Nurse staffing levels are affected throughout the world due to budget cuts, scarcity of nurses, the aging population, and the increasing healthcare requirement. In the nursing profession, safe staffing of nurses has become the main problem, leading to protests, extensive research, and support of the main nursing organizations for the right legislation.
The Safe Staffing for Quality Care Act was awesomely passed by the assembly of New York State in June 2016. Though the Senate has not approved it, it states the alarming situation of the low ratio of nurse-to-patient and the chronic problem of understaffing. According to experts, it is shocking and unwise for the well-being of the patients to ignore the problems of nurses. For many members of the alliance of the retired Americans, passing legislation about nurse staffing is a very urgent matter.
Quality care can be provided to the patients when the staffing levels are safe, the organization’s overall performance and withholding nurses are better, and higher job satisfaction. According to the studies published throughout the world, nurse staffing levels can be backed by the following points.
Impact of staffing levels on mortality and morbidity of patients
Those who take care of the patients in the hospitals round the clock are known as nurses. A nurse is fully responsible for the safety and welfare of the patient if her name is on the chart of the patient. But when a nurse is compelled to look after a large number of patients, it may not be possible for her to be everywhere and take care of the requirements of every patient. It can be a risky situation for the nurse’s license along with the welfare of the patients.
Several studies have linked nurse staffing of higher levels with a decrease in the staying period of patients, positive outcomes of patients, reduce mortality of patients, and lower admission rates. It means that the costs of patient care can be reduced by improving the levels of staffing and the satisfaction of the patients.
It is not surprising for nurses if researchers link the increasing incidents of infections in post-op wounds, errors in medication, pressure ulcers, poor management of pain, pneumonia, infections in the urinary tract, and various other issues occurring during their stay in the hospital with the low level of nurse staffing. It can be a lot of time spent by the nurses with seriously unwell patients, and they observe initial signs of complications at first.
Patients’ outcome can improve by increasing the ratio of RN
Hospitals usually reduce the highly qualified RN versus sub-category nurses to lower their costs. It has been proved through various studies that the mortality rate can be lowered, patient outcomes can be improved, stay of the patients in the hospital, and errors can be reduced when in the mixed staff, the ratio of qualified RN is higher.
Staff turnover can be reduced by improving nurse-to-patient ratios.
The fatigue and exhaustion caused by inadequate levels of staff compel many nurses to leave their profession or leave their jobs with an employer. The stress level of the staff increases, and their overall well-being decreases with the constant shortage in staffing. It can also cause absence for their duties due to ill-health. The rate of turnover of the staff also increases with a lower level of job satisfaction.
As reported by the Nursing Federation of Australia, a considerable increase in nurse-to-patient ratios was noticed when many nurses rejoined their profession. Student nurses were recruited after the legislation was passed in the state of Victoria. It provided more stability in this profession and improved the satisfaction from a job for the nurses.
The legislation should not prescribe particular nurse-to-patient ratios.
Though various studies have suggested 1:6, nurse to patient ratio, on average wards, but1:4 is considered an ideal and safe ratio. But nursing organizations like ANA etc., do not support the mandatory ratio suggested by the legislation. It can be dangerous to accept a single ratio as it does not consider the changes in the requirements of the patients, the need for mixed skills of nursing, and unique circumstances. According to nursing organizations, the plans for nurse staffing should be created on a unit basis, and registered nurses should be included in the direct care of the patients.
What should legislation provide for safe nurse staffing?
According to ANA, hospitals should develop reliable and valid nurse staffing plans on a unit basis.
In the proposed federal bill in the US, provision has been made for hospitals to collect plans for staffing by including enough RN in each shift and unit. These plans should be based on the requirements to provide quality care to the patients and the characteristics of the patients in each unit.
Each health care establishment should form a nurse staffing committee to implement the staffing plans, and for violating the Act, the hospitals should be penalized with financial and other penalties. In this act, a provision to protect the whistleblowers is also made. They can be patients or employees talking against the complaints and grievances about staffing requirements and other discriminations.
How can nurse staffing be promoted?
For healthy working conditions and safe levels of staffing, every nurse can work as an advocate. They can educate people in their contact by knowing facts in this regard. They can talk and convince leaders in their social circle, working environment, press, and political circle through e-mails, reports, and discussions. About the effect of safe nurse staffing on every nurse, they can talk to community groups.
In the field of healthcare, the group of nurses is the largest. Administrators of a healthcare unit can easily balance their budget by reducing the nursing staff. But it can be damaging for the organization, community, and nurses in the long run. So to promote nurse staffing agencies, they must use the same number of nurses to win the trust people have in this profession.