This episode includes Dr. Carole R. Myers, a professor emeritus at the University of Tennessee College of Nursing, discussing nurse staffing shortages with Dr. Marissa Bartmess of the University of South Carolina College of Nursing and the direct impact staffing issues have on patient outcomes, as well as the cost and quality of health care.
WUOT's Carole Myers: Dr Bartmess, why is this an important topic?
Dr. Marissa Bartmess: When it comes to nurse staffing in hospitals, that essentially relates to how many nurses are available to provide care, how those nurses are assigned to patients, and whether the numbers of staff nurses are sufficient in terms of nurse expertise when it comes to meeting the needs of patient populations. And the issue, as you perfectly described, is short staffing in hospital settings. And that's essentially when hospitals do not have enough nurses to provide timely, quality care, and this is a really big issue in the United States that was just made worse by the pandemic. According to the National Council of State Boards of Nursing, 100,000 nurses left the workforce during the COVID 19 pandemic, and by 2027 almost 900,000 nurses intend to leave the workforce altogether, and that's a really scary statistic. And I think it's very important to remember that we're not just dealing with a shortage of nurses, but a shortage of nurses who are willing to work in specific areas, like hospitals, and often that is because of poor work environments.
What are the consequences of contemporary nurse staffing issues? What does it mean to patients?
Short staffing is dangerous, and short staffing has serious implications for patients and nurses. For patients, it can increase the risk of complications, it could even increase the risk of death. A lot of this has to do with the fact that there's less time with nurses when nurses are consistently in the situation of short staffing over time. This can lead to burnout and emotional exhaustion for nurses, which studies have shown does impact patient outcomes, and that can negatively impact patients. But that consistent, perpetual state of short staffing with burnout and exhaustion, it contributes to nurses leaving hospital settings, which just furthers the cycle of the shortage.
What needs to be done?
This is a massive systems level issue, and it really needs to be addressed on multiple levels. I think at first we need to always produce more nurses to keep up with population needs and the growth of populations, and this happens through expanded education opportunities for nursing students. And while this is an important piece to the puzzle, it is not the only solution, because more than half of nurses tend to leave their job within the first two years. So we really need to shift our perspective to retaining, not restraining nurses. We really need to retain the nurses that we already have by improving existing hospital work environments, rather than just forcing them to work more or longer hours. And this can potentially encourage new nurses to stay. And I think with these levers of action, and one of the first things that we can do is to shift hospital culture. Hospital cultures can shift to be a more supportive hospital work environment, an authentic, supportive hospital work environment where nurses feel valued and listened to, where nurses feel like they have decision making capabilities and over care for their patients, and that they can make a difference in their institutions.
Can public and other policies be used to address the problem?
Yes, so one of them is nurse-to-patient ratio legislation, and that limits the number of patients per nurse. And this can support nurse retention, because it lessens the nurses workload and it allows more time with their patients. Typically, another policy option is to require hospitals to have staffing committees, and this is where nurses are specifically and directly involved in setting staffing standards and processes for their hospitals, and that can support nurse retention by allowing them to feel like they have decision making abilities at their institution. But I will make it that has to be done authentically, tying into that hospital culture we just talked about.
Any parting words, Dr Bartmess?
Well when it comes to nurse staffing shortages in hospital settings, there is not a single lever that will solve the whole problem. But each lever that we can pull brings us one step closer to keeping patients and nurses safer and happier in hospitals.
This transcript has been lightly edited for content.
