...Staffing Day to Day The American Nursing Association defines staffing as matching the registered nurse expertise with the needs of patients requiring nursing care services. There are many influences and factors that go into determining the staffing level. There are two different ways of staffing: centralized and decentralized. Centralized staffing is when there is one department responsible for all the units, float staff and on-call staff. Decentralized staffing is when unit leaders or charge nurses, managers, or directors determine the level of staff needed before and during the shift. Staffing nurses is typically set in a 24-48hr window, whereas scheduling can be a month out (Mensik, 2014). In addition to the two different ways of staffing, there are three different models that staffing...
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...be the answer to some of the key healthcare and employment problems the US is struggling with right now. Lindsey (2013) states “with the graying of America has come a shortage of healthcare professionals, especially nurses. From 2009 to 2011, 85 percent of Associate Degree Nursing programs turned away qualified applicants.” (para 1) Nursing programs at some schools are closed due to funding cuts. There is lack of faculty at schools to train nurses. The lack of faculty to train new nurses definitely can cause concern for nursing shortages. Applicants are being turned away. Nurse educators have to endure lower salaries along with unrealistic expectations about their academic roles. Some nursing faculty is expected to balance their academic roles along with advancing their expertise and managing clinical practice. The lower salaries are sometimes lower than their colleagues working in clinical settings. Hutson (2014) states also “nursing is a graying population even more so than the population at large. This means that nursing workforce is retiring at a faster rate than it can be replaced.“ (para 3) The aging nurses are retiring and this makes the nursing shortage even more. The chronic illnesses and complexity of clients will acquire more high level educated nurses....
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...When a nurse goes into a patient’s room, they do not ask the nurse what school they went to or if they received an ADN or BSN degree, they just expect that nurse to be competent in their job. The NCLEX-RN exam is based on minimal competency and does distinguish between graduate levels. Therefore, all nurses graduating from a nursing program and getting ready to take the exam are equal at that time. Regardless of whether a nurse graduates with their associates or bachelor’s degree, when they are hired at a hospital or health care facility, the extensive training gets them prepared to deliver safe effective patient care. Although receiving a BSN degree a person will achieve better assessment skills, critical thinking, communication, and leadership skills, graduating with an associates does not make a nurse less competent. All nursing programs teach how to assess, plan, implement, diagnose, teach, and evaluate, the skills it takes to be a nurse. In a hospital setting, acute care units have critically ill patient, which makes them unpredictable and challenging, therefore the nurses need have sharp critical thinking skills, perform quality patient care, and maintain positive outcomes. Patient load makes it difficult for any nurse to do her job well and efficient. Understaffing is a big problem in hospitals and it leaves the nurse to patient ratio significantly uneven which puts patient safety at risk. So the question is, are patients at risk because not enough nurses have their...
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...homeschooler do so well has nothing to do with parents of level of education, teacher certification, amount of money, level of government oversight, gender, or race. Public education has raised a few eyebrows on where and what kind of environment a parent is sending their children. It is a case of concern when the first thing that our children are greeted with going to school is a metal detector. Although most parents send their children to public education, homeschooling maybe an alternative for children who need more attention. Needing more attention could be medical issues, or a student who is having a hard time keeping up with the class, this is where homeschooling may be a better fit for the child. Children health could be a factor in deciding whether a child should go to public or be home schooled. Public school nurse have many issues to deal with and it can be something as small as a cut, to a chronic condition. The ratio for student to teacher can be like 30 to 1. I would like to take a look at the school nurse to student ratio. Chesterfield County Public Schools ratio is well below the nurse-to-students ratio...
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...or not there should be mandatory nurse-patient ratios. The article titled, “Mandatory Nurse-Patient Ratios” discusses the controversy about whether there should be mandatory ratios and how they can affect nurses and patient outcomes. Currently the state of California is the only state in the United States with mandatory nurse-patient ratios while 17 others have introduced legislation. Since California has passed legislation in 2005 there has not been any experimental evidence reported to support these ratios with more desirable patient outcomes. One of the positive outcomes for nurses is that it has made more jobs available but unfortunately has increased their workload because employers are reducing the number of ancillary staff which can lead to increased stress and burnout. The mandatory nurse-patient ratios claim to address the imbalance between patient needs and nursing resources but do not address the different levels of complex treatment required among patients. Nurses must understand their importance and advocate effectively for themselves and their patients. Providing quality research, lobbying, collaborating among members of the healthcare team and becoming more powerful with the help of special interest groups will help to make employers responsible for their legal obligations. This issue will affect me professionally because I am about to graduate from nursing school and will be actively looking for a position as a registered nurse. I am nervous about starting a new...
