Involving Nurses in Hospital Staffing Decision-Making

A qualitative study that looks at the experiences of nurses who have served on staffing committees.

When I am faced with challenging situations and issues that involve multiple stakeholders, I seek guidance or information from others to make the most informed decisions. This is a practice many health professionals and researchers emulate, and it makes sense to do this, yet when it comes to the topic of nurse staffing in hospital settings, nurses are not usually involved in the process. If they are involved to some degree, it is likely because of a hospital’s pursuit for nursing excellence recognition through shared governance and/or the external pressure of state laws, like mandated nurse staffing committees.

Nurse autonomy and engagement means better care.

Over the years, research has shown how increases in nurse autonomy and engagement can positively benefit patient care and support nurse retention, yet how do these concepts apply to nurse staffing? In what ways are those concepts translated into practice or policy efforts? These were the questions that initially guided me.

Seeking a real voice in nurse staffing policymaking.

In a survey exploring the concept of staff nurse involvement in hospital staffing policymaking, most nurses described feeling powerless. with little […]

2024-03-20T10:15:39-04:00March 20th, 2024|nurse staffing, Nursing, nursing research, patient safety|1 Comment
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Congress Could Learn from Global Nursing Unions

By Shawn Kennedy, AJN editor-in-chief

New South Wales Nurses and Midwives' Association rally New South Wales Nurses and Midwives’ Association rally

In this month’s issue of AJN, we report on the formation of a new international organization of nurses and health care workers in June—Global Nurses United (GNU). Under the auspices of the California-based National Nurses United, unions from 14 countries agreed to work together to “stop the harmful effects of austerity measures, privatization, and cuts in health care services.” The organization also is actively involved in advocating for other issues supported by labor unions, such as a tax on certain financial firms (called the Robin Hood tax) that would raise revenues to help provide needed services. Saving jobs and making workplaces safer unite all unions.

On September 17, the group held an international day of action. Member unions in Africa, Asia, Australia, and Europe held marches to protest cuts in health services and advocate for better working conditions for nurses, better staffing ratios and the Robin Hood tax. Unions in some countries had additional agendas—in South Korea, it was to save the Jin Ju Medical Center; in Australia, mandatory minimum nurse–patient ratios was a demand; in Costa Rica, the member union called for nurses’ right to participate in collective bargaining.

Will these marches and […]

2018-03-28T10:28:45-04:00October 7th, 2013|Nursing|0 Comments
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What’s So Hard to Understand: Patient Safety, Quality Care Linked to Nurse Staffing

shawnkennedy

The evidence linking nurse staffing and patient safety is strong.

The data linking nurse staffing as well as shift length with patient outcomes and satisfaction with care continue to roll in. The latest report on nurse staffing, published in the January 13 issue of Medical Care by McHugh and MA, links higher nurse–patient ratios and good work environments to reduced 30-day readmission rates. Read the abstract here.

Most nurses seem to support better nurse–patient ratios, but there’s continuing ambivalence about reducing shift length, as seen in the comments we received on a recent blog post asking whether it’s time to retire the 12-hour nursing shift.

In August, researchers reported a link between nurse staffing and hospital-acquired infections.  Publishing in the American Journal of Infection Control, the authors noted a “significant association” between nurse–patient staffing ratios and both urinary tract infections and surgical site infections. Further, they noted that reducing nurse burnout was associated with fewer infections. (Read our news report on the study here.)

Health Affairs published a report in November called “The Longer the Shifts for Hospital Nurses, The Higher the Levels of Burnout and Patient Dissatisfaction.” The findings were there, loud and clear—researchers Stimpfel, Sloane, and Aiken found that “extended shifts undermine nurses’ well-being, may result in expensive turnover and can negatively affect patient care.”

And […]

2018-03-13T10:41:13-04:00January 29th, 2013|nursing perspective, nursing research|20 Comments
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Nurse Staffing: Are the Brits on the Right Track?

By Maureen Shawn Kennedy, AJN editor-in-chief

hazard/jasleen kaur, via Flickr

According to an article at Nursing Times, hospitals in England may be required to publish “nurse-to-bed” ratios as part of an overall “dashboard” of indicators to measure  performance. While some say this is a step forward, UNISON, the public service union that represents nurses, argues that the better ratio to measure is nurse-to-patient and that variables in patient acuity should also be considered.

Nurse staffing has become an issue in National Health Service hospitals and in April UNISON released results of a survey of over 1,500 nurses and other health care workers about their shifts during the 24-hour period of March 6. The vast majority of respondents (73%) felt they did not have “enough time to spend with patients to deliver dignified, safe, compassionate care.” The Royal College of Nursing also supports mandatory safe-staffing ratios that take into account the skill mix of RNs to “health care support workers” or nursing assistants. 

Here in the United States, California is the only state to achieve any legislation for mandatory hospital staffing and it is a “minimum” nurse-to-patient ratio. While similar legislation has been introduced in a few other states and nationally, it hasn’t advanced.

The ANA does not support mandatory minimum ratios per se, noting in its Principles for Nurse Staffing (2nd edition), released earlier this […]

2016-11-21T13:09:48-05:00June 26th, 2012|Nursing|54 Comments
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What We Heard from the Leaders of the New National Nursing Union

By Shawn Kennedy, MA, RN, interim editor-in-chief

As we noted earlier this week, several major nursing unions have united to form a “superunion.” The National Nurses United (NNU) brings over 150,000 nurses together by combining the California Nurses Association (CNA)/National Nurses Organizing Committee (NNOC) with the Massachusetts Nursing Association (MNA) and some members of the United American Nurses (UAN).

There are three co-presidents: Karen Higgins (from the MNA), Jean Ross (from the UAN), and Deborah Burger (from the CNA/NNOC).

Ross told me this:

  • The CNA/NNOC will cease behaving as a national union and, like the MNA, be a state union; both will be affiliates of the new NNU.
  • The UAN will cease to exist as a national union; those state associations that were members will automatically be members of NNU, unless they decide not to.
  • NNU will focus on health care reform, will advocate for a single-payer system, and will seek to organize all non-union staff nurses in the country

Ross had this to say as well: “People in this country have been waiting for a long time for nurses to come forward to make true health care reform a reality.”

Co-President Deborah Burger told me that NNU will pursue the main objectives of a “massive organizing campaign to organize all nurses nationally” and an aggressive “social justice” agenda focused on advocating for a single-payer health care system. They will also work for passage of federal staffing ratios legislation introduced by Senator Barbara Boxer.

Said Burger, […]

2016-11-21T13:20:40-05:00December 10th, 2009|career, health care policy|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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