Issues of Nurse Staffing: The Perfect Storm
By: Janelle M. Zimmerman, RN, BA
Safe nurse staffing has been an issue since before nursing was first formally recognized as a profession. A perfect storm of changes has created a crisis in recent years, and many nurses today have horror stories of desperately trying to practice safely with an overwhelming patient load.
- COST. As insurers cut reimbursements, nursing is an easy target for cost cutting measures. Changes in reimbursement from insurance companies impact the way hospitals practice. Patients are sent home “quicker and sicker.” Gone are the days when a patient might spend a week or more as an inpatient, requiring relatively little care. This means that the patients who are in a hospital are acutely ill and require close monitoring and complex care. Nurse staffing numbers do not always reflect this new reality.
- VARIABILITY. Sheer variability in practice settings is part of the issue. A nurse working in an intensive care setting may be frantically trying to care for two critically ill patients, while another in long-term care is comfortably overseeing care for ten or more. Direct care versus supervision, acute care versus long term care, and so on. This variability makes it challenging, indeed, to draft effective state and national legislation since this variability is seen from unit to unit within a single facility.
- NURSING SHORTAGE. The U.S. population is aging rapidly as baby boomers enter retirement age. This affects the nursing crisis from both directions. Not only is there an increased demand for nursing services, but nurses themselves are aging and are projected to retire within the next decade. This not only affects direct care, but also academic settings where fewer nurses hold faculty positions, thus creating nursing school enrollment limitations. The impact is significant and the demands immense as nurses continuously work with limited resources while caring for individuals who are living longer with chronic disease and comorbidities.
Given these issues, is there any relief for us nurses? Yes! Nurses are in the best position to guide nurse-driven staffing solutions. The American Nurses Association developed several free resources to identify the major elements that are necessary to achieve optimal staffing.
Download their free e-book, which guides nurses in identifying and developing processes to improve nurse staffing at every practice level and setting. It’s a short guide (under 25 pages), but packed with great information that addresses interprofessional teams, workplace culture, practice evaluation and more.