Nurse Staffing Shortage Issue
Nursing Staffing Shortage

One of the greatest challenges to the continued development of a high quality health care delivery system is the continued and frequently increasing shortage of qualified nurses active in the profession of nursing. The nursing shortage has waxed and waned for decades but seems to currently be in a state of constant shortage (Fox & Abrahamson, 2009, pp.235-236). In addition the research associated with low levels of staffing and increased adverse patient outcomes has also increased, stating rather starkly that staffing shortages increase the odds that poor patient outcomes are a more frequent result, worse in some settings than others and also dependent on skill mix (Clarke, 2008, p.8). The consensus has and will likely remain that the system must learn to utilize existing practicing nurses in a smarter way by adjusting policy and practice to the situation at hand, i.e. there is a nursing…...

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References

Clarke, S.P. (2008 Dec) Nurse staffing and patient outcomes: getting to the heart of the matter in research, practice, and policy. Pennsylvania Nurse.;63(4):8-9.

Fox, R.L. & Abrahamson, K. (2009 Oct-Dec) A critical examination of U.S. nursing shortage: Contributing factors, public policy implications. Nursing Forum. 44(4): 235-244.

Flynn, M. McKeown, M. (2009) Nurse staffing levels revisited: A consideration of key issues in nurse staffing levels and skill mix research. Journal of Nursing Management 17: 759-766.

Leadership and Management
In the medical field, the recent topic of debate relates to Nurse Staffing atios where many argue that governments need to intervene in setting minimum staffing laws. Currently, the only state that has enacted a law is California and nurse unions in other states are fighting for the implementation of the same in their workplaces. However, most of the attempts made by other states to implement California's strategy have failed since hospitals fail to participate (Schultz, 2013). The argument of many hospitals is that the laws do not give them the opportunity or ability to make decisions regarding staffing and at the same time be a financial burden (Schultz, 2013, par. 3). As seen from many nursing unions, hospitals have abused the system to the point of employing few nurses and yet the patients are ever increasing. Inappropriate staffing ratios influence the safety of patients, the satisfaction…...

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References List:

Aiken L., Clarke S., Sloane D., Sochalski J., Silber, J. (2002). Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. Journal of the American Medical Association, 288: 1987-1993.

AONE. Mandated staffing ratios. Retrieved from  http://www.aone.org/resources/leadership%20tools/staffingratios.shtml 

Curtis, E., Vries, J. & Sheerin, F. (2011). Developing Leadership in Nursing: Exploring Core factors. British Journal of Nursing, 20(5): 306-309.

Hughes, R., Ginnett, R. & Curphy, G. (2006). Leadership: Enhancing the lessons of Experience, (5th Eds.). McGraw-Hill, Boston.

Staffing MatrixPart 1Various organizations usually use a tool known as Staffing Matrix to determine the level of each nursing unit that is appropriate depending on the census. Therefore, the staffing matrix is used as a guideline to make proper adjustments that consider the needs and acuity of the patient. Subsequently, Nurse staffing is essential in delivering quality services and patient care, and patient outcomes. Matrix staffing has potentially contributed to the organizations financial status following hospitals operational decisions on appropriate staff. For instance, through matrix staffing, some hospitals have managed to set staffing operation margin and return to measure financial profitability. Equally, matrix staffing ensures proper and quality service delivery that attracts many people, thus, good economic performance compared to hospitals losing clients due to inadequate service provision (Bettencourt et al. 2020).Most hospitals that are investor-owned tend to focus on matrix staffing to maximize profits. At the same time, non-profit…...

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References

Ahmed, K. U., & Ahmed, B. F. (2019). External Recruitment Practices of an Organization.

Bettencourt, A. P., McHugh, M. D., Sloane, D. M., & Aiken, L. H. (2020). Nurse Staffing, the Clinical Work Environment, and Burn Patient Mortality. Journal of Burn Care & Research, 41(4), 796-802.