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...PROVIDING QUALITY CARE Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units Sung-Hyun Cho, Kyung Ja June, Yun Mi Kim, Yong Ae Cho, Cheong Suk Yoo, Sung-Cheol Yun and Young Hee Sung Aim. To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. Background. Nurse staffing has been reported to influence patient and nurse outcomes. Design. A cross-sectional study with a survey conducted August–October 2007. Methods. The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. Results. The average patient-to-nurse ratio was 2Æ8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3Æ26; 95% confidence interval, 1Æ14–9Æ31) or 2Æ0–2Æ5 patients (odds ratio, 2Æ44; 95% confidence interval, 1Æ32–4Æ52), compared...
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...Everyone Abstract: Safe staffing is a vital component of quality nursing care. However, oftentimes units in healthcare facilities across the nation lack the personnel that give the units the number of human resources needed to provide safe and sufficient care. A variety of people are affected by unsafe staffing: the actual nurses and ancillary staff, as well as stakeholders such as administrators, government and legislative bodies, and last but not least, the tax payer. The adverse effects of short staffing and the future impending nursing shortage are discussed, along with specific actions that have been taken, and are in the process of implementing, to ensure safe staffing and positive patient outcomes for all states across the United States. Keywords: Safe staffing, nurses, patients, healthcare, problem, nursing shortage Safe Staffing: It Affects Everyone: An Introduction Safe staffing is an essential and vital component of quality care. However, safe nurse to patient ratios are often not met in today's healthcare environment. This paper will describe what safe staffing ratios are, the problems associated with the lack of safe staffing ratios, what some states have enacted to ensure safe staffing, and what the the state of New York is currently projecting to ensure safe staffing is a reality for the future. Safe Staffing McConnell 3 Safe Staffing: A Breakdown: Basically, a healthcare unit, be it a floor in the nursing home, a medical surgical hospital unit...
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...Lowering Nurse Staffing Ratios The growing need of more nurses in hospitals is becoming an issue in hospitals all over America. The patient’s safety is being put at risk due to the number of nurse to patient ratios (Welton 1). A low nurse to patient ratio will cause a lack of care for the patients. Nurses will have to take on more patients then they are capable of which will affect the health of the patient and the nurse. John M. Welton, an RN (Registered Nurse), said that “the safety of patients is directly related to the size and experience of the nursing staff” (Welton 1). A high nurse to patient ratio can be on the costly side for the hospitals. “Hospitals will not receive any additional revenue for providing more patient care”...
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...HEAD: Nurse-to-Patient Ratios A Literature Review: Nurse-to-Patient Ratios and Their Relationships with Other Variables Since the times when Florence Nightingale took care of patients, there has been a question about what factors affect patient care. One of these factors, nurse-to-patient ratios, has gotten significant publicity over the last several years due to a change in legislation in California. This increase in publicity has sparked many researchers' interest to further evaluate these ratios in connection with patient outcomes and other variables. Through lots of research and analysis there is evidence that a lower nurse-to-patient ratio does reduce the negative patient outcomes in patient care. Some of these outcomes include urinary tract infections, upper gastrointestinal bleeding, shock, pneumonia, failure-to-rescue, and death (Curtin, 2008). Although lowering the ratio does show a decrease in these outcomes, it does not solve all the problems in the nursing profession (“Safety in Numbers,” 2008). The other variables that have a significant relationship with these nurse-to-patient ratios include retention and recruitment of nurses, malpractice, medical errors, and cost. In this review of literature, a direct relationship between nurse-to-patient ratios and other variables should be visible to readers to better understand the issues that are currently identified in nursing in the health care industry. One of the most referenced studies done on nurse-to-patient...
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...Qualitative Methodology: Hospital Nurse Staffing and Quality of Care Keli Feathler, RN Grand Canyon University NRS 433v Nora Bazydlo RN MSN October 29, 2011 Introduction Does the issue of nurse staffing have an effect on quality of patient care? This study addresses the topic of nurse staffing, which includes nurses (RN and LPN) and nurse’s aides. Research in Action: Agency for Healthcare Research and Quality (AHRQ) presents the study “Hospital Nurse Staffing and Quality of Care”. Nurse staffing is measured in one of two ways: nursing hours per patient day and nurse to patent ratio (Stanton, 2004). The article looks at periods of high vacancy rates, assesses the patients needs, the development of care plans and administration of medications and treatments in factoring the quality of care. It shows the effect lower staffing levels and its direct link to higher adverse outcome rates. The study of staffing and quality of care is essential, to link the two together, and prove that the issue needs to be addressed in all forums of nursing. The way to making improvements in nurse staffing is to present documentation/research that supports the issue at hand. With factual information, ways to improve the problem can be formed. Higher levels of nurse staffing at all levels showed a 2-25% reduction in adverse patient outcomes. In order to improve the quality and delivery of health care staffing needs to be addressed, and by performing research...
