Nurse staffing has been a topic of concern for nurses for many years. Concern usually rises among the public and healthcare providers when there is a nursing shortage and declines when there is a nursing “excess”. However, nursing has seen a number of decades of shortages followed by excesses followed by shortages which means full employment followed by rising unemployment. These undulations have affected nursing service, as well as, nursing faculty.
For the practicing Registered Nurse (RN), staffing is an issue of professional concern because inappropriate staffing can threaten patients’ safety, RNs’ health and safety and the integrity of the professional’s commitment to patients. Staffing also concerns RNs because of the pressures put on them everyday by increasing patient intensity, increasing complexity of care and the fatigue they feel which increases over time.
Fatigue as it applies to RNs is a relatively newly researched topic. In 2004, Dr. Ann E. Rogers published an important article on fatigue and its impact on nursing and patient safety. The publication of this study was preceded by closed door testimony to the Institute of Medicine committee studying the nursing work environment. The findings demonstrate the effects of fatigue which not only endanger the patient but also the RN. These findings place new ethical pressures on both RNs as they decide whether to work overtime and on administrators as they develop staffing schedules and react to staffing shortages.
Much has been said about the environment in which the RN works. Most nurse satisfaction instruments ask questions about RN-RN and RN-MD relations and a number of questions regarding participatory involvement. A newer area of interest is the relationship between the RN and their managerial superiors, specifically, workplace bullying.
The issue of nurse staffing is not a simple one. Help to solve the challenges of staffing to provide the best care to patients in a manner that is safe, rewarding and empowering for RNs.