Hatton, C., Kolk, M., Eikelenboom, M., & Beaumont, M. (2017). Four approaches for staffing and structuring a product development team to identify the crucial unmet needs of B2B customers. Strategy & Leadership.

Jennifer Dillon, M. P. A. (2020). Registered nurse staffing, workload, and nursing care left undone, and their relationships to patient safety in hemodialysis units. Nephrology Nursing Journal, 47(2), 133-142.

Public Policy Annotated BibliographyOne potential public policy issue that may be of interest to me is the issue of mandatory staffing ratios for hospitals so as to ensure that adequate quality care is available to patients. Fox and Abrahamson (2009) note that nursing care arguably falls into the realm of protecting the common good, and therefore requires government oversight (p. 235). The sources in this bibliography relate to this issue and provide context for it.ANA. (2019). Nurse staffing. Retrieved fromhttps://www.nursingworld.org/practice-policy/advocacy/state/nurse-staffing/ANA states that proper nurse-patient ratio should be based on variety of factors, including patient needs, admissions rate, experience of staff, unit layout, and resources available. The thesis is supported by empirical research on the issue. It is an article with great relevance to the topic, and it provides rich context showing the complexity of the issue.Clarke, S. P., & Aiken, L. H. (2003). Registered nurse staffing and patient and nurseoutcomes…...

It is critical that NHAs are first qualified nurses, as their ability to relate to other nurses is essential to the organizational success of the nursing home ("Nursing home administrator jobs," 2011). Career paths for an NHA are rooted with education background and nursing experience. Although experience is necessary for being a successful NHA, a career path at minimum requires clinical licensing (Decker, & Castle, 2009).
The NHA is the management body over the facility, and their positions are in high demand. In the U.S. In 2008, approximately 17,000 nursing home administrators were responsible for the oversight of care for 1 million elderly adults and 1.3 million employees (Leister, 2009). Overseeing a large nursing staff, as well as vulnerable residents, are the daily demands of the NHA. The future of NHA field is concerning to researchers and professionals, as the number of licensed NHAs is on the decline. In Maryland,…...

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References

Decker, F, and Castle, N. (2009). The relationship of education level to the job tenure of nursing home administrators and directors of nursing. Health Care Management, 34(2), 152-160.

Leister, D. (2009). The vanishing nursing home administrator: stress and intent to leave.

Informally published manuscript, Capella University, Minneapolis, MI. Retrieved from http://gradworks.umi.com/3359575.pdf

Nursing home administrator jobs. (2011). Retrieved from http://www.nursinghomesjobs.org/nursing-home-administrator-jobs/

Nursing profession is among the oldest in history. Currently, there is much debate that surrounds the profession because of the need for more trained nurses. In recent years the nursing shortage has become a major problem for the medical profession and has resulted in poor patient care and slower patient recover. The purpose of this discussion is to provide an in depth examination of the nursing profession. We will discuss the current state of the nursing profession, including the causes for the shortage and the solution. We will also explore the status of the nursing profession in Australia. Let us begin our discussion by providing a comprehensive definition of what is means to be a nurse.
Definition of a nurse

According to the American Heritage Dictionary, a nurse is defined as " a person trained to care for the sick or disabled under the supervision of a physician." (American Heritage Dictionary, 1982)…...

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References

American Heritage Dictionary. (1982) Second Edition.

A www.questia.com/PM.qst?action=openPageViewer&docId=5000534396

Bashford, A. (1997). Starch on the collar and sweat on the brow: self sacrifice and the status of work for nurses. Journal of Australian Studies, (52), 67+. Retrieved August 24, 2003, from Questia database,   http://www.questia.com .

Tailoring employment approaches to this group is significant to their continued retention. A lot of the literature suggests that older, more knowledgeable nurses are more likely to expand their work life when the following conditions are present:

Supportive and flexible work arrangements and practices like modified workloads, flexible scheduling options and a reduction in hours of work.

An organizational culture that encourages participation in decision-making and independence over practice.

Work recognition, support and positive feedback from management.

Ergonomically friendly, safe and useful work environments.

