How to Fix Short Staffing in Nursing
The reports surrounding the problem of short staffing in nursing are troubling. Dr. Peter Buerhaus, a nurse and healthcare economist, predicts the crisis will have a devastating effect on the health of the nation, the durability of healthcare systems, and the future of the nursing labor force if it isn’t properly addressed.
So, how does a healthcare organization tackle this multifaceted, complex issue? We’ll help you answer this critical question by reviewing the impact of nurse staffing on patient care, assessing nursing supply and demand, hearing what nurses say about the crisis, and then offering solutions to short staffing in nursing.
Impact of Nurse Staffing on Patient Care
Nurse staffing and patient care quality and safety are closely connected. Short staffing in nursing occurs when the number of nurses is insufficient to safely and adequately provide quality care to patients. The Agency for Healthcare Research and Quality (AHRQ) completed an extensive research review, examining the full impact of nurse staffing, summarized in the table below.
| Adequate Nurse Staffing | Nurse Understaffing |
|---|---|
| Improved patient outcomes at hospitals | Decreased patient safety at hospitals |
| Improved quality measures at Skilled Nursing Facilities (SNFs) | Increased morbidity risk |
| Decreased mortality risk at SNFs | Increased mortality risk at hospitals |
| Decreased hospitalization risk at SNFs | Increased workload and hours increase risk of errors at hospitals |
| Decreased risk of urinary tract infections (UTIs) risk and pressure ulcer risks at SNFs | Nurse delaying, partially completing, or not providing care increases with more patients, leading to:
|
The Dilemma of Nursing Supply and Demand
The nursing staff demand is rising with the aging of the baby boomer generation. By 2034, there’ll be 77.0 million U.S. adults aged 65 years and older who’ll have an increased need for nursing care.
Meanwhile, an estimated 1 million highly-experienced RNs are retiring between 2017 and 2030. With over 90% of nursing residences and hospitals reporting staff shortages, the aging of America and nurse retirement exacerbate an already strained workforce.
High nurse turnover also contributes to a decreasing number of nursing professionals. Both experienced and newer nurses are leaving their positions. Consider the following nurse turnover rates:
- CNAs — 54.8%
- LPNs — 41.3%
- RNs — 46.2%
- New graduates — 45.5%
A reasonable solution to this supply and demand issue is to increase the number of nurses. However, this is not easily feasible given the nursing faculty shortage, which is the primary reason nursing programs have turned away over 91,000 qualified applicants.
What Nurses Are Saying
Each year nurses in varying roles and settings have their voices heard through the Pulse on the Nation’s Nurses Survey Series: Annual Assessment. The following data summarizes findings for long-term and acute-care hospital nurses that responded. Mental health and wellness, organizational support, and reasons for leaving were some of the key topics addressed.
Mental Health and Wellness
The survey found that the job demands of nurses continue to impact their well-being. Only 35% to 39% of nurses viewed their emotional health as healthy or better. Less than 25% felt happy in the 2 weeks leading up to the survey, whereas 27% to 29% of nurses felt depressed.
In addition, approximately one-third of nurses reported feeling stressed, and almost half were experiencing different stages of burnout. Short staffing in nursing was the leading cause attributed to burnout.
Organizational Support
The survey also revealed more about the relationship between nurse respondents and their employers. Less than 25% of nurses perceived that their organizations cared about their well-being or valued their contributions.
Nurses did appreciate their employers’ efforts to address short staffing. The solutions nurses found most compelling were staffing strategies, increased pay, and mental health support. They also reported the most important factors attributing to their work satisfaction were work-life balance, compensation, a safe environment, and feeling valued.
Reasons for Leaving
Over 50% of long-term care and hospital nurses reported contemplating or planning to leave their job in the next six months. The top reasons nurses in hospitals and long-term care facilities cited for wanting to resign include:
- Insufficient staffing
- Work negatively impacting health and well-being
- Inability to consistently deliver quality care
- Need for higher income
Solutions to Short Staffing in Nursing
There isn’t an easy fix to short staffing. Fortunately, from what nurses shared, there are ways to help you retain a happy and healthy staff.
1. Develop a Resilient Staffing Strategy
Nurses aim to provide quality care to patients while maintaining balance in their lives. The best way to achieve this is by developing a staffing strategy that supports a manageable workload and withstands the constant changes in healthcare.
The more diverse your strategy is, the better equipped you are to fix the fluctuating scheduling issues that arise. Consider adding the following tips to your existing solutions.
- Partner with a W2 staffing agency to provide nurses to fill short-term and permanent shifts.
- Create or add to your existing float pool.
- Adapt your staffing model to optimize scheduling flexibility.
2. Support Mental Health and Wellness
Nurses are strong, but they are also human. To safeguard their health, protect them from burnout, especially when challenged by short staffing in nursing facilities. Consider incorporating mental wellness as a part of your company’s core values. Some examples of accomplishing this are listed below.
- Have human resources (HR) meet with your team to review and encourage mental health benefits.
- Create a committee with your nurses to promote mental wellness.
- Train management and staff on how to help at-risk nurses.
3. Cultivate a Positive Work Culture
Many nurses would like to change their current work environment. Establishing trust and demonstrating care is the first step to cultivating a positive work culture where nurses feel safe, appreciated, and set up for success. It takes time and patience, but is well worth the effort. Here are some ways to help achieve this foundation.
- Engage your staff through daily rounding and regular check-ins.
- Invite your nurses to organization committees so they can participate in the solutions.
- Train staff and enforce rules for workplace incivility, bullying, and violence.
- Provide your nursing management with resources to build a positive work environment.
4. Re-evaluate Compensation Packages
Nurses rated compensation high among factors most important to their work satisfaction and reasons they’re considering leaving their jobs. To ensure your organization provides a fair and equitable pay and benefits package, consider comparing it to your competitors. Work with your staff to bridge any gaps. For example, offer planned incremental raises or provide tuition reimbursement for professional development.
5. Ease the Workload
Conduct an assessment of your nurses’ duties and unburden the staff with any unnecessary tasks. In addition, if administrative tasks decrease the direct care nursing staff provides to residents or patients, transfer those tasks to a different role.
Need Help Developing a Resilient Staffing Strategy?
Trying to enlist a full schedule of highly qualified nursing professionals and contending with short staffing in nursing is a formidable task. Thankfully, you’re not alone. Find out how your organization can protect your nurses and improve patient outcomes through strategic staffing solutions by partnering with IntelyCare.