Transitioning From Closed to Open Systems

Health care complexity shows the significance of nurses to practice individually to produce quality health care to patients which reflects on the broader health care system. Nursing is an essential factor especially in the determination of quality health care provision (Clarke & Donaldson, 2008). A closed system perspective displayed the nursing organization as a self-maintained and contained a system which requires little or no interactions with the external environment. The problem with such a view is that it places health care systems in an estranged position to deal with its issues on its own without external inputs. An excellent example of a setback brought about by the closed system perspective is the ratio of nurses to patients is 1:15 whereby many patients require nursing assistance causing the health care personnel to suffer from heavy workloads. Such situations make it challenging for health care systems to effectively provide excellent quality health care to patients who need personal care such as taking their meals or go for the therapies.

Researchers over the years reported that nurse staffing and the providing of quality health care interrelate. The use of an open-system perspective should assist in addressing the nurse, patient ratio. An open system perspective refers to the approach that views organizations like the health care systems as entities that takes inputs such as labor from the external environment and later on transforms these inputs to outputs as a reciprocal result. The sustainability of quality health care in nursing requires the health care systems to integrate the open-system perspective (Meyer & Pallas, 2010). The need to combine several aspects within and out of the health care systems for instance, organizational and financial is dire to provide adequate resources to nursing practitioners. Policymakers and the hospital executives need to understand that nurse staffing is not a phenomenon that requires minimal expense allocation if at all the goal is to provide quality health care (Aiken et al., 2018). The needs of patients such as diagnostic testing and surgical procedures outweigh the number of nurses assigned to patient care. Nurses complain of stress burn-outs due to the workload which makes them dissatisfied with their jobs causing most of them to quit within three years of practice.

Significantly, measures need to get integrated to solve the problem of nurse staffing. The need to employ collaborative measures such as the governments need to increase the number of nursing schools which will aid in increasing the number of nurses within the practice. The training of newly educated nurses will decrease the ratio gap of patients to nurses leading to improved quality health care provision. Another measure that would assist in developing health care in nursing practice is the allocation of more funds by the government to support the practice by increasing wages of already practicing nurses. The achievement of core competencies in providing excellent health care requires organizational interdependencies to develop effective system-based methods. Nurses should engage in interpersonal team activities which should help them learn from each other hence improve patient care. Education, training, and telecommunications are some of the sectors that should assist in developing the quality of health care with nurses (Johnson et al., 2008). Properly educating and training of more nurses should cut out on the shortage of nurses within the nursing practice. Telecommunication allows the transmission of information within the health care systems and organizations they need to borrow inputs from such as financial aid and practitioners.


Clarke SP, Donaldson NE. (2008). Nurse Staffing and Patient Care Quality and Safety. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 25. Retrieved from:

Horowitz, S. D. (2008). Systems- based practice improving the safety and quality of patient care by recognizing and improving the systems in which we work.

Meyer, R., & OBrien-Pallas L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838. Retrieved from Walden Library Databases

Linda H. Aiken; Consuelo Cerón; Marta Simonetti; Eileen T. Lake; Alejandra Galiano; Alda Garbarini; Paz Soto; David Bravo; Herbert L. Smith (2018). Hospital Nurse Staffing and Patient Outcomes. Revista Médica Clínica Las Condes, ISSN: 0716-8640, Vol: 29, Issue: 3, Page: 322-327. Retrieved from 10.1016/j.rmclc.2018.04.011