Understaffing is a chronic problem in many nursing
units, and has detrimental effects on nurses and patients.
For nurses, inadequate
staffing has been linked to job stress and dissatisfaction,
higher incidences of mental and physical illness, low
morale, and high turnover. For patients, understaffing
means a higher risk of adverse events and a lower quality
of care.
United States
The American
Nurses Association (ANA) surveyed more than 10,000
nurses in their 2008
Safe Staffing poll. An overwhelming 73% of respondents
said that their units and shifts had insufficient staff.
Forty-eight percent of nurses said that they would
not feel confident having someone close to them receive
care in the facility where they work, and 51% said
that the quality of nursing care in their unit has
declined in the past year. Nurses are often forced
to skip meals to complete their work, and 61% of respondents
said that they took a full meal break once a month
or less. Fifty-two percent of nurses said they considered
leaving their position, and 46% of those said their
reason was associated with inadequate staffing. Additionally,
24% said they were considering leaving nursing,
and of these, 42% said the reason is associated with
inadequate staffing. Among the respondents, 60% said
they knew somebody on their unit who had already left
direct care nursing due to concerns about unsafe staffing.
Canada
Like their American counterparts, Canadian nurses
also face chronic understaffing and its associated
challenges, but the problem seems to be less severe.
Findings
from the 2005 National Survey of the Work and Health
of Nurses was based on a survey of 19,000 nurses
across the country. Thirty-eight percent of hospital
nurses reported inadequate staffing levels at their
workplace, and reports of understaffing were more common
among LPNs than RNs. Twelve percent of nurses agreed
with the statement "My nursing team delivered fair
or poor care." When asked "Has the quality of care
delivered in your workplace changed over the past year?"
57% said that it has remained the same, 27% said it
has deteriorated, and 16% said it has improved. Staffing
levels were clearly important in determining the level
of care. Sixty-seven percent of nurses cited "fewer
staff" as the reason for a decline in the quality of
patient care. Among nurses that reported an improvement
in the quality of care, 29% gave "more staff" as the
reason, making it a close second to "improved management/reorganization,"
which was the reason cited by 30% of nurses.
* * * * *
Nurse understaffing is a result of the ongoing nursing
shortage, and there are no easy solutions for these
complex problems. The problem is so severe in the United
States that H.R.
4138: Registered Nurse Safe Staffing Act of 2007
was introduced in November 2007, with the endorsement
of the ANA.
If passed, this bill would require hospitals to develop
nurse staffing plans, publicly report staffing information,
and offer whistleblower protection for nurses who file
complaints about staffing. However, legislation alone
will not resolve the staffing shortage. Work conditions
must be improved to keep nurses in clinical areas,
and more places are urgently needed in nursing schools
to meet current and future demands. A long-term solution
to the nurse staffing shortage will require a concerted
effort from nurses, employers, and legislators.
Article published on Jul 14
08 12:59AM.
