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The impact of nurse to patient ratios
Efforts in eradicating nursing shortages
Staffing and its importance
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Recommended: The impact of nurse to patient ratios
It surprises me that only one state has enacted nurse patient ratios. Nurse to patient ratios are so important in patient safety as well as adequate staffing. It is hard to staff adequately with the nursing shortage that we have in our country. I know that in our hospital many staff are floated to other units. Liability could be lowered by only floating seasoned nurses to other floors. Seasoned staff some times are still uncomfortable floating to other floors but at least they are not new to being a nurse and new to that unit. Another way to reduce liability and to increase patient safety is to have a charge nurse or seasoned core staff member available to staff members to answer questions and assist with procedures. I work in the float pool
Gordon, S., Buchanan, J., & Bretherton, T. (2008). Safety in Numbers: Nurse-to-Patient Ratios and the Future of Health Care (pp. 1-2). Ithaca, NY: Cornell University Press.
The United States offers some of the most established and advanced health care in the world. Practitioners and administers are constantly trying to improve the quality of care received by patients in the US. Data has consistently shown that the presence of a registered nurse contributes directly to positive patient outcomes (Cho et al., 2016). The debate across the country, however, concerns the precise number of staff required to provide safe, high-quality care. The issue of safe staffing is one that is of great importance to all involved in the delivery of health care across the country.
Over the past years, there has been a nursing shortage which has led to the need of more registered nurses in the hospital setting. This is the result of higher acuity of patient care and a decrease in their length of hospital stay. In order for the patients to get safe and quality care, the staffing, education and experience of the nursing staff needs to be made a priority. Because of the lack of nurses, patient quality of care has suffered.
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?
Nursing standards are the building blocks that lead to excellent patient care. The ANA (American Nursing Association) has standardized sixteen common practices for the best quality care of patients by nurses. Nurses are only able to facilitate minimal standards to patients due to time restraints derived from patient ratios and lack of support from administration. The hope to achieve the best possible outcomes in patient care are limited to the minimal standards expected of nurses from the National Council of State Boards of Nursing (ANA, 2010). Patient ratios have been seen as a huge issue across the realm of nurses and health care facilities in deliverance on patient care. Addressing the issue of nursing shortages and the effects on ...
For my research paper, I will be taking the position that low nurse-patient ratios (the number of patients a nurse is assigned to care for during their shift) are beneficial to patient safety and should be adopted on a larger scale. What made you interested in this topic? I am interested in this topic because when I graduated from nursing school last year, I accepted a job where I am comfortable with my workload, while many of my classmates ended up in work environments where they are responsible for taking care of as many as 9 patients at a time while working as the Charge Nurse on the unit. Several have expressed to me that they feel their patients aren't safe because of the workload they face as nurses. How is it related to your field of study, major, or to what you plan on doing after you graduate?
Use professional standards and code of ethics to provide competent nursing care. It is "the ethical values of nurses and of nurses' commitments to persons with health-care needs and persons receiving care" (CNA, 2017, p.2). This is done by providing safe, competent care. By being accountable for your own actions such as properly making corrections to a care plan. I learned a lot about this in week 4 in lab, where we were practicing transferring a client. We were providing safe care as we were practicing. Promoting safe transferring of clients will reduce and prevent the risks of falls and injuries for the nurse and client. Being accountable for your actions and accepting where you went wrong will further develop safe nursing care, and self-awareness.
On April 17th 2013, Senator Barbara Boxer (California) introduced a federal bill that is aimed to reduce nursing shortages by establishing a minimum nurse-to-patient ration in hospitals. She is also ordering whistleblowing protection for nurses who report quality-of-care violations. The law requires that every hospital implement a written hospital-wide staffing plan that will guide the assignments to...
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”.
I am glad that you mentioned safe staffing in your post this week as one way that nurses can help facilitate positive change throughout the community. Not only does safe staffing help to save patient lives it also helps to prevent burnout at the nursing level. According to Peate (2015), nurses face major challenges in order to deliver the best possible care with fewer resources that is not only financial but human as well. This creates an environment of overworked nurses who are more than likely letting their health take a backseat. “Individual nurses are going the extra mile to get the job done, yet the damage to their health is real and is happening nationwide” (Peate, 2015, p. 133). There is one particular vivid memory of an example of short staffing that I personally experienced on my floor and although one of my
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.
Solutions for the nursing shortage beyond implementing safe nurse staffing ratios include: ongoing long-term workforce planning; institution of an education and practice system to promote more equitable compensation in the health care community based on a better understanding of the educational preparation required for different health care roles; implementation of specific strategies to retain experienced nurses in the provision of direct patient care, investigating the potential for using technological advances to enhance the capacity of a reduced nursing workforce; and advocate for increased nursing education funding under Title VIII of the Public Health Service Act and other publicly funded initiatives to improve
Bedside nurses want to change staffing levels to assure that they have enough time to both keep up with the constantly evolving health care and to provide safe patient care. Yet, healthcare employers consider that reducing nurse patient ratio is an unnecessary expense that has not been proven to improve quality of patient care (Unruh, 2008). Employers emphasize that raising nursing staffing level is not cost-effective. In fact, in accordance with ANA’s report (2013), a study, in the Journal of Health Care Finance, confirmed that reducing patient-nurse ratios increased hospital costs, but did not lower their profitability. Higher hospital costs were attributed to wages and benefits allocated to newly hired nurses. Yet, according to Cimiotti et.al (20112), it is more costly for hospitals to not invest money on nursing.
According to Good & Bishop, (2011) float nurses often are used to offset the effects of staffing shortages, changes in hospital census, and struggling budgets. Whether using permanent staff or established pools, floating can reduce overtime costs and use of expensive agency staff Unfortunately, floating is a sensitive issue to nurses, many of whom describe it as a frustrating and anxiety provoking experience ( as cited in Bates, 2013). However, nurses can do many things to make floating a better experience, such as maintaining a positive attitude, staying abreast of clinical skills, and working within their scope of practice. Unfortunately, the expectation often may be that the float nurse takes sole responsibility for his or her success in each new work environment, including addressing areas of concern, asking for assistance, and verbalizing feelings of discomfort (Bates, 2013). Because floating affects everyone — individual nurse, co-workers, patients —ensuring a successful experience becomes a shared responsibility. Providing the float nurse with necessary resources and assistance, as well as maintaining lines of communication and encouraging feedback, can make floating a more positive experience (Bates, K. J. 2013). Even as a new graduate nurse, I found myself floating 6 months after orientation without training to other units. These experiences were both challenging and frustrating, as I spent much of my time