Effects of Nurse Shortages on Patient and Nurse Safety

Najah Musa

N600 Roles, Issues and Public Policy

Dr. Schwindenhammer

March 3, 2022

Effects of Nurse Shortages on Patient and Nurse Safety

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Understanding the impact that nursing shortages have on both the nurses and patients is

the first step in recognizing the importance of policy in the nursing world. Having policies in

place that are specific to the needs of the nurses ensures that patients are safe when they are

being cared for in the hospital. Nurses shortages is a widely national problem given that nurses

are the backbone of healthcare. According to the United States Registered Nurse Workforce

Report Card and Shortage Forecast, there will be more nursing shortages between 2016-2030

causing more health safety problems for patients and hospitals as whole. Despite its growth,

there are many factors that contribute to a nursing shortage which include an aging population

and the retirement of more than a million nurses by 2030 (Aiken & Cheun, 2009). Given that

there is a direct correlation between patient safety and nursing shortages, these findings are

alarming and should be addressed in policy to ensure the quality and safety of patient care.

There are consequences for nursing shortages in the hospital on both nurses and patients.

Buerhaus explains in his article the contributing factors to nursing shortages which include the

number of retiring nurses is increasingly higher than those newly graduating nurses. This is also

specific to certain departments that require more experienced nurses like intensive care units,

emergency departments, and critical care units. This is especially problematic because these units

need experienced nurses which hospitals do not have, causing higher safety risk on patients

given that there can be more medical problems. Given that experienced nurses can handle high-

stress environments, they are more experienced in handling such issues when they arise.

Researchers suggested adding nursing programs to meet the demand for nurses and while that

can greatly impact hospitals, it doesn’t solve the problem as Buerhas claimed. The author

suggested that given the circumstances after the occurrence of COVID-19 only recently, it is
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unknown whether shortages will continue after the pandemic and how much it will impact the

healthcare system. Furthermore, the author analyzed the 1990s era where nurses were amongst

the highest paid employees in the hospital, thus due to budgeting, the hospitals started hiring less

nurses, which also brought a much bigger issue, which is the quality and safety of both nurses

and patients (Buerhaus, 2021).

Patient safety is of highest priority. When there are not enough nurses to take care of the

number of patients, the health and safety of patients is jeopardized. A research article was

published called Nursing Shortage: A Scoping Review of Contributing Factors, the research

highlights factors that have impacted hospitals negatively. According to the article, enhancing

support from administration may help in reducing the nursing shortage, as well as strong nursing

facilities in which unlimited support is available. This suggests that administrators can greatly

help nurses by providing them the support they need. The researcher correlates nursing shortage

with working conditions, retirement factor, organizational support, unsupportive leadership, and

stressful work environment. There are implications that nursing administrators can engage in a

more unified way to create better work environments for nurses. The author suggests enhancing

the way nurse managers communicate with nurses can be game-changing given that it can create

a better work environment and provide the necessary support when problems or questions arise

on the floor. This is important because it further highlights the contributing factors that are

leading to nurses’ shortages and how we address those challenges in hospitals to provide better

safe patient practice when dealing with them. While nursing shortages cannot be controlled in a

hospital setting, the support and attitude can tremendously impact the nurses’ attitude towards

patient care (Boamah, Callen & Cruz, 2021).

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Nurse shortages are not only due to lack of graduating nurses, there are many nurses

leaving the hospital floors because of stress and burnout. According to a study evaluating the

impact of stress on nurses, the researcher evaluated in detail how work characteristics

contributed to overall health and safety of nurses and how nursing shortages were critical

indicators of that. It also examined how nurse leaders can help in contributing to those work

factors. In the study, the researchers obtained responses from 507 registered nurses via online

survey through path analysis and invariance testing to explore how characterizing resilience and

burnout can play a role in creating more nursing shortages. As noted in the article, maintaining

qualified nursing staff is critical for patient safety. The researchers concluded that a positive

practice environment and favorable work characteristics lowered burnout and improved

outcomes for nurses. Nursing shortages have decreased patient satisfaction rate and have

increased burnout amongst nurses. As concluded in the article, leader support was critical in

shaping positive perception of a positive work environment. A nurse leader’s actions can

reinforce a positive work environment. This is important because it provides a platform for

nurse leaders to understand how to help provide better work environments and how the nursing

shortages can be a determining factor to patient-satisfaction. Positive practice environment and

favorable work characteristics helped in lowering the burnout rate, as well as improved the care

nurses provided to their patients. Nurse leaders can play a great role in helping create great

nurses. This is done through positive reinforcement and support from nurse leaders.

Nurse leaders can also hire more nurses to provide exceptional nursing care. Providing

exceptional nurses care means hiring more nurses for each unit giving patients enough time for
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nurses to provide therapeutic communication and one-on-one nursing care. Providing

exceptional care correlates with an increasing number of nurses which is essential for hospitals.

The need for urgent intervention results from providing each patient the necessary means

through providing a holistic approach focusing on body, mind, and emotions for optimal care.

According to the Neves, Parrerira, Rodrigues, & Gravto, policymakers can make this happen by

pushing laws in place that prohibits hospitals from giving nurses more than three patients at a

time. Proper political decision-making that is specific to hiring more nurses per unit is essential

in improving quality care.

To ensure the safety of patients and nurses, policymakers should be pushing for more

laws restricting hospitals from giving nurses more than number of patients they can handle.

Giving them more than they can handle can lead to burnout and stress, resulting from more

nursing shortages across the nation. When there are a sufficient number of nurses for each floor,

there are less medical mistakes given than nurses can take more time for each patient. Numerous

studies have proven more patient satisfaction when nurses have less patients and this is why

advocating for this will help nurses everywhere. Nurse leaders have as much as of job as policy

makers to advocate for nurses and their patients.

References
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Aiken LH, Cheung RB, Olds DM. Education policy initiatives to address the nurse shortage in

the United States. Health Aff (Millwood). 2009 Jul-Aug;28(4):w646-56. [PMC free article]

[PubMed]

Boamah, S. A., Callen, M., & Cruz, E. (2021). Nursing faculty shortage in Canada: A scoping

review of contributing factors. Nursing Outlook, 69(4), 574–588.

https://doi.org/10.1016/j.outlook.2021.01.018

Gensimore, M. M., Maduro, R. S., Morgan, M. K., McGee, G. W., & Zimbro, K. S. (2020). The

Effect of Nurse Practice Environment on Retention and Quality of Care via Burnout, Work

Characteristics, and Resilience: A Moderated Mediation Model. JONA: The Journal of Nursing

Administration, 50(10), 546–553. https://doi.org/10.1097/NNA.0000000000000932

Neves, T. M. A., Parreira, P. M. S. D., Rodrigues, V. J. L., & Graveto, J. M. G. N. (2021).

Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross‐

sectional study. Journal of Nursing Management (John Wiley & Sons, Inc.), 29(5), 1246–1255.