Short staffing in nursing: Tackling the epidemic in our healthcare facilities

A female nurse in scrubs standing at the front door of her home smiles while holding her phone

Having the right number of skilled personnel in any industry is pivotal. When people's lives and well-being are impacted, as in the healthcare industry ― especially within long-term and post-acute care ― the importance of maintaining an adequate workforce is even more critical.

Facilities that juggle budget constraints, patient needs and staffing challenges daily know this reality all too well. Every decision made has a ripple effect that influences not only the morale and well-being of the staff but also the quality of patient care. When nursing units are stretched thin, it's not just a logistical problem; it's a human one.

The effects of short staffing often manifest as increased stress, higher burnout rates and compromised patient outcomes. For facilities aiming for operational efficiency and optimal patient care, understanding the scope and repercussions of short staffing in nursing is necessary.

What is short staffing in nursing?

Short staffing in nursing indicates a situation where there aren't enough nurses available to meet patient needs in a facility. This isn't just a scheduling hiccup but a pressing concern that can jeopardize the foundation of care delivery.

This situation doesn’t result merely from immediate challenges, such as high patient-to-nurse ratios, increased acuity, or unexpected absences. It often traces back to longstanding systemic issues within the nursing profession and the broader healthcare infrastructure.

Factors like the industry's current labor shortage, budgetary constraints, recruitment challenges, retention problems and even outdated facility policies contribute to short staffing. Any healthcare facility prioritizing both the well-being of its workforce and the quality of patient care must comprehensively address short staffing issues.

Consequences of short staffing in nursing

The repercussions of short staffing in nursing extend far and wide and can influence every facet of healthcare. It’s important to understand this is more than a statistic or an inconvenience for facilities — it's a legitimate threat with real-world implications that stands to compromise the integrity of care offered and the morale of the professionals delivering it.

When there aren’t enough hands on deck, every task becomes more strenuous, every decision more urgent and every error potentially more consequential. The strain of short staffing impacts every aspect of facility operations, from the nursing units on the front lines to the boardrooms where strategies are charted, and requires impactful and sustainable solutions.

Burnout among professionals: Nurses are the backbone of healthcare. But when overloaded with responsibilities due to staffing shortages, they risk burnout. This mental, emotional and physical exhaustion can threaten not only their personal health but may also compromise patient safety.

Compromised patient care and safety: At the heart of nursing is the promise of reliable patient care. But overloaded nurses can accidentally make mistakes. The Agency for Healthcare Research and Quality (AHRQ) indicates that 55% of nurses linked poor staffing with diminished patient care quality. What’s also alarming is the correlation between unfinished nursing care and “higher rates of adverse events,” as researched by the International Journal of Nursing Studies.

Factors contributing to short staffing

To address the challenges of nursing short staffing, it’s essential to understand its roots:

  • High patient-to-nurse ratios: When patient intake surges without a proportional increase in nursing staff, the system inevitably feels the pressure. Each nurse has to manage more patients than what might be considered safe or efficient, with one study showing that both patient mortality rate and length of stay improved when the patient-to-nurse ratio was <5. Each patient gets less individual attention, and nurses are more prone to burnout from juggling their increased responsibilities. For facility administrators, this often translates to decreased patient or resident satisfaction scores and increased risk of medical errors or oversights.
  • Nursing shortages and turnover rates: The global challenge in healthcare isn't just about recruiting nurses, but ensuring they remain in their roles. A persistent issue plaguing many facilities is the high turnover rate, especially among newly licensed nurses. A significant number of them leave their initial jobs within two years, leaving facilities in a cycle of hiring and training new employees, only to see them depart soon after. This turnover can be attributed to several factors, including burnout, lack of job satisfaction or the lure of better opportunities elsewhere. For facilities, this means increased recruitment and training costs, and it also disrupts continuity of care for patients. According to a study by Nursing Solutions, Inc., the average turnover rate for RNs was 22.5% in 2022.
  • Inadequate resource allocation: It's not always about the sheer number of nurses, but how they are utilized. If resources are not managed or allocated correctly, a facility might have surplus staff during low-demand periods such as during the nocturnal shift and shortages during peak times such as during breakfast and other meals. This misalignment can arise from a variety of reasons: outdated scheduling systems, a lack of flexibility with real-time demands or just human error. Even when a facility seems adequately staffed on paper, the reality on the ground can be very different, leading to compromised patient care and overworked staff.

For healthcare facilities aiming to overcome these challenges, acknowledging these root causes and actively addressing them is essential. By doing so, they can ensure both their workforce and patients receive the support and care they deserve.

Addressing short staffing: best practices and strategies

A multi-pronged strategy can help healthcare facilities navigate this crisis:

  • Boost nurse retention: A high turnover rate can cause or worsen short staffing issues. To mitigate this, it's important to focus on nurse retention. When facilities foster a supportive and nurturing work environment, nurses are more likely to feel valued and stay. Offering competitive compensation, avenues for continued learning, mentorship programs and ensuring a work-life balance are some possible steps.
    For example, if a nurse feels burned out due to continuous long shifts, providing flexibility or offering mental health support and services can make a difference. Regularly checking in with workers, conducting feedback sessions and implementing their suggestions can make them feel heard, increasing their loyalty to the facility.
  • Promote team communication: Efficient teamwork is at the heart of a smoothly functioning facility. By encouraging open communication, nurses can more effectively distribute patient loads. Regular team meetings and huddles could be used more openly to discuss challenges, brainstorm solutions and allocate resources. This prevents instances where some nurses are overwhelmed while others are underutilized.
    A culture that emphasizes mutual respect and understanding leads to learning and support, and when people feel they are part of a cohesive team, they're more equipped to handle demanding situations without feeling isolated.
  • Leverage modern PRN shift solutions, not outdated staffing models: Technology, when used right, can be a game-changer. Marketplace platforms like ShiftKey democratize access to licensed professionals to facilities’s PRN shift needs. They not only provide facilities with access to available independent nurses, CNAs and other licensed professionals, but also allow for ongoing adjustments. For example, if a facility suddenly experiences a spike in patient admissions, they could use ShiftKey to help bring in independent professionals to handle the influx of PRN shifts, unlike with outdated staffing solutions, where such rapid adjustments can be challenging and result in shifts that are short staffed. Also, digital platforms like ShiftKey can offer analytics and insights into intake patterns, enabling facilities to predict and prepare for high-demand periods.

How healthcare organizations use ShiftKey to fill PRN shifts

ShiftKey isn’t just another platform; it’s a revolution of the modern workforce. By harnessing data-driven insights and promoting a sense of community and transparency, ShiftKey presents an innovative solution for healthcare organizations. It addresses not only the immediate problem of vacant PRN shifts but aims to reshape the entire workforce landscape.

With ShiftKey, facilities gain access to a broad pool of licensed professionals, ensuring that they find the right fit for their needs. Moreover, it provides independent professionals with the freedom to choose when, where and how they wish to work, promoting a more balanced and fulfilling work-life experience.

The threat of short staffing extends beyond mere inconvenience; it is a real barrier to the efficient delivery of healthcare services. Both healthcare professionals and the patients they serve are impacted. The root causes of short staffing are multifaceted, and realistically, significant nursing shortages are anticipated to continue as an industry-wide challenge. However, while a single solution may not resolve every aspect, technology platforms like ShiftKey offer facilities a significant step forward in solving this issue and filling gaps in shifts, so the delivery of quality patient care can continue.

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