A rising issue in nursing in recent years is how staffing levels effect nursing outcomes including, but not limited to, nurse burnout and job satisfaction. Three types of staffing contribute to nurse workload; they are staffing by hours per patient day, staffing by ratios, and staffing by acuity. Following is an in depth analysis of how nurse staffing affects nurse job satisfaction and burnout.
Nurse workplace environments have only really been studied during the last decade. There is growing research in this area especially due to the nursing shortage. International consensus is if you identify opportunities to improve working conditions for nurses, you will have a higher probability of maintaining staff (4). The success rate of retaining
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The number of patients assigned per nurse has been directly linked to nurse job satisfaction and patient outcomes; with a ratio of four patients to one nurse being the ideal ratio (7). Research has shown that the addition of just one patient per nurse has been associated with a higher risk of death for patients and an increase in nurse job dissatisfaction and burnout (2). This is significant because nurses wish to provide the best quality of care for patients and with increased patient to nurse ratios, nurses are unable to maintain their ideal quality of care; which leads to job dissatisfaction and nurse burnout. Originally, after the passage of the California nurse staffing act, which set mandated nurse-patient rations, overall job satisfaction appeared to increase (1). However, several longitudinal studies have suggested that direct care nurses are still dissatisfied despite increased nurse to patient ratios (1). From the results of these longitudinal studies, it has been found that there is still some shortcomings with staffing systems based solely on nurse-patient ratios. Therefore, even though the ratios staffing system accounts for appropriate patient care, it does not take into consideration different patient complexities and needs for nursing care (10). Staffing by acuity is the third and final staffing system that is considered when looking at nurse burnout and job
Without participating in a longitudinal study, it is difficult to truly assess the efficacy in mandating nurse staffing ratios. It is difficult to measure the benefits of mandated staffing due to numerous confounding variables. These confounding variables include the resources available at specific hospitals in addition to the populations that they serve. Hospital volume, RN job satisfaction and the relationship between physicians and nurses have also been shown to affect patient outcomes (Duval et al., 2007).
Inadequate rest which results in fatigue has major implications on the health and safety of registered nurses and can compromise patient care. Nurses often work three to four 12 hour shift a week without taking any breaks while on duty. They often have difficult workloads and challenges which can take a toll and impact patient care. I will be taking a look at nurse fatigue and the impact it has on the nurse’s wellbeing, work, and patient care.
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
Witkoski Stimpfel, Amy , Douglas M. Sloane, and Linda H. Aiken. "The Loger the shifts for hosital nurses, the higher the levels of burnout and patient disstisfaction." Health Affairs 31.11 (2012): 2501-2509. Proquest. Web. 11 Mar. 2014.
Nurses are the largest and the most trusted professional group in the health care system. They are highly educated and skilled in their areas of practice. However, today’s nurses are experiencing an ever increasing workload, which negatively impacts their ability to deliver safe patient care (Berry & Curry, 2012). This paper explores four published journals that report on survey results on nursing workload and their direct correlation with patient care outcomes. The purpose of this paper is to address the ongoing nursing workload issues and explore the reasons behind it.
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
These articles have many similarities when discussing the issue of staffing shortages. For patients, their loved ones and the general population, they don’t understand the ramifications and strain that staffing shortages have on nurses. People expect and deserve complete, competent and safe care when they are patients. These articles bring to light all the struggles that nurses have to deal with. Nurses are fearful that they will make mistakes, will harm patients, and will harm themselves. (Bae, 2012; Erlen, 2001; Martin, 2015) Overtime can be overwhelming and exhausting, which can lead to errors being made. (Bae, 2012; Erlen, 2001) These articles perceive that it may be beneficial for nurses, patients, and healthcare facilities to decrease the nurse-to-patient ratio, however, this option is not always
The nursing profession is one of the most physically, emotionally, and mentally taxing career fields. Working long shifts, placing other’s needs before your own, dealing with sickness and death on a regular basis, and working in a high stress environment are all precursors to developing occupational burnout in the nursing profession. Burnout refers to physical, emotional and mental exhaustion, which can lead to an emotionally detached nurse, who feels hopeless, apathetic, and unmotivated. Burnout extends beyond the affected nurse and begins to affect the care patients receive. Researchers have found that hospitals with high burnout rates have lower patient satisfaction scores (Aiken et al 2013). There are various measures that nurses can take
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
Factors such as, heavy workloads, stress, job dissatisfaction, frequent medical errors, and intention of leaving the job are all common for nurses to experience, especially during the nursing shortage crisis. Not only do the nurses suffer during a shortage, but the patients ' health outcomes suffer even more. For instance, there are higher rates of infectious diseases and adverse patient outcomes, such as urinary tract infections (UTIs), upper gastrointestinal bleeding, shock, pneumonia, prolonged hospital stays, failure to rescue, and mortality. As a result, this leads to higher re-admission rates for patients. Furthermore, high patient-to-nurse ratios cause heavy workloads due to an inadequate supply of nurses, an increased demand for nurses, a reduction in staffing and an increase in overtime, and a shortened length of stay for patients. Without the heavy workloads that nurses have to endure on a daily basis, there would more time for nurses to communicate more effectively with physicians, insurance companies, and patients and their families. Those heavy workloads are the result of hospitals reducing the nursing staff and implementing mandatory overtime policies just to meet unexpectedly high demands. Unfortunately, the nursing shortage has affected nurses ' mental and physical health. For example, the most common health concerns for nurses include cardiovascular health, occupational injuries and illnesses, and emotional and physical exhaustion. Therefore, safe-staffing ratios/levels have to become the main
Many people believe that nurses are overworked and it is true. Nurses that are overwork is no just in the United States but in serval other countries as well. They problem has been going on for several years and many wonder if there is any solution to fix it. OIverworked is defined as exhausted with too much work. Throughout the paper is a few reason that nurses are overworked.
Burnout within healthcare has been a prevalent topic of discussion and research for numerous years. Although the link between burnout rates and nursing as a whole has been well established; most studies do not distinguish the burnout rates within the specific branches of nursing. Among these branches is psychiatric nursing, specifically forensic psychiatric nursing; where studies regarding this topic is extremely limited. According to Pompili et al. (2006), psychiatric nurses were found to have higher levels of burnout than nurses of other speciality. More research regarding psychiatric nursing burnout rates within forensic will not only expand the knowledge of the nurses and the employers regarding the key stressors that are causing these