The economic impact on healthcare has taken its toll on the number of registered nurses providing bedside care to patients, compromising patient safety and dramatically increasing the potential for negative outcomes. Several factors have immensely contributed to the nursing shortages over the years, including healthcare organizations downsizing, increased workloads, inadequate staffing plans and job dissatisfaction. Mandated nurse-to-patient staffing ratios have been implemented in several states to date with many more trying to pass some type of legislation. Have these ratios affected the quality of care or is it more realistic to create staffing committees that are based on each unit’s unique situation and varying requirements?
Skyrocketing medical costs are some of the challenges being faced by hospitals today and among their major expenses are nursing labor costs. The burden of reduced spending and managing costs more efficiently is being placed more and more on hospital finance leaders with the expectancy of reduced reimbursements under the healthcare reform (Sanford 38+). Healthcare institutions, especially hospitals, argued that reducing the number of registered nurses and diluting the skill mix would not lower care standards, albeit nurses voiced otherwise (Hunt 18). Yes it is true, for years the debate amongst all sides regarding the best mix and right numbers and how much direct bedside care is considered the registered nurses’ responsibility, but the most critical issue of all, is that nurses want to ensure high quality care and the best possible patient outcomes.
At the peak of restructuring of American hospitals, nurses were deeply concerned about their patients’ welfare as well as their own ability to survive in their own profession (Gordon 233). To make matters worse, an aging workforce is contributing to the nursing shortages, with hundreds of thousands of nurses over the age of fifty, and forty-seven being the average age in the United Sates (Gordon, Buchanan, and Bretherton 76). According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).
Major studies in the last three decades have confirmed an...