Access to professional development actions that target the needs of experienced nurses (An Ageing Nursing Workforce, 2007).

There have been some legislative efforts put into place to battle the current nursing shortage but they have not yet had a noteworthy impact across the nation. The federal Nurse einvestment Act contains promising measures, including inducements to augment the number of nursing faculty. A number of states have also made efforts to address the…...

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References

An ageing nursing workforce. (2007). Retrieved from  http://www.ichrn.com/publications/factsheets/Ageing_Workforce-English.pdf 

The truth about nursing. (2011). Retrieved from  http://www.truthaboutnursing.org/faq/nursing_shortage.html

Staffing shortages in nursing are a consequence of poor nurse retention and nurse satisfaction. Being a nurse requires a lot of dedication, patience, and ability to keep updated in a constantly evolving world. When hospitals and other medical facilities have staffing shortages or shortages in qualified nurses, the healthcare delivery of that particular place dwindles. Nurses are the backbone of any healthcare facility.
Especially in recent times, nurses provide prescriptions, treatment protocols, and diagnosis when doctors are away or busy. This literature review is meant to explain such a phenomena and how it relates directly to nurse satisfaction and nursing retention. From here, the connection crosses over to nursing care and healthcare delivery as standards of practice. Things like arrhythmias will be viewed to understand how nursing shortages attribute to lower quality of care. Utilizing Polk's theory of esilience, this review will allow a look into performance improvement concerns and practice…...

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References

Bosch, R., Kirch, W., Theuer, J., Pittrow, D., Kohlhaussen, A., Willich, S., & Bonnemeier, H. (2013). Atrial fibrillation management, outcomes and predictors of stable disease in daily practice: Prospective non-interventional study. International Journal Of Cardiology, 167(3), 750-756. doi:10.1016/j.ijcard.2012.03.053

GIANFERMI, R., & BUCHHOLZ, S. (2011). Exploring the relationship between job satisfaction and nursing group outcome attainment capability in nurse administrators. Journal Of Nursing Management, 19(8), 1012-1019. doi:10.1111/j.1365-2834.2011.01328.x

Hudgins, T. (2015). Resilience, job satisfaction and anticipated turnover in nurse leaders. Journal Of Nursing Management, n/a-n/a. doi:10.1111/jonm.12289

Minhas, R., Vogelaar, G., Wang, D., Almansoori, W., Lang, E., & Blanchard, I. et al. (2015). A prehospital treat-and-release protocol for supraventricular tachycardia. CJEM, 1-8. doi:10.1017/cem.2014.53

739, p=0.009, e?=0.727). This study clearly highlighted that sleep shortage and work fatigue poses a threat to patient safety and that nurse self-care is warranted.[Dorrian et.al, (2006)]
Nurse Support Services

An earlier Australian study by Moore KA (2001) which observed 201 nurses working in three different hospitals had concluded that organizational restructuring policies and the consequent work overload was a high stressor for nurses and this was made worse by the poor communication style (top -- down approach instead of consultative style) that only contributed more to nurse burnout. [Moore KA, (2001)]. Given the high levels of occupational stress and burnout among nurses, it is important that nurse self-care interventions are prioritized. A recent literature review on the subject of work stress and coping methods among Australian nurses revealed that 'work load ', 'role conflict' and 'expression of aggression' were the three main stressors. The literature study also revealed 'seeking support', 'problem…...

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Bibliography

1) Linda H. Aiken, 'Image of Nursing Global Trends', retrieved Sep 4th 2010, from,  http://www.fpnl.co.za/downloads/Presentations/Presentations/Prof%20Linda%20Aiken%20-%20Image%20of%20Nursing%20-%20Global%20Trends.pdf 

2) Jillian Dorrian, Nicole Lamond & Cameron Van del Heuvel et.al (Oct 2006), 'A Pilot study of the Safety Implications of Australian Nurses' Sleep and Working Hours', Chronobiology International, Vol 23, Issue 6, pg 1149-1163

3) Lim J, BOGOSSIAN F. & AHERN K. (2010), ' Stress and coping in Australian nurses: a systematic review. International Nursing Review 57, 22-31

4) Moore KA, (2001), 'Hospital restructuring: impact on nurses mediated by social

Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.

