For my previous discussion post, I discussed how staffing shortages can lead to burnout due to increased workloads and longer hours. Burnout has been shown to significantly increase medication errors, reduce patient outcomes, and reduce productivity which decreases the quality of patient care overall (Bakhamis et al., 2019). Nurses will also become overwhelmed working in stressful environments, creating lower job satisfaction scores and lower nurse retention (Bakhamis et al., 2019). Because of this need to prevent burnout in nurses, the policy would need to be developed to address having an adequate nurse-to-patient ratio while also balancing budget costs. Despite attempts to develop policies to help healthcare organizations, competing needs related to the workforce and lack of resources make it difficult to address the shortage.
Nursing leaders would need to develop a policy that can create a supportive environment for nurses to care for patients safely. The goal would be to improve patient outcomes and improve retention, decreasing burnout. For example, developing a policy to establish set nurse-to-patient ratios depending on the unit. Adequate staffed units have been shown to result in lower mortality rates, shorter hospital stays, and less risk for adverse risks like medication errors (Saville et al., 2019).
Specific Competing Needs that May Impact Nurse Shortages
For adequate staffing, there needs to be a balance between the funds available and the organization’s available budget so that it is sustainable while also providing the best patient outcomes. In other words, there needs to be staff and funding available for this to happen. Within my healthcare organization, we have used travelers to fill in shifts to help supplement staffing. There have been times when the number of travel nurses outnumbers staff nurses on a given shift. While these travelers provide much-needed help, they also have expensive contracts and will work a few months per their contracts. When discussing this dilemma with hospital leadership, we have been told this process is not sustainable in the long run. Instead, the hospital risks losing more money in paying travelers than losing staff nurses. According to Kelly and Porr (2018), this is an example of how the business model of healthcare can negatively impact nurses and their ability to provide safe, high-quality patient care. Over time this can increase nursing stress due to ethical dilemmas, increase burnout, and ultimately worsen staffing anyway (Kelly & Porr, 2018).
Nurses should recognize these issues as serious ethical dilemmas as patients risk subpar care due to increasing healthcare costs. Milliken (2018) suggests nurses develop ethical awareness, by challenging situations and understanding the outcomes of these actions. For example, in my healthcare organization, we have discussed how the lack of staffing can lead to increased medication errors and our CLABSI/CAUTI rates due to nurses being in a ratio that’s fifty percent or even double what their normal ratio is. For example, in my ICU unit, the standard nurse-patient ratio is 2:1. However, there have been times we are 3:1 or even 4:1 while being expected to provide the same care with more strain on time and resources. Nurses must speak up when they feel they are in an unsafe patient assignment, further developing ethical competence (Milliken, 2018). By speaking up, nurses can be advocates for changes in policy, improving on the current process.
Conclusion
Overall, staffing shortages have created challenges in the healthcare field, leading to increased nurse burnout and poor patient outcomes. Attempting to develop policy to support nurses has been difficult as the organization must also care for its own interests including available funding and budget costs. In other words, the organization must provide funding to staffing, as well as the resources needed to care for patients like the building costs, technology, and other miscellaneous costs. It is recommended that nurses become ethically competent so that they can address moral dilemmas when there is concern that patient care is subpar due to available resources.
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