Challenges in the Nursing Profession and Healthcare

There is a plethora of challenges in the nursing profession and healthcare field today. Many of which result in effecting patients. A nurse's number one priority should be their patient. They are responsible for providing the best care to aid patients in recovering back to optimal health. Nurses are crucial in delivering high quality care to all patients. However, a major problem that seems to stand out are the effects of nurse to patient ratios. Nurse staffing is measured in one of two basic waysnursing hours per patient, per day or the nurse to patient ratio. Factors contributing to the issue are the increased needs of higher acuity patients and the number of qualified registered nurses to fill open positions. Studies are being done to prove that hospitals with lower levels of staff have higher rates of poor patient outcomes.

Review of Literature

Mark Stanton, a medical assistant, wrote an article about how nurse staffing effects the quality of care delivered to patients. According to Stanton, each additional surgical patient per nurse was associated with a 7% higher likelihood of dying within 30 days of admission. In the 168 hospitals with a mean patient-to-nurse ratio ranging from 4:1 to 8:1, 4,535 of 232,342 patients died within 30 days of being admitted. If the patient-nurse ratio had been as low as 4:1 in the 168 hospitals, then possibly only 4,000 patients might have died, and had the ratio been as high as 8:1, more than 5,000 might have died (Stanton, 2005, p.70). These statistics indicate that patients benefit greatly from an increased number of nurses on duty. Nurses are given the ability to provide the patient with the correct amount of attention he or she needs; therefore, lessening the number of errors in the medical field and patient deaths. Moreover, the higher the nurse patient ratio, the better patient outcomes.

Patients, however, are not all at equal risk of experiencing negative outcomes. Research by Clarke and Donaldson states, elderly, chronically ill, and physiologically unstable patients, as well as those undergoing lengthy or complex treatment, are at much greater risk of experiencing various types of adverse events in care (Clarke & Donaldson, 2008). Carefully defining the populations of patients at risk is important in determining how many nurses need to be on staff. This information suggests units containing patients with high risk of adverse outcomes may need to be staffed with more nurses, rather than units consisting of patients with less severe problems. Without adjustments to the ratios, any associations between staffing and outcomes may result in unwanted consequences.

Discussion

By educating the public on the issue of nurse to patient ratios, more people may become interested in the profession and become nurses; as a result, increasing the number of nurses in the world. The availability of nurses to patients would, therefore, also be greater and could resolve the problem. Current nurses could visit high schools and inform the students of the issue. This could have an impact on the students who are conflicted with deciding on a major for their future. However, education isn't the only way to resolve the problem.

In order to reduce the issue of nurse to patient ratios, a formal staffing plan can be created. Each patient will therefore be guaranteed the care they deserve through the nurse's high-quality skills. A staff plan would provide nurses with shift specific information; for example, where and when they need to be on their unit to ensure the correct number of nurses on staff. This strategy will support the standardization of care in each department. Moreover, health care facilities can guarantee staffing decisions focus on the most common factorsthe number of admissions and discharges, patient acuity, and each nurse's level of expertise.

An easier, possibly more logical, approach to the situation could simply be consulting the staff nurses. Direct care nurses are known for their direct care with patients. One of their main contributions to hospital staff is providing insight into care delivery and patient flow. Although a staffing plan may be beneficial since it can be organized ahead of time, the uncertainty of unexpected events such as nurses calling off due to an illness, or floating into another unit due to a high demand of staff creates a downfall. To improve processes, direct care nurses can take note of scheduling issues and make new suggestions.

Conclusion

Optimal staffing is associated with improved patient outcomes. Published studies show that appropriate nurse staffing helps achieve clinical improvements in patient care. For example, enhancements in patient satisfaction and health related quality of life. There has also been a noticeable decrease in medical errors, patient mortality, and nurse fatigue which contributes to safer patient care. Having the average patient acuity on the unit controlled, the proportion of RNs on staff is inversely related to the unit rates of medication errors, decubiti, and patient complaints (Blegen, Goode, & Reed, 1998). With an increased focus on value-based care, an ideal number of nurses staffed throughout hospitals will be essential in delivering high quality care.

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