Introduction

Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures vs. patient load;…...

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REFERENCES

More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA

Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newslettershttps://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_

Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft

For the Council on the Economic Impact of Health System Change. Retrieved from:  / Council-Dec-14-2001-Aiken-paper.pdfhttp://council.brandeis.edu/pubs/hospstruct 

It has been shown through research to be critical that the organization make the provision of support for the nursing staff in terms of their education and provisioning career support as well through making time and financial allocations to provide the necessary support system in which the nursing staff may advance their education and hence their career. (Cook, Horz & Mildon, 2006; paraphrased citing the work of: Robinson, (2001 and Hinshaw (2002) Additionally falling within these provisions of support are time and financial allocations for "research, special projects and publications (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006) the research fact sheet includes the necessity for organizations to "Support a 'bias toward action' (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006); and to "Enhance nurse-staffing rations (Hinshaw, 2002; as cited by Cook, Horz, & Mildon, 2006) and lastly to provide encouragement…...

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Bibliography

Cook, a. Hiroz, J. And Mildson, B. (2006) Strategies and Outcomes Associated Magnet Hospitals Fact Sheet II of II - Nursing Health Services Research Unit 2006 September Online available at   www.nhsru.com/factsheets/Magnet%2520factsheet%2520Part%2520II%2520of%2 520II%2520-%2520Strategies.FINAL.pdf+Nursing+Leadership:+Healthcare +organizational+analysis&hl=en&gl=us&ct=clnk&cd=79.http://64.233.161.104/search?q=cache:wmmvrr7kMqUJ :

Quality First: Core Values and Concepts for Quality Leadership (2006) American Health Care Association - Provider Guidelines. Online available at  http://www.ahca.org/quality/qf_corevalues.htm .

Alexander, Jeffrey; Bloom, Joan; and Nichols, Beverly (1991) Nursing Turnover and Hospital Efficiency: An Organizational Level Analysis (1991) Institute of Industrial Relations University of California Berkley

Nursing Leaderships Role: 'Key' Factors in Organizational Analysis

" (Allen 2008) This means that nursing educators are also a key stakeholder.
Other stakeholders include healthcare facility administrators, corporate trustees and public office holders, who will often have entangled or competing interests relating to the profitability of operations and the political expediency of policy orientation. This will also be true of the various professional advocacy groups, nursing associations and lobby groups that will vie for influence in the discussion on any legislation relating to the nursing shortage.

Policy Objective:

A primary policy objective is to endorse any legislation that would aggressively enforce better recruitment of nursing students, better training of existing nurses, improvements in working conditions for nurses and mandated nurse-to-patient ratios. These objectives are underscored by evidence of the opportunities to save lives facilitated by mandated ratios. According to the text by Health Services Research (HSR) (2010), "key findings of the study reportedly include that 10-13% 'fewer surgical patients in New…...

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Works Cited:

Allan, L. (2008). The nursing shortage continues as faculty shortage grows. Nursing Economics, 26(1), 35-40.

Berkowitz, B. (2012). The Policy Process. .

Cullen, E.; Ranji, U. & Salganicoff, A. (2010). Addressing the Nursing Shortage. Kaiseredu.org.

GovTrack. (2010). S. 1031: National Nursing Shortage Reform and Patient Advocacy Act. govTrack.us.

/nursing homes.
Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.

In terms of socio-demographic characteristics, the literature collated regarding nursing home care does not specifically distinguish…...

cute care facilities try to maintain low costs and employ quality nurses. Within this statement is a double standard. How can we have quality nurses and cut costs at the same time? This is where the skill mix comes into play. In the skill mix, there are Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. If the lesser skilled staff free RNs they can be better able to perform their nursing duties and assessments. If acute care facilities can agree on an appropriate number of each type of staff member within the facility, they might be better able to accomplish safe patient outcomes while keeping costs down.

