Nurses play an indispensable role in our health care system. They provide round-the-clock care for patients with fragile (and often life-threatening) health conditions. They administer medications, change dressings, insert catheters and IVs, lift and transfer patients, keep meticulous records and much more. Nurses serve as tireless advocates for their patients, and they're a vital link in keeping paths of communication clear.
It's no surprise, then, that when hospitals don't have enough nurses, patients pay the price. Numerous studies have shown that nursing shortages correlate with higher rates of patient harm - including death. Understaffing jeopardizes patients' quality of care and increases the risk of serious medical errors.
Staffing concerns spike in 2016
Although we're fortunate to live in a state with some of the nation's top-ranking medical institutions, staffing issues are still a major problem. According to a recent report from the Minnesota Nursing Association, staffing concerns rose nearly 10 percent in 2016. This spike is alarming in light of the fact that roughly 22 percent of the nursing workforce was out on strike for seven weeks (and thus didn't report specific staffing issues during that timeframe).
The dire consequences of understaffing
Staffing shortages negatively affect patient care in numerous ways, including:
- Delayed medication doses, which can undermine the effectiveness of treatment and result in unmanageable pain levels
- Delayed dressing changes
- Incomplete or delayed assessments
- Delays in getting call lights answered
- Rushed discharge, leaving patients without adequate guidance on critical self-care
- Poor communication
- Patient falls
- Shortcuts in dealing with patient concerns
In understaffed hospital units, patients are far more likely to leave against medical advice - or without even being seen.
How the problem gets mishandled
Far too often, when nurses raise red flags about staffing concerns, management does nothing. When they do take action, hospital administrators often resort to patently unacceptable solutions for coping with the shortages, including:
- Pulling new nurses out of training or orientation early
- Floating nurses to units where they aren't adequately trained
- Requiring nursing assistants or other staff to fill roles beyond their skillset
- Pressuring nurses into working excessive overtime, such as consecutive double shifts
Increasingly, nurses are expected to worker longer and more strenuous shifts. The vast majority end up staying an extra hour at the end of their already lengthy 12-hour shifts, and many report having to work 16-hour shifts. Stretching exhausted nurses too thin in this way undoubtedly puts patients at risk.
"Minnesota needs to set a minimum number of nurses that will be scheduled to work every day and every shift so that there are enough of them available to care for patients properly." - Minnesota Nursing Association
When addressing these staffing concerns, hospital administrators often focus on the number of patients in each unit. They fail to take into account each patient's unique condition and needs - or the reality that some patients require much more intensive care than others.
This approach leaves nurses themselves shouldering an impossible conflict. They have an ethical and professional duty to provide the highest quality of care, yet they're often powerless to make the institutional changes necessary to provide that level of care.
How to fix it
The solution to this far-reaching problem is simple: Hire enough nurses to get the job done. Yet implementing that solution is far from easy. Fluctuating patient loads, labor negotiation issues and nationwide nursing shortages can make it difficult for hospital administrators to accurately forecast (and fill) staffing needs.
Nonetheless, given the critical role nurses play in patient care, it's a problem worth prioritizing.