A proper nurse-to-patient ratio is important for the success of any hospital. A single nurse can only account for so many patients, within a single shift. This is why there are recommended staffing ratios for each department. For example, it is recommended for critical care units to operate with a 1:2 nurse-to-patient ratio, while emergency departments ideally operate at 1:4 or lower. The reality of the situation, however, is often less ideal. Hospitals are currently contending with multiple key shortages in every single department. With less manpower available, nurses have been working short-staffed shifts where the number of patients greatly exceeds the recommended maximum capacity. Why have shortages ravaged the nursing world? And what can be done to address them? This article will cover all this and more.
Where did this nursing shortage come from?
Nursing shortages and burnout have long been a problem in the industry. In the past 5 years alone, hospitals have turned over around 95.7% of their staff. However, it is inarguable that the pandemic sped up pre-existing trends to a drastic and unprecedented level. At COVID-19’s peak, hospitals were drowned in waves of hospitalizations and COVID cases. Facilities were operating on a staffing shortage, which leads to intensely long and demanding nursing shifts.
Between the overwork, stress, and fear of catching COVID-19, nurses were burning out at a dramatic rate. RN turnover rose by 8.4% in 2021, which resulted in a national average of 7.1%. Depending on the region, the turnover percentage can range between 5.4% and as much as 64.1%. Even as the pandemic has settled somewhat, nurses are still planning to leave the industry in droves. According to a survey, as much as a third of nurses are planning to leave the industry by the end of 2022. Unsurprisingly, burnout and work-related stress was the most commonly cited reason for their departure.
What issues does short staffing cause?
Short staffing issues can dramatically affect facility operations. When nurses are burnt out and exhausted, they rarely have the capacity and focus to provide life-saving care to patients in need. It was found that nursing shortages and insufficient patient-to-staff ratios have direct links to errors, higher mortality rates, and worse failure-to-rescue ratios. For example, nurses are entrusted with handing over the proper medications at the right times, which requires much focus and effort. Burnt-out nurses are more likely to rush this task, which makes them more prone to carelessness. This lapse in judgment may lead to potentially disastrous medical mistakes.
When the care quality suffers this much, both staff and patients will inevitably feel dissatisfied as well. If left unaddressed, the hospital’s bottom line will suffer in the long run. Patients and staff alike will be less likely to return or recommend the facility to others. Conversely, fitting ratios have direct links to higher nurse retention and markedly improved patient outcomes. At the moment, only California and Massachusetts have concrete legislation regarding nurse staffing ratios. In the case of the latter, this only really applies to the ICU. Every other state can raise its patient ratios to meet ever-changing demand.
What are good short-staffing solutions?
Initially, it may be tempting to bring in more new full-time nurses outright. After all, why not address a staffing shortage with more staff members? With around one-third of nurses planning to retire within the next 10 to 15 years, some new blood may be appreciated. While this kind of long-term planning has its place, bringing in a bevy of new nurses has its disadvantages. Demand for nursing is more volatile than ever. Rookie nurses will not contribute meaningfully for a while, which means that case counts may have plummeted by the time they are fully trained. This leaves you with a mountain of redundant labor costs.
There are a number of forward-thinking solutions to this problem. You can bring in per-diem nurses to fill in the vacant positions, as needed. If you know a shift will inevitably be short-staffed, assign tasks by priority to make sure that the units or tasks most in need are being covered. If it is absolutely needed, you can resort to overtime provided that your staff is compensated accordingly. Short staffing issues cannot be brute forced. Rather, They must be navigated in a pragmatic manner that satisfies both sides.