NURSE STAFFING RATIOS
The debate about the optimal number of nurses required to give quality medical care cost-effectively. The National Health Services (NHS) Act 1999 guarantees all patients the right to be cared for in a safe environment by experienced and qualified staff. Many hospitals across the world have a big caseload of patients and a limited number of nurses to attend to them. Nurses work for long hours and have to attend to more patients. A study conducted by the American Nurses Association revealed that 54% of nurses say that they do not have enough time to spend on each patient (American Nurses Association, 2012). Individuals and organizations that support the enforced staffing ratios suggest that care quality and patient safety is undermined when a nurse has too many patients. In 2004, California implemented a legislation that required all hospitals to limit the number of patients nurses could attend to at a given period. Insufficient staffing ratios is a major factor in undermining the security of the patients and the right to be treated by qualified staff in a safe environment.
How nurse staffing ratios impact quality of care and patient security.
Nursing staffing ratio mandates improve patient safety and patient care quality. A study published in the Annals of Intensive Care in 2017 revealed that higher nurse staffing ratios increased the chances of survival. The study analyzed eight hundred and forty five patients, and found that the likelihood of survival was ninety five percent more when the nurse staffing ratio is high. Another study by Agency for Healthcare Research and Quality (AHRQ) acknowledged that patient safety and care quality improve when nurses adhere to a hospital mandated patient-nurse ratio (American Nurses Association, 2012). According to AHRQ, nurse’s close vigilance to every patient is vital to their ability to guarantee patient safety. Several seminal researches also demonstrate that increased number of patients per nurse increases the risk of patient safety events, mortality, and morbidity.
Enforced nurse staffing ratios could however limit patient care access. A study by Mass Insight found that enforce nurse staffing ratios would limit patient care access and impose negative financial implications on hospitals. Higher nurse-patient ratios would impose extra expenses on hospitals that might have to hire more staff. Mandatory nurse staffing ratios cause financial constrains to hospitals, and may force the hospital to restrict access to services and care. The likelihood of severe negative consequences exists if hospitals are mandated to meet the minimum nurse stuffing ratios with inadequate resources.
How professional standards of practice should be demonstrated to address nurse staffing ratios
The implementation of mandatory nurse staffing ratios requires well-developed guidelines and professional standards which are sensitive to the nurses and healthcare consumers. Registered nurses should have a substantive role in making staffing decisions to ensure that their needs and concerns are addressed. Appropriate nurse staffing ratio should be based on allocating the ideal number of qualified staff to a care situation, meeting consumer and organizational needs, adhering to federal laws, pursuing quality of care indices, and attending o a quality and safe work environment.
The staffing needs should be determined on bases of the analysis of healthcare intensity, acuity, degree of stability, and the context in which the care is provided. Other factors which should be considered include; mix of staff, skill set, previous staffing patterns, and professional characteristics (Donaldson et al., 2005). The cost of mandatory nurse staffing ratios should also be considered because healthcare facilities may face financial constrains in implementing the legislation. When hospitals face financial constraints, they may be forced to hire underqualified staff or restrict access to care and services.
Roles of nursing leaders and nursing managers in addressing nurse staffing ratios
Nursing managers are responsible for ensuring that workers do their job efficiently. Managers are also responsible for assessing the nursing working environment and determine how they can allocate duties among nurses. When nurse-patient ratio is low nursing leadership and management are affected because the quality of patient care and safety is undermined (Ball, 2010). Nurses may be overworked because they have a bulk number of patients to attend to. In this case, nursing managers can manage the situation by recreating work schedules. For instance, in a case where a nurse has done a long shift and attended to many patients, the manger should ensure that the nurse gets adequate recovery time before they get back to work. When nurses are given enough recovery time, their level of performance increases and patient outcome is improved.
Nursing leaders have an obligation to motivate people around them to attain organizational and personal goals. Several studies indicate that transformational leadership improves patient outcome. Transformational leadership is a form of leadership style whereby leaders inspire people to change for the better through their actions and behavior. Transformational leadership supports the nurse staffing strategy of valuing and empowering nurses (O’Neill, 2012). Nursing leaders can use transformational leadership to empower and hire qualified nurses. Nursing leaders can also incorporate ideas from the workers and help improve the working environment. Better working environment will encourage more people to pursue nursing and the issue of nurse-patient ratio can be resolved.
Additional aspects managers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing nurse staffing ratio
Nursing managers are responsible for staff management, treating planning. Developing educational plans, case management, and mentoring. In order to perform these duties effectively, managers need to have strong leadership skills and outstanding communication skills. To ensure professionalism within the healthcare settings, nursing managers should be able to effectively coordinate resources and personnel, as well as meeting organizational goals and objectives. They should also be able to create a balance between working with hospital administrators and the nursing staff. Nursing managers are also obligated to implement federal regulations for patient safety (O’Neill, 2013). Nursing managers need to possess management skills, leadership qualities, interpersonal skills, and business and budgeting acumen.
Nursing leaders, on the other hand, are responsible for motivating and inspiring people around them to attain organizational and personal goals. Nursing leaders inspire others to change positively through their actions and behavior. Leaders instill vision and motivation in their staff; thus creating high performing workforce. In order to perform this functions adequately, nursing leaders need to develop their emotional intelligence and enhance their technology skills and literacy. Nursing leaders need to possess good interpersonal skills and outstanding communication skills. Leaders also need to be professional, mature, and management and leadership skills.
A leadership style that would best address nurse staffing ratio
The best leadership approach for addressing nurse staffing ratio is relational leadership approach. Relational leadership approach encompasses involving everyone in decision-making processes and encouraging feedback. Relational leadership approach would help solve low nurse-patient ratios by ensuring that nurses are involved in the decision-making process so that their needs and concerns are addressed. The approach would also help address the issue of low nurse staffing ratio by ensuring the nurses stay motivated and inspired. Relational leadership approach would help attract more individuals to pursue nursing; thus addressing this controversial issue.
References
American Nurses Association. (2012). ANA’s principles for nurse staffing.
Ball, J. (2010). Guidance on safe nurse staffing levels in the UK. RCN.
Donaldson, N., Bolton, L. B., Aydin, C., Brown, D., Elashoff, J. D., & Sandhu, M. (2005). Impact of California’s licensed nurse-patient ratios on unit-level nurse staffing and patient outcomes. Policy, Politics, & Nursing Practice, 6(3), 198-210.
O’Neill, J. A. (2013). Advancing the nursing profession begins with leadership. Journal of Nursing Administration, 43(4), 179-181