses are satisfied with their jobs. Because it was found that for each nurse-sensitive outcome there was an increase in prevalence for those who were exposed to understaffed shifts (Twigg, Gelder, & Myers, 2015), preventing understaffing is imperative for improving patients’ quality of care. As nurse understaffing has been linked to poor patient outcomes, contemplating its significance is unnecessary. In order to ensure a high quality of care, nurse educators and administrators should unite forces to resolve the problem.


While solutions for preventing or minimizing nurse understaffing are vast, one of the initial steps towards solving the issue is associated with the promotion of positive work relationships among the nursing staff in order to enhance the work environment (Moore, Leahy, Sublett, & Lanig, 2013). Because nurses can leave the profession because of poor nurse relationships that create a negative work environment (Moore et al., 2013), understaffing can occur in cases when such an environment is not improved.

Adequate preparation of nurses to becoming professionals in their field can also contribute to the solution of the problem along with the provision of necessary resources that support nurses operations with a health care setting. Since understaffing can be linked to nurses’ dissatisfaction with their jobs, it is crucial to take into consideration all factors that could add to their satisfaction: positive nursing relationships, adequate education, balanced work schedules, supporting tools and resources, as well as high compensation for their services.


Aiken, L., Clarke, S., Silber, J., & Sloane, D. (2003). Hospital nurse staffing, education, and patient mortality. Penn LDI, 9(2), 1-4.

Aiken, L., Clarke, S., Sloane, D., Sochalski, J., & Silber, J. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16), 1987-1993.

Hamilton, K., Redshaw, M., & Tarnow-Mordi, W. (2007). Nurse staffing in relation to risk-adjusted mortality in neonatal care. Archives of Disease in Childhood. Fetal and Neonatal Edition, 92, 99-103.

Michtalik, H., Yeh, H-C., Pronovost, P., & Brotman, D. (2013). Impact of attending physician workload on patient care: A survey of hospitalists. JAMA, 173(5), 375-377.

Moore, L., Leahy, C., Sublett, C., & Lanig, H. (2013). Understanding nurse-to-nurse relationships and their impact on work environments. Medsurg Nursing, 22(3), 172-179.

Motacki, K., & Burke, K. (2016). Nursing delegation and management of patient care (2nd ed.). St. Louis, MO: Elsevier.

Stimpfel, A., Sloane, D., & Aiken, L. (2013). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affiliation (Millwood), 31(11), 2501-2509.

Twigg, D., Gelder, L., & Myers, H. (2015). The impact of understaffed shifts on nurse-sensitive outcomes. Journal of Advanced Nursing, 71(7), 1564-1572.

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NursingBird. "The Problem of Understaffing in Nursing." February 26, 2021.