Contemporary Issues in Nursing Paper: Nurse Staffing Issues

Emily M. Deskin
School of Nursing James Madison University
NSG 462: Issues in Contemporary Nursing
Professor Garman
November 3, 2023
 Staffing in Nursing Issue

Staffing nurses in hospitals has long been an issue in the field of nursing, but with the

emergence of COVID-19, hospitals have struggled to keep staff in house. Unfortunately, many

nurses left to take travel contracts for more money and better patient ratios. According to

Chervoni- Knapp (2022), staffing shortages are spreading throughout the United States in every

industry, not just nursing. Hospitals had to quickly come up with ways to retain and incentive

their staff to stay. Not only do nurses suffer from the staffing shortage, but patients also suffer as

well. These shortages can compromise patient safety as nurses may have more patients than they

can safely care for. With the nursing staffing shortages happening all over the country, this is

leading to more nurses becoming burnt out and putting patients’ safety at risk.

Background

Nursing has been a field where staffing shortages ebb and flow. With the unexpected

COVID-19 epidemic, the nursing field was not prepared for all the staffing shortages that would

come with it. Hospitals had to come up with short-term solutions to curb these shortages as these

shortages could greatly risk patients’ and nurses’ safety. These short-term solutions, according to

Chervoni-Knapp (2022), were causing hospitals to bleed money and did not offer any long-term

solutions. Nurses are being given unsafe assignments and told to do the best they can with the

cards they are dealt. Which is where the ANA Code of Ethics, Provision 2 comes in, as nurses are

obligated to provide the best care to their patients no matter what the circumstances may be. As

early as the 2000s, studies have shown that negative impacts on patient safety and mortality can

be tied to hospitals with low levels of nursing staff (Pittman, 2022, p. 19). For example,

according to Pittmann (2022, p. 19), low staffing levels significantly affect patient care. Some
negative effects include, hospital acquired pneumonia, respiratory failure or cardiac arrest,

hospital acquired pressure injuries and falls, just to name a few. With all these negative effects

that can occur due to low staffing issues, this can negatively affect nurses as well. Unsafe patent

ratios can cause nurses to become burnt out as they may believe the care provided to their

patients is simply not enough. Pittman states (2022, p. 19), nurse burnout can lead to job

dissatisfaction and occupational harm such as needle stick injuries. Also, nurses might be more

likely to not ask for help when turning patients or doing any heavy lifting, as they know their co-

workers are extremely busy with their patients which can put them at risk of hurting themselves.

At least three other studies have shown that higher staffing levels correlate to higher patient

satisfaction and lower patient mortality (Pittman, 2022, p. 19).

Burnout has been linked to lower patient satisfaction as well as worse health outcomes

and many nurses experience burn out at some point in their careers (Kelly, Johnson, et. al., 2021,

p. 114). According to Kelly, Johnson, et. al., 2021, burn-out is not just the problem of the

individual nurse, but rather the whole organization. Provision 6 of the ANA Code of Ethics states

that the conditions of employment are safe, and nurses must be able to provide quality care.

Therefore, this is part of the hospitals’ responsibility to help reduce burnout among nurses and

other staff, which can lead to better patient outcomes and better staff satisfaction. When nurses

feel appreciated and supported, this can help foster more positive work environments leading to

better patient care and satisfaction.

The Student Perspective

As a nurse who attended nursing school through the pandemic and is now working as

nurse through the lasting effects of the COVID-19 epidemic, there are ways that staffing

shortages and nursing burnout can be addressed. Many hospitals, including VCU used travel
nurses to supplement nursing shortages. This led to reduced satisfaction in nurses who chose to

stay at their hospitals, as the travel nurses were making more money and led to less unit

camaraderie. Nurses work well when they feel supported in their environments and have

supportive staff surrounding them. It is in the hospital’s best interest to find ways to retain their

nursing staff to lead to better patient outcomes and better satisfaction. Continuity of care is a very

important piece of better patient outcomes as well as satisfaction and hospital units are unable to

do that if they do not have adequate staffing. Without adequate staffing, patients may be seeing

different nurses each shift leading to no continuity of care and patient dissatisfaction as well as

worsening patient outcomes.

Recommendations for Improvement

As a nurse working in a hospital that was deeply affected by the staffing shortages caused

by COVID-19, as well as working on a unit med-surg unit where turn-over is at an all time high,

there are many ways in which the not only the hospital can approve but also improvements can

come at a unit base level. VCU hires for rotating shifts only on in-patient units, but offering a

day or night shift option could greatly increase applicants who want to work a particular shift and

help with the staffing shortages. Rotating back and forth between shifts can be very tiring and

can lead to burnout. Also, having a unit-based incentive program encouraging staff to stay longer

could also help. On Main 9C, after 2 years of working rotating shifts, nurses do not have to rotate

anymore and can work either day or night shift. Lastly, increasing pay and incentivizing shifts

could help reduce staffing issues hospitals are seeing.

 Conclusion

In conclusion, nursing staffing shortages can be detrimental to hospitals. Increasing

staffing and retention can lead to better patient outcomes and greater patient and nurse

satisfaction. Staffing shortages can unfortunately not only lead to burnout, but worsening patient

outcomes as nurses may be caring for a greater number of patients than they are used to. Nurses

work well in environments where they feel supported. Hospitals should investigate ways that

they can increase staff retention, such as offering non-rotating shifts and incentivizing staying at

the hospital for a certain period. Fixing the staffing shortages within nursing can lead to less

burn-out among nurses and reduce patient safety risks.

 References

American Nurses Association. (2015, January). Code of ethics for nurses. American Nurses

Association. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/

code-of-ethics-for-nurses/
‌
Chervoni-Knapp, T. (2022). The Nurse Staff Pandemic. Journal of Radiology Nursing, 41(2).

https://doi.org/10.1016/j.jradnu.2022.02.007

Kelly, L. A., Johnson, K. L., Bay, R. C., & Todd, M. (2021). Key Elements of the Critical Care

Work Environment Associated with Burnout and Compassion Satisfaction. American

Journal of Critical Care, 30(2), 113–120. https://doi.org/10.4037/ajcc2021775

Patricia, P. (2022). Evidence on Hospital Staffing Outcomes: Implications for Washington State

[Review of Evidence on Hospital Staffing Outcomes: Implications for Washington

State]. Washington Journal, 52(2), 19–20.