Kelly Adams McCann
The Impact of Nurse Staffing on Patient Outcomes
When my daughter was in the Neonatal Intensive Care Unit (NICU) 11 years ago, I was I was blissfully ignorant of patient-to-nurse ratios and budget constraints. I had confidence in the competence of the nurses and believed that they had the time and the tools necessary to care for my child. Now that I'm a nurse myself and I see my support staff numbers cut and my patient load rise, I wonder what my patients and their families think of me. In an age when we are all being asked to do more with less, nurse staffing levels are no different. The business of medicine is just that, a business, and businesses are profit driven. Even if the facility is not a for-profit institution, it still must operate within the confines of a budget. However, what is the impact of nurse staffing on the quality of patient care and patient outcomes? Are government mandated minimum patient-to-nurse ratios the answer? A nurse has a finite number of hours in a shift to complete an ever-growing number of tasks for each patient. In a shift, those tasks could include the administration of medication, physical assessment, patient and family teaching, personal needs, conferring with physicians, supervision of support staff and charting. Charting is critical, because every nurse had heard “If it you didn’t chart it, you didn’t do it.” How many of us have realized on the drive home that we didn’t record Mrs. Smith urine output or document a dressing change? When the number of patients per nurse rises, the time spent performing each these tasks falls and mistakes happen. While some tasks can be delegated to support staff, others cannot. Tasks are left undone at the end of a shift and passed on to the next in a vicious cycle. In my own practice, my colleagues and I believe we are working harder than ever, but feel that we are accomplishing less. Studies have...