The Impact of Understaffing among Nurses in Tertiary Hospitals of San Fernando, La Union

Background of the Study

Shortage of nurses has been one of the relevant problems in the Philippines as most registered nurses

chose to migrate to other countries that pay well and some nurses chose to pursue other job that pays

more and is less exhausting, which leads to nurse understaffing. most of the related studies that were cited

focused more on the patient’s safety and the researchers would want to study on the impacts of

understaffing to the nurses’ well-being as the researchers consider it as a big problem because it might

lead to severe exhaustion physically, emotionally, mentally which will also lead to health problems. this

research study will stand up for those nurses affected by understaffing for the people and the government

to be able to hear their voices.

The study will take place in Lorma Medical Center, La Union Medical Diagnostic Center and Hospital

Inc. (LUMED Hospital), Ilocos Training and Regional Medical Center, and Bethany Hospital, San

Fernando City, La Union under the supervision of Mr. Red Jimeno.

These four tertiary hospitals are located in San Fernando, La Union. The Lorma Medical Hospital is the

leading private care referral center for tertiary cases in Northern Luzon. It offers a wide range of various

services to meet the health-related needs of the public. La Union Medical Diagnostic Center and Hospital

Inc. (LUMED Hospital) is a private hospital accredited by DOH as Level 1 General Hospital that ensures

the safety and health of all its stakeholders in the delivery of quality and affordable services. Ilocos

Training and Regional Medical Center (ITRMC) is an ISO-certified institution; one of the few DOH-

retained hospitals outside Metro Manila with 13 fully accredited residency training programs. As such,

continually expanding their current 54 subspecialty services, with their allied professionals to strengthen

the pillars of universal health care, a service-learning opportunity for our wide array of stakeholders.

Lastly, Bethany Hospital has transformed from the oldest to one of the most modern hospitals not only in
La Union but also in the Ilocos Region. The hospital stands magnificently in a "small hill" in the center of

town restored to its former grandeur befitting to the call of the modern ministry of healing.

Moreover, the researchers decided upon conducting the research in Lorma Medical Center, La Union

Medical Diagnostic Center and Hospital Inc. (LUMED Hospital), Ilocos Training and Regional Medical

Center, and Bethany Hospital, San Fernando City, La Union to further investigate the impact of

understaffing among nurses in tertiary hospitals of San Fernando, La union.

Understaffing is associated with higher missed treatments in hospital units. Standardized, integrated

information systems within a hospital are associated with less missed treatments. Furthermore, employee

teamwork within a hospital unit is associated with a direct effect on missed treatment rates as well as an

indirect effect by weakening the negative impact of understaffing. (Metcalf, A.Y.., et. al.,2018)

On the other hand, Epic reported that the nurse staffing demand increased by 245 percent between

September and December of 2020, as ICU beds filled and COVID-19 cases surged. The demand was

particularly high in metropolitan areas. Research has also shown that reducing nursing staff in order to cut

costs can lead to employee burnout and poor patient outcomes, and these factors have only been

exacerbated by COVID-19. (Jill McKeon, 2021)

Furthermore, lower RN staffing and higher levels of admissions per RN are associated with increased risk

of death during an admission to hospital. These findings highlight the possible consequences of reduced

nurse staffing and do not give support to policies that encourage the use of nursing assistants to

compensate for shortages of RNs. (Griffiths et al., 2019)

Moreover, during the first weeks of the COVID-19 pandemic, 120 nurses were surveyed about nurse-to-

patient staffing ratios, skill mix, and near misses in their hospitals. Personnel understaffing led to

increased use of workarounds, and expertise understaffing led to increased cognitive failures, both of

which shaped near misses. Hospital leaders should recognize both forms of understaffing when making

staffing decisions, particularly during times of crisis. (Andel SA, AM, W, et al. J Adv Nurs. 2021)
Finally, the proportion of understaffing and increased nursing workload are associated with unfavourable

patient safety outcomes, most markedly in-hospital mortality, demonstrating that an adequate level of

nurse staffing in relation to patient complexity is a prerequisite for the availability and quality of critical

care services. The proportion of understaffing did not differ between survivors and non-survivors. (Miia

Jansson.., et. al., 2020)

In this study, the word understaffing means the employment of too few nursing staffs, may the reason be

from not having enough staff in a particular hospital or not having enough staff at any given time.

The nursing profession, is that which is not to be taken for granted. Therefore, healthcare staff proportion

is that which is very critical to patient satisfaction. Their major role and responsibility encompasses

around patient care experience. In normal settings, the nursing with proper patient ratio proportions is

known to be physically and emotionally exhausting due to the demands that is associated with the job.

Recent developments however, has seen the nurses to patient ratio decreased statistically, a result of

consistent migration of competent Filipino nurses to other countries in search of high salaries and other

incentives. The increase in workload for available nurses most especially in government hospitals has

reduce time structure through which nurses might have helped their colleagues. This has become a major

problem as many unit nurses in government hospitals has made complaints due to lack of focus,

supervisors which leads to medical errors, which in worst cases lead to increase in patient’s mortality rate.

According to national study that was published in 2018, as many as three out if four governmental

hospitals lacks healthcare workers. And as projected, this is expected to continually worsen till 2030. As

short staffed nursing is expected to reach a high of 249,843 by the year 2030. (World Health

Organization, 2020).
Today's nurses are vital members of society because they promote health, educate the public and their

patients on how to avoid illnesses and injuries, take part in rehabilitation, and offer care and support and

there will be a time where nurses might think that working abroad is better than staying in the country.

This study is of great help to know the impact of understaffing in tertiary hospitals so it can help

emphasize on how shortage of nurses can lead to increase patient safety errors and also how this shortage

in staff can cause burnout to nurses that might become a reason why there is a turnover in employment.

By this, it will give awareness to the government on how they should give importance to address the

nursing shortage.

Statement of the Problem

The researchers generally aimed to determine the impact of understaffing among nurses in

tertiary hospitals of San Fernando, La union.

Specifically, the study sought answers to the following:

1. Profile of the respondents

2. What is the impact of understaffing on nurses in terms of:

3. Significant

4. Proposed output

5. Validity
Significance of the Study

This study will be made with its aim to provide crucial information regarding the impact of nurse

understaffing in the tertiary hospitals in San Fernando, La Union which will greatly benefit the following

individuals:

1. Student Nurses. The researchers hope to help the student nurses in further knowing more about

understaffing among nurses.

2. Registered Nurses. This study would be of great help to nurses as it studies the impact of

understaffing among nurses in San Fernando, La Union. In this way, the government would be

able to address this issue and provide a solution out of it.

3. Future Researchers. The researchers hope to help future researchers in their conduct of the study

for information about understaffing among nurses.