When nurses are forced to work with high nurse to patient ratios, patients can develop a variety of infections, get injured, and can lead to death. Often at times patients are discharged home too soon without adequate education about how to manage their illness or injury (Raquel & Sean, 2011). Because of patients being discharged to soon, this causes them to return back to the hospital often sicker than they were before. Increase in rate of admissions, transfers, and discharges on hospital unit’s raises nurses’ workload. When nurses have fewer patients, they are able to provide high quality care (Raquel & Sean, 2011). A quantitative research was done based on knowledge of unit’s attribute and shift by shift nurse staffing levels. The researchers inspected 43 units of medical and surgical patient’s mortality in an infamous magnet hospital here in United States. The units and shifts staffing data from 2003 to 2006 were obtained and consolidated with patient data resulting in 3.2 million unit shifts for 197961 patients.
The outcome of two staffing variables were scrutinize using a shift unit level: understaffing actual registered nurses staffing eight hours or more below target staffing levels generated by a patient classification system and high turnover which means unit admissions, transfers and discharges exceeds mean day shift by one standard deviation. Patient survival rate was analyzed using Cox proportional hazard regression models with adjustment for clients, unit and shifts risk covariates was practiced. The risk adjust mortality was evaluated to staffing and turnover within the first 5 to 30 days after admission and during previous shifts. The result was dangerous ratios (Raquel & Sean, 2011).
The result shows that each shift and unit that where understaffed by 4 to 7% and also has high turnover the risk of patient’s death increases by 2 to 5%. The authors also pointed out that low acuity patient on units that are understaffed, the risk of death is 4 to 12% and with high turnover the risk of death is 7 to 15% (Raquel & Sean, 2011). The strength of the study is that the researcher was able to analyzed patients in the units, staffing, shifts levels and turnover. The authors pointed out that the limitation in the study is that the patient sample was not identical; some confounding of staffing decision with patient clinical conditions and differentials in staffing could have influence the study. The authors elaborated that the findings in this study is consistent with previous association between registered nurse coverage and lower hospital mortality rate, (Raquel & Sean, 2011).
Contrast and Compare Nursing Leaders
Sigma Theta Tau International (STTI) and 40 other healthcare groups of organizations and leaders are helping to find solutions on the war of nurse shortage. The affiliation designed a website, made advertising movements and secured media footage (Sigma Theta Tau International). These measures were being done as a way to entice young people to enter the nursing profession. The advertisement measures also helped to spread the word to the public of the drastic need for nurses. STTI has risen over $1 million dollars to help towards the campaign of nurse shortage. The campaign continues to receive new coverage nationwide to raise awareness of the nurse shortage (Sigma Theta Tau International). Johnson & Johnson and The Honor Society of Nursing worked together and contribute $20 million a year towards campaign to scale down on nurse shortage.
The goal of Johnson & Johnson and The Honor Society campaign is to attract people to work in hospitals and extended care facilities (Sigma Theta Tau International). August 1, 2002 the former president Bush, signed Nurse Reinvestment Act. The Nurse Reinvestment Act is intended to alleviate the nursing shortage by offering incentives with tuition reimbursements. The Nurse Reinvestment Act details five main functions: Scholarship for future nursing students with loan reimbursement programs. Public business announcement to entice people to enroll in nursing programs (ANA 2015). Career advancements programs for workers that would like to further their profession. Awarding grants to administrators for magnet programs. More focus on gerontology programs by offering grants for long-term care training. Fast track staffing reimbursement programs for those who decide to teach nursing curriculum (ANA 2015).
Contrast and Compare Nursing Managers
Mangers can help decrease nurse shortage by increasing the staff morale on the units. New nurses often feel intimidated; some are giving tough assignments that they may need help with. As a manger overlooking is essential to make sure the work load is evenly distributed (ANA 2014). Management by Walking around (MBWA) is a manger that is always on the move making their rounds. When making rounds focus on what the staff is doing, offer help if needed, interact with the family members and the staff. This type of manger is in long-term care facilities. By making rounds you can ensure that all staff is being treated fairly, you are able to see what works and does not work (ANA 2014).
My Personal and Professional Leadership Style
As a nursing leader I prefer Transformational Leadership style. With transformational leadership the focus is on motivating and constructing relationships among the staff, so that the same mission and vision can be obtained. Transformational are good communicators, they use their charm to get people to see the perspective on situations. Praise and encouragement is often used by transformational leaders, I am also a great problem solver both at work and at home. As a nurse manager my approach would be to continue community with the staff and encourage the staff through humanizing nursing theory. A good manager will treat their employees with a holistic approach. It is not every day that the workers are working up to 100%; they could be having a personal problem. Continue to be assertive when needed, confront and deal with conflicts as they arise. When you treat your employees with respect, dignity, and allow autonomy they will be willing to work hard at their jobs.
Hospitals used both per diem nurses and traveling nurses who sign short-term contracts to fill individual shifts and accommodate short-term staffing needs arising from staff vacations or medical leaves. Some hospitals used internal staffing agencies or float pools. The downsides to these strategies include high cost and decreased quality of care. Hospitals looking for more long term strategies are investing more in nurse education, lower nurse to patient ratios or limiting volume of patients so not to overload available staff. Hospitals are also partnering with nursing schools in an effort to grow population of new nurses and possibly secure contracts with students who attend clinical at their facilities. Nursing shortage can lead to increase patient harm and decrease in access to quality care. The nursing shortage is not a quick fix, but acknowledgment of the problem is a beginning to a solution. It is imperative that health care facilities staff their units properly so that the patients will receive quality care that they deserve. Understaffed and high turnover shifts increase the risk of death.
American Nurses Association (ANA 2014). Nursing leadership, management and leadership style. Retrieved on April 22, 2015 from. http://www.aanac.org/docs/white-papers/2013-nursing-leadership—management-leadership-styles.pdf?sfvrsn=4
American Nurses Association (ANA 2015). Nurse reinvestment act background. Retrieved on April 22, 2015 from. http://www.nursingworld.org/NurseReinvestmentAct.aspx
Raquel, M., & Sean, C. (2011). Staffing with nurse understaffing and high patient churn linked to heightened inpatient mortality risk in a single site study. Evidence based nursing, Vol. 14, p122-123. Retrieved on April 22, 2015 from. http://dx.doi.org/10.1136/ebn.2011.100052
Sigma Theta Tau International (1199-2015). Honor Society of Nursing. Facts on the nursing shortage in North America. Retrieved on April 22, 2015, from. http://www.nursingsociety.org/Pages/default.aspx