Nurse Staffing Issues

Step 1 – Describe the IDEAL

This proposal shows that there is a dire need to address problems facing nurse staffing in the United States. Advocates of mandatory nurse-to-patient ratios have been lobbying the US Congress as well as the state legislatures to implement laws that enhance the overall working environment in the healthcare systems (Glette, Aase, & Wiig, 2017). Most hospitals are experiencing significant challenges because of the current decrease in the number of registered nurses. Adequate staffing in hospitals is a crucial factor in establishing the quality of care and patient outcomes. Currently, the American Nurses Association and the National Nurses United have been actively lobbying for the implementation of the Registered Nurse Staffing Act to improve the nurse-patient ratios across the United States.

Although the nurse-patient ratio varies depending on the hospital setting, for instance 1:1 in the operation room 1:6 in the psychiatric ward and 1:4 in the emergency or pediatric units, nurses have today been stretched to handle up to 10 patients per day (Glette, Aase, & Wiig, 2017). Additionally, apart from their usual working hours, these nurses are forced to take extra shifts to compensate for the few available nurses causing extreme exhaustion. Therefore, this proposal holds that establishing more nursing colleges and universities will help hospitals achieve the correct nurse-to-patient ratios thus improving healthcare provided to patients.

Step 2 – Define the REALITY

Existing research shows that understaffing in the healthcare system has been associated with an increased rate in hospital-acquired infections, medical and surgical errors, falls and death of patients (Martin, 2015). Similarly, the research has shown that increasing nurse-patient ratio will help to reduce workload for the available nurses hence reduce medical error. However, there is a need for more research on how nurse to patient ratios will reduce medical errors in the US. Over 250,000 individuals lose their lives due to preventable medical errors in the United States but due to lack of enough nurses to attend them. Additionally, 25% of the patients admitted are always at the risk of experiencing injuries while 4% of the patients contracted a hospital-acquired infection. Errors occur in different fields including the otolaryngology, general practice, laboratory, and anesthesia. Some of these errors include post-operative errors, testing mistakes, surgical planning mistakes, equipment-related mistakes, medication errors, wrong-site surgeries and technical mistakes (Martin, 2015). While some of these mistakes lead to suspensions and warning, others can jeopardize the hospital due to damage to reputation, lawsuits and huge fines. Additionally, nurses can lose their license or their jobs leading to stress. Therefore, there is a need to come up with a strategy for improving the patient-nurse ratio.

Step 3 – Explain the Consequences

When healthcare standards are poor because of factors like an inadequate number of nurses, inefficient policies, scarcity and poor allocation of resources, nurses shoulder most of the responsibilities given that they directly interact with the patients daily (Martin, 2015).  However, the lack of enough nurse0patient ratios makes it impossible for the available nurses to attend all the needs of the patient. Therefore, improving the number of available nurses helps to ensure that all the needs of patients are met on time. When the working conditions are not suitable for work, hospitals experience high levels of employee dissatisfaction leading to high turnovers, low level of motivation, increased errors, low patient satisfaction levels, regular nurse transfers, lawsuits and fines, high levels of complaints from physicians and incomplete documentation of patient outcomes. All these consequences jeopardize patient safety and the credibility of a hospital.


Step 4 – Propose the Solution

This proposal holds that the Congress and the State Legislatures need to approve the establishment of more registered nurses facilities that will boost the number of available nurses in the health facilities. Opening more colleges and universities where learners can study nursing and be equipped with the necessary skills to facilitate healthcare is crucial. Establishing more institutions can solve the current understaffing problem in less than four years given that trained nurses and licensed nurses can join these institutions and advance their education to become registered nurses in two years. This solution will solve significant challenges facing the healthcare system given that those hospitals with gain the legal nurse-patient ratio (Glette, Aase, & Wiig, 2017). In these institutions, nurses will be equipped with technological skills to deal with the current acquit challenges that are facing the current generation particularly the aging people in the United States. More so, nurses will not have to take mandatory overtime shifts that leave them extremely exhausted. This will increase the level of motivation and retention of employees. Therefore, increasing the available number of registered nurses is a necessary undertaking.





Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses and patient safety in hospitals-A literature review with thematic analysis.

Martin, C. J. (2015). The effects of nurse staffing on quality of care. MedSurg Nursing, 24(2), S4-S4.