4 | 5 Staffing Strategies for Engaged Nurses Better Patient Outcomes
Nurses are often required to work long shifts. But in
a number of cases, nurses must work back-to-back
or extended shifts, risking fatigue that could result
in medical mistakes.
A 2012 study published in Health Affairs found that
the longer the shifts for hospital nurses, the higher
the levels of burnout and patient dissatisfaction.
Survey data from the study showed that more than
80 percent of the nurses in four states were satisfied
with scheduling practices at their hospital. However,
as the proportion of hospital nurses working
shifts of more than 13 hours increased, patients'
dissatisfaction with care increased. Furthermore,
nurses working shifts of 10 hours or longer were up
to 2.5 times more likely than nurses working shorter
shifts to experience burnout, job dissatisfaction and
intent to leave the job.
And a 2014 study in the American Journal of Critical
Care found that nurses impaired by fatigue, loss of
sleep, daytime sleepiness and an inability to recover
between shifts are more likely than well-rested
nurses to report decision regret, a negative cognitive
emotion that occurs when the actual outcome
differs from the desired or expected outcome.
2. Long working hours.
Indeed, a Minnesota Department of Health review of
literature found strong evidence linking lower nurse
staffing levels to higher patient mortality, failure
to rescue and falls in the hospital. There was also
strong evidence that other care process outcomes
such as drug administration errors, missed nursing
care and patient length of stay are linked to lower
nurse staffing levels.
Furthermore, a study published in Health Affairs
found that inadequate staffing can hinder nurses'
efforts to carry out processes of care. Researchers
found that hospitals with higher nurse staffing had
25 percent lower odds of being penalized under
the Affordable Care Act's Hospital Readmissions
Reduction Program compared to otherwise similar
hospitals with lower staffing.
That's why unionized nurses often bring up staffing
levels when they are in the middle of contract
negotiations. For instance, dozens of nurses protested
Aug. 3 outside of St. Petersburg (Fla.) General Hospital
over staffing levels and wages. Additionally, nurses
and other healthcare workers planned to hold a
picket July 15 outside Renton, Wash.-based Valley
Medical Center over staffing levels.
3. Compensation.
When it comes to nurse compensation, regional
differences are to be expected based on cost of living.
Nurses living in certain regions of the U.S. make
much more than nurses in other regions, according
to the Association of periOperative Registered
Nurses organization
Nurses in the Pacific region make about $18,000 more
than the average staff nurse, for instance. Next is
the Mid-Atlantic region, where nurses make $14,800
more than average. Nurses in the East South Central
region, however, make $4,300 less than average.
Beyond regional differences in pay, nurse pay gaps
also persist between genders.
Male registered nurses earn, on average, upwards
of $5,000 more than their female counterparts.
The gender pay gap is present in all specialties
except orthopedics, according to a study published
in JAMA. Among nurse specialties, chronic care
had the smallest gender pay gap, at $3,792, and
cardiology had the highest gap, at $6,034.