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...the Nursing Shortage In America today the nursing shortage has affected health care in many ways. The article “Nurse-Staffing Levels and the Quality of Care in Hospitals” written by Needleman, Buerhaus, Mattke, Stewart, Zelevinsky (2002), describes the effects the nursing shortage has on the quality of care provided to patients in the hospital setting. The authors of the article present the methods used to obtain data, background information causing the nursing shortage, results of the data obtained and proposals to improve patient outcomes and nursing retention. Influential Factors Contributing to the Nursing Shortage The nursing shortage today is because of a number of influential factors that has resulted in a decrease in new graduates in the health care workforce. The nursing shortage is believed to have started around the mid-1990s, and during this time span, the turnover rate for LPN’s and RN’s began to rise (Page, 2004). The article did not identify the reasons for the shortage of nursing. The American Association of Colleges of Nursing (AACN) identifies five of the most common factors contributing to the shortage. These factors are high patient to nurse ratios, declining nursing school enrollments, insufficiency of nursing school instructors, increase in the age of the average nurse over the past decade, and high stress levels have led to nurses leaving the profession (American Association of Colleges of Nursing, 2013). The AACN reported a 5.1% increase in...
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...solution well you can just take them all and it is just for one day we can be out of ratio. Really lady!! How did you get your job. We can not be out of ratio because it is unsafe. Plus if anything happens guess who will be the person who gets sued. Oh ya ME! Followed by her calling up one the of teachers to see if she is really sick. The girl called out with a stomach bug! Let her sleep and not infect the entire staff. Which leaves calling in the paraprofessional (Aide) from her day off to come and work. The person who makes nothing come and run the class. Ya that seems right. OR perhaps we can hire a school wide sub so we do not have to get into these situations again. Because this has happened about five times this year. One were she told a teacher with a 102.3 temp. that she had to come in because there was no one to cover. Can we just think of how many levels that is wrong....
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...“How do you see the role of the Registered nurse change over the next ten years?” The nursing profession has a long history of being undervalued and has faced many challenges in regards to professional status, wages and working conditions. These challenges have been fairly constant and all the while, nurses have been fighting to enhance nursing skills and roles, while also maintaining the core nursing values. This research aims to identify the future of the registered nurse and how this may be expected to change over the next ten years; in order to do this it will explore the past history of nursing, their working conditions, challenges and achievements. Following this brief historical overview , a detailed view of modern day nursing will be the key focus of the paper, with particular relation to the latest professional battle of the 2012 Enterprise bargaining agreement and the Australian government’s planned policies for Australian nurses and what this means for their future. Nursing began in the homes of families as an intuitive and untaught way of caring for sick family members, with the role being given to women based on their care experience and observation. Throughout the dark and middle ages (500 AD to 1400 AD) this ‘care’ later developed a religious aspect, and nursing became an expression of Christianity and seen as ‘acts of mercy’ (D’antonio 2007). This ‘care’ aspect of practice still exists strongly in modern nursing today. However, the nursing reputation took...
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...staff turnover a problem in the nursing profession? First and foremost, this is not a unifactoral issue. In fact, staff turnover is the byproduct of multiple job related factors and stressors in the nursing profession. For instance, job-related stress plays a major factor in decreasing one’s job satisfaction. Stress in nursing usually occurs when one perceives that his or her resources are exceeded in a given situation (Esther, et al., 2005). Typical factors that can promote stress in a nurse are high job demands and excessive work hours. With these factors, the nurse may continually feel overworked, while also feeling like they are working “all the time.” Other factors that could cause stress are having little control over your work environment or having limited supportive relationships in the workplace. As we all realize, at least some sense of control and peer support are necessary to promote feelings of job satisfaction (2005). Finally, staff turnover itself can cause stress for the nurse, as he or she may feel overwhelmed by the increasing workload, which is promoted by the decreasing amount of available staff. Furthermore, “burnout” will usually occur after a prolonged period of stress causes increasing exhaustion, emotional instability, and career dissatisfaction (2005). It should also be mentioned...
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...Examine Nurse-to-Patient Ratios Primary health care organizations such as New York Presbyterian (NYP) are impacted by low nurse-to-patient ratios. The recent implementation of the Patient Protection and Affordable Care Act (ACA) has required organizations such as NYP to explore many approaches to improve quality and patient outcomes that contain costs. “Numerous studies reveal an association between higher levels of experienced RN staffing and lower rates of adverse patient outcomes” (www.nursingworld.org, 2015, para. 1). For this reason, nurse-to-patient ratios is an issue that needs to be addressed at NYP in order to improve quality healthcare within their organization. The acuity of the unit in which patient care is being provided, should determine the acceptable nurse-to-patient ratio. According to the American Nurses Association (ANA), factors that influence the nurse staffing needs include: patient complexity, acuity, or stability; number of admissions, discharges, and transfers; professional nursing and other staff skill level and expertise; physical space and layout of the nursing unit; availability of or proximity to technological support or other resources ("Optimal Nurse Staffing," 2015). Currently, New York is one of only fourteen states that addresses the nurse staffing issue in hospitals. New York State requires organizations such as NYP to disclose their nurse-to-patient staffing ratios to the public; however the state does not require a minimum nurse-to-patient...
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