Nurse Staffing: Does One Size Fit All?
Two major forms of staffing guidelines will be discussed, nurse-to-patient ratio and staffing by acuity. This paper will discuss the history of each staffing form. It will point out the benefits and negative features of both practices, describe how hospitals deal with staffing and discuss the states that have laws requiring certain guidelines be followed.
Nurse Staffing: Does One Size Fit All?
What is the one conversation that usually gets heated when talking to nurses? Bring up the subject of staffing levels on their unit. As a nurse assistant, staff nurse, charge nurse or nursing administrator, inadequate staffing creates tension and stress. When staffing is inadequate patient safety, infection rates, patient satisfaction and staff satisfaction are only a few of the areas affected. Many hospital administrators and lawmakers want to make patient care a numbers game. The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to create a staffing plan that defines staffing effectiveness as the skill mix, competence, and effectiveness related to the services needed. (Morgan, 2004) When it comes to staffing, one size does not always fit all. Patients are individuals with individual needs and one patient with a certain diagnosis can take much less attention and time from the nurse than a patient of the same age with the same diagnosis. For good nurses the main goals during their shift is giving exception patient care and providing a safe environment. “The notion of high-quality care in hospitals is essential to public safety isn’t new. In 1751 Benjamin Franklin founded America’s first hospital-Pennsylvania Hospital-and commented that patients ultimately suffer and die without sound nursing care.” (Clarke, 2003) Nursing leaders are under tremendous pressure to lower costs while improving quality. (Carter, 2004) It is often found that hospitals during low census times or times of budget cuts will try to let ancillary staff go and assign their duties to the nurse caring for the patient. Nurses can replace several other positions in a healthcare setting but no other position can replace the nurse. Nursing is not only a highly trained individual but someone who is called to be compassionate, caring and dedicated individual. There are many reasons why staffing by acuity or nurse-to-patient ratios should not be mandated by lawmakers. Direct care nurses should be involved in staffing decision. Outcomes are better when nurses have control of their workload. (Anonymous, 2005) Adequate staffing must be priority for anyone involved in healthcare and there are pros and cons to both staffing by acuity and nurse-to-patient ratios.
With our aging population and the increased age of the baby boomer generation nurses are going to increase in demand. Healthcare is changing so quickly and this also affects the shortage. The average acuity of patients has increased over the last decade while the nursing shortage continues. Nurse-to-patient ratios are supposed to draw people into the filed but there is a shortage of educators at present time as well. Many colleges have long waiting list for nursing programs, yet many nurses only stay in the field for a short time after graduating. Many universities turn away good candidates to nursing programs due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. (Allen, 2008) We as a nation must come to a conclusion to deal with the nursing shortage. Too many lawmakers are paying attention to the staffing formats suggested above and not doing anything to fix the nursing shortage. Whether by acuity or ratios, for each nurse to take fewer patients we will definitely need more nurses. Staffing by acuity is a format used to decide how many nursing hours are needed for certain diagnosis...