Determining nurse-to-patient ratios is a complex issue where one solution is not sufficient to cover all circumstances. The merican Nurses ssociation assembled a panel of nursing and health professionals to research appropriate staffing levels. The panel developed the following Matrix for Staffing…...

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Aiken and colleagues have been pioneers in studying nurse patient ratios and their relationship to patient outcomes.

Aiken, Sochalski, and Lake (1997) demonstrated that nursing presence, whether measured as RN ratios or as RN hours relative to other nursing personnel hours, is significantly correlated to mortality. When studying patient outcomes in specialized AIDS units,

Aiken, Sloan, Lake, Sochalski, and Weber (1999) found that at 30 days post admission, mortality rates were 60% lower in magnet hospitals, and 40% lower in dedicated AIDS units than in conventional scattered bed units. The researchers concluded that higher nurse patient ratios were a major factor in these lower

Nurse-Patient Ratios.
This is a legislator information sheet on nurse-patient ratios (as adapted from Aikan et al. 2010) for a busy legislator who will only have time to read bullet points:

The ratio of nurse patient is lower in California than in other states with nurses in CA having at least one patient less than nurses have in other states (as for instance in New Jersey and in Pennsylvania as mentioned in Aikman et al. (2010))

California nurses had lower nurse-patient ratio on medical and surgical units when compared to other states. The average amongst CA nurses was 2 patients less than those in other states.

The lower the nurse-patient ration, the lower the level of mortality amongst patients

When nurses' workloads paralleled those of workloads of Californian nurses, the following results occurred:

a. nurses' burnout decreased

b. nurses' job dissatisfaction decreased

c. nurses reported consistently better quality of care

d. Nurses took greater care in improving their…...

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Sources

Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1), 12 pp.

 http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/tpc32_216091.aspx 

Aikan, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., & Smith, H. (2010, April 9). Implications of the California nurse staffing mandate for other states. Health Services Research. Retrieved from  http://www.nursing.upenn.edu/chopr/Documents/Aiken.2010.CaliforniaStaffingRatios.pdf

## Thesis Statement:

A comprehensive and multifaceted approach, including enhanced communication, patient-centered care, staff empowerment, and data-driven decision-making, is necessary to effectively improve patient satisfaction in nurse quality care.

### Introduction:

Patient satisfaction is a crucial indicator of the quality of healthcare services. Enhancing patient satisfaction leads to improved clinical outcomes, increased patient loyalty, and reduced healthcare costs. Nurses play a pivotal role in shaping patient experiences and influencing satisfaction levels. This thesis will explore the multifaceted strategies that can be implemented to improve patient satisfaction in nurse quality care.

### Body:

1. Enhanced Communication:

Establish clear channels of communication between nurses and patients, allowing....

We have a variety of essays on nurse ratios available, including research-based essays analyzing the impact of nurse-to-patient ratios on patient outcomes, persuasive essays advocating for mandated nurse staffing ratios in healthcare facilities, and historical essays tracing the evolution of nurse staffing ratios and their implications for nursing practice. Let us know which type of essay you are interested in, and we can provide you with more specific options.
If you have a specific preference, please let us know so we can tailor our recommendations to suit your needs. Whether you are interested in exploring the evidence-based research behind nurse-to-patient ratios,....

Research-Based Essay: Impact of Nurse-to-Patient Ratios on Patient Outcomes

Introduction

The nurse-to-patient ratio is a key factor that influences patient care quality and outcomes. Extensive research has demonstrated a strong correlation between lower nurse-to-patient ratios and improved patient outcomes, highlighting the critical role that nurses play in providing safe and effective care.

Evidence

Reduced mortality: Studies have shown that patients cared for by nurses with lower caseloads experience lower mortality rates. A study published in the Journal of the American Medical Association found that for every additional patient assigned to a nurse, the risk of in-hospital mortality increased by 7%.
Shorter hospital stays:....